How's Your Marriage, Doctor?

It is estimated that 25% of Americanphysicians are international medicalgraduates. Their marriages, like USmedical school graduates, can becomestrained. The following is an example.

Dr. M, an obstetrician, complainedthat her husband Mr. M, a businessman,seemed withdrawn and less involved infamily life. Like her, he worked very longhours, but unlike her, he was frequentlyaway on overseas trips. When he washome, he liked to play golf and spendtime on his computer instead of spendingtime with their teenage sons. Shewondered if he was depressed or maybeeven having an affair.

Both Dr. and Mr. M were very successful.In my initial visit with the two ofthem, I learned that Dr. M had graduatedfrom medical school in India and herhusband studied commerce at the sameuniversity. They married shortly beforecoming to North America, where shebegan residency and he completed hisMBA, and then started their familytoward the end of her residency. Whenthe boys were young, Mr. and Dr. M hada series of nannies and a housekeeperonce both children were in school.

I asked Mr. M about his wife's concerns."No I'm not depressed, and I'mnot having an affair,"he said. "But Ihave pulled away from my wife. Why?She's obsessed with our sons becomingdoctors. She seems to respect what Ido, yet when Sanjay talks about pursuinga business career, she shuts himdown. I feel insulted."

Dr. M explained herself, "Medicinegives you autonomy, even in today'sworld of health care. Most people stillrespect physicians. I want our boys to belooked up to. Also it's very gratifyingbeing a doctor and helping people."Mr. M responded harshly, "You areliving vicariously through our sons.You want to brag about them to yourcolleagues, telling everyone that theyare on the honor roll and want tobecome doctors. Neither one has everexpressed an interest in medical school.You are trying to program them. Theyare both quite indulged, love expensivethings, and just want to make a lot ofmoney. Would you disagree?"

What transpired in this visit and a singlefollow-up visit was interesting. Thesubtext to Dr. M's goals for her sons wasanxiety. She worried that she neglectedher children by having nannies to helpcare for her children while she worked.She loved being an obstetrician, but feltguilty that she loved it too much. Eventhough she was raised by domestic helpand had a good relationship with hermother, she felt insecure as a parent. Sheassociated their following in her path asvalidation that she was a good mother.

The two of them agreed to changetheir interaction. Dr. M backed off andlet her sons discover their own talentsand aspirations, and Mr. M becamemore involved in his family life.

Michael F. Myers, a clinical professor in the

Department of Psychiatry at the University of

British Columbia in Vancouver, Canada, is the

author of Doctors'Marriages: A Look at the

Problems and Their Solutions (Plenum Pub

Corp; 1994) and How's Your Marriage?: A Book for Men and

Women (American Psychiatric Press; 1998). He is the past

president of the Canadian Psychiatric Association and welcomes

questions or comments at myers@telus.net.