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Being on proximal call required doctors to remain at the hospital. Hence, couples relatively spent little time together. For instance, Carl, who had separated from his wife, ascribed his failed marriage to not being able to spend sufficient time with his wife because of his long hours on-call. However, when time was available, he had difficulty being intimate with her because he was tired. He explained that, “when […] you’re tired […], you want to sleep and if you have things to get done at home, your libido kind of goes down.” Unlike other proximal doctors, he had more than 10 years on-call experience and although his wife was understanding of his on-call commitments at first, over the years, it “had taken its toll on her” (Carl).

The inadequacy of time spent with each other was exacerbated where both partners were doctors because they usually had different schedules. When proximal on-call partners did have the opportunity to be together, they usually would rather rest. Macy was

unmarried but, in a relationship, and felt that she would sacrifice time spent with her boyfriend for the opportunity to rest. However, she explained that this was not a source of conflict in her current relationship because her boyfriend was also an on-call doctor “and it [was] something [they] both [understood]” (Macy). Thus, despite their lack of time together, she perceived that it was advantageous to be in a relationship with a doctor like herself because he understood her on-call demands. On the contrary, while Billy shared Macy’s reasoning, he was divorced from his ex-wife who was also a doctor. He explained that although they were both doctors and she understood the demands of being on-call, they did not share the same priorities.

My ex-wife she was a medic but for her, […] she didn’t really commit much to surgery as I did. So, she would suffer in work for it. […] But she was willing to accept that […] in terms of trying to do more outside. But for me, I want to make sure what I do, I do it properly. (Billy)

For Billy, making sure he was successful at his career meant prioritising it over his life outside of work. On the contrary, it was more important for his ex-wife to have time to do more outside of work. This was evidenced by her switching to a specialty which was “much lighter and lower in volume” (Billy). Ron, a distal doctor, also believed that his commitment to being on-call increased his skill but required him to make familial and personal sacrifices including not expending energy on activities he considered trivial in his marriage. Thus, he was less patient in his interactions with his ex-wife as the following revealed.

On-call took priority over everything, including marriage! The on-call at that point in time had a lot of one in one call. It did a few things. It made you very competent at what you’re doing […], but also made you highly intolerant of anything that wasted your time, including small talk, banter and the day to day small things that involve a marriage or any relationship outside of the professional one. (Ron)

As with Billy, Ron was also divorced. In fact, while there were no differences per on- call type with regards to doctors who were divorced and separated, all divorced and separated doctors were men. Ron explained that those who were unwilling to make familial sacrifices usually “switched [to] disciplines” with fewer or no on-call shifts as Billy’s wife did. However, no doctor (i.e. distal or proximal) in the sample, who was a man, explicitly expressed their willingness to do so. Nevertheless, Drew, who was also divorced, pointed out that both men and women have now begun to prefer medical fields such as primary care with relatively fewer on-call shifts to balance work and life.

Guys in the primary care service who never choose to […] move up the ladder with the on-call service because they say from flat out from internship you see this on-call thing, I ain’t able with that. […] and I use to think that it was mostly applicable to the female officers, but you have an abundance of male officers doing it. (Drew)

Yet, while according to Drew there was an abundance of men opting to practise in fields with less on-call responsibilities, the stereotypical views held within the medical fraternity with regards to the inferiority of these fields or as Drew put it “lazy man

medicine” made going into such disciplines frowned on by “the average hospital guy” (Drew). This might explain why no other man in the sample corroborated Drew’s comment about leaving their intense on-call specialties. Women on the other hand, were more articulate about their consideration of leaving their current on-call specialties for those with lesser on-call burdens. However, the ideal situation would have been if they had the option of lessening their on-call shifts or not being on-call within their current specialties. However, as previously explained, this option was hardly available within the T&T medical context.

When compared with proximal doctors, distal doctors’ partners seemed more understanding of their on-call requirements perhaps because they had become accustomed to it over time. As stated earlier in the chapter, distal doctors were usually on-call for a greater number of years than proximal doctors. Barbara who had been working on-call for over 10 years, said this about her husband:

Since I started working, that’s all he’s known! I’ve always been on-call one in every four days. […] That’s the norm for us. It wasn’t like I had a particular job before and then all of a sudden, I’m not home one in every four nights.

Furthermore, distal doctors reported that their partners had supported them in their on- call duties by answering phones; driving them to work when the doctors had to respond to a call and taking care of household duties including childcare. Still, they spoke about how being on-call disturbed their partners’ rest as indicated in the following quote.

It would be distracting and disturbing too because we would be keeping the phone with us all the time and if it rings in the night, [it] disturbs the whole family. […] my phone rings, [she] wakes up. […] but apart from that, it’s ok and my wife, she understands. (Tom)

Overall, most doctors (i.e. distal and proximal) failed to talk extensively about their intimate relationships and had to be probed more with respect to these issues. Additionally, as pointed out in the last chapter, they either failed to invite their partners to the study as was the initial intent of the research or reported that their partners were unwilling to participate.