The Lives and Times of Two-Doctor Families
Dual doctor couples are not a novelty: A 2014 survey by AMA Insurance puts that number at 26 percent for physicians under 40 and at 18 percent for physicians 40 to 59. Nor are such couples unusual at Stanford, nor in the Department of Medicine, nor — as it turns out — in the division of nephrology. Among a faculty of 15, four members of the division are married to physicians, all at Stanford, none in nephrology.
Here are the four couples:
Fahmeedah Kamal, MD, clinical assistant professor of nephrology, and Robin Kamal, MD, assistant professor of orthopedic surgery.
Vivek Bhalla, MD, assistant professor of nephrology, and Kiran Khush, MD, MAS, associate professor of cardiovascular medicine.
Alan Pao, MD, assistant professor of nephrology, and Sun Kim, MD, MS, assistant professor of endocrinology.
Pedram Fatehi, MD, MPH, clinical assistant professor of nephrology and pulmonary and critical care medicine, and Kristina Kudelko, MD, clinical assistant professor of pulmonary and critical care medicine.
All eight individuals agreed to recent interviews, by couples, during which they answered a series of questions about their work and personal lives.
Meeting, Marrying and Having Children
Unsurprisingly, doctor couples tend to meet during medical school or postgraduate training. In the case of Pao and Kim, it happened earlier: “We actually met at Stanford,” said Pao. “We were in the same undergraduate dormitory. It was my junior year, her senior year, and we were right across the hallway.” The Kamals met in medical school and, as Fahmeedah Kamal says, “We were in the same group of friends, and one thing led to another.” Fatehi and Kudelko were introduced by a mutual friend when both were residents in New York, at Columbia and Cornell. Bhalla and Khush met when they shared a patient in the emergency room at the University of California at San Francisco when she was a resident and he was a fellow.
These couples have been married between five and 17 years. One couple has three children, two have two and the Kamals were expecting their first just as 2016 was ending. Their children arrived between one and eight years after marriage.
The question “Is it crazy around your house in the morning?” provided the first hint at the difference children make in professionals’ lives. The responses were both telling and amusing:
Khush responded, “Very; that’s why we’re speaking at 7 in the morning.”
Kudelko said, “The answer to that is a resounding ‘yes.’” Fatehi concurred: “Morning, evening…,” then added: “The chunk of time after leaving work is the ‘kid vortex’: The hours between 6 and 10 p.m. fly by, dedicated to child maintenance, which is mostly but not always enjoyable, and no real work can reliably happen. During some of my attempts to put our 4-year-old son down for bed, he ultimately leaves his bedroom to go find Kristina to tell her that I’ve passed out.”
Kim’s response demonstrated skill at multi-tasking: “It’s pretty crazy right this second. While we’re talking to you I’m doing my daughter’s hair.” Pao extended the craziness to the other end of the day: “Pickup after school and making dinner and getting them to bed is another real crunch.”
Those couples might read Fahmeedah Kamal’s response with more than a little envy: “It’s very peaceful. Rob’s a surgeon so he gets up earlier than me most of the time. So he’s pretty much ready by the time I’m getting ready.”
Finding a Balance
There is much talk about the need for people to seek a balance between work and life. When both wife and husband are doctors seeing patients and doing research, the challenges are measurably greater. Here the individual responses to the question “How do you balance work and home?” were similar in tone but varied in the details.
Robin Kamal believes he and his wife succeed at finding balance “through good communication and time management. Sometimes I’m busier than she is and vice versa, so it just takes planning, most of it around who’s going to make dinner.” Fahmeedah Kamal reinforced her husband’s sense of balance: “Right now it’s all around knowing when he’s busy and when I’m busy.”
Humor appeared in the Pao-Kim response. Pao: “We have different roles. I am the one who focuses on the nitty-gritty, day-to-day school work, and I’m the one who cooks. And she… What do you do, Sun?” Kim’s reply: “Alan has very clear roles and I try to do everything else: the cleaning, the laundry, getting everything ready for school, all the supplies, the doctors’ appointments.”
Khush sensed that “It’s actually gotten more challenging as we’ve both gotten busier in our careers. At any one time one of us can be in the hospital or traveling or going to a meeting or giving a talk. The hardest part is when one of us is away.” Bhalla felt that it’s even more complicated: “We have to have work-life balance and work-work balance. That sometimes makes it quite hard.”
Fatehi also focused on tensions that can arise. “When one of us is on service, the other knows that he or she will be the person doing the pickups and drop-offs for the kids and doing the extra stuff. That way we don’t have to make the decision about whether to be with the family or the patient.” Kudelko went on: “I am now super-efficient at work, meaning that I know I don’t have the time I used to have at home to pick up my computer and review something. I plan my day so that work is work and home is home.”
Roles Around the House
When asked if they find that they revert to traditional gender roles around the house, the universal answer was almost a resounding “no.”
Kudelko said, “I will be responsible for grocery shopping and for cooking, sure. But Pedram is amazing in how much he does: laundry, garbage, diapers being changed, kids being bathed and put to bed. For sure I have a 50-50 partner.” Fatehi jokingly clarified his household role a bit: “I also fix all the broken stuff, so maybe more like 51-49, with me doing more.”
Robin Kamal answered for both of them: “No, we don’t, because of our work schedules. We balance ourselves around 50-50 for most roles, especially the dinner part.”
The fact that the man does the cooking in the Pao-Kim household does not go unnoticed. Kim said, “Whenever one of the guys does something unexpected, he gets 10 times the credit. We’re a modern couple trying to share the duties.” Pao observed, “My male counterparts participate more, possibly not as much as they should, but I think it’s definitely different from the older generation.”
The Bhalla-Khush approach is different. Khush says that they “outsource a fair amount of housekeeping. Probably where our gender roles are most typical is that I do the cooking and Vivek does the cleaning up after meals. As far as child care I think we’re pretty evenly balanced.”
All four couples were then asked if they wished they had a stay-at-home spouse and, if they did, what would they have him or her do. These answers were all over the map.
The Kamals said no. Fahmeedah Kamal felt that “We’ve learned through communication to balance our roles. We’ve figured out a way to work together.” Robin Kamal agreed, adding that “it makes it more difficult but more interesting to have the empowered spouses and occupations we have.”
Fatehi and Kudelko also said no. Kudelko “derives a lot of joy doing the things that are very mommy oriented. I wouldn’t want to hand that over to anybody.” Fatehi sometimes feels that “I do more of those things if Kristina is busy with work or on service, and it’s nice to be able to.”
Bhalla and Khush don’t quite agree on the answer. Khush quickly answered, “Yes, I could do with that for a while,” while Bhalla said, “We need a personal family assistant. A lot has to happen between when we get home and when the kids need to go to bed. All that time is taken up by chores, sometimes including transport and homework. It would be great if we had somebody we could go to for the little things so that we could hit the high points with the kids.”
Pao and Kim also had different answers from one another, although the effect of granting either of their wishes would likely be the same. Kim said, “I wish I did because it’s hard to come home and have another job.” Pao, on the other hand, wanted another helper. “Having a nanny would make our life much easier. For example, I get a service to drop off and pick up for soccer practice because I can’t always do it and Sun can’t always do it.”
The Biggest Chore: Cooking
We’ve already learned that the cook in the Pao-Kim household is the dad, but even he was perplexed by the question, “Have you ever used Blue Apron or another service that provides ready-to-cook meal ingredients and recipes?” Pao responded that he does not use an apron and that’s why he has spatters on the front of his shirt. His wife clarified, “We used a cooking service once, and we found it very limiting and very expensive.”
There was no uniformity in the responses to questions about cooking.
The Kamals cook at home four or five days a week and who does the cooking depends on who gets home first. “Most of the time we try to cook together,” said Fahmeedah Kamal. Her sister gave her a week of Blue Apron and she liked it but missed having leftovers. So now they “use their recipes and buy a larger quantity so we’ll cook one day and then have leftovers the next day.” Robin Kamal felt that Blue Apron “taught us that there were recipes that we hadn’t mastered. So now we’re able to create our own. The quality of the food is better.”
The Fatehi-Kudelko household depends on Kudelko to do the cooking most often, usually four times a week. Kudelko really likes Blue Apron: “It makes me feel like I’m a cook when I’m really not. The most stressful part is planning and shopping; Blue Apron delivers those ingredients and just allows me to cook. That’s the most fun part for me.”
The Bhalla-Khush couple decided on roles around cooking early. Bhalla explained that “Before Kiran and I married she told me that she liked cooking but she never cooked because she hated cleaning up. And I don’t mind the cleanup. So Kiran does 99 percent of the cooking and I do 99 percent of the cleaning.” Khush said, “We try to prepare pretty much all of our meals at home. It’s rare that we go out to eat, and we never order in.” Nor do they use Blue Apron–like services.
Take the busyness that any two professionals in a couple might have and layer on critical illnesses, emergency surgeries and deadlines for grant applications on which one’s livelihood for the next several years depends, and a question like “How often do you go out on a date?” might fall somewhere between silly and preposterous. But married couples need “us time,” just as individuals need “me time.”
Once again the responses were as varied as the couples, although two couples recently hit on a clever twist on date night.
The Bhalla-Khush duo have a routine. Khush says, “We have what’s called our Big Four, four nice dinners that we do every year: my birthday, Vivek’s birthday, Valentine’s Day and our anniversary. Other than that, the evening is really our family time, so we try not to spend the evening away from our kids.” Bhalla pointed out that they recently “went out on a lunch date to a very fancy restaurant. Didn’t have to get a babysitter, didn’t have to take time away from the kids in the evening, and got to go to a nice restaurant when it wasn’t all that crowded.”
Fatehi and Kudelko take advantage of a service their day care offers: monthly parents’ night out. “That’s an evening date out to dinner when our kids stay late at day care,” said Fatehi. “Because we have the benefit of working so close together, we meet occasionally for lunch dates and have a few quiet moments without kids.”
Kim and Pao struggle to find time for themselves. Kim said, “We lack the date night aspect. We do a lot of things with other families on weekends. We have family date nights.”
Robin and Fahmeedah Kamal defined date night a bit differently. Fahmeedah Kamal said, “We hang out together a lot, cooking together at night or going for a run or a hike. All those are date-like activities. Not having kids, we’re together a lot and do a lot of activities that are dates in a sense.”
If they had the opportunity to have a date night, what would each couple do with it?
Bhalla and Khush would go out to dinner: “Vivek and I both are kind of foodies, and we both like going out to a nice restaurant,” said Khush.
Fatehi admitted to being “sleep-deprived enough that it’s not as though we would want to be out at a raging party all night long.” He continued, “Usually a chance to go to happy hour with friends and then have dinner and go home by 10:30 is enjoyable and satisfying.”
In answering this question, Pao recalled that he and Kim actually went to a concert last month. “It was date night with another couple.”
The Pluses and Minuses of Being in a Dual-Doctor Relationship
There is so much need for planning and strategizing in two-doctor families that a final question arose: What is the biggest advantage and biggest disadvantage of being part of a dual-doctor family?
Pao responded: “The greatest thing is instant empathy and shared experience. My wife always knows what it’s like to have a bad clinic day or get a grant rejected. For me, the greatest drawback is time — not enough time for work, family and spouse.” Kim pointed out another drawback that most of the parents mentioned at one time or another: “When you have a dual physician couple, there is not much reserve. When something unexpected happens — your child has a fever and needs to be picked up from school — it can unravel a delicate system.”
Fahmeedah Kamal said the biggest advantage is that “It is fun to talk to Rob about my day because he has an understanding about what I do.” Robin Kamal declared that “Being in a dual-doctor family can be awesome when you appreciate it for what it is. Our shared understanding of our professional demands makes it easy to relate to one another.” About the disadvantage, Fahmeedah Kamal responded: “We both can be busy with demanding schedules especially when we are on call on nights and weekends.” He responded similarly: “Time. This isn’t something that can’t be overcome with thoughtful planning and establishing priorities, but it requires work.”
Kudelko responded: “Truthfully I never thought I was going to marry a doctor because of the potential drawbacks. I was considering the usual, you know, lead guitarist or professional tennis player,” she continued jokingly. “But now I’m so happy I did. He gets it. Hard days, complex patients, unexpectedly long call days. No explanation necessary. We often talk about interesting medical stuff at home. The biggest drawback is juggling the scheduling. We miss out on a lot of time as a family because of weekend calls.”
Khush said, “One of the greatest things about being married to another doctor is the intimate understanding of each other’s daily lives and careers. We discuss interesting and challenging cases, hospital news and gossip, what happened in clinic or on rounds.” As for the drawback, “I think a challenge particular to dual-doctor couples is how to coordinate call schedules. We have to make sure we are not on service at the same time, in case a patient emergency arises and we have to return to the hospital. Since one of us is often on call over the weekends, it becomes difficult to have weekends together as a family.”
Despite the stresses of being a doctor times two, all appreciate the value of their marriage. As Bhalla pointed out: “If not for the fact that we are both physicians, I might not have found Kiran. For that I am most grateful.”