Relationships in Medicine-Getting What Matters, Getting What You Need

Photo Credit: David Pierre, Jr.

Rosalyn Chrenka, Ph.D.

Kendra* smiled shyly, lowered herself into a comfy therapy chair, and began her relationship story at the end.

“I can’t believe he broke up with me.  Even though I broke up with him, twice.  Even though we only were on the same campus for a few months before going to different cities.  Even though we’ve been apart for two years and will be for four more years. He always said, ‘Baby, you’re going through some bad times, but I know we’re meant to be.’”

“Seriously, you were surprised that Kelvyn* broke up with you after you had rejected him twice?”

It began when he had gotten a better MCAT score, and had gained admission into a prestigious medical school out West.  She had to settle for a specialty post-baccalaureate program in the Midwest.  He would always be one year/one step ahead of her in school and in the residency match.
“Once I broke up with him when I was angry that he was always talking about his White Coat Ceremony and new West Coast friends, while I was still competing to get into medical school.” The second time she tried to break it off was another similar meltdown about how “unfair” it was that he got to be doing such cool medical school things. “Until his break-up, he listened and supported me, and said he was always going to be there for me.”

I commented that I was actually quite surprised that they had lasted so long in the relationship.  “What were you getting from this relationship, and what do you think that Kelvyn was getting out of it?”

She said that she loved him unconditionally and supported his efforts—“it’s easy to support him because he’s happy and getting what he wants”.  She herself didn’t feel very supported or understood by him, given that he was always going to be ahead and they were 2000 miles apart.  And then (spoiler alert), she talked about the secret element of the relationship that she hated losing.

“But to be honest, what kept me in it for this long was that I had a sense of control over him.”

Kendra felt like people do when they hope they’ve found “The One”–comforted by being in a secure, exclusive relationship that predicted a stable future.  She felt in control by watching his myspace page for any new classmate contacts he was making and reaching out to them. She repeatedly had worried herself that the females weren’t “just friends”—but there was no evidence of infidelity—and this caused more tension and emotional distance in the relationship.  This may, indeed, have led to Kelvyn’s well-founded realization that the two of them, their partnership, could not withstand years of separation.

Despite the tentative sense of security and stability that Kendra’s “control” gave her, psychologists don’t think that seeking or needing a sense of control over your boyfriend/girlfriend to be either a viable long-term emotional position or a formula for a happy, successful long-term relationship.  The good news is that psychologists and physicians do have some ideas about what makes for good relationships in medicine.

At the April 2010 SNMA conference in Chicago, I had the privilege of facilitating a conversation with some married/parenting, engaged, and dating physicians about what works and what needs work in the presentation, Relationships in Medicine.  Here are some of the highlights:

One of our panelists reminded the audience that the marriage vow, “I do”, really means, “I do compromise.”  Compromising with your spouse or partner is a negotiation in which you both share control over your relationship by a) knowing your bottom-line needs and b) being responsible for listening to and making space for your partner’s wishes and needs.  We actually saw some compromise in action and an example of how balancing love and work happens, when two of our local married panelists worked out who was going to leave the presentation a little early to tend to their sick babies at home.

Compatibility makes the hard work of relationships and marriage meaningful and worthwhile. When you’re seeking a relationship, you should look for someone who “gets” who you are and whom you can relate easily to, without having to impose a lot of expectations for change.  Recent research confirms that the best relationships expand, not deflate, your sense of self.  (Parker-Pope, T. “Sustainable love: The happy marriage is the ‘me’ marriage”, January 2, 2011, New York Times.)

Finally, when it comes to relationships, my #1 “take-away” message is, First do no harm begins with you.  Relationships flourish when you know your needs, wants, and what you’re bringing to the table.  You may desperately want to be in a stable relationship, but if you’re prioritizing your medical school studies and struggling to keep your head above water, you may not be in a good place for a relationship and may be cheating yourself of important learning time and space.  Good relationships, as well as professionalism in medicine, both rest upon a healthy sense of self.

Also, many people are too hard on themselves when they’re not in a committed relationship, especially when their various “clocks” are ticking away.  Try to be easy on yourself if things don’t work out the first, second, or even third time.  Our panelists were emphatic about how important waiting for the right one is.  Given that waiting may be a reality, optimize this “me” time while in medical school–build your self-concept, expand your medical knowledge, make good friends.  Then, when you’re confident, and have a healthy and well-defined self, you can leave behind an imagined sense of stability, find a truly compatible mate, and compromise from a position of strength.

To summarize in a short and sweet takeaway tweet: Relationship equation solved: (Find yourself + Wait) x Find “boo” who gets you = Way to get relationship that comes alive, survives, thrives.

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