My choice…

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    I sit in a dimly lit bedroom with soft classical music playing staring at my ERAS application. Remembering the anxiety, fear and excitement that I felt last year when staring at the same screen. This year the only thing I’m feeling is my 12 day old daughter gently put her hand on my chest as she falls asleep nursing, again.

    Why the mood lighting? Today is the first day my husband and I are attempting to begin a bedtime ritual. After twelve sleepless nights and having our days flipped upside down we are starting to find a pattern in her chaotic sleep schedule. Some find that it’s too early to set a sleep schedule. My humble, inexperienced, opinion is that gentle early coaxing into differentiating between day and night (before novice parental units go insane) never hurt anyone. But I digress.

    While my daughter eats I pontificate. As newborns take their time nursing, I have loads of free time to think about my career choices, or lack there of. Last year during the peak of interview season my husband and I found out we were expecting. Sitting through my interviews I frequently thought of a female surgery attending whom I trained under. Her story reverberates in me from time to time. A young blonde petite nurse and a single mom to a son in a time when divorce was still looked down upon. She went to medical school after a 15 year nursing career and was determined to become a surgeon. Overcoming road blocks and walls, she knocked on every program directors door until someone gave her a chance. She tells horror tails of sexual harassment, discrimination, subordination and her teenage son growing up alone. But despite all that she prevailed, now in her seventies she lectures medical students, operates two days a week and runs a breast clinic. Her Hermes bag and perfectly tailored designer dresses, witty comments and no nonsense approach to closing up a breast perfectly, made her my hero.

    Keeping her story in mind I braved my interviews with a poker face knowing that I would be 8 months pregnant when July 1st rolls around.

    The dialect in my head went as such; “I can do it, plenty of people have done it before me, worse working conditions. I am in shape, pretty sure I won’t blow up. I’ll just carry snacks around with me. I will have my mother in law quit her job and move in with us so that I could go back after four weeks, and pump. It will be fine. Maybe they will let me take more time off, maybe I can defer, maybe…maybe… It will be fine. I can do it.”
    And it was fine, for the first seven months.

    After finishing up rotations in November and reading all the ‘Fifty shades of Grey’ books in under two weeks, I took a position as a medical scribe at a local urgent care center. Mostly to keep busy until residency but also so that I can contribute something besides debt to our household. For the first time in four years I actually deposited non-borrowed money into my checking account.

    I breezed through my first trimester working 12 hour shifts with a daily morning routine that included one Zofran and my daily cup of green tea with fruit. Second trimester was also easy and no one could see that i was pregnant until about the sixth month. My hair grew like grass and my complexion was at its best. I didn’t require any time off due to pregnancy related issues and never left work early. Everything was going according to plan.

    The day before the rank order was due was one of the toughest for me yet. Decision time was upon me. A big part of me wanted to match, to get my career started. An equally large part desperately wanted to take a back seat and be present for the first year of my child’s life. I thought about what it would be like to be an intern with a newborn. I also thought about my future fellow interns, whom would have to cover for me. At night I dreamt of how it would impact our yet to be determined relationships.

    At the end of the day I am not a person who gives up. As any other determined, ambitious but perplexed woman… I chose to delicately self handicap instead: by ranking only one program. Of course I did not match, no surprise there. After the initial shock of rejection wore off, I was truly happy. Deep down it was what I wanted all along.

    Armed with my husbands support, a flexible work schedule, eight minute commute and easy pregnancy, I had a plan: next year.

    Towards the end of my seventh month and as most of my friends started orientation doubt began creeping in. But my growing belly, waddling gait, aching back and unrelenting Braxton Hicks quickly soothed all my doubts, temporarily.

    Now the dialect in my head was different, not the Amazonian female I was six months ago. ” Did I make the right choice? Will they understand why I took a year off? What will I write as an explanation? Will they hold this against me? ”

    And most importantly:
    Have we progressed far enough in the profession from the times where my hero of a female surgeon was discriminated against for being just that: a pretty, blonde female with a child? Will the program director, subconsciously or not, choose someone else over me just because I have a child? Did I sabotage my own career?

    I still cannot answer all those questions, which brings me back to my now dimming computer screen. What do I write?

    But much closer than my computer screen is my perfect daughter, who is sleeping on my chest. I do not worry about leaving her in 2 short weeks to go back to work. I am in no rush, drinking in every little noise she makes in her breast milk induced slumber. I gently kiss her freshly bathed golden fuzz and nothing else matters for the time being.

    When I left to go on maternity leave at 38 weeks my attending asked what I wanted. He also told me to take as much time as I need. Smiling at him, I let him know that I would come back to work the weekends when she is two months so that my husband can watch her and then transition back to full time over the next few months. My husband would bring her to me once a day to feed and also pick up the pumped milk that will be stored in my own mini fridge and however long I need to pump. No rush.

    Truth is, I love medicine, I love urgent care and I love working. But these days and months of intoxicating clean baby smell, I will never get back. Every day I watch my daughter change, grateful that I have an opportunity to watch her up close, not through the eyes of an exhausted , guilt ridden intern.

    Although some women would not choose my path, I am confident that my choice of not ranking more programs and sitting a year out was the right one for me.

    In the grand scheme of my medical career, what is one year? But in the span of my daughters development… One year is priceless.


    Thanks for sharing your story! I am thinking about taking a year between residency and fellowship to have a baby. My concerns are mostly financial–my husband recently got laid off, and we are living far from our families because of my residency program (we relocated for me). I am hoping and praying that things all fall into place so that we can make this happen… Did you find that your loans wanted you to start repaying, for example?

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