How's Your Marriage, Doctor?

Physician's Money Digest, May 15 2003, Volume 10, Issue 9

By now you've most likely heard theold saying, "Don't fix it unless it'sbroken." Unfortunately, some marriedcouples can't fix their relationshipproblems because they don't know it'sin need of repair. Dr. and Mrs. Ellis area perfect example of this predicament.Neither spouse realized they had a maritalproblem until I intervened. Fortunately,their interesting story has justas interesting an ending.

OUR FIRST APPOINTMENT

Mrs. Ellis was referred to me by herfamily physician for "empty nest" symptoms.Since her 4 children had left home,she was becoming fretful, she startledwhen the phone rang or the doorbellbuzzed, she had trouble falling asleep,and she was worried about her health.She was especially fearful of colon cancer,and devoured any information shecould get her hands on. Despite herfears, a complete medical investigationturned out normal. And Mrs. Ellis accepteda referral to me easily.

Surprisingly, the first words out ofMrs. Ellis' mouth were: "I'm hopingthat you can help me accept the cancerthat my doctors haven't found yet." Myinitial thoughts were that she might bedepressed, or even delusional aboutcancer. But she wasn't. She talkedalmost nonstop in an anxious and self-effacingmanner. After listening to Mrs.Ellis talk for a while, I came up with thesource of her problem: Mrs. Ellis wasdesperately lonely and just neededsomeone to listen to her, to pay hersome needed attention.

NO TIME FOR MARRIAGE

During my 4 sessions with Mrs. Ellis, Ilearned that her husband was a muchloved, dedicated, and "old-fashioned"family doctor. Dr. Ellis has a solo practice,and is well known for his warmthand kindness. Mrs. Ellis explained that"his patients wait up to 2 hours to seehim, but they don't mind because he'llgive them all the time they need. He'svery thorough and he keeps up. He'sthe only one in his group who still doesobstetrics, and he's 63 now."

It turned out that Mrs. Ellis' husbandworked 12-hour days, Monday throughFriday, and 7-hour "half days" onSaturdays. This insight led to the followingconversation:

"So what's this like for you, Mrs.Ellis?" I asked.

"Oh, I don't mind. Medicine hasalways been Derek's first love. I learnedthat long ago when I asked him if wecould maybe go out to celebrate ourfirst wedding anniversary. He said thathe was too busy, but that it was ok withhim if I celebrated with my sister."

"Do you ever get lonely for him?"

"Well, not really. But I have beenjealous before of his patients. But thenI feel bad about this."

"Are you looking forward to yourhusband slowing down or cutting backon his practice?"

"No, that makes me feel worse. He'salready told me that he has no plansfor that. I just have to be strong, don'tyou think?"

THE RIGHT MEDICINE

I scheduled a visit for Mrs. Ellis andher husband. Dr. Ellis was very happy tocome in. After thanking me profuselyfor helping his wife, he turned hisattention to her.

"I've been really quite worriedabout you, dear," he said.

"You have? Well, you didn't say anythingto me about that," a surprisedMrs. Ellis responded.

"I know. I didn't want to upset you.And I didn't want to meddle in yourdoctor visits."

Mrs. Ellis was obviously touched byher husband's expression of concern.She became teary, and with difficultysaid, "Your concern means so much tome. Thank you, Derek."

I had 3 more visits with Dr. and Mrs.Ellis, during which time a lot happened.But the pivotal change was Dr. Ellis' decisionto hire an associate and cut backsubstantially on his work. The 2 of thembegan walking together in the morning,joined a bridge club, and took up birdwatching. My secretary summed it upbest: "I call them the ‘newlyweds.' Notmany couples sit in your waiting roomholding hands, Dr. Myers."

Michael F. Myers, a clinicalprofessor in the Departmentof Psychiatry atthe University of BritishColumbia in Vancouver,Canada, is the author ofDoctors' Marriages: A Lookat the Problems and Their Solutions (Plenum;212-620-8000) and How's Your Marriage?:ABook for Men and Women (AmericanPsychiatric Press; 800-368-5777). He is thepast president of the Canadian PsychiatricAssociation, and welcomes questions orcomments at myers@telus.net.