In the second of a two-part series of editorials, Vascular Specialist Medical editor Malachi Sheahan III, MD, offers further insight into the world of surgeon-surgeon marriages with a little help from a few friends.
Welcome to the first Vascular Specialist editorial of 2025. If your spouse did not learn from social media that you wrote an article about your marriage, your year is already off to a better start than mine. As promised, here is the second part of our series, examining surgeon-surgeon marriages. I have assembled an all-star cast of married surgeons to offer advice, counsel and condolences. Participating were vascular surgeons Sunita Srivastava, MD, and Matthew Eagleton, MD; vascular surgeon London Guidry, MD, and surgical oncologist John Lyons, MD; vascular surgeon Kelli Summers, MD, and plastic surgeon Michael Borrero, MD; vascular surgeon Marie Unruh, MD, and plastic surgeon Adam Hauch, MD; pediatric surgeons Fabienne Gray, MD, and Jenny Stevens, MD; and a few others who learned from my misadventures and requested anonymity. I have presented their guidance unattributed, loosely categorized under a few broad topics.
❤ Selecting a spouse
– It’s important to identify a spouse who understands the urgency and the unpredictability of surgery as a job. Surgery requires the doctor to leave planned family gatherings unexpectedly when duty requires. This can be very frustrating for a non-medical spouse, therefore it is vital to select a spouse who is understanding and tolerant of this unpredictability.
– We met in training and early career. We both wish we’d had the opportunity to meet each other in “normal lives.” There is a whole experience of “normal dating” that just didn’t happen for us (or for anyone in medicine, in particular surgery). It wouldn’t have changed anything, but sometimes we feel like we missed out on the fun aspect of courtship.
– I have observed that having a spouse in healthcare is helpful for my female surgeon colleagues, and another surgeon is preferable. Non-MD/healthcare husbands don’t seem to understand the obligations of their spouses.
– I think we both wish we’d met outside of the hospital and could’ve gotten to know each other in a more natural habitat, as was previously said. But it’s really hard to meet people when you’re mired in this world. I met so many fascinating people as I moved from city to city for research, and residency and fellowship, but it was always hard to find someone who understood/had time for/could handle the significance of the job (time constraints, emotional toil, prolonged schooling). That said, I am so frankly impressed (with myself ) by the person I found to share it all with. Being at different points in our careers certainly made it harder. Conflicts between supportive partner, “back in my day” historical narratives, and mentoring opportunities were confusing and not always handled correctly (by me). As we all know, the muted highs from a case that went well and the devastating lows of any complication are simply not fully grasped by those who don’t do this.
– I think it’s very different if you’re asking a male surgeon versus a female surgeon. I think female surgeons have a narrower criteria than males (and no, not because we are “picky”). I think there are still societal norms in place for male versus female roles in the house, and being a female surgeon breaks a lot of those rules. We have to find someone who understands and accepts a busy work and call schedule, is willing to work as a team (cannot have a breadwinner mentality), and is OK with picking up our slack. Also, we have to physically find someone, which can be challenging when we are working all the time. If you don’t find a spouse before med school, I think it’s probably more likely that a woman will find a male physician as her partner (no, I don’t have data). Another physician automatically meets most of the criteria.
– We met while I was still early in training and there was an instant connection that was beautiful. However, we knew that the next 5–10 years of making a relationship work while one of us was moving across the country trying to accomplish the goal of becoming a pediatric surgeon would be very challenging. There are advantages and disadvantages of having a spouse in surgery. One thing that I think has been wonderful for us is having someone to talk through difficult cases with, to bounce ideas off of, to work through a bad outcome, etc. We have a deep understanding of the intricacies of this job and how it impacts us as humans, and it has been nice to have a partner to walk through that with. It is fun to learn things about surgery from each other and to celebrate our wins, and also to grieve our losses together. I am thankful for that.
– Your heart will choose who your heart will choose. Then your brain will have to spend the rest of your life trying to figure out how the hell to make it work. (Editor’s note: OK, some of these are mine. You’ll have to find the rest.)
❤ Balancing work obligations
– If you operate together, pick who will be in charge and who will assist. There are no co-surgeons in marriage.
– I still don’t think we’re doing this right, but she is the person I trust completely. And it is really nice that she has a handle on most of the players in the script. We both have really worked on learning to step out of ourselves and listen to each other without our personal opinions playing too much of a factor.
– I think it’s important to try to get work done on the fringes of family time—early in the morning/late in the evening. One has to be smart about their schedule, penciling in and protecting family time in order to balance both. You have to make best use of down time when the family is less likely to miss you.
– We were once told by a vascular leader: “You both cannot be successful. Choose which of the two of you that should be, and the other just shouldn’t plan on having a successful career, especially in academics.” I think this was a motivating statement for us. This is completely false.
– We are often viewed as one employee or partner, and there are a lot of issues with this. People think we share practices and should be responsible for each other’s patients (NOT!). We share benefits and salaries, so we should be compensated less. Benefits available to other surgeons should only be available to us as a couple and not as individual surgeons. We take too much time away at the same time, which makes more work for the rest of the team. People think we will use our “power couple” dynamic to influence the department’s direction. The truth is we frequently do not agree on programmatic issues.
– This has been hard as I have been in training for the entirety of our relationship up to this point. My hours and flexibility have not been great. Additionally, I have spent a lot of time over the last few years living in another city or even state. At the same time, my wife is a full-time pediatric surgeon with a demanding schedule and career goals of her own. I think we have tried to value both of our dreams and goals, and support each other in accomplishing those. When we live together, we try to schedule our calls in a way that allows time off together, or that supports the other one during a difficult week/ month.
❤ Balancing home obligations
– Have a “call” bedroom.
– You’ve got to pick your battles. Especially as a mom. You aren’t going to be able to have it all so you have to prioritize. If your kids or spouse are getting antsy about you being gone too much, then you have to give up some stuff that you might want to do at work or for yourself (i.e. morning workouts or journal clubs).
– Call schedules done a year in advance are always helpful, so at least you have some idea of holidays and weekends.
– When one spouse is on call, the other spouse just keeps the routine. Don’t wait to eat! The routine works so much better, especially when the kids are in school.
– Committees work well for some decisions but not for running a home. Make sure every responsibility is clearly assigned to one of you.
– Both spouses need to be OK with the fact that the division of labor will sometimes be uneven due to forces that are out of your control.
– We outsource everything we can (house cleaning, drivers to take our kids to sports practice, etc.).
– With one of us being a trainee traveling between cities and then living long-distance for research (during COVID!), and now for fellowship, we’ve mostly had to maintain separate homes. It’s been hard when we do share a living space as it takes a minute to figure out life together (you should also bring a glass of water to bed if you are going to want some water in the middle of the night) and chore responsibilities. Sometimes, amidst these difficult times, work is the common denominator that we can always agree on and more easily navigate. Outsourcing is extremely helpful, and also educational.
– We split chores. I like doing the laundry, and I hate grocery shopping. My spouse cooks, and I only do that if it is a special occasion; otherwise, I’m an Uber Eats person.
– At home, we work as a team. The person who is not as busy picks up the slack. He does the trash and I do the laundry. I guess we still have some traditional roles.
– This is a tricky one for us, as we have not lived together for the majority of our relationship due to surgical training. We also added a child into the mix 15 months ago and that drastically changed the “responsibilities and obligations” at home. We try to have certain chores that are split in order to offload some of the mental load of those things for the other person. Admittedly, I think we are still in the process of figuring this one out. Understanding that we can’t do this alone and having help (nannies, cleaning services, etc.) have been helpful, I think. Right now, we live in separate states and each have our own home and home responsibilities. I think this is a challenge but will hopefully help us learn the best way to divide labor once we live together again.
– We “outsource” many things. I now have the nanny do our child’s laundry and the housekeeper does most of our laundry. We have the meal delivery service for our baby. The housekeeper comes once a week. The nanny does our dishes and does some food prep/meals for us.
❤ Time for your spouse
– Scheduling time for each other is mandatory, and unfortunately the first to get cut when there are work needs.
I think all marriages have ups and downs, and this is amplified for those with dual-surgeon families. Currently, we are both working harder and more hours than we have ever worked, including residency (we are not accomplishing more though). I think we are learning that children are a great grounding force for the family. We are empty nesters and had high aspirations of dating each other again, traveling, getting to know each other as individuals all over again—and hoping we still liked each other (we do). That’s not happening on the timeframe we had hoped, as work sucks the life out of us.
– One day, I hope to have this. I think we have to wait until the baby is about 5 years old. I will then be old, but she’ll still be younger than I am now. So, maybe they can bond over visiting me in the nursing home.
– We are always prioritizing, and the first person to fall off the list of priorities is our spouses. We just assume they’ll understand (and they do, but it gets old sometimes. No, it gets old all of the time). This is in both directions.
– The advantage is that my partner is everything to me and the person I most want to hang out with. Making your partner the priority is hard with competing needs and work. You always regret not choosing your partner.
– One of the things I love about my wife is her love for community and life outside of the hospital. She has always been involved in so many aspects of life in New Orleans, and one of the things I think we do really well is prioritize time outside of the hospital for fun (Mardi Gras, going out to dinner, Saints games, Jazz Fest, travel). As we have added a child into the family, we are in a new phase of figuring out what time for the two of us together looks like.
– My biggest piece of advice is to maintain and cherish common interests and each other.
❤ Children
– Our kids are all exactly three years apart. That’s how long it takes to realize that you will never have life under control, so you might as well have another kid.
– Building a network of other parents is my saving grace. You will be underwater, and these people will throw you a lifeline. Let them into your world of chaos, and you will be surprised by how many will be there to help you. A pro tip: you do not need to do in-person, 10-minute parent-teacher conferences, but you can definitely be available by phone, and so can your husband. On that note, if you have a good school from pre-K to 12th grade and multiple children, life is way easier with one drop-off and pick-up point.
– There was some time consideration as a woman who had completed training at the tender age of 38. Female surgeons have a 50% serious complication rate. It was hard to be the birthing parent and pause my job, while my partner was still working so hard to finish her training. We have a long way to go with him, and our nannies are arguably the best thing that ever happened to our household. But our village is strong, and I hope we continue to provide the time and loving home for him that he needs and deserves.
– You have to get a good nanny if you are a two-surgeon family. Period. It’s not gonna happen any other way. You have to be OK with the fact that, at least once, your kids are going to call that person “Mom” if the nanny is female. It’s awful, but it’s going to happen.
– We try to always do vacations with our kids, which is not true for a lot of our non-medical friends. People definitely think we are crazy for having taken our kids to Iceland when they were one and three, but they loved it, and they still talk about it to this day. So, I guess I try to take the time I’m with them and be really present and focused on them so they feel special whenever I’m around.
– Our children used to get annoyed when we would talk work at home, especially during dinner. We ultimately set a timer—10 minutes each to vent/ talk/question when we were all together. Timer goes off, and you’re done.
– I think if you have two physician parents, it is very difficult to have the children in every single extracurricular activity. That is very challenging in today’s climate of travel sports and over-scheduled children. Additionally, it’s important to make time to be present at the children’s extracurricular programs. It is unreasonable to think that you can make every one, but you should attempt to make some of them (prioritize the big ones).
– Children forced at least one of us to be available somehow. And that meant the other pitched in more in the hospital or with other obligations. We scrutinized our travel more rigorously. And we said no more. We really relied on each other to make it work. I trust no one in the world more than my spouse—and she has never let me down. Our children specifically are not choosing medicine because they do not want to live the chaotic, uncontrolled lives we have. They are not bitter towards us, they are just potentially prioritizing things differently. I don’t think they feel like they have missed out on anything, but I do think they feel for us for not getting to relax more.
– We had our son 15 months ago, and he is an absolute joy and the love of our lives. Having said that, the process of getting pregnant, having the baby and the first year of life has been one of the hardest experiences for us. Having kids is so hard. And as a same-sex couple, there were additional challenges for us. We went through IVF (part of which we did while I was still away for my research years) and had to balance that process while both still practicing as surgeons. The pregnancy was not easy, but as many female surgeons experienced, there were difficulties. I was in my chief year of residency when our son was born, and then left for fellowship for two years. Being away has been really hard, and my wife is now doing the bulk of the work at home. We have been saved by having an amazing nanny who is basically a part of our family now. I hope that we can show our son that a life in medicine and as a surgeon is hard but is also extremely rewarding. My father is a physician and the reason that I went into medicine, and I hope that I can pass the joy of medicine down.
– With our initial nanny difficulties we really had to balance work obligations because we were unexpectedly without childcare multiple times. We constantly compared schedules to see how long each person’s day would be and who could go in a little later or come home earlier to avoid paying overtime. We had to make sure our operating room days weren’t the same and we were never on call at the same time. Another strategy for some people is having a live-in nanny.
– When your kids are young, they don’t recognize that you have made a choice, but when they are older, they do. So they may grow to resent your jobs and time away.
❤ Miscellaneous
– I’ll throw a couple of trite phrases in here: the hours were long, but the years were short; and enjoy the journey—there is no destination
– Sometimes I wish I could quit it all and just hang out with my spouse. We see each other less now than we ever have. Working in the same hospital does not ensure you will have time together.
– I will offer a few things I would tell my younger self! Take out loans, borrow from family and friends, use credit cards, beg, borrow or steal to make your life as easy as possible. Hire a cleaning service, get childcare for a few hours on the weekends you are off and work out or sleep, have a delivery food service, always have childcare backup no matter the cost, and stop worrying because you will make the money to pay it back.
– You continually grow together. There are so many stages of adulthood and surgery life, and it’s fascinating to do it with another person, as we all learn things at different times and in different ways. The things I’ve learned from my wife about surgery, from her perspective and work habits and thought processes, and the “how does that staff do it?” are innumerable. I learn about her from her responses and about myself from mine. Adaptability and resourcefulness are things we develop as surgeons, and things that I depend upon in myself and my spouse.
– It also feels really cool to have a partner who is doing something they love and care about as much as I love and care about my job, basically because it’s the same damn job and it’s the best job (for us).
– As two surgeons, understand your spouse’s aspirations and be supportive. Make sure each of you has friends you can lean on in your respective fields.
– We are a same-sex couple in surgery and I think that is an even more rare thing. There are not a lot of examples to look up to as mentors or as a guide of how to navigate life in this unique space. One of the challenges of that has been that there are no true “gender roles” at home or at work. That is unique when it comes to raising children and obligations at home, etc. We are working through all of that and learning a lot about each other in the process, and I hope that we can be a resource for others that find themselves in this unique space in the surgery community.
– Overall, it’s amazing that my spouse is a surgeon too. Our main topics of conversation are how amazing our son is and cases. I love that he truly understands what I deal with, and I find that helps me immensely with the emotional toll this job can sometimes take.
– Some final tips: try and leave work frustrations at work, but also recognize that’s not always possible, so give your partner some grace.
– Make sure you keep hospital communication and home communication styles separate. Your partner is not a resident or PA, etc., that you are dictating orders to. Be a team. It will never be equal so don’t try and make it 50/50.
Malachi Sheahan is the Claude C. Craighead Jr. professor and chair in the division of vascular and endovascular surgery at LSU in New Orleans. He is Vascular Specialist medical editor.
