Paul Elledge Triste Lieteau & Ian Smith

Triste Lieteau: M.D. 1998. Associate General Counsel, Northwestern Memorial Hospital.
Ian Smith: A.B. 1991–92. Author, Medical Expert.

Triste Lieteau had her eye on Ian Smith.

She was in her first year at Harvard Medical School, and she’d been complaining to a classmate that she hadn’t met any cute guys. They were walking together in Harvard Square when they passed Smith, who it turned out played tennis with her classmate. He was in his last year as an undergraduate. “Now see,” Lieteau said, “he was cute. That’s the kind of guy I’m talking about.”

Turned out to be the guy she married, too. Even though it took them 14 years to make it to the altar.

“Our first date was horrible,” Lieteau recalls cheerfully.

“I wasn’t ready to get serious,” Smith confesses. “I was always open to the idea of a pretty woman, but not a long-term relationship.”

What they had instead was a long-term and mostly long-distance romance; they were in different cities for all but two of those 14 years they dated.

While finishing medical school, she took time out to earn a law degree at the University of Chicago. He got a master’s in science education from Columbia and went to med school at Dartmouth and Chicago. They’re both physicians, but neither practices medicine: She’s an executive at Northwestern Memorial Hospital in Chicago; he’s a TV journalist, magazine columnist, novelist, and author of the bestselling The Fat Smash Diet, his second diet book. A third is on the way. After a spectacular wedding last year, they finally settled in New York (she commutes three days a week to Chicago), and they’re expecting a baby in January.

Lieteau and Smith both have dazzling smiles and an infectious charm that makes it all look easy.

“When people look at Ian and Triste, they think they’re lucky,” says Ronald Mitchell, a New York entrepreneur who played basketball with Smith at Harvard and shared an apartment with him after they graduated. “But the fact is that you’re not going to find harder-working people.

“They always thought they were going to be together,” he adds. “But in order to fulfill who they wanted to be, they were willing to wait.”

Jonathan Cardi, another friend since Harvard who teaches law at the University of Kentucky, describes the arc of their relationship as the opposite of a conventional one, in which an initial honeymoon period gives way to increasing tension: “They both have forceful personalities, with forceful ideas about pretty much everything,” he says. “Over time they’ve developed a much more harmonious relationship than they had early on.”

Both Smith and Lieteau grew up assuming they would be doctors.

When Lieteau was a toddler in Chicago, her mother went to medical school, with her daughter often in tow. “I went to gross anatomy lab when I was 3 1/2,” Lieteau recalls. “I saw a human brain in a Tupperware dish. It kind of made me ill—but it was also kind of cool. For me, science was always fun and exciting.”

While in med school, during the Clinton health care initiative, she was drawn to policy issues. “We saw all these people making decisions, and no doctors were involved.” She later worked at a law firm before going in-house at the hospital, where she is an associate general counsel and director of government relations.

Smith grew up in Connecticut and started out wanting to be a surgeon, but he found, also in med school, that medicine couldn’t contain all of his interests. A news junkie, he interned at a Chicago TV station one summer, and that led to jobs in New York, in local and then national television. He’s a medical contributor on The View, writes columns for Men’s Health, and published The Fat Smash Diet last spring, after several years of slimming down competing celebrities on the VH1 show Celebrity Fit Club. He invites dieters to share their stories on his website, and offers text messages with tips for daily encouragement.

Last year Smith published his first novel, The Blackbird Papers, a thriller set at Dartmouth; now he’s deeply into a second, this one a love story. He focuses on fiction between TV appearances, book tours, writing assignments, and deadlines for the next diet book—about losing weight fast—all of which he manages without so much as an assistant. “When I’m in the fiction zone, I can write anywhere, any time,” he says. “But mostly I write very early in the morning. Before the sun is up.”

“We’re talking 2:00 to 4:30 a.m.,” Lieteau interjects. “Then he goes back to bed for a nap.”

Domestic life obviously hasn’t been high on the agenda for this pair, who until the last year spent more time in different cities than in the same place, and went out most nights, separately or together. Still, they’ve worked out an amicable division of labor: She cleans the kitchen and bathroom—“Even if he did it, I’d want to do it better,” she explains—and he does the laundry and ironing for both of them. Smith’s kitchen repertoire includes breakfast and burgers, and, Lieteau notes, “he has his George Foreman grill.” For her, cooking is a pleasure—“it’s like meditation”—especially the kind of “grand meals at home” she enjoys with relatives in New Orleans.

“Here I am this ambitious career woman,” she confesses, “but secretly I’m very domestic. I love parties, weddings, babies, traditional things.” When they threw a lavish wedding for 230 at Manhattan’s Rainbow Room last year, Lieteau handled virtually all of the planning herself: “I did everything right down to the hot-pink dinner napkins.”

Now she’s focusing her formidable energy on the baby—Dashell Quinn Smith, or Dash, for short—who already has a walk-in closet full of cool gear she couldn’t resist buying.

Another thing they couldn’t resist buying—you could call it their other new baby: a 1986 Porsche that, it turns out, both of them were obsessed with in high school. “I had posters on the wall in my bedroom with that exact model,” she says.

“Turbo with the whale fin on it,” Smith explains.

“My mother said, ‘Girls don’t have cars on their walls!’” Lieteau adds.

Clearly, she wasn’t the sort of girl who’d be cowed by convention. In fact, Smith says, being independent is one of the things they share. “We don’t feel that our lives need to be circumscribed by other people’s expectations,” he says. “Like what it means to be a doctor.”

“They’re both competitive people, people who want to make their mark in our community,” says Keith Amos, Lieteau’s med school roommate, who is now an oncological surgeon in Houston. “They’ve chosen nontraditional routes to do that. Many people think about doing something outside their original field, but they’ve both gone out and done it.”

“We believe in working very hard,” Smith says, perhaps unnecessarily. “And treating yourself well.”