Thursday, May 27, 2010

Forget 50-50

Yesterday I saw a new patient in my clinic, an elderly woman with metastatic breast cancer for several years. In oncology, the only part of the history that interests me more than the HPI is the social history. It is often where I start when I meet the patient, and not only because it's an ice breaker and comforting territory (most patients come to oncologists scared out of their wits). It is there that I learn how educated my patients are and whether they work in science, accounting, or engine repair, which helps me to decide what "level" of explanation of very complicated stuff will best serve them and whether I might be able to draw analogies with things that are familiar to them. It is there that I get some early prediction of compliance and ability to cope with the disease and its treatment: does she have family to bring her to appointments?, does she have someone to go across town to the 24 hour drugstore for her at midnight when she needs more nausea medicine? The social history is my gem.

The patient I saw yesterday had been married for almost 70 years. Wow! You don't see that often. Many people don't even live for 70 years all total. I congratulated them on it and remarked about how wonderful it was, but the conversation quickly turned to their concerns: their kids and grandkids and greatgrandkids (can I still be around them if I am on chemo?) and vacationing in Florida every winter (is is still safe for her to do it?)

At the end of our visit, my last of the day, her husband said, "May I ask you a personal question?" "Sure," I answered. "Are you married?" "Yes, for 8 years, 3 kids 6, 4, and 2." They beamed. Then he said, "So, don't you want to know the secret to staying married for 7 decades?" I thought about that for a moment. Of course I wanted to know. I am in a profession with a high divorce rate. I am married to someone who is active duty military, a group that also has a high divorce rate. I am the child of divorced parents. I hadn't really given it much thought before, but if I had, I might have felt doomed. So suddenly, the social history felt more like a gem than usual. "ABSOLUTELY! PLEASE!" I replied. He said, "Forget 50-50." I must have looked confused because he went on. "Your generation has come closer to equality for women and men than any in the history of our country. And that's a wonderful thing. Only trouble is that now everyone thinks everything, every minute, should be perfectly equal, perfectly divided, 50-50. And the reality is that, in a marriage, it just about never is." His wife had been listening quietly, but then piped up. "It's the truth. When our kids were very young, I was at home with them, and he traveled most weeks Monday through Thursday or Monday through Friday. There were years there where I felt like I was doing 90% of the work of our home and family." He interjected, "You didn't feel like you were doing 90% of the work, honey. You WERE doing 90% of the work." She nodded in agreement. She went on, "Even after he changed jobs and was home more, I still was the one who ran the carpools and worked the bake sales and double-checked the homework. It was 70-30, maybe 60-40 at times, but never 50-50, though we didn't really think or talk in those terms back then." He admitted, "There were times when we thought it wasn't worth going on. Mostly she thought it wasn't worth going on. But we stuck it out." She said, "It's true. There were times when I thought the tables would never turn. But...the last 8 years, Henry has done everything. He cleans our house. He gasses up our cars. He weeds the garden. He shops for the groceries. He makes every single meal. He even buys the cards for all the kids' and grandkids' birthdays and anniversaries and so forth, brings them to me with a pen to sign, and gets them into the mailbox on time. I still remember the day I was told I had metastatic breast cancer almost 9 years ago. I never thought I'd be sitting here having a conversation about it in 2010." Her eyes filled with tears. "We're taking one day at a time," her husband said, clasping her hand in his. "She's long ago beat the odds everyone gave her. And if she keeps it up, we MIGHT actually end up 50-50 after all. And that's the secret."

So, there you have it, folks. Quit counting beans. Forget 50-50, and perhaps you'll find yourself still married 70 years from now. And you might even realize on your 70th anniversary that you are, finally, in fact 50-50.

13 comments:

  1. beautiful story...beautiful.

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  2. This post made me cry. I had *that* day! My spouse left at 6 AM for work, I got three kids up, dressed, breakfasted, lunch made, ready for the nanny. I left at 8. Rushed through my day, and came home at 5. Made dinner, did laundry, got car to car place for inspection and oil change tomorrow morning. Spouse arrived home at 8. It is _definitely_ not 50/50 around here. I was very glad to read this post, because my husband is a good man, a good provider, and a good dad (when he's home). Gah, life is HARD!!!

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  3. What a sweet story. Thanks for sharing.

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  4. Great story Tempeh! Here I am, calling it quits at 13, and looking to start over again someday. Might not make it to 70, but this is a good basis for any numbered goal.

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  5. My grandparents were married 70 years. Funny thing my grandfather beat my grandmother quite a bit. Their two sons beat their wives, both sons are divorced. My grandparents are dead. Their son, I don't care about, I have not seen him since I was 8, I am now 33. And their son did not want me, his child. He wanted me dead, and beat the f@ck out of my mother hoping I would do so. Seventy years does not mean a thing to me.

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  6. I like this story, Like a few other mum's in medicine our house is the opposite to this beautiful couple.
    It is my husband that picks up the bulk of teh house duties at the moment while work and gestating keeps me busy.
    This story reminds me to let go of the guilt. Our aim is to both work part time once the daunting junior doctor years are behind me, so swings and round abouts!

    It keeps us strong, the ever changing balance of our lives, I gestate, give birth, have time to cook and organise. Then work hits, i work, cuddle and try to sleep! So far two babies...two more on the horizon...incubating is a pretty serious contribution too!

    Lovely post!

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  7. I love it!! This is so true! What a pearl of wisdom from this patient and her husband! Thank you for sharing.

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  8. thank you for sharing this... it is a beautiful story and a great reminder. I am engaged to a pedatric resident and we have recently moved in together. I posted today about how this story serves as a reminder to me about how It can work over the years (and why) I linked to your page and I hope others will read it too.

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  9. Thanks so much for sharing this encounter! It's a testament to how much we can learn from patient every single day. :-)

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  10. Tempeh! I love this post. I have been thinking about you, and how you have been getting along with your husband's latest deployment. I truly appreciate this story in light of a recent bout of feeling like I am ALWAYS left to pick up all of the pieces. The military calls, and they don't care what or who is left behind in it's wake... We are nearing the end of this long deployment stretch that started last October, and I am looking forward to splitting things a little closer to 60/40. ;0) Our 13th wedding anniversary was on Monday, what a fabulous reminder that no matter what, life isn't always fair, and 50/50 isn't always possible. Blessings to your family this Memorial Day Weekend.

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  11. That is beautiful. Thank you!!

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