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"My life's a mess," said Jan, 44, who's been married for 18 years and has three children, ages 13, 12, and 10. "Last year my husband had a heart attack at 44. Yes, Scott has borderline high cholesterol and high blood pressure, but he was in good health otherwise and wasn't taking medication. Now I live in fear that he's going to drop dead. Some days it's all I can think about! I'll imagine him dying and burst into tears. Or I'll have a nightmare about it and wake in a cold sweat. I don't want to upset him, so I just remind him to take his meds, watch his diet, and go easy at the gym. He's worried, too, and keeps telling me I need to go back to work in case something happens to him. But it's not that easy.
"Eight years ago I gave up my career as an endocrinologist to stay home with my kids, who were all in preschool. We'd had a bad experience with a nanny and I didn't want to leave them with someone I didn't completely trust. And I felt I couldn't be both a great mother and a great doctor. Scott supported my decision, but now he's hounding me to go back to medicine.
"The thing is, to reenter my medical profession I would need to be recertified and relicensed, which would mean taking courses and passing tests. The thought terrifies me. I used to be so confident, but now I feel as though the only thing I can do well is take care of my family.
"It would help if Scott would stop nagging and acknowledge all that I do. Would it kill him to call from work to see how my day's going? Is it too much to ask that he leave the office early once in a while for a parent-teacher conference? I hate being taken for granted.
"I should discuss all this with Scott, but I don't want him to get upset -- it's bad for his heart. So I keep everything inside until I can't take it anymore and then I explode. At night we go our separate ways. I watch TV in our bedroom while he reads in the den. We almost never have sex, and I can't remember the last time we went out alone. I won't use babysitters, and it's too hard to arrange sleepovers for all three kids.
"I met Scott when I was still in med school. He was already an investment banker. We clicked immediately. We both came from strict Catholic families, were serious skiers, and loved reading thrillers. We dated for three years and got married after I completed my internship. Around our fifth anniversary I got pregnant with Kate, and then, just six months after she was born, with Lily.
"Scott and I loved our jobs and worked crazy hours, so we hired an au pair to look after the girls. She was terrific but after a year she went back home to Spain. Our second one had a horrible temper and I fired her for screaming at Kate for dropping a sippy cup. We put the girls in daycare but when I got pregnant with Mark we went back to live-in help. When that au pair stole from us I said to Scott, 'That's it -- I have to quit my job. I don't want anyone else to care for our kids.'
"It was the right decision, but I miss practicing medicine. I miss other doctors. I even miss getting dressed up and putting on makeup in the morning. When I look in the mirror I barely recognize the pony-tailed woman in the baggy sweats staring back at me. My days are spent running errands, driving the kids to lessons, and cooking dinner. By 8 p.m. I'm wiped out.
"I hate the way I feel -- so tired and blah and anxious about Scott's health. I want to get my groove back but I don't know how."
"It's time Jan got out of her rut," said Scott, 45. "Her misery is making me miserable! I'm tired of watching her mope around. And I hate the way she accuses me of taking her for granted and starts a fight whenever I suggest she go back to work. I guess Jan doesn't see herself as I see her -- a high achiever who needs more in her life than volunteering and carpooling. She can be an excellent mother and physician. She needs to lose this all-or-nothing mentality.
"There's so much I miss about our old life, before Jan stopped working. We couldn't keep our hands off each other. These days I'm lucky to get a peck on the cheek. We'd talk for hours about her cases and my business deals. We'd read and discuss the same novels. For the past eight years the only topic she's interested in is our kids. If she's not talking about their schoolwork or activities, she's quiet and withdrawn. As for her being angry that I don't take time off for parent-teacher conferences, this is news to me! I work 45 minutes away, even with light traffic, so leaving the office in the middle of the day is not an option.
"Jan has a really short fuse. She'll fly off the handle at the slightest thing -- if Lily leaves on the bathroom light or I forget to take out the trash. I never know what's going to set her off, or when she'll give me the silent treatment. And of course my heart attack has taken a terrible toll on our relationship. We used to love skiing as a family and even though my cardiologist has cleared me for all sports, Jan is convinced I'll keel over on the slopes. So no more ski trips. This is ridiculous. Okay, I know she's a doctor, but she's not an expert on heart conditions.
"After the incident with the last au pair I supported Jan's decision to stay home, but I didn't expect it to be permanent. Now she won't even hire a babysitter. I used to love going out to dinner or seeing a movie with another couple. So that's one more thing I miss.
"I want the old Jan back, the sexy, talkative one with the easy laugh. I understand that Jan is scared I'm going to die. I'm scared, too, but I've followed my doctor's instructions to the letter. The rest is out of my control. She's so deep in denial that she won't even discuss it. I love Jan and wish she'd stop letting fear control our lives."
"Jan didn't realize it when the couple started therapy, but she was lost both emotionally and intellectually because she didn't have a career. She blamed her unhappiness on fears about Scott's health, his dismissive attitude, and their conflicts over her going back to work. But over the years her self-esteem had plummeted. In order to restore it, Jan needed to rejoin her profession. Once she felt better about herself, I was confident that her anxiety would subside and she and Scott would communicate better.
"Jan refused to believe she could be a good mother and a good doctor. My job was to help her understand that she could succeed in both roles -- and that her family did not have to take a backseat to her profession. 'You'll be a happier and more interesting person if you have your own life, too. And you'll have more to offer your family.'
"Jan broke down when I raised the subject of her returning to medicine. 'I know I should work in case Scott dies, but I'm afraid I'll fail,' she said, sobbing. 'And who'll run the family while I'm studying and working? I don't see how I can do it.' I pointed out that she had a long history of academic and professional success and that, with her children getting older, this was an ideal time to launch the next phase of her life. 'It's okay to be nervous,' I said. 'But it's not okay to let nervousness paralyze you.'
"I encouraged Jan to view going back to work as a project she could break into small pieces, such as taking one course at a time. Using that framework, she enrolled in a course on new trends in endocrinology with the intention of going back to work part-time next year, when both girls are in high school. To make time for the class, she scaled back the kids' activities and reduced her volunteer work. Scott now takes the kids to school. 'It's great not to feel constantly pressured to get somewhere,' Jan said.
"Next we addressed Jan's anxiety about Scott's health. 'You can't just sit around terrified he'll die,' I said gently. 'Scott is doing everything he can to stay alive. The only thing you can control is your attitude, so think positively -- and go skiing.'
"The couple also improved their communication. Instead of bottling up her feelings until she flew into a rage, Jan learned to say, 'I'm upset about XYZ. Can we set aside a time to discuss it?' Scott admitted that he often dismissed Jan's concerns with a sharp remark. I urged him to ask himself two questions before responding: 'Is it worth fighting about? Or does it make more sense to acknowledge Jan's perspective, reassure her, and give her a hug?' Scott put this advice into practice and almost immediately the couple's day-to-day interaction became smoother.
"The lack of a social life also hurt Jan and Scott's relationship. At my urging, Jan asked a few mothers she knew for recommendations for reliable babysitters and now the couple go out every Saturday night. 'Having dinner together makes me feel closer to Scott,' Jan said. 'And that seems to have kick-started my sex drive.'
"Over the next year the couple's marriage improved steadily. Jan signed up for another class and will take the recertification exam this year. She also changed her hair and bought new clothes. And the family recently took a ski trip. 'I feel so much better about myself,' Jan said, 'and I'm much more relaxed because I'm not obsessing over Scott's health or whether the kids have done their homework.'
"'I love seeing Jan smile again,' Scott said. 'She's back to being the girl I fell in love with.'"
Originally published in Ladies' Home Journal, March 2011.