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Everything You Want to Know About Living with a Hospitalist


 

As a hospitalist, patient satisfaction is top of mind. Then there’s another group of people whose satisfaction is also paramount: your family. What do they have to say about life with a hospitalist? You’re about to find out!

The Hospitalist asked family members of David Pressel, MD, PhD, a pediatric hospitalist at A.I. DuPont Hospital for Children in Wilmington, Del., and a former member of Team Hospitalist, for their impressions, and wife Karen and son Rob’s honest answers (and gentle ribbings) show that for whatever ups and downs life may bring, being part of a hospitalist’s family is full of rewards and lots of love. Of course, that’s not to say they didn’t have some suggestions for improvements.

For Hospitalists’ Spouses Everywhere

Karen Pressel

Karen Pressel

Marrying a doctor was never on my to-do list. In fact, my list specified quite the opposite; I was never going to marry a physician. My stereotypical perception of the lives of physicians included long hours, too much stress, no family time, guaranteed interruptions at social events, calls at all hours of the day, never enough sleep—you get the picture. I imagined too many headaches to make being a “doctor’s wife” in the slightest bit enticing. I wanted no part of it, and besides, I had my own career to think about.

But then I met my husband, and my list went out the window.

Still, after a couple decades of negotiating a balance between the demands of his job (see above) and the demands of his family, there are things I’d like to say to him. So here goes. Hospitalists, take note.

There Are Only 24 Hours in a Day

How many times have you called to say, “I’ll be leaving the hospital in 10 minutes”? How long did it take for me to realize that relying on that kind of statement was crazy? I’m embarrassed to say that it took me way longer than it should have to come to that understanding. After many overcooked dinners and missed social events, I finally realized that your anticipated departure held no validity and I could only trust that you had left the hospital when you called from the car with the wheels rolling. Fortunately, you were more astute than I and changed your communication habits rather quickly, although the timing of said notifications still does not always take traffic into account and could use some work.

Still, I recognize that “leaving the hospital” is really just a physical indicator of your location, not necessarily a reflection of your state of mind. When you get home, please tell me if you still have work to do (notes, email, patient follow-up) or if you are done for the day. I suppose second-guessing your clinical decisions and calling the hospital to check on patients are unavoidable, but give me a clue whether I should actually expect you fully home to join the rest of the family—or if you will just be working at the home “nursing station” all evening. The burden of healthcare in America doesn’t fall on just you. If you can’t figure out what is wrong with a patient or don’t know what to do, you have many colleagues who can help.

Please remember that you are only one person. Don’t think that if there is a staffing shortage to fill, the responsibility for working is yours. Your colleagues are wonderful and, almost without exception, are happy to pitch in to help carry the extra load. The same goes with holidays; you don’t need to work more than everyone else. I know you are not a slacker. If you try to spread the load when you manage patient care and work schedules, you will have a happier spouse. Remember, a happy wife is a happy life. (I’m sure there is an analogous saying for your colleagues’ husbands and partners.)

Along those same lines, please limit the moonlighting you choose to do. My preconceived idea of a physician’s salary was very different from your reality. You are a pediatrician, an academic pediatrician. Having said that, we lead a wonderful life. We have what we need and have been very happy without the fanciness of some of our neighbors. Although the extra income is nice, I’d rather see more of you than more money. Besides, we just wrote the last check for college tuition, and I’m sure the boys will never ask us for money again.

Being Grumpy (No, Not the Dwarf)

My thoughts on moonlighting lead me perfectly to a discussion of your frame of mind: your mood. By definition, your patients are seriously ill hospitalized children. The bursting hospital census, the acuity of your patients, and the relative craziness of some of their parents invariably elevate your stress level. This, in turn, drives more frequent calls to the hospital and time on the computer all hours of the day or night. This does not allow for a restful sleep, when you sleep at all. I may be biased, but I think you are in the minority of hospitalists who bring their jobs home. Not that I’m complaining too loudly; this is who you are and why I love you, but if you haven’t noticed, when you are on service you tend to get grumpy. Think about this: If you’re not on call, why not turn off your pager, turn off your phone, and leave email alone?

Given the pressures inherent in your job, please tell me again why you would want to moonlight. Moonlighting means even longer hours, more stress, and less sleep for you, all of which make you grumpier and, as a result, tend to make me grumpy.

No, thank you.

Everyone we know has some form of “honey-do” list, whether intended for himself or herself, a spouse, or a professional. I know it makes you feel like a competent husband and man to do things around the house, but here’s a bit of advice: Let me hire someone else. Keep in mind that contractors were invented for good reason. The aggravation you’ll have trying to fit whatever project we’ve contemplated into your schedule will be dwarfed by the aggravation I’ll have when you can’t. I’ve never heard you ruminate about not cutting the lawn after we hired the landscaper and you got rid of the lawnmower.

The same goes for quality. Do you really think you did anywhere near as good a job replacing the leaking toilet as a real plumber? Should we talk about the breakfast room light fixture? Do you want me to continue?

My annoyance probably lessened any satisfaction you derived by completing these projects yourself. You should always keep the Pressel money-management credo forefront in your mind: “You earn it, I spend it.” Please let me do my job.

Let Me See If “The Doctor” Is In

Please leave the professor at the office; don’t talk too much medicine when you are not at work. Your trainees might need to hear all the minute details of whatever medical issue is at hand, but your family and friends do not. Most of those close to us chose careers outside of medicine a long time ago and probably don’t want to change direction now. Why do you think they call me for medical advice? It’s not because I’m a better doctor but because they know they’ll hear one of two things:

  1. I’ll tell them I don’t have a clue and they should ask you; or
  2. I’ll answer their questions in a tenth of the time that it would have taken you. And we’re talking easy questions because, while I’ve listened to you speak to medical students and residents for the last 20 years, we both know I am not a doctor.

Nevertheless, I do pretty well even with some of the hard questions, if I say so myself. Don’t worry though, there’s no need for concern. Please know that I am not practicing with your license.

Relative to the home practice of medicine, it’s OK to look in our kids’ ears! You must remember the huge fight we had when our son exhibited all of the classic signs of an ear infection and you refused to examine his ears. I know you agonize when you make a clinical error with a patient, but this was just an ear infection. I would have taken him to a real doctor if he was sick enough to merit consideration of what you were worried about missing (brain abscess or meningitis). Really? If I had known how to work your otoscope back then, I would have looked in his ears myself. I’m still not sure how treating minor illnesses in our children is different from the same thing with children of our friends.

You have a perfectly reasonable excuse to be exhausted, yet you are often embarrassed when you fall asleep at our friends’ houses during social events. But the truth is they consider it a mark of true friendship when you go missing before dessert is served. When we were still new in the area and someone would realize that you had disappeared, I was mortified. I quickly realized though that our friends would all rather you and I join them than stay home entirely. No one is offended to find you asleep on the sofa (and your disappearance is now almost expected). To tell you the truth, I’m not sure anyone misses your conversation.

Meetings make the world go round, and your attendance is obligatory at many, even if you’d rather not attend. When I was still working, someone came up with the idea of a stand-up meeting. It was a brilliant idea that made meeting participants use the time more efficiently. Why don’t you propose that some of your administrative meetings be run that way rather than depending on me to page you, “Dr. Pressel, we need you urgently in room 23!”? Sorry I’m calling you out on this, but I’m not always available at the exact time you’ve specified that you want to be interrupted. Besides, it is sometimes amusing to hear that you fell asleep at some senior hospital administrator’s meeting.

I started this by writing that I never wanted to marry a physician, but the last quarter century with you has been the adventure of a lifetime. I just sometimes ask myself, “Why didn’t he become a dermatologist?” TH


Karen Pressel is the wife of David Pressel, MD, PhD, a pediatric hospitalist at A.I. duPont Hospital for Children in Wilmington, Del., and a former member of Team Hospitalist.

What I Want My Hospitalist Father to Know

Rob Pressel

Rob Pressel

Let me start out by saying that I think you have a great job and I am proud of you. But there are some things you should know. I’ll begin with the good ones.

We lead a very comfortable life, and I am grateful for all that you do for me. You don’t need to remind me, though, every time you manually scoop poop from some constipated kid that it pays for the roof over my head, clothes on my back, and my expensive university education.

I get it.

Even so, having a parent who is a physician is way better than having a parent who is, say, an accountant. I don’t need help with my taxes, but it sure is nice to get some quick medical advice when I have a rash. I even still trust you after you missed my broken arm when I was in sixth grade. Do me a favor though: Just tell me what it is and how I can fix the problem. Save the lecture on the pathophysiology, epidemiology, and differential diagnosis for your residents and medical students. It’s only poison ivy.

When we were growing up, you always gave us a “case of the week.” There were some consistent themes, and I’ve never been sure if these patients were real or fake. Most were either adolescent girls with belly pain or children experiencing bizarre spells who ended up being intoxicated from some ingestion. Was there supposed to be a not-so-subtle message here not to use drugs and to choose my romantic interests carefully?

I actually enjoy hearing about interesting patients, although maybe you could vary the cases, focusing more on human-interest situations rather than on complex technical patients. Relative to the human-interest stories, shouldn’t some of the names parents give to their children be considered child abuse? You probably don’t know, but in Iceland, there is a government Naming Committee that actually maintains a list of approved children’s names.

I know you have to take both clinical and administrative calls. When you get a medical call while we’re having dinner, would you please go somewhere else to talk? Hearing you ask about a patient’s diarrhea when we are eating sort of ruins my appetite.

Similarly, please let me vet topics before you discuss them with my friends. You have some cool stories, but Dad, I’m not sure my friends want to hear about child abuse or vaginal discharge. I will say that the absolute best phone calls you get occur when, after 22 years of Pressel Medical School, I’m able to make the diagnosis or give the correct advice (sometimes faster than your medical students and residents).

Let’s talk about what you learned from me. Though you may not agree, you should think of all the times you found me annoying, particularly when I was a pain-in-the-ass kid, as CME. Over the years, I gave you regular opportunities to enhance your knowledge of child development and to improve your parenting skills—things that undoubtedly continue to help you as a pediatrician.

I like visiting you in the hospital. I know you enjoy showing me off. When you introduce me to your coworkers, it’s OK if you tell them I’m not going to medical school. Still, you should know that I fully intend to repay all that you have done.

Hearing from you about all that happens in a hospital, I can understand why you never want to be a patient. I’ll do my best to ensure you don’t get admitted to a hospital and are able to die peacefully at home. You can count on your loving son, Dad. I’ll be sure you don’t have a hospitalist with you at the end. TH


Rob Pressel is the son of David Pressel, MD, PhD, a pediatric hospitalist at A.I. duPont Hospital for Children in Wilmington, Del., and a former member of Team Hospitalist.

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