Husbands and Wives

When a wife suddenly comes in for her husband’s appointment, I usually worry a little; when a husband shows up for his wife’s visit, I sometimes worry a lot.

I have come to expect that when I enter an exam room and a male patient has his wife with him in the room, she is there to make sure I hear some part of his symptom history that he has never told me before.

It may be vague chest pains after splitting wood, snoring and interrupted nighttime breathing, excruciating headaches or profound and worrisome memory lapses. Men can be minimizers when it comes to bodily symptoms, and women end up being the designated worriers in many families.

Sometimes, the wives talk about their husbands during their own appointments, and I can listen, but I can’t usually say much. Even if spouses have given me permission to share their medical information, the foundation of medical diagnosis and treatment is the exchange and relationship between doctor and patient.

Not infrequently, wives ask me to speak to their husbands about something without letting them know who put me up to it. That can be a difficult request to honor, but sometimes I know I am in a unique position to turn a bad situation around.

Concerns about things like problem drinking are easy to handle, as we are expected to screen for those sorts of things anyway. Less straightforward is the angry and irritable husband who himself denies any psychological symptoms when I screen him for depression in the office. Not long ago, such a husband admitted to insomnia and feeling some stress but denied that it affected his mood or behavior. I treated his insomnia with an antidepressant that is commonly used for insomnia, rather than a straight sleeping pill. He was pleased with how the medicine worked, and his wife was very grateful when she told me he wasn’t just sleeping better, but he also wasn’t tense or edgy anymore.

One request I get periodically is from wives of recently retired husbands to help get the men to stop following them around, questioning and offering helpful advice about everything the wife used to do without the husband’s interference all the years he was working. “Please tell him to get a hobby or something“, is a plea I have heard more than once. In that kind of situation I offer what sounds like generic advice I might give to anybody in that particular stage of life.

Two things about wives’ visits worry me.

The first thing is the wives who come in numerous times with multitudes of concerns. Usually the underlying problem is somatization and anxiety, which can often be very difficult conditions to make better, but sometimes the source of the psychosomatic symptoms or anxiety is a bad or abusive marriage that the patient may or may not be admitting, even to herself.

Sometimes the frequent return visits of wives, or in some cases mothers with children, are acts of self-protection in situations of domestic abuse. By going to the doctor’s office often, abused wives sometimes create a measure of relative safety by indirectly letting her husband know that there is someone who will notice if she is distraught from emotional abuse or if she has a bruise or any other visible sign of physical abuse.

The second worrisome type of wife visit is when the husband starts coming in. Unlike the wives who add to their husbands’ medical history, a lot of men who come in for their wives visits sit quietly and just listen. That raises the possibility that instead of being there out of concern for her health, he could be there to discourage her from revealing anything about a bad or abusive relationship.

Nobody wants to be paranoid, but as members of a healing profession, our mission is not only to prevent and treat disease, but also to prevent and relieve suffering when we have the opportunity to do so.

One in four women in this country will experience domestic abuse in her lifetime, which makes this a true epidemic, almost as prevalent as obesity. Are we physicians considering it in our differential diagnosis often enough?

2 Responses to “Husbands and Wives”


  1. 1 susan November 7, 2015 at 12:12 am

    So true. I work at a community mental health clinic and so in a restroom there is an 8″ by 10″ paper alluding to Domestic Violence; then on the bottom are the little perforated tear-off pieces of paper just with the phone number to call for help. A person being abused can take one of the tear-off’s can put it inside a pocket or purse, and call when s(he) can. DV is worst, statistics show, on the weekend of the Super Bowl.

  2. 2 Diane November 7, 2015 at 12:51 am

    I never thought of it that way. My husband started coming to my visits with me because despite my visits to the Dr with various symptoms I often left with no answers.. He felt that the Drs. were not listening because I was just a “woman”.. and you know, with women it is all in our heads, or we must be anxious, or high strung, or as you mentioned have an abusive husband. When my husband came in to provide “back up” and support me as well to ask questions I got better care(every time so now we always go together). Less recommendations for anxiety medicine, or recommendations for yoga.. and when the right tests were finally run(because my husband came to my appts and supported me) the real medical issues came to light. Without my supportive husband willing to come to Dr. appts with me I was getting poor care. I will admit to going to a few of his appointments purely because I KNEW he was not telling his Dr. all of the symptoms and I was worried. I was correct, with my support his Dr ran the right tests and he got the right care finally too.

    I always recommend my friends take their significant other to their appointments now, more the merrier. 🙂 My husband even grudgingly admits he is glad when I am willing to be his support and help him get the right care as well. Marriages are funny that way, we need each other at times to be our best and in this case, to get the best care.


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s




Enter your email address to subscribe to this blog and receive notifications of new posts by email.

Bookmark and Share

Mailbox

contact @ acountrydoctorwrites.com
© A Country Doctor Writes 2008-2017. Unauthorized use and/or duplication of this material without express and written permission is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given.