agonyaunt | Help! We’re Visiting the Small Town Where My Husband Used to Be a Doctor....

Help! ...Everyone Still Thinks We’re the Enemy.

Dear Prudence,

My husband was a rural primary care doctor from 2012-2021. I was overjoyed when he took a position in an underserved county near my extended family. He’s gentle and hardworking, and I was the primary earner to make it work financially (Medicare and Medicaid reimbursements are garbage). But with the pandemic, he got burned out hard. Everyone brought politics into medical appointments. A neighbor screamed at me in the grocery store for “being part of the vax conspiracy.” Parents were weird to our kids. Most of our county health department was so intimidated or demoralized that they quit. He felt like patients didn’t trust him.

We moved to a small city and have been much happier. We both got better jobs and are chipping away at school loans. Our marriage is so much healthier, and so are we. Our kids are getting a better education, making friends and there’s better support for us as parents. We’re going back to visit my extended family several times this summer for funerals, a wedding, and helping move my aunt into assisted living. I love my family and the land but I’m dreading it. They still haven’t permanently filled his old job and everyone blames us for leaving, acting like we took an easy way out. An old neighbor told me she blamed my husband for her husband’s suicide the last time we visited, because there was no doctor for him to see. It’s horrible and we’ll be seeing lots of these people this summer. My husband usually freezes, and I usually get angry. How do we handle this?

—Tired Wife

Dear Tired Wife,

I’m mortified that more than one person has irrationally blamed you for leaving. I mean, even if they’re thinking it, I can’t believe they would say it to your face! It sounds like you have a great argument for why you made the right choice for your family, and the key to becoming impervious to the attacks you’re facing will be to really, sincerely believe that you both didn’t do anything wrong. It’s more important for you and your husband to convince yourselves than it is to convince others. At that point, any comments you hear will just be the ridiculous rants of inappropriate relatives and old neighbors.

In the moment, you’ll still need some quick responses, so I suggest, “I can tell you care a lot about healthcare equity. How much of your monthly income are you donating to make sure your neighbors have the care they need?” or “It was a tough decision. The good news is, you could actually become a doctor by the time you’re 49 and help fill the gap. You’re obviously passionate enough to do it. Would you like us to send you advice on the med school application process?”

Flat | Top-Level Comments Only

The first paragraph of the response is okay; the second is a little off. I think a more direct response, said calmly, would be better: “Too many residents of the county were actively hostile to Husband and our family, so we had to make the difficult decision to leave.”

I agree, the response Prudence gave is the sort of thing that feels good when you're imagining it in the privacy of your own home, if that, not when you're actually saying it to your former neighbors.

I think other useful responses might be, "We're here to celebrate A&B's special day with our family. Please excuse me." "We're here to mourn C and honor her life. Please excuse me." "We're here to get D settled. Please excuse me." Because in all three of those cases, wedding, funeral, and moving into assisted living, you have a specific reason for being there that might expose you to the outside world but also is important enough to be worth it and should not have the focus diverted from it. Reminding the other person that, hey, they're ALSO here to ATTEND A FUNERAL etc. is far more useful than snarking at them.

Especially--yes, "I blame you for my husband's suicide" was inappropriate. It absolutely was. But as the LW--are you really going to look back and say to yourself, "I'm so glad that I snarked at a widow whose husband recently killed himself about how she should give more money to charity and/or go to med school"? Yes, it was horrible for her to cast that blame, but if the rest of the community had been reasonable it would be easy to put into context as lashing out in a time of extreme grief. Sniping back is not going to make anything better.

Also, the line about med school baffles me, because they cap the number of doctors trained every year. People get rejected from med school every year. So "oh, are YOU going to go to med school?" is just a boggling response, like...no? that would not change the number of doctors trained per year? The core problem here is not the same as staffing a Panera Bread, "insufficient applicants" sure is not it.

I would have thought that med school was the quintessential example of why "if you think something is important, YOU have to do it," because a great many people don't have the memory to pass anatomy classes, the steady hands to become a surgeon, etc. etc. etc.

Right? It’s a non-witty attempt at a witty response.

I also really liked your point about redirecting attention back to the occasions they’re there visiting for.

“Too many residents of the county were actively hostile to Husband and our family, so we had to make the difficult decision to leave.”

This is exactly what LW should say to hammer the message home. I live in a community that serves a huge rural area; my province has been struggling for decades to attract rural doctors. While Prudence may be mortified by what people told LW to their face, I am not; it's one of the main reasons why doctors leave rural practices. Especially if the doctor trained in another country, and/or is a member of a marginalized group. Being part of the "in" group is more important to some communities than having healthcare available.

Yeah, bounce it right back at them. Actions have consequences!

This is an excellent answer and should have been the one Prudence used.

Another possible set of answers would be something like "we left because we were tired of my husband and our kids being harassed. Nothing you're saying makes me want to move back here."

Rather than "why don't you apply to med school?" the LW could say something like, it's a shame that the insurance companies and the government make it so hard for a doctor to earn a living here. I can't help with that, maybe you should be talking to the governor/Congress/state legislature. People aren't going to want to hear "you haven't filled this position because nobody wants to put up with this crap," but they might understand "doctors and their families need to buy groceries and pay for housing too."

…it's a shame that the insurance companies and the government make it so hard for a doctor to earn a living here. I can't help with that, maybe you should be talking to the governor/Congress/state legislature.

Exactly! Frame the problem in terms of a common point of agreement: nobody likes insurance and bureaucratic hassles.

Help! We’re Visiting the Small Town Where My Husband Used to Be a Doctor....

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