As the culture of medicine becomes increasingly progressive and diverse, relationships within medicine follow a similar trend. Once occasionally pursued and rarely well maintained, long-distance relationships are becoming more common amongst medical professionals.
One of several reasons is that more women are becoming physicians and understandably valuing career goals over the location of their significant other. My wife is currently a NICU fellow in a rigorous academic Mid-West program, while I am an anesthesiology resident on the West Coast. We each chose the long-term goals of clinical excellence over the short term, more comfortable preference of living together. While our relationship is far from perfect, I wanted to share the successes and insights we have learned over a nine-year relationship, of which six were in different states or countries.
I feel as though I ought to disclose that my wife and I are relatively privileged in a few regards. We have the means to afford airline travel every 3-4 weeks without major financial burden, we have access to free, excellent healthcare via large universities, and we both have supportive families within two hours. Finally, we trust each other entirely. Our foundation is solid.
This is not meant to be a “Dear Abby” column, self-help text, or cautionary tale, but simply a reflection on a moderately successful young marriage between two physicians in training with a bit of optimistic, applicable advice likely heard many times before this essay.
Long-distance presents a variety of obstacles to maintaining a healthy relationship. Effective communication can be extraordinarily challenging. We live three time zones apart. We practice vastly different specialties. Maintaining emotional depth and support requires more than the 30-60 minute window at 6pm PST when I arrive home, and right before she needs to sleep. We can go through the motions of talking about our days, distracted by emails and text messages, say goodbye and move on. But our marriage is strengthened by our desire to share our accomplishments, mistakes, joys, fears, and growth as physicians.
Occasionally I struggle with breaking bad news, such as call or vacation schedule changes that lead to frustration and anger of having to reshape plans. However, I learned that confrontation, while difficult with limited communication, is vital to preserve the sanity of your partner who cannot keep track of your schedule from across the country. Luckily, we also have FaceTime – a modern miracle that feels awfully similar to being in the same room. Seeing each other’s faces over the phone daily, and in my case our Yorkie’s face as well, lifts our spirits and can carry us through grueling days of work. We are far from perfect at sharing everything we ought to, but we work hard to communicate both our grievances and our successes.
One of the most valuable lessons I learned is to be flexible to a constantly changing life, without being a martyr, no matter the size of the conflict. We tolerate relentless inconvenience. Work hours force missed calls, night shifts prevent almost any communication, and catch up sleep becomes the first priority. Adjusting to unexpected change with patience prevents unnecessary stress. It does not require dramatically dropping everything in life that could interfere with our relationship. If I work late and miss her calls, she understands. If she visits family and misses my video chats, I understand. We often end up sacrificing sleep, exercise, nutrition, or hobbies to maintain our emotional support. These sacrifices are neither made in vain nor accumulated to hold against the other person, but rather acknowledged and appreciated; we forgive and forget. Expectations of physicians are endless and enormous. We understand and empathize with each other. This characteristic of a relationship between medical professionals cannot be undervalued.
Finally, we each pursued the best programs in our respective fields without limiting location, thereby choosing career over our marriage. This forced us to postpone having children, a choice we purposefully made. We allowed each other the opportunity to become our best selves without fear of guilt. Although we both acknowledge occasional regret primarily due to missing the other, our career development has been worth the sacrifice thus far.
Long before we were married living thousands of miles apart, we developed a strong sense of independent self-worth. We were self-motivated students that were career and goal oriented. My wife, a year ahead of me in medical school, was an invaluable source of guidance. We supported each other through several physically and emotionally taxing years of training. We pursued our respective specialties without the need to actualize someone else’s image of who we were supposed to be or what we were supposed to provide to a family. Luckily, our jobs are enormously fulfilling.
While our independence is important, it also toes the line of emotional separation. Living away from each other for months or years can become normal, drifting couples apart, leading to separation or divorce. Our emotional connection is maintained by sharing in our mutual successes and the love of something or someone else. We enjoy playing sports, yoga, and reading alone. We hike and cook together, but most commonly we enjoy our mutual obsession for the well-being of our Yorkie. We do not rely on the other for validation of happiness but come together to find more. Independence in work and fulfillment of life allow us to be strong, separately.
Despite our generally mature attitude towards a healthy relationship and everything we have learned from other un/successful marriages, we still struggle. However, our struggles are usually alone, amplified by loneliness that comes from being so far away from your best friend. This often makes residency, fellowship, life, etc more challenging. Thankfully neither of us routinely breaks duty hours. We are able to catch up with our mutual support, preventing a further spiral towards exhaustion, burn out, depression, etc. But not everyone can say this.
There are a few common pearls that many relationship experts provide, which I will echo in the hopes of it assisting some of my colleagues who share similar challenges with long-distance relationships.
- Acknowledge sacrifice by verbally expressing your appreciation to your significant other.
- Be empathetic. As medical professionals, we have the unique ability to fully understand what the other is going through.
- Compliment each other. You likely married this person for a myriad of reasons. Occasionally reflecting on those reasons and telling your loved one can make their day. This I need to improve on the most myself.
- Develop your own sense of self. My wife and I add to each other’s happiness, we are not co-dependent on the other to provide it. We are independent, but happiest in each other’s company.
I thank my parents for providing an exemplary physician relationship built upon communication, acknowledged sacrifice, and mutual respect which I strive for in my marriage. I would not be where I am without my wife’s perseverance, never ending support in times of frustration and loneliness, and patience. We will live together again soon, I promise. Finally, I thank my dog Stella for bringing me joy.