I Need to Go on a Boat. Also Known as “The Medical Marriage,” A Book Review

By April Thorpe

April Thorpe

The summer before my husband’s M4 year, he came home one day and announced that he wanted to go on a boat. Ok, a ship. A very large ship. He had found out about a six week volunteer stint on a Navy hospital ship which was embarking on a humanitarian mission to Cambodia and Vietnam. He inquired if spots were available for a medical student and was told, “No, you have to be finished with medical school, but that PhD in Nutrition will get you a spot.” He was cautiously elated. I was pretty sure I was going to have a heart attack.

I remember having kind of an out of body experience while he was pitching this whole idea to me. In a less than five minute spiel, my thoughts ran through the entire five stages of grief.

Denial. No way is he going to do this to me mere months before away rotations and residency interviews start. This is insane. There has to be a punch line coming. Ha ha. Very funny.

Anger. That’s it. I’m leaving him. This has got to be the most selfish, pigheaded thing I’ve ever heard in my life.

Bargaining. Ok, what I if I promise him to give him final word on his match list? Does he really just need to decompress by backpacking Europe? Uh, maybe he wants steak for dinner?

Depression. But I’ve hardly seen him all year. Our only child will start kindergarten while he’s gone and I’ll be all alone. We’re already draining our savings account on interview season and moving. There’s no way I can handle this. Waaahhhh!!!

Acceptance. Fortunately, by the time he was finished talking, I had landed on acceptance and I was ready to turn on my supportive medical wife face.

There were lots of ways that I could have chosen to react and I often think back to how it would have affected our marriage had I lashed out with anger and malice, or outright forbidden him to go, or sunken into a huge depression and played the victim or the martyr. Fortunately, in this one instance, I really heard him. I really listened. I saw on his face that this was something he felt in his gut that he needed to do to achieve some much needed fulfillment after years of grueling graduate and medical school. I was able to see that this was actually an unselfish act. He didn’t necessarily want to spend six weeks on a ship with a bunch of Navy guys in the steaming waters of Cambodia. He felt a call to serve and he was responding and truly felt that it would be the best thing for our family’s future in the long run. I am grateful that in that moment, I didn’t make it all about me. I made it about us. I didn’t think of it as HIS career and MY sacrifice. It was OUR decision and we ultimately were able to make it together. I wish that I could say that those six weeks were easy. They weren’t. I wish I could say that we saw palpable outcomes from that trip. We didn’t. I can say that the hardships that we faced before and during that trip to Cambodia strengthened our marriage and our support for one another and our chosen path as a medical family.

So what happens in medical marriages when our interactions don’t go quite so well? Let me tell you from experience, those interactions are inevitable in this lifestyle. We can get angry, or we can get prepared. A valuable resource is “The Medical Marriage: Sustaining Healthy Relationships for Physicians and Their Families” by Wayne M. Sotile, PhD and Mary O. Sotile, MA. Endorsed by the American Medical Association and written by psychologists, this book is not a light read. It is theory and experience driven, and dense with psychological and behavioral research. It is broken into three sections:

  1. Stress, Personality and Marriage
  2. The Basics of Love and Romance: Now and Forever
  3. Medicine, Marriage and Stress

I will admit, that after the first section, I was depressed. The stats are alarming. The anecdotes hopeless. After reading that “Rather than being a positive and reinforcing experience, medical training often functions as a ‘colossal castrator’ for the unwary student,” I was ready to pull my husband out of his radiology reading room, pack my family up and move to the French countryside to sell vegetables. Halfway through the section, I was psychoanalyzing myself and everyone around me. What do you mean we are all Type A personalities who bounce between being “superperson,” depressed or angry? Ok, yeah. I got a little angry there. Huh. Maybe they’re on to something…

Section two focuses on all the things that go wrong when the personality types in section one get married. Crisis, Disillusionment, Retirement, More Crisis, Empty Nesters, Affairs, Triangulation. My head was swimming at this point and my husband came home for dinner and was hit with a barrage of stats and facts and personality analysis and triangulation patterns and got a little worried that I was telling him that we might as well throw in the towel now because our marriage was doomed from the start.

It really was not until section three, the last 100 pages of the book that I started to really feel like the text was more than just an analysis of extreme behavior and that the information was useful for change or prevention rather than just identification. Different marriage types are analyzed (I got a little uneasy when I identified our marriage type and then read the predictions for the “pitfalls” that we will face in the future despite our relative happiness and success now) and tools for anger management, communication and marital success are laid out. Finally, in the very last chapter of the book, we are given hope by delving into successful “high-powered relationships” and what makes them work. This is where I thought the best advice and examples were given and just when I was feeling hope that I would be able to cope with this doomed medical marriage after all, the book was over.

All in all, I think that “The Medical Marriage” is an important read for an overview of the challenges that we, as strong personality types in medical marriages can face. While it is important to understand the way that we are all thinking and the motivations and subtext and brain chemistry and pathology, I think what the reader who picks up a book like this is inevitably seeking is guidance, understanding, hope and encouragement. I can tell that the Sotiles are skilled with this guidance. It is obvious that they are experienced and successful in dealing with families in crisis. I just wish that there had been less theory, fewer statistics and more tools and practical advice using every day scenarios prevalent in the different stages of a functioning medical marriage. Like tell me what to do the next time my husband comes home and wants to go on a boat…

April Thorpe is the stay-at-home mother of a very precocious future doctor, the master of a rather naughty Havanese puppy dog named Oliver Wendell Holmes, and the wife of Dr. Matthew Thorpe, MD, PhD, Resident Physician of Radiology at Duke University. Before finding her doctor, April studied Theater Design and Vocal Performance at Brigham Young University and worked as a professional musical theater actress and director. For years during the medical school and graduate school years, she kept herself sane by maintaining a popular book review blog and still gets hounded for recommendations constantly by family and friends. She is currently working on her first novel. She and her little family can easily be found at one of the many local foodie haunts in Durham, North Carolina.





One thought on “I Need to Go on a Boat. Also Known as “The Medical Marriage,” A Book Review

  1. Thank you so much for this article! As I was reading, I thought “That is exactly how I act and feel!!”. Your article was encouraging to me. I’m looking into getting that book now, too!

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