Monday, March 16, 2015

MiM Mail: (Un)happy match day - "It doesn't matter what YOU want"

As match approaches, it is with a heavy heart that I await the results.

This is a story which has been culminating over the years, and in fact, I have many unsent emails addressed to MiM which tell the tale. I am a 4th year medical student with two girls - a preschooler and a toddler. Both of these I gave birth to during medical school (I "took a year off" and did an MPH between 3rd and 4th year). I am married, and it is not a match made in heaven. Few relationships are perfect, but I feel like ours has some really deep underlying issues that perhaps make it stand out. We had a fun relationship in the beginning - but we got married more so because of an unplanned pregnancy. We were legally married in a courthouse. It was important to him to get married prior to the birth because he was already plotting his custody rights. I didn't tell my mother, who would have counselled me against it (and she would have been right), and none of my family or friends were in attendance. I worried about our significant age difference, but he promised me support, and we framed the relationship in that way - he has no competing career, which frees me up to pursue mine while having a secure family life. (Perhaps something like this.)

I wanted to send this story in because the title of the previous mailbag letter, "Whose dreams come first?" struck me. The reason that this resonated with me so much is that my husband told me when I was explaining my rank list, "It doesn't matter what you want."

Having children during medical school has been extremely draining, and now that I am plotting my career path, I wish I had more control over what I wanted to be and where I wanted to go. I am an excellent student and work extremely hard. Despite being a full time student, I have also taken extensive care of my children, especially as babies. I have "studied from home" while taking care of my children as infants for about 3/5 years of medical school/MPH (M1, M2, MPH) so that my husband would continue to have opportunities to work. Opportunities that I don't feel he ever took advantage of.

My husband and I have no family nearby and no family equivalents. As a result, all childcare responsibilities fall completely on us, unless we pay a babysitter. We did have a regular sitter 3 days a week for about one year, which I think was an overall great experience (with the exception that I felt from my perspective that we were hiring her so that my husband could work, with the implicit understanding that as a medical student I needed to work all the time, but from his perspective I was hiring her so that I could go to school while preserving his autonomy), but she went out of town and since the financial equation didn't add up (his overall work income = cost of sitter, and that includes time that I took care of the kids for him to work as well) by mutual agreement we didn't find someone to replace her.

There is not much of a culture of stay at home husbands of doctors. I have seen several blogs out there of the proud and self-sacrificing "doctor's wives" but nothing similar to that for the "doctor's husband." These blogs tell of the hard work of the male doctors, the pride of the doctor's wife in her husband's service to humanity, her story of self-sacrifice for her husbands career, helpful recipes, and parenting tips. My husband doesn't feel this way about my career at all. Perhaps it's because this culture doesn't exist for him. We are essentially at odds about my schedule, my need to study, the housework, the possibility of needing to move.

Because my husband decided on his own volition to be a stay at home dad, he now makes even more minimal income than before. He receives a $1000 annuity monthly from an accident.  I transfer money to him to pay the mortgage on his house/workshop and other bills. Most of it is money from my mother, and she is sending it via me to him with the understanding that he is supporting me in my career and taking care of her grandchildren. He says that he has "sacrificed" his work for my career, but in fact he adamantly did not want to get childcare and work. He has not given up financial security either - when we met, his bank account was completely overdrawn. He has recently characterized himself as been a "servant" of my "wealthy family." However, suggestions I have made that would make him more financially independent: renting his workshop space for income, getting a regular job, etc, have previously been shot down as inconceivable. We paid his leftover defaulted college loans - from almost 30 years ago! - with our tax return credits. I have also enabled him to pay off credit card debt. Meanwhile I feel like I have sacrificed much of the quality of my medical training for him, having lost out on the experience of a normal M1 and M2 year and career development opportunities along the way, but still taking on full expenses for the family either via loans or via my mother's contributions.

Rewind to the end of 3rd year: I am 9 months pregnant and concurrently preparing for the medicine clerkship exam,  starting MPH coursework, and studying for Step 2CK. I destroy the exams because I work hard. I am a machine! Woot! But things really go downhill over the next year. While in labor, I try to write a paper. It exemplifies my experience over the next year: working in pain. The intense emotional pain of trying to do well in school while your infant cries. I had done something similar in M1 year, but the memorization was much more tolerable than the reading and paper writing. And things are much more complicated now with two kids. My husband had encouraged me to do the MPH because of financial reasons - the fact that I will continue to have loans available and that my mom will continue to contribute to us if I am in school. After trying to write my paper between contractions, I give birth the following morning. It is a joyous day. Shortly after, I initiate total 24/7 care of our second child while taking 6 online courses, about 60 hours per week of work. His contribution is taking care of our oldest about 2/3 to 3/4 of the time, and taking her to school every morning. I work from 9pm-3am every night (the hours she most predictably sleeps) plus whatever else I can get my hands on. Even with this, he is pressuring me to do more school pickups for our oldest so that we are being "fair." In all this time, he theoretically could be working at least between 9am and 3pm M-F (and longer when I do pickups) but apparently does not since my mom is still paying the bills. I am feeling like sh*t, alone at home (online courses), taking care of baby, working, doing all laundry, washing diapers, most of the housework, plus the winter is complete hell and I can't even go outside for fresh air or a run because it is too cold for the baby. His first conclusion is that I am cheating on him with a classmate because I am withdrawn from him. !!!!?????! WTF ??????!!! I blow up. I tell him that I don't like him. That I could have done better. Someone younger, better looking, and more financially secure. Yes that is a very hurtful thing of me to say, which is why I guess I didn't say it until it really came to a head. And yes, I knew this about him going in, but I valued the support and partnership he promised more than any of those "shallow" things. I guess, when I felt the support slip away, I wished I had at least some of those shallow things left to hang onto.

He goes and talks to his friend who graduated from law school. Then he tells me that if I leave him, that he will keep the kids in the state. The other stuff he talked about "is between him and his lawyer."

I wish I had initiated something then (legal counsel?) but despite these misgivings, I had no plans to divorce him.  I felt like I had made the commitment, and I was going to do the best I could with it. Perhaps it was me (too picky? don't deserve better?), perhaps I would just never be satisfied with anyone, so I should try and make it work.  Living with him seemed and still seems like the only way I will ever see my children as a medical student or a resident, and they are young. They also love him and I don't want to take them away from him. I value what he provides for them as a father. So I kept it going. M4 starts and he now has finally taken over full childcare responsibilities.

He was not supportive during the application process and was more interested in my lack of sex drive than my career prospects. Then he blames me for not having worked hard enough to find a good program in our area and says I don't deserve "the best" that I should settle for "good enough." I feel like this is a recurring theme in a lot of his beliefs. He has a disdain for wealth. He calls me a "princess" for wanting to live in a nicer house and city. I am not a pro-wealth person and have a fairly nuanced view on the relationship between income and happiness, but he is full out against it, perhaps a defense mechanism for his personal lack of financial success or stability. I don't know if this attitude can be resolved. When I say that my career will bring the family financial stability, he says our kids can go to community college, take out loans, and that they would be happy living out of a van or homeless shelter. Maybe there is some element of truth to this. I think they will be happy anywhere they are with a loving family but I wonder if we can provide that.

I interviewed at 11 programs, 5 within our city and 6 around the country. In this process I have sought out advice from many people, only one of whom said I should make the "self-sacrificing" choice, most who said I should pursue my "dreams." Many have said that my husband can't keep the kids if I move out of state (they are wrong - our state favors keeping kids in the state and I confirmed this independently).

My mother called my husband and asked him if he will support me. He said he was not moving. Why? He was protecting himself from divorce because if he stays put, the state custody laws favor him, but if we move to another state and I divorce him there, then I would be more likely to maintain custody if he then moves out of state. I asked him whether in this scenario (refuse to move, keep the kids) he would continue to ask me to pay his bills? No, apparently he will get it together. Call me doubtful, but he could not pay his bills prior to having children. And wow, if he could actually work to pay the bills, then why wasn't he doing this all along? The wildly emotional thoughts running through my mind include:this man is going to take my kids from me AND live off my future income unless I do what he wants.

Long story short I submitted my rank list while sobbing. My top programs are somewhere in the middle of my list, probably never to be realized. I have given up on the possibility of living near my family - consisting of my mom and sister. In fact, I did not even rank my preferred specialty first given I was so disillusioned, and I really regret this as well. I often wish I had submitted the list I wanted and dealt with the fray rather than be here in this limbo, unable to change or withdraw my rank list. But it was my children that he threatened to keep from me. My children. It made me crazy. (He would say: no, he did not threaten that - all he said was that "I'll keep them in the state" - he is a stickler for legal language.) My mother withdrew her financial support of him and he is now calling her evil and manipulative. She will no longer help us buy a house that he would live in. Nor should she. He now says that since I'm not paying his bills that I need to share half the parenting, including school drop offs at 8:30am (long after I am supposed to have reported to the hospital), BUT that I should NOT quit medical school. I don't know if he actually expects me to do this, or if he is just holding it over my head that I CAN'T do it.

He is looking at my future resident's salary, most likely the local program I ranked first, and salivating with the income "boon" - not concerned about what it means to me. I have watched my fellow "MiM" classmates give up their dream residency for their husband's careers, and I felt bad for them. I feel less bad for those who make the practical decision because of close-by family who are supportive. Now I feel bad for myself. I do not want to pay this man's mortgage with my blood, sweat, and tears. But he has my kids, and I will not have the hours in the day to take care of them for a long, long time.

We are in counselling now and I feel worse and worse about him the more I think and talk about it. I don't think I can forgive him for the position he postured. As far as the possibility of divorce goes, I am sincerely worried that I would lose custody of my children because of my work hours. I could drop out of residency after my contractual period and then divorce him, at possible loss to my career. Then there is always the possibility of a match day miracle, whereby I get the program I actually wanted. I suppose if that happens, I will have to be nice to him if I have any hope of making the move with my family. Or, I will submit a waiver to my dream program. Or I will visit my kids on my day off. Or at this point, do I actually want that program anymore, given that I have already started to plot a career that would be better for a single mother or co-parenting situation?

I know I am not his ideal wife. I don't idolize him and will probably never be in love with him. But I have given him so much of my life. I am willing to work with him in a partnership and possibly even an affectionate relationship for mutual benefit. Perhaps I am willing to settle for "good enough" in this "romantic relationship" part of my life, but not at the expense of settling for "good enough" in the professional part of my life? He probably feels the same way. He is willing to settle for "good enough" in our relationship if we don't move and everything stays status quo, but requires my adoration to move. But I can't fake adoration. I alternate from feeling like maybe I am a "privileged princess" to think that I could actually rank the program I wanted first - big whoop, who cares, you're going to be a doctor no matter which program you go to - to feeling enraged that I worked so hard against so many odds and am placed in this situation where I have to settle.

Maybe the best solution would be to get divorced after Match but prior to graduation, drop out after the contractual 45 day period of residency or apply for a waiver, enjoy a year with my children in the interim while HE works, and apply in a more single-parent friendly specialty with the new understanding that I am restricted locally, and with a feasible plan to co-parent. Compromise like hell, but more on my terms and with more warning.

It took me some time to get oriented on my career path with some bumps along the way as a young adult. Now I feel like I am pining for my own lost potential of self-determination that I was finally on the brink of realizing. My sister recently married a nice young man she has been long distance dating for years, who will follow her unpredictable and highly specialized career anywhere, and is excited to do so, a comparison that is painfully made. I will never get to marry a nice young man who is willing to unconditionally support my career. I will never have the experience of my family celebrating my wedding day. I will never feel deeply head over heels in love with my husband. I will never have autonomy over my career. I have what I have. Such beautiful and wonderful children! So much! Everything!

But so hard.

Well, that is my long story. I don't know what kind of advice I am looking for. Past experiences? Commiseration? Strategy? A reality check?


  1. My heart broke for you reading this. I don't have much to suggest as I have never been in a situation like what you're describing. I believe that if you wouldn't want your daughter or sister to be in a relationship like the one you're describing then you shouldn't either-both for yourself and for what you model for your kids. I think you should talk with a lawyer and start planning an exit strategy. This might involve transferring programs to be closer to family if they can help with childcare. Because of the logistics of residency, it could take you a while to figure out a plan that is acceptable and things will be hard. However, I truly believe that things can be a lot better for you than what you're describing. What you want matters. Being happy matters.

    My second recommendation might he hard since much of your free time is spent with your kids. If your medical school offers student counseling, that might be a good thing to avail yourself of in the time before residency.

  2. Right now, you only know that he has told you laws would favor him. But you are the main source of income right now. How much better could you support your family without him and if you actually had help? Talk to a lawyer stat and find out where you are coming from. Right now he is manipulating you and you need facts. Plus your sleep deprivation is almost certainly clouding your entire outlook.

    Also if your family would be good support for you please talk to them! I also agree with counseling.

    I hope you find a good solution!

  3. Absolutely agree with the recommendations above. I also wonder about seeking the counsel and support of an advocate at an intimate partner violence (i.e. domestic violence) agency. I've learned that there are so many ways for a partner to be abusive that don't involve physical abuse. You, and your children, deserve so much better than this relationship. Also recommend keeping a log (somewhere that he can't access) of any threatening he does, and of who does what regarding taking care of your children.
    Sending you thoughts of courage and strength.

  4. 1) Get an IUD
    2) Talk to a lawyer and find out what your rights are. Maybe your mom can help you with this.

    I dated someone like this years ago. THANK GOD we did not reproduce. I've been planning on writing about my feelings about being trapped after I had my daughter. I think it's pretty common, but nobody ever really talks about it. On the bright side, a) you are going to be a doctor, and b) you have a supportive family. Some people have neither. I know it seems bleak now, but you will get through this.

  5. TALK TO A LAWYER. Talk to a lawyer … talk to a lawyer … talk to a lawyer. … And if you don't like that person, talk to another lawyer.
    I skimmed this post because it's long but I get the drift. And I commiserate. On the other hand, I think in some ways your husband is acting reasonably and it's time for you to do the same. Whatever his (many, many) personal flaws, he has provided a lot of the childcare, he recognizes your marriage is flawed and perhaps doomed, and he recognizes that many states favor the mother. He also realizes he has a good argument for custody. All the other information you give is good evidence that you should divorce, but it is not at all related to the task at hand, which is protecting your own case for custody or, maybe joint custody. Frankly, I think in this light his behavior is in no way conducive to a good marriage, but exactly what I would have advised a female friend to do. So it's time for you to act rationally and do the same. … You need a lawyer, and probably to interview a few to find a good one. I actually think it's reasonable, if you are on the road to divorce, to try to stay in the same state where you can establish joint custody, etc. I don't think his pushing for this is necessarily bad for you. I realize that you have worked hard and deserve your pick of programs, etc. But you also deserve to have your career in a place where you can be a parent to your children. … Let the other students worry about getting their dream program. You are a mother, you have to balance lots of demands, you are good at that. Now get to work balancing. So look at the facts. You have a marriage that is crumbling and a "partner" who has some valid arguments for custody. Your next step is absolutely to get a GOOD lawyer. Then consider your options as far as the match possibility based on that. Any possibility of a good connection where you are getting you placed outside the match or something creative like that? Or maybe a good connection somewhere else? (But don't pursue anything until you have hired a good lawyer with good references after perhaps interviewing several - have I said that enough times?)

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  7. My ex-husband was just like this--full of criticisms, manipulation, and controlling behaviors. It started little by little while we were dating, so slowly I didn't recognize it, but after marriage it came into full bloom. After a lot of thought and careful consideration, I decided to leave. It was the best decision I ever made, and the moment I did a huge weight lifted off my shoulders. I have since found a supportive, loving man and I couldn't be happier. I echo above comment about looking into characteristics of verbally abusive relationships, in which spouses subversively control and manipulate. What helped me make my decision was thinking about what I would like my life to be like in 10 years from now, and what would that older, wiser version of myself tell me to do now? How do you want to model how husbands and wives treat each other for your children? You are just in the beginning of your career and motherhood...there are so many possibilities and opportunities ahead to make your life a happier one. Start taking actions now that will lead you to that future life you envision for yourself.

  8. I have so many thoughts after reading your post....
    First, don't tell yourself any of those "nevers" in your last paragraph. Your path WILL straighten out, but it just might be a while before you get there.

    Now to your situation..... One of my first thoughts while reading was will he really want custody, given how he was before your fourth year. Just something to think about.
    I really believe that you have to figure out your personal life before figuring out your professional life. It sounds like there are options to get into your desired specialty and location. It also sounds like you know what to do with your husband -- even if it's a hard choice, I really think you need to listen to your heart. Even if it means you stay in the same city so you can be around your children, you don't need his abuse in your life.

    Another thought I had.... If you do your residency in the city where your mom lives, will she watch your girls? Even if you can't do your dream residency, that may be something to consider.

    Please remember that YOU ARE STRONG. To get through everything you've been through says so much about your strength. Let your strength carry you through your next steps. And please check back in and let us know how you're doing.

  9. As mentioned above, get an IUD, an attorney, and a full exit strategy, in that order. If things do not improve despite counseling and you choose to stay with someone who manipulates you, with profound disrespect, the two of you together are setting a poor example for your children. Get out while they're still young.

  10. You deserve a better life than this and you CAN have a better life. Hopefully you can pull it all together and realize this is possible. He has emotionally blackmailed you into thinking a different life would be more horrible than the one you are in...but the reality is that it may not be and you will never know unless you allow yourself that reality.

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  12. can you update us on what happened after match day? Also.. I switched specialties/residencies after my intern year which involved relocating.. I was a single mom and moved to be closer to family for help raising my son at the time. If you want more info on the process/ interviewing as an intern / doing residency with kids (esp as a single parent) feel free to email me My heart goes out to you!

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