Courtney and Russell Jenkins celebrated their fifth anniversary with turkey sandwiches in the Massachusetts General Hospital cafeteria. It was three months into Russell’s internship in one of the country’s most demanding physician training programs, and he could not get time off.
He fiddled with his pager as Courtney reminisced about their wedding day in Roanoke, Va.
“I can’t believe it’s been five years,” Courtney recalls saying, when a random announcement came over the intercom. “Oh my God,’’ Russell exclaimed, “did someone call my name?!’’
That month, Russell was for the first time working in the intensive care unit for the very ill, where “residents are expected to bring their A game everyday,’’ he said later. Colleagues had agreed to monitor his patients while he met his wife, “but you can never really turn off totally,’’ he said.
Scenes like this play out regularly among significant others and residents who work long days in top-drawer teaching hospitals, and who are regularly on-call for 16- or 24-hour stretches. Working 80 hours a week in a job that requires physical stamina and unwavering focus can challenge family relationships in ways small and large.
Spouses wind up eating alone many nights. They often relocate for the training slot, sometimes putting their own career on hold. At work, residents witness illness and death day after day, which can sap energy for conversations at home. And when the couple are both residents, they can be on opposite schedules, requiring them to vacation separately.
Organizations that oversee training do not collect data about marital status, but anecdotal evidence suggests that more of these new doctors are juggling marriages and children. And many more residents now are women who may choose to take off time during training to give birth.
Faced with these lifestyle shifts, hospital training programs are slowly changing, too, by including spouses in the recruiting process, providing social and career support to them, and making it easier for residents to take maternity and paternity leave. Restrictions on the number of hours residents work also have helped.
“It used to be like the Army. You lived here,’’ said Dr. John Mullen, director of the surgical residency program at Mass. General. “If you didn’t have a life, how could you possibly conceive children? We’re moving toward a culture where life outside the hospital has value.’’
Last year, a popular second-year resident confided to Mullen that he was “head-over-heels’’ with a woman who was training at Columbia University Medical Center in New York. “He said, ‘Dr. Mullen, we have to find a way to get her to MGH.’ ’’ At first Mullen thought, “I am not going to change my program for her and create a job.’’
But when the pair got engaged several months later, Mullen worked to find a spot for the resident’s fiancée. “I want him to be successful and people are successful who are happy.’’
Mullen said he’s not sure that would have happened when he began training at Mass. General in 1996. One of the places he applied to was Duke University Medical Center, which was infamous for its high breakup rate among residents. Trainees “would say don’t even plan on getting married; if you do, you’ll get divorced,’’ Mullen said.
Russell Jenkins, 33, knew after his interview at Mass. General last December that the program was his first choice, but his wife, Courtney, had no desire to move to Boston from South Carolina. She had her own career in communications at a Medicaid managed-care organization, and family in nearby Virginia, where both she and Russell grew up.
When Russell told doctors at Mass. General that his wife was uneasy, they arranged a recruiting trip for her that included a private hospital tour, drinks next door at the Liberty Hotel, and a chauffeured car to take the couple to Monica’s for an Italian dinner in the North End. The next day, Katie Holt, a resident’s wife, texted Courtney and offered to meet her at a Starbucks to answer her questions.
By the end of the day, Courtney was sold. But even with the hospital’s efforts to include significant others, including a wintertime Cape Cod family retreat, she said residency can strain relationships. And there still are inconsistencies among programs in terms of family-friendliness. Long, intense training programs like cardio-thoracic surgery can be as inflexible as ever.
During the early months of Russell’s internship, which started last July, Courtney said it “was so unbelievably frustrating’’ because she never knew if he would make it home for dinner.
Eventually Russell discovered that he could download his schedule to Courtney’s iPhone in advance, and she grew to accept the rhythms of his work. As for the anniversary sandwich, she said, “I could be mad about that, sure. But I got to spend 15 minutes with him.’’
Russell knows his schedule is hard on Courtney, and said he felt especially guilty early on in Boston, before she had a job and friends. Before he leaves for work at 6 a.m. — Courtney is still asleep — he makes her coffee and leaves a short note next to her mug. “When we do have time together,’’ Russell said, “we try to make the most of it.’’
Holt is a lawyer who had been laid off from her firm in St. Louis, when she moved to Boston for her husband’s residency in 2009.
“There can be resentment,’’ she said. “Everyone feels it, it’s not talked about that much.’’
Moving to just blocks from the hospital has helped them — they can meet for a quick meal. So has Holt’s independent nature. She’s taken their daughter to visit family on holidays or meet friends for a vacation, when her husband has had to work.
Ariane Sroubek, 27, said she is “not naturally independent but it’s something I had to learn how to do’’ being married to a first-year resident, or intern, at Mass. General. On Jan. 2, she and her husband, Jakub, had a daughter, Hana, and the hospital allowed him to go on two weeks paternity leave immediately. Now, her parents often drive down from New Hampshire to help. Jakub is from the Czech Republic.
“I don’t know what we’d do if we didn’t have her family nearby,’’ Jakub said. The past few months have been more challenging than he anticipated, he said, because he started two intense jobs at once: doctor and father.