Not on the Same Page

During the course of my practice, I’ve seen many couples struggle to make difficult treatment decisions.  Should they do in vitro? Donor egg?  Donor sperm?  Take out a second mortgage?  Do insemination in spite of what the priest says?  Reduce a triplet pregnancy down to twins?  It’s bad enough that we can’t guarantee outcomes.  It’s bad enough that treatments are expensive.  It’s bad enough that there may be ethical, religious, or moral implications to these decisions. 

It’s worse when they can’t agree between themselves.

It’s not only couples with infertility who have trouble agreeing on a course of action.  I would say nearly all married couples reach a point where one is ready to move forward with a decision and the other is hanging back.  This usually seems to happen with high stakes decisions that have very unpleasant outcomes if they go wrong, and iffy outcomes at best if they go right.  We are facing a decision like this right now.  We moved from the East Coast to the Midwest for work.  We sold our house, but kept our vacation home in Vermont.  This place was always more home to us than any daily house.  Our Christmases, Easters, summer vacations, winter breaks, dog’s birthdays were spent in this house.  Most of our best memories are linked to this peaceful and beautiful place.  We hoped eventually to retire there, maybe keep a horse, take daily walks on the dirt road, write, garden, ski in the middle of the week.  We hoped to host Christmases with our grown children and grandkids.

For a couple of years after we moved, we managed to hold on to the house, maintain it, and travel to Vermont during school breaks to use it.  But it has become clear that the expense and difficulty of maintaining the house are beyond our capabilites, and it is time to let it go.

Well anyway, it has become clear to me.  To my husband, not so much.

So we are not on the same page about this.  And as we have struggled each to sway the other to our point of view, I began to wonder why it has to be this way.  And I began to wonder why my patients have to struggle through this discordance as well.

And I think I’ve figured it out.  This was an epiphany to me, but maybe everyone else already knows it.  Maybe there is even a psychological term for it that I never caught because I slept through the lecture.  (Let’s be honest, I slept through a lot of lectures.  Once the lights were out, so was I.)

The reason we aren’t on the same page is that we need to be on different pages.  Take the example of the couple who is deciding to do in vitro.  Other treatments have been tried and haven’t worked. It’s time to make a decision.  On person is ready to move on.  Often this is the woman, because she is the one who has to do all the treatments and she’s sick of it already.  The other is not ready yet.  The reason they need to be different is that the one who is moving forward is in crisis.  She is devastated that she need to take this step to have a baby.  She has been hopeful for a long time, and hope has run out.  She is emotionally running on fumes.  He is in denial.  This is actually a good thing, because it allows him to remain cheerful and optimistic, which has helped her get through this crisis so that she can now consider IVF, unthinkable until now.  But now that she’s able to be optimistic and hopeful, the reality of their situation is sinking into him.  He is beginning to realize that having a baby “the normal way” may not happen.  He is beginning to lose hope.  He needs her optimism and resolve.  So the couple passes hope back and forth like a hot potato.  It’s necessary, but on the surface, it just looks like they disagree.  Once I realized this, and was able to think of my own marriage in this way, it opened up reserves of patience and gratitude toward my husband that I would never have tapped otherwise.  This doesn’t mean that we are now magically in agreement.  But at least now, I think I can see why it’s not so bad that we’re not.


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Happily Ever After Isn’t a Thing

source: Keely Cain

source: Keely Cain

How many times have you read, “and they lived happily ever after”?  It’s as if the next 70 years after the wedding, baby, new job, whatever can be summed up in 3 little words.  Isn’t that a little glib?  Do we really think that once we’ve landed the guy or dream house that nothing else happens and nothing else is required of us?  In this Huffington post piece by Glennon Melton she mentions almost as an afterthought, “Happily ever after is not a thing.” I loved her article and I thought this point deserved more comment.  In fact, a lot of maintenance happens after “I do”.  Suddenly life ain’t so perfect anymore.  You aren’t getting your happily ever after! What gives?

When I asked other women doctors what the most important factor was in their ability to get everything done, they all replied, “marry the right person.”  Choosing the wrong spouse can waste a lot of time.  Decades, in fact.  Think about it, spending years of your life walking on eggshells, disagreeing about money, in-laws, chores,  child rearing, or sex.   That is a time-waster.  You simply cannot live a good life if you are chained to a bad husband.  Even good partners are tough.  Case in point, your husband’s fifties (God, let it pass).

Here some things that no one tells you and one or two that everyone tells you but no one believes:

1.Marriage means that you will spend the  rest of your life consulting with some one else about every little thing.  Nothing is too trivial to merit comments from your spouse.  From your hair color, to your vacation plans, to what to have for dinner, you will have to keep in mind someone else’s thoughts on every little matter.  I’m not saying you need permission– that’s ridiculous– but just that someone else will have an opinion and there will be a negotiation more often than you would like.  If you don’t believe me, change the arrangement of the living room furniture, buy only your favorite foods, and cancel cable to save money and let me know how that goes.

2. Sexual dry spells are not a sign of failure. Here’s what happens: kids get sick. Partner gets sick.  You are exhausted working full time and taking care of sick people and you get sick.  You get better, hubby gets a cold sore. That goes away, you get your period. He goes out of town, you get annoyed, and he throws out his back reaching for a towel.  You run out of birth control pills because you forgot to go to the gynecologist and now she can’t see you for 3 months because she just had a baby herself…Life happens. Forgive each other, move on, and try not to let the dry spells go too long.

3. Maintenance is not fun to do or talk about’s boring.  With maintenance, the best you can hope for is that things don’t get any worse.  That’s what maintenance is.

4. You will go weeks with no conversation more interesting than who will pick up the kids.  This will be okay with you because interesting conversations often devolve into bickering.

5. that part about richer/poorer, sickness/health, better/worse? They actually weren’t kidding.

6. You will really screw something up by the time you’re 40. 45 at the latest, and only then if you’re super smart and talented.

7. If you’re lucky, you will still be married when your husband enters his 50′s.  This will not be enjoyable for anyone.

What is a thing?

1. Remembering that getting through life is like driving across the country at night without a map.  You will make it eventually, but you will never be able to see more than 200 feet ahead.

2. Wheel of fortune is a thing.  Good times follow bad, bad times follow good and nothing lasts.

3. Learning to keep your mouth shut is the number one cause of successful marriages.

4. Forgiveness  is the number 2 cause.

5. Life is too short to hold grudges.  That is a very true thing.

6. You aren’t perfect and don’t deserve a partner who is.

7. “Happily ever after” is really a confusing, exhilarating, exhausting, trying and wonderful life.  It’s teenage kids that borrow your shoes because you are now all the same size.  It’s being able to help your parents in some small way to thank them for all they’ve done for you.  It’s having belly fat contests with your husband and staying up all night with a terrified dog during a thunderstorm.  It’s reading all the Harry Potter books out loud five times.  It’s listening to “Hot Cross Buns” on the recorder by the entire third grade and trying so hard not to burst out laughing during the elementary band concert that you burst into tears instead.  It’s taking a fantastic vacation to Santa Barbara and spending most of it trying to fly home to a sick child.  It’s moving at Christmas.  It’s making a fortune, and losing it.  It’s not knowing what the next 200 feet will look like.  That’s a thing.

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