We're Driving Cadillacs In Our Dreams

"Doctor's make way too much money."  I remember this day vividly.  I am sitting on my couch, 9 am in the morning, in our tiny apartment in Washington, DC.  This is our 4th year of my husband's surgical residency.  Surgical residency is a five year program after graduating from a four year medical school.  At this point, however, my husband is actually into his 6th year of post graduate training due to doing a two year research fellowship between his 3rd and 4th year of surgical residency.  We are struggling.  Just surviving another move to help my husband advance is his career, we now have two children under the age of 3 and once again his hours at the hospital are grueling.  I am alone.  His time off revolves around going to any meeting to present his research papers, trying desperately to have his name and work published. He is hoping someone will recognize his work, recognize his name so that when he applies for the Holy Grail of the Pediatric Surgery Fellowship, he will get a spot.  All of this traveling has taken a toll on our finances. To put it flatly we are broke. I am picking up per diem shifts at the hospital myself, as a Physical Therapist. It's the most cost effective way of supporting our family, yet we are still having trouble making ends meet, but we keep pushing forward. My husband has a dream, and I am his biggest believer and that is what's getting us through.  We've had many dips in the road, many paths have been blocked.  Our finances are weighing heavy on us, with his path in front of us still unknown.  I no longer dare to open up his statement from Sallie Mae.  His medical school loans are still being deferred, with interest piling. If I want to have a pleasant day, I just put this letter aside.

So here I am, just returning home from dropping off my oldest son to preschool, and our 1 year old is home with me for the day. I am getting my morning started with a cup of coffee and Good Morning America on the TV.  The term Obamacare is starting to gain momentum and George Stephanopolous is interviewing a 'doctor' who is advising The President on the issues with our healthcare system. Intrigued and to be honest, quite scared with the career that my family has been indebted to now being in the hands of a politician, I sit quietly waiting to hear this interview.  First question George asks, "Dr. what is wrong with healthcare." The man's response, " Well first, George, Doctor's make way too much money."  The anger that rises from the pit of my stomach is overwhelming.  A knot forms in my throat and tears well up in my eyes.  "What?" I yell!  Expletives fly out of my mouth and I startle my baby.  "Second, blah blah blah..." It was something along the lines of reimbursement rates.  I can no longer make out what this so-called expert is saying, or 'doctor' for that matter.  I am not sure what his credentials are, but for any real Physician or anyone who works in healthcare, it is a struggle to get paid to for services.  All insurance companies base what they will pay based on Medicare's rates and Medicare is run by the government, so how much more of a hand does the government want in healthcare?  I cannot walk into the grocery store and not pay my bill.  Should I tell the cashier, "Here's my insurance card.  See what they will cover."  A lawyer charges his/her own fees and politicians have better health care coverage than any one person who even works in health care.  I'm pretty sure we should be focusing on the economy, so are we deflecting from what the real problem is here?

What happened to the American dream for those who work in health care?  I know too many Physicians who are starting to close their doors because the over head to run their clinic is too expensive. I know surgeons, who after 30 years of practice are closing their businesses because they are not being reimbursed adequately for their surgeries.  I hope one day this struggle with the government/healthcare will be a wash and my husband, whose paycheck nowhere near covers his hours at the hospital, doesn't have to worry about the politics of healthcare and can focus solely on his patients. We are pushing towards a European model of socialized medicine, with a government who does not cover the cost to go to medical school.  Guess we will be driving a Cadillac soon... in our dreams.

Post-Call

First of all, you have a dirty mind :) But, since you're here, I will oblige. It's a Tuesday afternoon and my husband arrives home from the hospital, after his call shift that started on Monday morning..  He is now what is considered 'post-call'.  I am cleaning up the kitchen and trying to make the house some what presentable for his arrival home and in the rarity of the moment, both of our younger children are asleep.  They are down for their afternoon naps and my oldest is at school. So, there is a chance of alone time?!  I'm in the kitchen and my husband places down his briefcase, walks over to me and gives me a hug.  The kind of hug that can explain a thousand hardships with just one embrace.  Much doesn't need to be said, because just by the weight of his hug, I can tell that he needs it more than I do.  After our embrace, he kisses me on the lips and he realizes the house is quiet.  "Where are the kids?" he asks.  "Asleep!" I respond, as if I just solved the national debt crisis.  I can tell by the look on his face, he is happy to come home to a quiet house and that he needs sleep himself, but by surprise, he winks at me and says, "I am going to lie down for a bit.  Why don't you come and join me?"  "Okay," I respond coyly. "I'll meet you up there." He heads up the stairs before me.  I quickly finish up in the kitchen and start to head up the stairs myself.  "Is this really happening?" I ask myself.  "On a Tuesday afternoon, really? Well he is my husband, so why not?" Walking through the hallway, I can see in the haste of his excitement, he already starting undressing.  A trail of green scrubs leads me to our bedroom door.  It's cracked open and I can see he's already drawn the blinds closed, the room is dark, with a little bit of daylight seeping through the blinds.  I can make out his body in the bed.  The anticipation is so exciting as I creep into the room and slowly close the door behind me.  I turn around and "ZZZZZZZ."
 "What is that?...Oh" I sigh.  He looks so peaceful.  His chest is slowly rising up and down, his eyes are closed and lips are separated small enough to let out the beginnings of a snore.  My disappointment is starting to dissipate into empathy.  I know he needs his sleep.  So,  I crawl into bed and snuggle up next to him. Happy he is home and comforted knowing my family is together.  All is well with the world, and I start to feel myself nodding off.  Underestimating my own fatigue, I can feel my body get heavy, my breathing starting to slow down, drool is starting to creep into the corner of my mouth and I am falling into a blissful slumber....SEX with the Good Doctor.

"MOOOOOOOMMMMM!!!" I hear coming from my son's room.  No rest for the doctor's wife.

On-Call

"On-call" A dreaded term meaning my husband is required to complete a 24 hour shift at the hospital. This day, as do the majority of his days, start around 5:30 am.  I am usually half asleep when I feel a faint kiss from my husband, his way of saying goodbye and trying not to wake me at the same time.  For his night "on call" means that I too will have a night on call.  In no way do I have the same responsibilities that he will have to uphold for the evening.  He will need to take care and maintain the health of every sick patient on his service. He will also be required to attend to the needs of any new patient that may be admitted to the hospital who will require surgery. He will work tirelessly throughout the day and into the night.  He will grab a bite to eat when he can and most often miss a meal or two.  Although, he is required to take breaks for meals, he cannot stop performing a surgery part-way through because its his lunch break and the surgery is running longer than expected.  He cannot sit down to eat or call home to let us know he is doing OK, if a patient is starting to take a turn for the worse.  There is a lot of patience that comes with being his wife. 

 For myself, 'On call' has another set of meanings.  While my husband's entire focus, and should be, the care of his patient's, I have my own little patient's to attend to.  I am the only go-to person for all things related to this family, at least for the next 24 hours. I am the finance department, health department, chauffeur, etc.  I am a single mom, who has a partner, but I can't really rely on him.  There are so many things that I want to share with him when he is at work. Too many things, that by the time I am able to have a brief call with him, it's only the most important stuff that I can run by him and the rest will have to wait until he gets home.  There are plenty of times when the kids and I need him, but I can't bother him at work. How can I call my husband when our son strike's out at his baseball game?  Do I tell the nurse that answer's the phone, " Um... Hi, ma'am. Is there any way you can pull my husband away from performing that life- saving surgery because our son is in tears that he struck out at his final at bat and I can't control him at this point." When he finally returns home,  I don't want to share all of the bad with him and I don't want to bore him with the mundane things either.  He is only home for such a short period of time.  Shouldn't I make it a happy experience for him?  Unfortunately, no matter how much it means to you, you have to put yourself and the kids last and you do this willingly knowing that your significant other is saving the life of another human being.  You just hope that the multiple pics you send during the day, manage to bring a smile on your husband's face without his coworkers wondering if he is being distracted by the outside world. Yet, you can still hear the slight pang of sadness in his voice when he realized he missed out on a moment in his own child's life.  One that he will never get back.

So the next time you run into a physician, I hope that you may be able to give him or her a little slack. They are just human too. I know how frustrating it can be to be a patient and the anxiety that comes along with being sick.  Just know that he or she is placing your health or the health of someone you love first and that they have loved ones too that are missing them at that very moment.

It's now 9am the following day and he still isn't home and and we are both still 'on call.'