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Balancing Act
Mixing medical training with family life is doubly difficult when both parents are doctors or doctors-to-be

The Coylewrights, from left, Jeremy, Megan, Indigo and Izaia.
Jeremy Coylewright, 29, is in his first year at the School of Medicine. His wife, Megan, 30, is an intern in the Department of Medicine. Between them, they already have three advanced degrees—a law degree, medical degree and a masters in public health—and two kids, ages 6 and 3. Jeremy spends the better part of his days in lectures or in the library; Megan takes care of patients, putting in 80-hour workweeks and taking call every fourth night.

When they’re at home, though, their world of medicine abruptly falls away. On a recent evening, Megan was in the kitchen, stringing beads and producing pipe-cleaner art on a child-size table with daughter Izaia. Jeremy, who does all the cooking, was preparing dinner. Soon, after the children were in bed, he would start the daunting task of memorizing all the muscles and innervation in the forearm for the upcoming anatomy final.

This is not an easy way of life, and most dare not attempt it. In Jeremy’s SOM class of 120, only one other student has children. In the Department of Medicine, there are several teams of married couples, both in training, and some have kids. But among the 39 interns in the Osler residency program, only three, including Megan, are parents.

Clearly, say the Coylewrights, a supportive network of family and friends helps. They have formed babysitting co-ops with other young parents, and Megan’s mother, who lives in Washington, D.C., is a frequent sitter. “She’ll look at Jeremy’s exam schedule or my call schedule and plan her visits accordingly,” says Megan.

But there’s another phenomenon at work here that is easing pressures on residents and hence, their families. Strict new rules mean residents can’t work more than 80 hours a week or more than 30 hours in a row (including six with no patient care) and must take off at least 10 hours between shifts.


Megan "can do it."

In the Department of Medicine, the rules have been fine-tuned so that call now starts at noon instead of 8 a.m. and ends the following evening at around 6, instead of 2 in the afternoon. The change has allowed interns to be in the hospital after test results come back so that they can see how things are resolving with their patients. But it’s also affected their personal lives. Now interns have every fourth morning—the morning they’re most rested—off. “This change has had the single largest impact on interns,” says assistant chief of service Brad Drummond. “They have a chance to rest, to spend time doing the things they need to do.”

The Osler residency training program is reputedly one of the toughest in the country. “Our education is based on experience, not books, so we spend lots of time in the hospital,” says Drummond. “Interns are expected to give everything they can for their training but also maintain the rest of their lives. The 80-hour week means they can be more involved with things outside the hospital. It helps them develop their humanistic side that allows them to go into medicine.”

Jeremy is less philosophical, more practical. Over the din of the acrobatics in the living room—3-year-old Indigo has just discovered the sliding board—he says, “I couldn’t go to medical school if Meg were working 120 hours a week.”

*******

Megan Coyle and Jeremy Wright met in biology class when they were sophomores at the University of Wisconsin. They married after junior year when they were both 21. After graduating, they joined Teach for America and taught in public schools in the Bronx.

Megan had already been accepted to the School of Medicine, and Jeremy planned to apply. First, though, he wanted to start a family. He volunteered to be a stay-at-home dad, and that is what he did when Izaia was born during their second year in the Bronx. Nights, he worked as an EMT doing medical transports and emergency response for Yonkers and some correctional facilities in upstate New York.

Jeremy gets some help with his anatomy final.
The job solidified for Jeremy, the son of a physician, his ambition to work as a doctor in the prison setting. “I was deeply affected by some of the mistreatment prisoners faced and the hopelessness of their situation. I decided that when we came to Baltimore I would learn more about our criminal justice system at night in evening law school and bridge my interest in medicine with that of justice and governance.”

Jeremy eventually enrolled at the University of Maryland Law School, where he studied health care law. They decided to become pregnant again during Megan’s second year of medical school so that she could take the following year off to pursue a master’s at the Bloomberg School of Public Health. Indigo was born that December. Finally, in 2005, both graduated, she from medical school, he from law school.

The biggest challenge has been making ends meet. For four years, they lived on loans alone and have acquired no small amount of debt. Now, as a first-year resident, Megan makes $41,500. She and Jeremy bought into an East Baltimore housing cooperative. Monthly payments for their three-bedroom row house are slightly less than $600.

Day care for Indigo at the nearby Johns Hopkins Child Care and Early Learning Center is about $600 a month, a reduced rate based on the ratio of their income to their debt. Izaia attends public school at Hampsted Hill near Patterson Park. Because they live within walking distance of the hospital, they get by with one car and pay no monthly parking fees.

And yet, says Megan, “We’re not able to save at all. Our life is minimalist. A date means going out for a beer or to a bookstore. We don’t buy things, we don’t need anything. We have a TV, we have a computer. The kids get presents from their grandparents. Most of our furniture is hand-me-downs from our parents, things from our rooms when we were kids.”

Jeremy, who does all the cooking, gets his just desserts.

Megan says her ACS, Drummond, and her residency program director are sensitive to her situation but never single her out as a mom. “They make me feel like I’m just the same; I’m held to the exact same standards as all the other interns.”

But it’s not the support she gets from them, friends or family, or even the 80-hour workweek that has really helped to balance the pressures of a medical education with the obligations of family.

“The real story,” says Megan, “has been Jeremy’s willingness to break the mold and make a sacrifice. He decided to put off medical school and raise a family. He has truly loved and enjoyed his time with the kids and is proud that he can run a house and go to law school or medical school at the same time.

“What really makes this work is our marriage and our ability to know that all this other stuff—our careers—is in second place. When you make that decision, things work out.”

—Anne Bennett Swingle

 

 

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