Family Practice: Hope for Medical Marriages

by William Cutrer, M.D.

He claims she’s just a “special friend,” but I know better. The goofy eyes, the affectionate glances, her pictures plastered across his truck visor next to the paper heart she made him—my son categorically denying he is in love. Yet he’s smitten, in the eyes of his old dad.

I am a physician whose son is following his dream to practice medicine (he just took the M.C.A.T. and did well). Despite the fact that more than 50 percent of practicing physicians discourage future generations from entering the profession, I am optimistic about his future and the future of medicine. There will always be a place for servant-hearted doctors who desire to care for the needs of hurting people

Nevertheless, I think about the challenges that lie ahead if he and his sweetheart decide to tie the knot. The statistics look discouraging for anyone in the medical profession: The divorce rate for physicians is 10 to 20 percent higher than for other professionals; of those who stay married, almost half the physicians and more than half of their spouses report they are unhappy.

So what will I tell him? I who have enjoyed 26 years of Christian marriage—what can I say him and others in the medical field who are either preparing to marry or are already there? How can they beat the odds?

C.S. Lewis wrote that “Often we need not so much to be taught as to be reminded.” That is certainly true of marriage. God has designed marriage and provided foundational principles for making it work. I have counseled many couples, both as a physician and later as a pastor, and most often they have simply needed reminding about the basics they’ve already learned:

First, make time together a priority. Medicine makes varied and subtle demands, and with changes in medicine threatening the economic future of physicians and their families, it promises only to crunch harder. Voices of patients and peers who respect your education, compassion and ability to affect healing in critical situations draw you away from your family members, who see you as real flesh and blood with dirty socks. Combine that with fatigue and sleep deprivation. You discover it’s easy to be cruel to the ones you love because you know they’ll stay with you through it.

So fight to carve out time. Take mini-retreats and mini-vacations, even if it’s only getting together for a meal when on call at the hospital. During medical school, my wife, Jane, would come over, or I would go to the lab where she worked, to share lunch and a few moments of company. After we had children, she brought them to the hospital with a meal so we could “connect”—at least for a few moments. Taking twenty-minute walks after dinner will give you the chance to hold hands and enjoy undivided attention. And you have control over some demands so, whenever possible, intentionally schedule elective surgeries, inductions, and consultations around anniversaries, birthdays, and ballet recitals.

Communicate. Really communicate. Talk about things that matter—how you feel, and not just case histories and complaints about managed care, HMOs and malpractice attorneys, though they might be great conversation starters! In any marriage relationship, both partners grow, ideas change, and personalities mature. Thus, partners must talk instead of attempting to read minds. Otherwise, feelings get hurt, questions remain unresolved, and slowly distance develops.

The average couple talks only 37 minutes per week, and that “communication” does not necessarily have any depth. Sentences such as “Honey, did you pick up milk on your way home?” and “Where’s the remote?” don’t count. Listen attentively. Proverbs tells us that to get wisdom we have to get understanding. So listen actively with understanding—not necessarily agreement—as your goal.

In our medical school class on clinical diagnosis, we learned, “If you ask the right questions and listen carefully to the answers, the patient will ‘tell you’ the diagnosis.” This is true of relational health as well as physical health. Yet men all too frequently do not share at meaningful levels. And studies suggest that men and women often mean different things when using the same words. In addition, many in medicine, whether men or women, have used up all their compassion with needy, demanding patients and by the time they arrive home, they feel drained. Apathy has replaced energy and there’s a general lack of interest in the work of relational intimacy.

Nevertheless, commit to talking together. One of my colleagues chose car time as telephone time when he was on call. However, this made his wife tense. When they talked about it, she expressed concern that he drove carelessly when he focused attention on something other than the road. Now, whenever he is on call, she drives. Meaningful communication includes such daily maintenance. In addition, it involves a broad spectrum of other conversation levels from the expression of deeply internal feelings to playful banter.

3. Honor your marriage commitment. It’s easy to take the home relationship for granted and begin to believe the adoring words of your patients. You will be tempted to think you are entitled to some extra benefits for all the hard hours you work. Be careful! Many have sacrificed their integrity and the joy of a pure and unified home on the altar of temporal pleasures.

I received a letter from a Christian physician friend who said, “No one had ever told me that marriage required work and careful attention. I’d never been to a marriage seminar or read a single book about marriage.” She drifted into extramarital relationships and found that her husband had likewise been unfaithful. Now they face the enormous challenge of trying to rebuild trust, questioning whether it’s even worth the effort. It could happen to any of us; be careful with your heart.

4. Grow spiritually. There are no secrets or shortcuts here. You develop physical stamina by exercise, diet and rest—discipline. In similar fashion, spiritual growth requires discipline. Commit yourselves to regular prayer and Bible study. Jesus Christ, the Great Physician, was easily the most in-demand healer in all history. Yet he made time to draw apart and pray. Acknowledge your daily need for God’s supernatural intervention.

Also, consistently worship with a group of believers who will encourage you and hold you accountable. This can be especially difficult during the third and fourth year of med school and residency because regular time slots are hard to find. We found a church with multiple services during the week so we could stay involved.

5. Last, but by no means least important, keep the physical intimacy in your marriage alive. Although the one flesh picture of marriage goes far beyond the physical act, God gave sexuality as a gift for our pleasure and His glory. Data indicate that the nature of sexual dysfunction even in physician couples, who are trained in anatomy and physiology, is not fundamentally different from that of other professionals. However, establishing a Christian home gives you an advantage here. In what is probably the most scientific, comprehensive study ever done on sexuality, researchers found that a healthy marital relationship and a high level of commitment to one’s marriage play a major role in the extent to which a person is satisfied sexually. The best foundation for a satisfying sexual relationship is a loving, Christ-centered marriage.

Make time for intimacy. Be creative. Love each other in a way that expresses your devotion and concern, recognizing that intimacy goes beyond the physical to include the emotional, spiritual and intellectual. One physician couple shared that during medical school, they would go weeks without expressing their love physically because of the demands of studying. Finally, they determined that the best time to re-establish intimacy was after dinner, before re-focusing on the books.

If you have paid attention to all of the above—if you have cherished time together, learned to communicate at the level of deep feelings, if you’ve kept your commitment to your spouse and to your relationship with the Lord, physical intimacy will be the crowning joy that God created it to be.

Perhaps my son will need to think about these things sooner than I expected. During the months since I set out to write my thoughts, he has admitted he is in love. And when my daughter got married last weekend, he caught the garter. The love-struck grin on his face said it all.

This article first appeared in Today’s Christian Doctor.