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Nursing a marriage: Married to the doctor

From the Winter 2011 issue of Scrubs

When I tell my fellow nurses that I’m married to a doctor, and that for the past 10 years he and I have been partners in a women’s health practice, their reactions are split. Half imagine it must be wonderful to work with one’s soul mate, shoulder to shoulder all day long, looking into each other’s eyes, meeting for romantic lunches. The other half cringe. Spending 24/7 with your mate…while he’s acting like your boss!

The truth? They’re both right.

Yes, our eyes do meet with affection—sometimes. And occasionally Tom will bring me a salad from the cafeteria so I can finish my charting.  I get to spend every day with someone I love, doing work that I love.

Since we are aware of each other’s needs, we are able to help each other. If my stack of charts gets too high, he’ll sign off my labs. If he’s running behind, I’ll see one of his patients. If something bad happens, a surgical complication or a miscarriage of an infertility patient, we can support each other.

At night when we sit on our porch with a cup of tension reliever tea, we can discuss interesting cases, new things we’ve learned or the latest research. It’s not boring as it might be with other couples because we’re in it together. Like anglers on a mountain stream, we compare notes, tell fish stories and empathize with each other’s successes and failures.

This is the good part of working together, but it has taken time to evolve. We’ve operated as a team our entire married life—30 years and counting. We met during our commune days, built log cabins together, planted fruit trees, started food co-ops and marched in peace demonstrations against the war in Vietnam. Eventually, Tom and I took turns going back to school. One of us worked while the other studied, back and forth. He became an EMT, then I became an LPN. He became a paramedic, then I became an RN. He worked as a medical assistant in an oncology unit while I studied midwifery. He went to medical school and did his residency while I taught maternal nursing and did deliveries in a university nurse-midwifery practice. During this time, we also had three kids and managed to pull off the usual things parents do: feed them, do their laundry, make it to PTA meetings.

When we started our private practice, the real challenges began. I was the administrator, but he was the medical director. I was in charge of the staff, but he was in charge of the nurses—and me! We had to be careful of each other’s feelings. No offhand remarks. The work was too intense. Patients’ lives were at stake. When the lines between colleague and spouse blur, distractions occur.

So I’ve learned to constantly remind myself not to interrupt my husband with domestic concerns. “Hey Tom, did you remember to go to the bank this morning?” I’m tempted to ask as I pass his desk.

I also show respect and not seek his advice on a patient as casually as I’d ask him to stop for a jug of milk home on his way home.

In front of patients, I always call my husband “Dr. Harman.” And I normally preface my questions with “May I consult with you” rather than “Hey, what do you think?” Likewise, he has to remind himself to treat me as considerately as he does the rest of the nurses.

Here’s an example that happened this morning.

“May I consult with you, Dr. Harman?” I notice he has frosting on his fingers and I frown. He’s supposed to be on a diet, but I resist my urge to comment.

“Sure. What’s up?”

I flip open Lilac Morgan’s yellow chart and run through her history. “This is a 57-year-old patient, overweight, hypertensive and having severe hot flashes. She smokes a pack of cigarettes a day and wants hormone replacement.” I’m ready for him to say No, she’s too high risk.

“Get blood work on her and if the results are okay, you can start her on something.”

Here’s the point. Would he answer a clinical question from another nurse or a nurse practitioner in the same casual manner? I don’t think so. He would sit down, listen attentively and then discuss the critical issues.

I give an inward growl, then toss my irritation aside.It’s not worth the hassle to go around mad. Progress, not perfection—isn’t that what they say?

There’s another thing. I know my husband so well, I’m always aware of his moods, even when he’s 40 feet down the hall. I can tell by the way he walks what kind of day he’s having. Jolly means he’ll stroll around the clinic, joking with the staff. Bored and he shuffles back to the kitchen to look for baked goodies. Hassled, he whips back and forth from exam room to exam room without a smile. Frustrated, he might snap my head off.

Like the nurse I am, when he’s having a bad day, I want to make him feel better, but I’ve come to understand that I have to let him be rather than asking all the time, “What’s wrong?” I try to respect his need for space and allow him to withdraw until he returns to his usual mellow self.

Because we work together, Tom and I tend to talk about our profession too much. I try to leave work at work, but still thoughts creep in. “Do you think we can give bonuses this winter?” I might ask as we’re getting ready for bed. We’ve learned that we have to call a halt to that and schedule a meeting for those kinds of conversations. Planning ahead has helped and, in fact, now we do the same thing with domestic concerns. I organize a sit-down, give warning of the topic, put a time limit on the discussion and include food—sushi, hot dogs or Kentucky Fried. Tom’s easy to please.

When all else fails, I remind myself what a competent, kind person I have for a partner—and tell him… “Tom,” I might say, “You are the best backup physician a midwife ever had.”

He smiles because he’s heard this from me a hundred times, but I think he still likes it.

Working with your husband is a delicate dance, more boogie than ballet. But then when you think of it, any marriage is. The lessons are the same, including the one you always hear: Leave time for romance. I’ll admit that I don’t always follow this advice. Fortunately, Tom is better than I am.

“Did I tell you about the 17-year-old I saw today with chlamydia?” I prattle on as I put my bare feet up on the porch rail and stare into the dark across our two acres of freshly cut lawn and surrounding woods. “She cried. I felt so bad. Her mother committed suicide when she was eight and she has a history of sexual abuse. On the other hand, she was having unprotected sex. I just hope she learned something….”

“Give it up, Pats.” That’s Tom. Fireflies flicker in the forsythia bushes. “Let’s think about the way the grass smells and how the tree frogs sing down by the lake.” He puts his hand tenderly on the back of my neck…I still get goose bumps….

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Patricia Harman

Patricia Harman, CNM, has published in the Journal of Midwifery and Women’s Health and Journal of Sigma Theta Tau for Nursing Scholarship as well as in alternative publications. She is a regular presenter at national midwifery conferences. Her first book, "The Blue Cotton Gown" (Beacon / 7291-2 / $16.00 pb), was published to acclaim. Harman lives and works near Morgantown, West Virginia, and has three sons.
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