Why I Chose My Specialty

Throughout my first three years in medical school, I attempted to do this, but it just didn’t work for me. I was frustrated, confused, unhappy at times; I liked certain aspects of each specialty, but I was unable to conceive of a lasting career as an internist, an obstetrician, a dermatologist, a radiation oncologist. It just didn’t feel right. I wondered if becoming a physician was the right choice for me at all, that is, until I found psychiatry. This was not really a "Pollyanna" moment; I am not spinning a fairy tale. But I did finally feel excited to wake up in the morning, found myself thinking deeply about my patients when I came home, reading more and more in my spare time, and felt naturally comfortable and at ease on the wards. I can rationalize and tell you reasons why I found this specialty exciting — the brain as the final frontier; the illness narrative and our attempts to decipher where person ends and disease begins; weighty questions involving morality, ethics, philosophy, science; you are encouraged to spend prolonged time with your patients; I relish complexity and uncertainty, and there is plenty of it in psychiatry — but in truth it was the qualitative, emotional change that I noticed in myself when I spent time around psychiatrists that really drove me.

Do not misunderstand: Not everyone stumbles upon a path that immediately stirs their soul. I was very lucky. You can still build a satisfying, rewarding, deeply meaningful career when you make a choice based on pros and cons; many of us do, and in fact, as you work and live in the profession and it becomes ever more a part of you, the soul stirring ultimately will come. But if you are so fortunate as to discover something that truly excites your passions or even just puts a bigger spring in your step, then I suggest you listen to those instincts and see where they lead you. The rest will follow. And if you need any help discovering those drives or listening to and understanding them in yourself, I can recommend plenty of good psychiatrists.

Prior to medical school, I had always thought that the greatest benefit of medicine was the ability to save and prolong lives. However, I came to realize that the role medicine can play in improving the quality of our patient's lives can be just as important.

The conditions that we treat as dermatologists, such as severe acne, eczema and psoriasis can often cause significant daily physical and emotional discomfort and even sometimes lead to social isolation. Acne while common, can often be painful and lead to low-self esteem. Eczema, while not life threatening, can lead to a debilitating itch that keeps patients up all night scratching. Psoriasis, while sometimes localized to small areas, can often be widespread, itchy, painful and lead patients to feel embarrassed about exposing their skin to others. Anyone who has experienced the intense itch, burning-skin-on-fire feeling of a bad case of poison ivy can remember how uncomfortable your own skin can make you feel.

Our patients come to us seeking help, and they are so motivated to find ways to improve their conditions. As a dermatologist, I find that patients value our services highly. Everyday, we experience the satisfaction of our patients expressing their gratitude when we have been able to provide relief from the discomfort caused by their skin conditions.

After my training, I was shipped to Saudi Arabia to serve during Operation Desert Storm. During this time, I was assigned as a biologic weapons tester and was exposed to various testing techniques to detect biologic weapons. After returning to the United States, I started college at the University of Illinois and majored in microbiology. My exposure to microbiology continued in the military, where I was able to work at the U.S. Army Medical Research Institute of Infectious Diseases in Maryland. I worked in biosafety level 4 suites and I learned more of the microbiology of various viruses and bacteria.

After I received my bachelor’s degree in microbiology, I worked at Abbott Laboratories with HIV-infected cells and HIV genetics. At this time, I started volunteering at the Bonaventure House for individuals afflicted with HIV. This work started me thinking about a career in medicine, in which I could take my knowledge of microbiology and science and more directly help people. During medical school, I was attracted to many different specialties: surgery, radiology and dermatology, but I found that internal medicine offered me the best way to directly care for patients and build relationships with them. As I completed residency, I discovered that I could link my interests in microbiology and patient care through the field of infectious disease. The specialty offers me the ability to participate in a wide range of interests, from caring for HIV-infected individuals, to seeing patients in immunocompromised states, to managing difficult-to-treat infections and antibiotic stewardship. I still find all aspects of medicine fascinating, but my one passion remains infectious disease.

I chose to pursue this specialty in earnest during my third year at Feinberg after rotating on the urology service and found myself inspired by the faculty and residents working in the department. I chose urology at the most basic level because, ultimately, it felt “right” as I considered the decision between the many great fields in medicine. However, like any major decision there was, of course, far more nuance to the choice than that.

Urology, to me was – and remains – a captivating field offering a great deal of diversity in the spectrum of diseases managed, the tools used to address those issues and the timeline over which patients require your care as a urologist. This variety, in conjunction with my affinity for surgery and the fact that I generally found the specialty populated by affable people who I enjoyed working with, helped me finalize my decision. As a surgical specialty that often has no direct medical correlate, urologists routinely find themselves on the front lines of many complex medical problems. Urologists play key roles in a broad spectrum of issues, such as: male factor infertility, problems with renal filtration leading to kidney stones, congenital urinary malformations that may need lifelong management, and three of the top six cancers affecting American men. The tools used to address those issues vary, from delicately titrated medications and impact hormonal imbalances to massive operations in order to remove 20 centimeter tumors. In short, urology struck me as a specialty where I would never be bored. I would routinely use both intricate knowledge of physiology and pathophysiology alongside complex surgical expertise. To date, my estimation has been right­ — urology has been a very fulfilling and exciting specialty.

After shadowing an epilepsy neurologist in clinic during my first year and a half of medical school, I realized I would likely become somewhat frustrated by the "revolving door" aspect of their practice where you see patients regularly and frequently manipulate their medications. I completed my surgery rotation during my third year of medical school and loved it immediately. I loved the ability to see a patient with a problem and take them to the OR to "fix it." Now, of course, I understand it isn't always quite that easy, but from my perspective as a student, it was so straightforward!

Sometime during my surgery rotation, I was talking to a resident I worked with about how great it was to be able to help patients the way surgery can and she said to me, "It sounds like you want to be a surgeon." I was incredulous at first but the more I rolled it over in my mind, I realized she was right. Given that last piece of the puzzle, together with my love for neuroscience and neuroanatomy, I decided to go into neurosurgery. Now, as a neurosurgeon specializing in the surgical management of epilepsy, I love my patients and what I do. I love that my skills are able to offer the opportunity for seizure freedom to patients who have lived with epilepsy and seizures for many years. I love that I work with a multidisciplinary team to care for complex, young, generally healthy patients. I love that I can combine my research interests together with my clinical care for almost every patient I treat. In summary, I feel fortunate that neurosurgery found me and gave me the opportunity to love what I do so much.

Simply put, that is how I decided to go into orthopaedic surgery.

I grew up as an active student. I played sports, loved science and I got some fulfillment out of a hard day of heavy labor. By the time I got to medical school, I realized I loved physiology, but anatomy was what changed things for me. Form and function became my focus during school. The ability to improve the function of my patients with surgery was when orthopaedics became the specialty for me.

Alignment, mechanics and movement were critical. The patients got better — a lot better, very quickly — which was great for my inpatient nature. Ortho was very close to some of the heavy labor jobs I had as a kid. Machining in the shop or using a planer in carpentry was similar and comfortable. Most of the tools we were using in the OR were familiar, and I enjoyed the physical nature of the surgery itself.

I knew I had picked the right field early. As a fourth-year medical student, I was on service doing joint replacement surgery. We had a difficult day in the OR and a patient on the floor had a VTE. I asked the attending at the time, “Why do you do this?” He responded, “Because I like getting hugs from old ladies!” I still tell that to students today, and I get a lot of hugs in clinic for the care I provide to my patients!

Students choose orthopaedic surgery for a variety of reasons. Whether it is their sports background (and the injuries that come with it) or the functional improvement that the surgeries provide, orthopaedics is a fulfilling career that will improve the physical function of your patients.

Although I perform surgical procedures using technologically advanced equipment, I still enjoy the intellectual stimulation of solving medically-based problems. I also enjoy the large breadth of diagnostic variety in clinic and the OR. Urologists work very hard but are able to leave the office/hospital at a delightfully reasonable hour. This enables urologists to maintain a healthy work and life balance. Urology is a wonderful specialty that enables the clinician to deliver life-changing medical and surgical care.

Our patients came in with undifferentiated problems, which were of neurological, psychiatric, malignant, infectious – not to mention cardiac or pulmonary – etiology. We interacted with all the specialties and got to put the puzzle pieces together, and though we were often convinced of the diagnosis before they came in, it was nice to get the answer reinforced. It was exciting and it hooked me.

As a resident, I planned to subspecialize. I wanted to be the expert and swoop in and give my advice. I did multiple consult months but had a hard time focusing on one single organ system. I always worried about who was taking care of the issues that the consult team wasn’t following. I realized general internal medicine was for me.

Initially, my clinical focus after finishing residency was to be an excellent diagnostician. Although this is still something I strive to be, I realized that my patients appreciate me more for being their 'doctor' rather than diagnosing their diseases. I find that my patients do want me to treat their medical conditions, but more importantly, they want me to listen to their stories and offer advice. I am always amazed at how they let me into their lives. At this time of change in the healthcare system, primary care physicians are going to be taking an even more important role. But being someone’s 'doctor' is the most rewarding part of being a primary care physician.

Key considerations include a preference for procedural vs. predominately nonprocedural fields and primary care vs. more specialized areas of medicine. These are important issues for students to consider as they progress through their first three years of their medical training.

I will never forget my third-year surgery clerkship or my urology rotation that same year, as both were very formative experiences for me. I learned early on that I derived a great deal of intellectual stimulation and personal satisfaction through participation in both surgical cases and office-based procedures. However, I also quickly realized that I greatly valued the opportunity to have longitudinal relationships with patients over time, and that framework was largely missing from many surgical disciplines. Upon beginning my urology clerkship, though, I realized that I might have found my optimal “fit.” Like other surgical fields, urology provides its practitioners with ample opportunities to engage in office-based procedures and surgeries, but I found urology to be fairly unique among surgical specialties in that there is also a longitudinal component to the care that we provide our patients. Looking back over my career to date, I have found these long-term patient relationships to be the source of some of my greatest personal satisfaction as a physician.

Urology is, in my opinion, one of the most intellectually stimulating areas within medicine. The genitourinary system involves the critical integration of several organ systems, and numerous pathophysiological processes can arise and have substantial negative impact. Urologists routinely encounter a host of congenital and acquired conditions that can have detrimental effects on the day-to-day lives of patients. Many of these conditions are malignancies, which can be particularly devastating. Urology patients and we as their physicians are fortunate, though, as the medical and surgical therapies that we can offer enable us to successfully treat the vast majority of patients for whom we provide care.

One final aspect of urology for you to consider is that it has always been a “forward-thinking” field. Urologists have traditionally been early adopters of transformative technologies, including endoscopy, microsurgery and robotics. Finally, contrary to the initial impression of some students, urology is not a field limited to male physicians only. A high percentage of the rising stars and key senior leaders within our field nationwide are women, and our program here at Northwestern welcomes and supports all applicants.

With my options narrowed to the non-surgical specialties, I was drawn to the fast-paced environment and acute illness of the inpatient population. It was very satisfying to be able to help patients at their sickest, when they truly needed treatment. I was intellectually stimulated by the process of diagnosing an unknown case, working through history and data to urgently find a solution. Despite enjoying the above aspects of inpatient care, I did not have that “ah-ha” moment while on inpatient medicine or pediatrics that convinced me I had found my calling. I spent quite a bit of time talking with attendings from both specialties, figuring out what their lives were like and what they loved about their jobs. These talks really helped fill in some of the unknowns that I had about life after medical school. I eventually realized that adults were the age group best suited to my personality. Even though I still had no idea what my actual job was going to look like, I knew that internal medicine would be able to provide me with a vast array of options.

In medical school, I always found the heart pathology and anatomy most fascinating, so I gravitated towards cardiology as a potential career. I immediately sought out cardiology research and started to connect with cardiologists. But as the research progressed and I became more familiar with the field, I found myself wanting to think about more than just the heart. I was interested not only in cardiology, but also all the other specialties within medicine. I enjoyed the variety and challenges of all medicine cases, and knew that I would not be satisfied in a job where I only focused on one particular field. It seemed like general internal medicine was the direction I was headed in. I already knew I preferred an inpatient setting, but meeting my first true mentor solidified a career in academic hospital medicine. Towards the end of my intern year, I had a hospitalist attending who was one of the best teachers I had ever worked with. She paid attention to all members of the team, especially the students. She was approachable, intelligent and created a great learning environment. I hadn't really thought about education or teaching until then, and it was something that I started to enjoy immensely.

The great part about being a general internist is that there is no fellowship required, so I went directly from being a third-year resident to an attending. And the even greater part about being a hospitalist is that the schedule is “seven days on, seven days off,” with a full-time hospitalist only working 26 weeks out of the year. A career in hospital medicine provides ample time for patient care, educational activities, research, non-medical hobbies and time to just enjoy life. With three young kids now, I cannot stress how important it is for me to spend time with my family and not feel like I am overworked. Within hospital medicine, there are a plethora of different career options. There exist additional specialties such as perioperative medicine (assisting surgeons with medical care before and after surgery) and palliative care (pain and end-of-life care). At an academic medical center like Northwestern, hospitalists have the freedom to get involved in any number of teaching and research activities. I personally have found that teaching students and residents is what makes this job so great. I am a college mentor and attend on the general inpatient wards, but I also am involved with student remediation, developing and teaching the clinical medicine curriculum in the CEC, reintroducing the MSTP students to clinical life and creating a hospital medicine selective. I am lucky to have a position that provides endless teaching opportunities, intellectually stimulating inpatient care and a lifestyle that ensures a healthy work-life balance.

I took the traditional college route of studying biology and was accepted into medical school at Rush University. From early in my clinical training, I knew training in pediatrics really was my destiny. I loved pediatric medicine and tolerated surgical rotations and adult care. I matched at Children’s Memorial Hospital (now Ann & Robert H. Lurie Children's Hospital of Chicago) for my Pediatric training and quickly started considering specialty training. I liked many of my electives and really liked the pathophysiology I learned while caring for PICU patients. To my surprise and shock I shifted gears; I started a pediatric dermatology elective after a PICU month, and dermatology clicked with me. I had no previous experience with dermatology or pediatric dermatology in medical school, but it felt like a natural fit.

I think this decision was a combination of the diseases seen, surgical procedures performed and mentorship. I was fascinated that the attending physicians could see a patient in clinic and know, sometimes before walking in the room, that the patient had a systemic disease or syndrome. I loved and still love seeing patients with rare diseases and problem solving to make a diagnosis. I also took note that my mentors in pediatric dermatology genuinely still loved their jobs after many decades of practice. I have been at Northwestern practicing as a pediatric dermatologist for 16 years and feel grateful to have landed in this specialty. I completed two full residencies and a research fellowship and have never begrudged the extra years of training. It was a small price to pay for my long-term job satisfaction and academic growth.

During medical school, I took an elective in healthcare economics and enjoyed the topic so much that I elected to enroll in the concurrent MD/MBA program. I completed my first year of business school between my M3 and M4 year. I completed the last few courses during the end of my fourth year of medical school. When I started fourth year, I was focused on a future career in orthopedics surgery. I even went as far as doing two away rotations, but when I completed my general surgery sub-I, I was pulled back to general surgery because of the multi-system care that I saw that general surgeons were able to provide. I liked that there was also a subjective portion of deciding on whether a patient needed to go to the operating room. As opposed to many other surgical specialties where surgical interventions have very clear indications, general surgery was appealing in that the patient’s care plan was dictated not only by the findings on their history, physical, laboratory and imaging findings, but also their ability to tolerate an operation vs. continuing non-operative treatments like in the management of a small bowel obstruction.

While I had a “last-minute revelation,” I was able to secure a spot in the general surgery residency program at Vanderbilt. Having never had any transplant surgery experience, our residency had a robust transplant resident experience, doing kidney/pancreas transplant as a PGY 2 and 3, and liver transplant as PGY 1, 3, and 5. I found that I was drawn to the complex “sick” patients. It was obviously rewarding to be part of a process to take someone who has organ failure and completely reverse that process with transplant. From an operative standpoint, I enjoyed the macro portion of open surgery as well as the micro portion such as vascular anastomoses. It was also appealing to me to see attendings, even at their level, be challenged during some of the surgical procedures. Given my MBA background, I enjoy the team aspect of transplant. Not only do I have fabulous surgical partners, I work very closely with transplant nephrologists, transplant hepatologists, transplant infectious disease specialists, intensivists, anesthesiologists, pharmacists, APPs and nurses. Because of all these reasons, I elected to do a two year fellowship in transplant surgery at the University of Michigan in Ann Arbor, Michigan. I started at Northwestern Medicine in 2017 and in addition to my interest in transplant surgery, I also perform dialysis access surgery, HPB surgery and some general surgery. Given an ongoing interest in surgical education, I am one of the associate program directors in general surgery.

In thinking about a career in transplant surgery, I was often asked about work-life balance, given the sporadic nature of transplant and the unpredictability of the schedule. While this is true at some level, the unpredictability of my schedule as a transplant surgery attending is much different than as a trainee. While I do perform some transplants at night, we as a field, have focused with help of our local organ procurement organization to delay some donor surgeries such that the recipient operations can occur during the day as opposed to the night. At some level, though, I do enjoy the unpredictable nature of my schedule in that some days I may leave early while another day I may spend some time at night doing a transplant operation. As part of a great transplant team, I also have partners who share in similar work-life balance goals. So, if I have been awake all night doing a liver transplant, my partners can easily step in and relieve me in the morning or elect to cover some of my other clinical responsibilities that day so I can sleep and have some time outside of the hospital. While I don’t think we have it figured out perfectly in medicine, I think our field has made significant strides to improve the work-life balance that we all can appreciate.

Even more so, on my psychiatry rotations in medical school, I was disappointed by the lack of information to guide medication management for pregnant women. My interest in optimizing psychiatric care for perinatal women led me to choose a career in psychiatry. I recall OB/GYNs and many psychiatrists being intimidated by pregnant patients with mental illness. I often saw women with mental illness diagnoses receive suboptimal care because their doctors didn’t know how to manage their illness in pregnancy or while they were breastfeeding. Some doctors stopped medication for fear of legal liability, whereas other doctors under dosed medication. What I found astounding was that there wasn’t a common standard practice or clear guidance on what should be done for the perinatal woman with mental illness. The variable treatment approaches rarely resulted in sufficiently positive psychiatric outcomes. For these reasons, I was inspired to serve as a researcher, clinician and educator in women’s mental health. I have devoted my career to advancing mental health treatment for women across the reproductive life cycle with particular attention to optimizing pharmacology during the perinatal period in women with bipolar disorder.

Seven years after completing my fellowship in clinical research and women’s mental health and becoming a faculty member, I remain excited about the work that I do. I am encouraged every time a patient does well throughout pregnancy and postpartum as a result of optimal medication management. I am reassured in my role as an educator every time I observe my trainees and students learn to consider gender-specific psychosocial and biological issues when treating psychiatric illness. Finally, I continue to be energized by my research participants who often remind me why effective medical management is important to them. One patient said, “I didn’t think having a baby was possible with Bipolar Disorder…that’s what I was told by my last psychiatrist. Because of your study I felt more confident about having a baby.” This patient delivered a healthy baby without complication. Stories like this are my daily inspiration. Instilling hope, restoring confidence and being able to make a positive impact on a woman’s childbearing experience is invaluable.

I know some will laugh at that statement, however, one lecture may capture your attention and direct the focus of your career. For the past 15 years, I have been a pediatric gastroenterologist who specializes in intestinal rehabilitation and liver/intestinal transplant. This is a growing field – especially given the advancement of surgical lengthening techniques, development of new drug therapies, and the use of alternative lipid emulsions. Thirty to 40 years ago, children with short bowel syndrome or intestinal failure faced certain death.

One of the amazing aspects of pediatric gastroenterology is the long-term relationships formed with patients and families. I may see children as infants and follow them until they graduate from college. Patients who would cry every clinic visit now call my name across the hospital lobby. One of my patients recently underwent an intestinal transplant and was discharged home. I suspect in the next several weeks, she will no longer require intravenous nutrition and will have her central venous catheter removed. This is a tremendous step for a child who has required intravenous nutrition for her entire life. She looks and behaves like a regular eight-year-old princess. The gratitude from the family and the feeling that I have improved this patient’s life is one that I will always treasure. Although some of my colleagues have left academia for industry, I can never imagine being as fulfilled as I am taking care of patients daily.

It was less from more practical considerations such as remuneration, lifestyle and employment/academic opportunities. One aspect of ICU practice that attracted me was that it requires an understanding of a wide range of illnesses that can affect all organ systems, and thus it necessitates a broad scope. There are common themes for sure (respiratory failure, sepsis, circulatory shock, acute kidney injury), but on any given day in the medical ICU I might see drug overdose, seizure, stroke, myocardial infarction, cardiac arrest, arrhythmias, critical electrolyte disturbances, acid-base disorders, endocrine emergencies, cancer, spinal cord injury, liver failure, adverse drug reactions, heat stroke and many other conditions.

I was drawn to the challenge of making high-stakes decisions under time pressure (and often in the face of uncertainty) and in performing select procedures. These decisions require a firm understanding of pathophysiology and complex reasoning. The complexities of the relationships between ICU teams and their patients and families also interested me. More often than not, ICU doctors take care of patients without having known them or their families beforehand. This requires a commitment to developing relationship-building skills. Trust between doctors and patients (or their surrogates) is crucial to best care and is extremely important when having to give bad news or caring for dying patients.

A number of paths can lead to ICU practice in the United States. I completed a three-year fellowship in pulmonary and critical care medicine after a three-year residency in internal medicine, and so I work in a medical intensive care unit. A less utilized option is to complete a two-year critical care fellowship after medicine residency and forego pulmonary training. It is also possible to do a one-year clinical fellowship in critical care after completing another fellowship (e.g., three-years of cardiology) or a two-year fellowship in general internal medicine that has at least six months of critical care followed by completion of a one-year clinical critical care fellowship. Thus, pulmonary training is not required to become board certified in critical care medicine. ICU fellowships can also follow residencies in surgery, anesthesiology, neurology, pediatrics and emergency medicine. Intensivists following these paths, of course, staff surgical ICUs, neuro-ICUs and pediatric/neonatal ICUs.

It follows that most intensivists co-train in other areas (e.g., most medical intensivists are also pulmonologists). This is good, because as the name implies ICU practice is intensive, stressful and difficult to do full time; I practice pulmonary medicine when I am not in the ICU. Co-training also provides skills that allow for higher-level ICU care. Physicians practicing only in the ICU may choose to work in an institution with ICUs staffed in shifts, much like an emergency department. This option allows for predictable hours and adequate time off.

I enjoyed various aspects of so many. Ultimately I chose family medicine. Here, I found a wonderful connection to patients and their families in relationships that expand and flourish over time. I have worked at my current clinic for over nine years now. It has been amazing to watch some of my former prenatal patients raise their children from tiny newborns to young children going to middle school. It has been my honor to care for one family member, and then later be introduced to their parents and grandparents, some of whom then became my patients as well. Seeing and understanding my patients in the context of their family has added extraordinary depth to my clinical experiences, which I hope has made me a better doctor for them.

I also love the variety within the specialty. From prenatal visits, to well-child visits, to diabetes check-ups, to office procedures, there is always an engaging visit waiting for me in the next clinic room. But underlying all of that is a commitment to partnering with my patients to improve their current health and help to prevent future health complications. We are experts in families and preventive care. In the larger family medicine community you will find family physicians in a wide variety of settings, including community health, hospitals, academic centers and public health departments. Others dedicate their time to research, health system innovation, or advocacy. There is a path for all, and all share in the commitment to making our patients' individuals lives and our healthcare system better.

I may have met some of you through FMIG, ECMH or CEC over the years. I hope to see you again soon and meet many more of you as you journey through your medical training.

I enjoyed working with this population and my first thought was to pursue a career in pediatrics.

As I began the clinical years of school, I did a two-week rotation in anesthesiology. The operating room was an exciting place, and the application of pharmacologic and physiologic principles was right up my alley. (I was not very strong in anatomy class.) Subsequent rotations in orthopedics and neurosurgery blurred my thoughts a bit, primarily because I liked the people with whom I was working. During my pediatric rotation, I liked the people and the children but didn’t really like the work.

When decision time came, I considered my strengths and my interest in acute care medicine in a procedural setting, and I chose to apply to anesthesiology residencies. I enjoyed almost every aspect of my residency. I worked with great people and felt part of solid teams. Pediatric anesthesiology was my favorite rotation.

My current job has allowed me to care for a wide variety of children in many different settings. One day, I may take care of a sick newborn with a congenital heart defect, and the next day may be caring for healthy children for ear tubes and tonsils. I work with amazing people who do amazing things. While I am never the star of the show, I never regret my career choice.

In a not-too-uncommon story, a career in surgery was so far down on my list when I was a medical student, that it was not even on my list. I did my surgery rotation in the middle of my third year of medical school, and was inspired by a variety of people, the most influential of whom was a chief resident who was an amazing doctor, loved to teach, and whose enthusiasm for his chosen profession was palpable. He could take care of the sickest patients in the hospital without blinking an eye, and I wanted to be like him. But I liked physiology, too, and also considered internal medicine specialties as a career. Once I realized how much “medicine” went into the care of a surgical patient, the decision to go into surgery became easy.

As medicine (in a global sense) becomes more complicated, more and more physicians choose to specialize, and I was no exception. I did three years of research at the NIH in the middle of my residency, with the intention of becoming a surgical oncologist. While there, I was introduced to the field of endocrine surgery. As one can imagine, patients being treated at the NIH are not run-of-the mill patients, and so almost everyone had an inherited genetic syndrome predisposing them to the development of endocrine tumors in multiple organs. The genetics were interesting, the physiology was interesting, and the field of endocrine surgery provided a balance of patients with both benign and malignant disease. I knew I had found my specialty.

Back to my taking drugs away from patients. I once had a patient with primary hyperaldosteronism who was taking nine antihypertensive medications. After adrenalectomy, he was able to get down to three drugs. A patient with a pheochromocytoma was taking medications for both hypertension and “diabetes” and after adrenalectomy was able to discontinue everything. A patient with difficult-to-control Graves’ disease taking antithyroid drugs, beta blockers, iodine, and sometimes steroids was able to discontinue all of these medications after thyroidectomy (admittedly with the trade-off of now having to take thyroid hormone). You get the idea.

So that’s my story. I hope you will consider a career in surgery; I have never regretted it!

My primary identity is as a physician, however, turned out to be a revelation to me (see longer story). My father trained as a general surgeon and did a lot of primary care, but I had little interest in what he did for a living. I don’t think I ever wanted the responsibility that comes with being a physician. However, I later learned to trust my training and embrace the humility associated with being a good physician; I’ve come to relax some over that particular anxiety.

My theater background was all about my profound interest in narrative stories, and the internal and external motivations for my own and other people’s behaviors. It was also about emotions and feelings. This was what I was drawn to. However, during my acting training at NYU, I found I was more interested in other people’s minds and feelings than drudging up my own for other’s entertainment (the main job of an actor). But I did learn that the best way to connect with fellow actors, to really be good at the craft, was to really listen to what they were saying (or not saying) and react to that. Sounds very much like what a psychiatrist does, right?

I always had an interest in philosophy and the world of ideas. Although I appreciate the wonders of technology and the hard sciences, I would never spend my vacation time on the beach reading a tech journal, like my son, the engineer. I spent a lot of my adolescent and young adult years in the trance of books, primarily nonfiction — thick books of ideas. What is real? What lies beyond the surface? What does it all mean? Grasping these concepts came easier to me. In fact, I think I got through medical school telling stories: What is the story of the kidney? What’s up with the immune system? I read my class notes more like a novel. It was the only way I could remember it. What was the biggest intellectual mystery of it all? The brain.

So, later in my training, after years of having no idea what I was doing, feeling a lot of shame about that and uncertain if I was ever going to find my calling, I suffered what I would now deem a period of major depression, extreme career uncertainty and some poor personal decisions. This led me into therapy and then an actual seven-year psychoanalysis in New York while I was working at Cornell. I’m still not entirely sure what transpired in my therapy, but I rediscovered a few things. One, when I was young, my older brother was in a persistent vegetative state for two years after being hit by a cab. Maybe this had some influence on my interest in the brain. Second, during medical school, my younger brother, who was rooming with me at Michigan, had taken one too many magic mushrooms and had a psychotic breakdown and had to leave school. Hmm... why had I never dealt with that? Why had I dated a series of depressed, neurotic women, feeling somewhat emotionally detached, but unable to leave them much the same. Physician, try to heal thyself, then maybe you can help others.

My story has many twists and turns, with humor and pathos, but I would not have it any other way. In fact, I had no choice in this. I have come to accept and have a deep reverence for the complexity of our lives. I’m blessed. I’ve had a career that I can actually say I love. Although I haven’t always been up to the task, the opportunities for fulfillment have been endless. I have a wonderful family, wife and children. Being a little wiser, now that I am older, has helped me to be a better father and husband. That is why I’m a psychiatrist.

The irony in my choice to become a pulmonary/critical care physician is not lost on me! I take care of patients who can’t talk to me and I contend with the family factor — and love every bit of it! My love for pulmonary and critical care caters to my complex personality while offering balance at the same time. Critical care was my first love. I enjoy the intensity of the medical ICU — it is extreme internal medicine, which is both mentally stimulating and emotionally rewarding. With each patient interaction, I am grateful for the opportunity to take care of patients and their families during their most vulnerable moments, to participate in a journey through the complexity of critical illness to the sigh of relief on the other side when it’s time for discharge. It is also humbling and an honor to share in the moments of the loss of a precious life, but also hear the family say thank you for taking care of their family member through your unrelenting care. Pulmonary medicine, as my second love, offers me balance for the fast-paced world of critical care. Practicing pulmonary medicine, I am able to establish long-term relationships with my patients as we maneuver together through their respiratory illnesses. The reward of the asthmatic whose symptoms have improved or the COPD patient who can now take an evening stroll with his wife constantly reminds me why I chose pulmonary medicine. Pulmonary/Critical Care medicine for me is not only what I have to offer my patients as their physician, but what they give me that makes me strive to be a better physician daily.

After my internal medicine rotation, I knew that I wanted to be an internist. Then I tried pediatrics and really loved it, so I thought that I would go into Med/Peds or family practice. After that came surgery, and I realized that I did not like adults that much after all!

I have been a pediatrician for almost 20 years, working in an academic community health center in Chicago’s Uptown neighborhood. I teach medical students during their outpatient pediatrics clerkship and pediatric residents in their continuity clinic. My patients come from all over the world, and more than 50 languages are spoken in the area. Most of the families I serve are on Medicaid. They work hard and are grateful for the care we provide. I learn from them every day.

I love that as a pediatrician I can treat illness, prevent injuries and promote healthy habits. I particularly enjoy the developmental aspects of my work. It is an amazing privilege to watch a child grow from birth through adolescence and to be a trusted part of the family. Most parents will do anything they can for their children, and when the pediatrician recommends something, they usually take it to heart.

My area of expertise is literacy promotion and encouraging parents to read with their babies, toddlers and preschoolers. Studies show that reading aloud is one of the most important things that parents can do to help their children succeed in school. Because I have multiple contacts with families, starting at birth, I have the opportunity to provide this advice way before parents are even thinking about sending their children to preschool. This is particularly important for families that live in poverty, whose children reach kindergarten significantly behind and are at higher risk of school failure when compared with their more affluent counterparts. There is nothing more satisfying to me than walking into an exam room, seeing a parent reading with their baby and knowing that I had a hand in helping make that happen. That, and seeing my patients grow up and then come back with their own children.

I was certain I was going to be a retina specialist ophthalmologist. I had done research and worked with a fantastic group of ophthalmologists since my senior year of high school. I purposely created my third-year schedule to do OB-GYN in January/February. At that time, the 80-hour work week had not been implemented and it was routine to move from pregnancy to diagnosis, to ED visit, to discovery of an ectopic, to failed medical management and eventual emergency surgery. I found it to be exhilarating! The field allowed me to think critically, recognize a problem, create a plan of management and then be able to take the patient to the operating room to fix the problem and make the patient’s life better. It was during my clerkship when I found myself wanting to read more about it every night. Once I finalized my career decision early in my fourth year of medical school, I never looked back. The diversity of practice is what keeps me on my toes: each day is different, each week is different, and each call is different. I am incredibly fortunate to care for patients throughout their lives and to contribute to the happiest day of their life, or to support them through some of the most difficult days.

I can distinctly remember reading about the blood-brain barrier in fifth grade (although I can’t remember understanding any of it). Later, after deciding to go to medical school following college, I wasn’t so sure about neurology as a field. Everyone I came into contact with kept saying the same thing: “You can’t treat anything, all you do is diagnose…”

By lucky happenstance, my assigned medical school advisor was Dr. Fred Myers. Dr. Myers was an old-school child neurologist. He took me to his newborn follow-up clinic, and I can still remember the first patient like it was yesterday: an infant a few months old with some mild hypoxic injury. Dr. Myers showed me the sustained clonus on exam and then explained the implications regarding white matter injury. I was sold. It was the classic neurology approach, the approach to medicine that I love: history, exam, localization along the neuro-axis, differential diagnosis. That sequence, handed down from neurologists in the 18th century is still the way we evaluate our patients today. The diagnostic studies, the MRIs, EEGs and genetic tests, are all secondary. It’s a thinking person’s game. We don’t run around yelling “stat” frequently, but it’s always interesting. The kids and their families multiply that. I love my field and my job.

However, after a great deal of agonizing over which field to choose, I ultimately realized that I found more joy in caring for children. I didn’t know much about the field of endocrinology but, on a whim, decided to do a pediatric endocrinology elective as a fourth-year student. I couldn’t believe the variety of interesting cases I saw, including conditions I had only read about in textbooks. On my very first night on call as a pediatrics resident, I admitted a critically ill infant with undiagnosed congenital adrenal hyperplasia. Throughout residency, I always found myself most interested in the endocrine cases. And for my senior research project, I studied precocious puberty in neurofibromatosis type 1 and I enjoyed that project so much that it really sealed the deal for me!

There is so much I love about pediatric endocrinology. I don’t like doing procedures; I prefer having the chance to think critically about clinical problems to try and piece together signs and symptoms to make a diagnosis. Elegant hormone feedback loops make sense. Since hormones are involved in multiple body systems, I get to interact with medical teams from many other pediatric disciplines, such as oncology, neurosurgery, ENT and cardiology. And even after 22 years of practice, each and every day is interesting. In clinic, I may see children for short stature, diabetes, early puberty, hypothyroidism, Turner syndrome, adrenal problems or hypopituitarism, all in one day.

Since I have the ability to replace missing hormones, I can really help kids participate fully in their lives. I generally follow my patients for many years, often from birth until the early college years, so I have the privilege of getting to know each and every one of them and their families well. It brings me such joy when a young lady wants to share pictures from her quinceañera with me or a little boy bakes me cookies because he knows we share a love of cooking.

Pediatric endocrinology also offers good work-life balance. I do not have to take calls from the hospital, and there aren’t many endocrine emergencies. Because most pediatric endocrinologists work in an academic setting, I have the opportunity to interact with, teach and learn from medical students, residents and fellows, and share with them my love of pediatric endocrinology.

I knew surgery was for me as a medical student the first time I was allowed to make a skin incision. The awe and reverence I felt at that moment stays with me every time I perform an operation. I am humbled by the trust and faith that patients put in me. I find the operating room to be a haven. The rest of the world must wait while I lead my team and focus on the patient and the task at hand. As much as I enjoy the operating room, the most rewarding aspect of surgery is the relationships that form with the patients. The surgeon must shepherd patients and their families through some of the most stressful and frightening moments. I sometimes help patients make difficult decisions. My reward is to see health restored or pain relieved. But first, I may inflict pain and sometimes the patient has a complication. These complications lead to hard self-reflection: What went wrong? What could I have done differently? Despite the challenges of surgery, at the end of each day I am grateful for the opportunity to be a surgeon. For me, there is no other profession that offers the intensity, the camaraderie among colleagues and the appreciation from patients.

He was dying in front of us on my medicine rotation and I (and I think all of us on his medical team) felt powerless to do much to help him. My other memory of him combines medicine and religion in an odd way — I was in Yom Kippur services and realized I needed to get back to the hospital to “finish my note.” A second patient was a woman I met on my surgery rotation who was admitted for the repair of a diaphragmatic hernia. Healthy all of her life, she was found on the operating room table to have several liters of ascites in her abdomen. This, I learned that day, was almost certainly metastatic ovarian cancer. I still remember our discomfort with the prospect of telling her the news that would change her life from a healthy person with a minor hernia to a "sick person" with metastatic cancer.

In each of those situations, I remember feeling like (or perhaps wishing that) there was so much more we could do to help these patients, even though we couldn't reverse their illnesses. And so, I was steered over that year and the following ones toward palliative medicine, even though it didn’t really exist as a field at that point. There were hospices and there were physicians I knew who did some hospital-based palliative medicine, but as a field with its own curricula, journals, boards, fellowships, etc., it was in its infancy. That also made it an exciting time to enter this field.

Although those two patients were catalysts, it’s been clear for many years that my attraction to palliative medicine goes deeper for me and fulfills my interests in communication, ethics and humanism, and how we can help patients and their families in the most creative of ways.

I started my career in primary care internal medicine and, to this day, see palliative medicine as an intensive version of primary care. By definition, the patients are more seriously ill and often have a shorter lifespan, but the values of primary care —seeing the patient as a person, communicating well and compassionately, and helping patients and families make hard decisions that are best for them — are all central to palliative medicine. I also remember struggling as a medical student deciding between internal medicine and psychiatry and found palliative medicine had aspects of both fields that I embraced. Interestingly, although most palliative medicine physicians are internists as their primary specialty, you can also become boarded in palliative medicine as a psychiatrist.

Finally, during my time as a student and resident, I realized that not only did the "topics" of palliative medicine (communication, ethics, spirituality and medicine, teamwork, symptom management) engage me, but so did the people whom I met in the field. This includes most prominently the patients and families from whom I continue to learn amazing things about strength and hope and sadness every day. But it also includes fellow physicians, nurses, social workers, students, residents, fellows, and others, whom I get to work with, learn from and laugh with.

More than 20 years after graduating from medical school, I continue to be fulfilled as a physician in this field by the patients and families I help care for and by the colleagues and trainees I learn from and teach. It can be tiring (not unique to palliative medicine) and it can be sad (also not unique to palliative medicine, but perhaps a little more concentrated in palliative medicine), but much more prominently it can be a source of joy, discovery and of hope to make things better.

Answering a life calling to help those in despair:

Trauma surgery is a fascinating specialty, as for most of the time we deal with otherwise healthy people who had the misfortune of being in harm’s way for no fault of their own, more likely than not. Traumatic injuries are the number one cause of death among 1-44 year-old individuals; this is the most productive age group for the community. This translates to a total of 3.7 million years of lost productive lives; this is more than double the loss attributable to all neoplastic diseases combined! Traumatology looks at trauma as a disease process. Like other disease processes, trauma has identifiable causes that can be eliminated, has gender and age predilection, seasonal patterns that help establish education programs, and also has defined natural history and patterns of progression that can be modified to improve individual patient outcomes and promote community well-being at the same time.

While real estate is all about location, location, location, traumatology is all about time, time, time. Time is an important variable for traumatic injury — time to transport, time to intervene and time to heal. The physiological response to traumatic injury evolves with time including hypothermia, acidosis and coagulopathy, or what is known as the triad of death. The ability to implement time sensitive, decision-making and surgical interventions to stop bleeding, prevent contamination and reverse irreversible shock is paramount. Patient healing and successful rehabilitation to allow integration back into the community is also a time sensitive process. Trauma surgeons train and thrive in the fact that they have to take life and death decisions in split seconds to help their patients, even if their patients are not able to contribute to the decision-making due to their condition. Unlike what many think, trauma surgeons do not have a lone-ranger mentality, in fact the reality is that trauma is a team sport, and trauma surgeons are one of many participants, also including nurses, EMS technicians, anesthesiologists, emergency medicine specialists, laboratory technicians, social workers and others.

Nourishing a healthy and fulfilling family life:

Contrary to widespread myth, trauma surgery is a family-oriented specialty; 40 percent of trauma surgeons are females and the percentage is rising. Sixty to 80 percent of trauma surgeons have families and live very fulfilling lives. Although trauma is a 24/7/365 affair and trauma groups are as well, individual surgeons are not. The way this works is that trauma surgeons practice mostly as a group practice. Trauma groups develop evidence-based algorithms for patient care and management processes, which decreases variability between individual members and allows transitions of care between individuals to be on or off clinical service. This arrangement means that you can be there for important family celebrations and functions similar to other specialties in medicine.

I hope this provides a more humane picture to our lives as trauma surgeons and evokes your curiosity to ask more questions and maybe even choose trauma as your calling!

However, I also knew I enjoyed doing things with my hands. I loved drawing, sculpting and sketching. Additionally, my mother had made me take sewing lessons since I was 10 years old, so designing and sewing clothing and dolls blankets were second nature to me.

I had to deal with death head-on in second year of medical school when my father had a stroke. The honest direct nature of the surgeons was much appreciated in a time of crisis and decision-making. It wasn’t a surprise, after I scrubbed for the first time, that the creative problem-solving nature of surgery drew me in. It is one of the few disciplines where one’s hands, in addition to the mind, have a direct impact on a patient’s outcome. Once I started surgical residency, I was drawn to the delicate yet complex nature of pediatric surgery. It is one of the few specialties where a surgeon is still a “general surgeon”…operating on the lungs, intestines, hernias, lumps and bumps, and congenital anomalies all in one day. It is also one of the few surgical specialties where a patient may be followed longitudinally and a physician may affect a patient for their entire life, an aspect that drew me to medicine in the first place. Most importantly, it is much easier to get out of bed in the middle of the night for a surgical emergency on a child who is truly a victim in the course of their disease process. To be successful in this field, empathy is necessary, not only for the patient, but also for their family members who are distraught with concern and overwhelmed by making decisions on behalf of another human being. Being a mother of two children and married for 15 years only makes me a better at being able to understand this.

Pediatric surgery is a long road—four years of medical school, five years of general surgery residency training, two years of research, and two years of fellowship in pediatric surgery at a minimum—but I truly believe this long road to be worth it. I love all the variety of surgeries I do, diversity of ages of children I see, and the many patients whose lives I am able to touch…and I am fortunate to be able to do this on a daily basis.

I chose neurology because I was (and still am) fascinated by the nervous system and all of its complexities and intricacies. In neurology, we often talk about “localizing the lesion,” which we do by taking a very thorough history and performing a detailed neurologic exam. This is different than many other specialties in medicine and is part of what attracted me to neurology. While there are increasingly more diagnostic tools available, there is something very satisfying about identifying a patient’s pathology by using the history and physical exam findings alone.

I also chose neurology because our understanding of neurologic diseases is constantly evolving, and it is exciting to be a part of a field that continues to develop new treatments that are improving our patients’ outcomes and quality of life in ways that were previously impossible. In addition to my neurology training, I subspecialized in sleep medicine. There is a lot of overlap between neurology and sleep, and many patients with neurologic conditions also have co-morbid sleep disturbances. Additionally, sleep is an area where people commonly struggle for one reason or another. While there aren’t really sleep emergencies, there is also no shortage of patients with concerns about their sleep. Many people assume that sleep physicians mostly interpret sleep studies and see patients with sleep apnea and snoring, but we also manage patients with a variety of other conditions, such as insomnia, parasomnias (sleep related behaviors), circadian rhythm disorders, restless legs and hypersomnia disorders like narcolepsy. I feel very fortunate that because I see both general neurology and sleep patients, no two days are ever really the same, which keeps things interesting for me.

I enjoyed the excitement that comes with delivering a new baby on OB/GYN, the problem-solving with patients in the emergency room, and the interesting presentations and pathophysiology of neurological diseases on my neurology rotation, but in each rotation I wasn’t sure I had found my "home."

Physical Medicine and Rehabilitation (PM&R or Physiatry) is a small, and in many areas of the country, relatively unknown field, but for me it was the place where my different interests and strengths coalesced into a field that was right for me. In many areas of medicine, the focus is on a "cure," but for some of my patients a 'cure' is not possible. I get to problem-solve with my patients and care team creative ways to get them back to doing what they love, or looking forward to things they may have thought were taken away from their futures. I also get to see a wide range of (what I find) interesting diagnoses which challenge me intellectually and allow me to continue to practice my diagnostic and examination skills. Finally, I get to serve a population of people who may not otherwise receive adequate care.

I often tell people that to practice medicine is more than job, but a way of life. Because of this, I knew I needed a specialty where I would be completely invested and personally fulfilled to make it all "worth it." I, like many other physicians, have days or patients that frustrate or upset me but those days are often followed closely by days where someone will tell me how much of a difference I made in their life and how much they appreciate that I was their physician. Those are the days that keep me working hard and keep me loving what I do.

As I began to think more about what I liked, I realized that many of my most memorable and educational experiences had originated in the ED, either as a consult or a new admission to my team. I was always intrigued by the team approach to patient care I had seen, as well as the breadth of patient complaints (from minor illness or injury to critically ill in need of resuscitation) and exposure to patients across the age spectrum. I decided I needed to explore this opportunity first hand and did my elective at the beginning of my fourth year.

By the end of my first shift I knew I had found my specialty; the pace of the work, immediacy of action required to effectively resuscitate critically ill patients, and the satisfaction of completing small tasks like suturing a laceration or providing relief of pain to a patient were all exciting and rewarding, and I had done all that in one shift. I have always enjoyed being part of a team and accomplishing goals in that manner and a well-functioning ED requires teamwork and goal-directed behaviors. Practicing emergency medicine requires frequent collaboration with colleagues from every specialty and that gives me the opportunity to learn every shift. Finally, being available to patients in their time of need and providing access to care for people 24/7/365 drew me to EM initially and is an aspect of my practice that provides great satisfaction.

While these are the patient characteristics that initially led me to choose pediatrics as a specialty, I have found there is so much more to the field. In pediatrics, I am not only caring for the individual patient, but for the whole family. As a pediatric hospitalist, I primarily work with patients who are admitted to the hospital, and I am often meeting these patients and families at a critical and stressful time in their lives. Regardless of a patient’s diagnosis – whether it is something very common and treatable compared to something chronic or life changing – these families are typically in crisis mode, as their day-to-day life has suddenly been upended by a hospitalization. Although I might only get to care for a patient and family for a brief period of time, the intimacy and intensity of our interactions means that I often get to know families on a deeper, more personal level that I ever thought I would. Developing quick rapport and the responsibility of having a family whole-heartedly trust you with the care of their child can be so humbling and also incredibly rewarding.

As much as I love patient care, one of my favorite parts of being a pediatrician is that there are so many different avenues and opportunities you can follow to find your passion. Is it advocating for those who cannot yet speak for themselves? Is it caring for the underserved and the disenfranchised? Is it pushing for health policy reform that will dramatically alter the lives of our future generation? Is it teaching the next generation of doctors about the nuances and intricacies of pediatric care? Is it researching innovative solutions for a pediatric condition? As the pediatric sub-internship clerkship director, I have a clear passion for medical education, but my career allows for me to explore other interests as well. I love how these moving parts can evolve along with my career.

If you have decided that urology is for you, congratulations, you can count your blessings.

Urology is a small, unassuming and extraordinarily rewarding field in medicine. “A chance to cut is a chance to cure.” As most of my surgical colleagues will often say, the immediate gratification of offering a patient a chance to fix their problem today is extremely rewarding. Urologists face problems that are usually clearly defined. For example, a patient that presents with blood in the urine or localized prostate cancer has a problem that can be pinpointed. We can find the problem, offer a meaningful and focused solution and the patient is able to feel the immediate effects of the intervention. Patients are very grateful for the care we deliver and hold their urologist in high regards.

Urologists are also able to take care of a wide variety of patients from children to the elderly. This includes taking care of congenital abnormalities and helping elderly patients improve the quality of their lives in their golden years. Since we follow our patients long term, we establish very close relationships with them over the course of their lives. We get to know our patients and their families and form tight bonds with our patients.

The scope of what urologists treat is vast. This includes many of the locations around the urinary tract which allows urologists to be comfortable navigating many different types of surgeries, including the lower and upper urinary tract, the peritoneal, and retroperitoneal contents. Urologists master many different techniques including complex endoscopy, robotic surgery, open surgery, and office-based procedures. While the scope of the treatment options is large, many urologists can focus on a specific defined area of urology in which they are interested. This includes infertility, oncology, stone disease, female urology, reconstruction, voiding dysfunction and andrology as well as other avenues based on what interests them. Urologists are at the cutting edge of technology and research. For example, urologists pioneered many laparoscopic and robotic approaches in surgery two decades ago which are just now being taught in many other surgical specialties. Urologists get to use a lot of “toys” in the operating room and have fun doing it.

Urologists can tailor their practice patterns according to their own interests. This includes tailoring a practice to a more office-based setting or being very heavily involved in the operating room. With this degree of flexibility, urologists tend to practice for a long time as they can transition over the years to a more office based practice if they choose. This transition allows for great flexibility in a career which can be tailored according to personal preferences or life situations.

A lifestyle of the urologist is excellent. Although many surgical lifestyles can be quite challenging, the rarity of urologic emergencies that require immediate intervention are few and far between. Most cases can be electively scheduled and this allows urologists to devote themselves to surgery and still get a good night sleep at home with friends and family.

The demand for urologists is booming. The baby boomers are turning 65 and this translates to a growing need for urologists to take care of them. There certainly will be no shortage of job security in the decades ahead.

Urologists are friendly, funny and happy with what they do. This satisfaction with their career choice soaks into their everyday life and translates to the high satisfaction of others that surround them.

If you have decided to become a urologist, congratulations! You have chosen wisely. You will have a long fulfilling career taking care of a wide variety of patients who are very grateful for the care you provide. What more can you ask for? If you have not chosen urology, there is still time to make the change!

Instead, I chose Med-Peds because I love being an internist and a pediatrician, separately and equally.

As a Med-Peds hospitalist, I spend one day explaining heart failure to a 75-year-old and her children, and the next day I comfort the parents of a wheezing infant and splint a broken hand. The variety keeps things fresh and exciting, and I am always reminded how incredible an opportunity it is to care for someone from birth through life. When families trust me to be a part of these significant events – the birth of a child or the death of a parent – I am pushed to be a better doctor and a more compassionate person.

Following the question “Why did you choose Med-Peds?” typically comes the question “How is it possible to do both?” As a medical student, I was fortunate to have met many Med-Peds physicians who were excellent role models in the areas of primary care, subspecialty and global health. It can be done! Nonetheless, to choose this specialty, one must be self-driven and flexible. It demands extra time studying to keep one’s skills sharp, so I recommend against choosing this specialty simply because you cannot decide between Medicine or Pediatrics – rather, choose Med-Peds because you can’t imagine yourself not practicing both.

Fast forward an hour to when I’m struggling to see anything with the ear microscope and am trying to figure out if Rhinne is pronounced “rin-na” or “rin-nay.”

So why did I go from this to a five-year ENT residency at Northwestern, followed by a year fellowship in thyroid and parathyroid surgery in Boston, before returning to Northwestern to join the faculty? The simple answer is because I love it. I love the challenge of mastering the minutiae of head and neck anatomy — of understanding the structure and how it relates to function, such as learning the paths of the cranial nerves as they traverse the head and neck and translate into sight, taste, smell, speech, hearing, facial strength and sensation. I love the process of investigation when normal function goes awry and then figuring out the best management.

Take the parathyroid gland, for example. Measuring in at 4-5 mm or so, it’s an afterthought at best in the minds of most physicians. But give me a miserable patient with kidney stones and osteoporosis with a calcium level of 12 in the setting of a PTH of 250, and things begin to change. For the surgeon, this means further investigation with imaging (some of which the surgeon can do right in the office) to elucidate the culprit parathyroid(s). Then it’s off to surgery, where a vast array of technology can be used to help craft a bloodless surgical excision through a small incision with perfect preservation of surrounding structures such as the nerve to the vocal cord. The beauty and artistry of this procedure lies in the details, allowing for surgical correction of a significant problem with minimal added morbidity.

In medical school, you spend quite a bit of time agonizing over the correct path. You wake up in a cold sweat to movie quotes echoing in your head: “You know the Greeks didn’t write obituaries. They only asked one question after a man died: ‘Did he have passion?’”(Serendipity) Maybe that was just me… Either way, I discovered my passion for head and neck surgery quietly over time, in the mix of anatomy and art, form and function, technology and skill.

While I enjoyed many of my rotations, I realized that I was happiest while on my pediatrics clerkship. I could see myself doing the work of a pediatrician, but also realized how much joy each ordinary, everyday encounter would bring. Despite the long hours and grueling work-load of residency, my decision to work with families and care for children was completely cemented by the contented and often happy exhaustion I’d feel leaving the hospital each day.

Many of the reasons I chose to become a physician stemmed from my experience working with underserved populations, so I was ecstatic when I was able to find a career that allowed me to combine this population with my love of pediatric care. As a pediatrician at a Federally-Qualified Health Center (Erie Family Health Center), I am able to form meaningful relationships with my patients and their families, often from the time of their birth. I am getting to see families grow as new siblings are born, help adolescents navigate difficult issues and peer pressure, and support patients dealing with devastating diagnoses or family crises. I have the privilege of caring for many immigrants and refugees, which has allowed me to learn even more about culturally sensitive care. As a general pediatrician, I am further able to combine these everyday experiences with a position that allows me to advocate for these patients and affect healthcare policy. While each of these reasons makes me love being a general pediatrician, I also love the flexibility that this career offers. I am currently able to care for patients while they are hospitalized at Lurie, care for children in our outpatient clinics, participate in health outcomes research, and teach residents and medical students. While I never imagined as a third-year medical student that my career would become this mix of clinical care, teaching and research, I could not imagine a more fulfilling career than the one I have now as a general pediatrician.

As an intern, I was assigned to the benign hematology consult service and, while watching me at the microscope, my senior resident remarked, “You’re going to be a hematologist, aren’t you?” She noticed what ultimately inspired me: a genuine excitement in what I was learning and in the cases I was seeing. That curiosity and interest propelled me through training and continues to this day. In benign hematology, I like that while much of the field is concrete and numbers-based, there are many situations that do not necessarily have a “right” answer. As a result, there is an “art” to diagnosis and management. Furthermore, hematologic conditions affect essentially all organ systems, which allows me to see patients across the entire spectrum of medicine — from general medicine, to surgery, to OB-GYN, from healthy patients in the outpatient clinic to critically ill patients in the ICU. I like the variety of seeing patients of all ages and diseases involving all organ systems. Finally, hematology involves a wide breadth of diseases, which keeps my practice interesting and challenging, and keeps me sharp and focused.

They are so honest and usually, very funny. I went to medical school thinking I would be a pediatrician. Every step of that journey proved to be the right path for me. It turned out, the diseases of childhood were very interesting to me. Throughout my pediatrics training, the more physiology I learned, the more I loved it. I had a difficult time deciding between pediatric cardiology and pediatric critical care. Ultimately, I decided to train in both and I am now a pediatric cardiac intensivist. My clinical world exists in the pediatric cardiac intensive care unit. I care for newly-born babies to adults with congenital heart disease as they recover from cardiac surgery, primarily, but also in any other context that necessitates care in an intensive care unit.

What I enjoy about my clinical career is the cardiac physiology and the connections made with patients and families. Congenital heart diseases can be quite complicated, but the basic rules of cardiac physiology can be applied to each to figure out a management plan. We work as a multidisciplinary team of cardiac intensivists, cardiac surgeons, electrophysiologists, cardiac imagers, cardiac interventionalists and heart failure/heart transplant specialists to work together to give these kids the best opportunity for a meaningful life. The connections made with patients and families are very powerful. I often tell new patients and parents that we become an adopted extended family that they never wanted, but that we are here, and we are in this fight together.

I asked if the position had been filled, and he responded, 'yes, you’re hired.'

I was fortunate to have gained exposure to the surgical specialties at the dinner table, through the stories of my dad, a general and vascular surgeon. But it was the dissection of a cat in Mrs. Smith's ninth grade anatomy class that piqued my interest in surgery. During my undergraduate studies in biomedical engineering, I particularly liked the neuroscience classes in which I had enrolled. And upon entering medical school, I was certain about pursuing a career in neurological surgery. But then the summer started...

While studying the inflammatory response to cardiopulmonary bypass, my research position afforded me the opportunity to observe complex cardiac surgery, and I was hooked. Despite – or because of – my limited knowledge of myocardial preservation, intricate cardiac anatomy, cardiovascular physiology, and patient comorbidities, I was awed by the initiation of cardiopulmonary bypass, the translocation of the pulmonary valve to the aortic position, the replacement of the aortic arch, and the coronary revascularization of a beating heart.

A couple years later, I chose to rotate on pediatric surgery during my surgical clerkship, having always enjoyed working with children. While at Lurie Children's, I had by chance wandered into "Room 1," the pediatric cardiac OR. Dr. Mavroudis asked, "Who are you?" after which I was instructed to "go scrub in." In the words of Michael Ruhlman, author of Walk on Water: Inside an Elite Pediatric Surgical Unit, the pediatric heart surgeon "had to have it all – the intellect and the skill, the grace and decisiveness, the sewing skill of the craniofacial plastic surgeon and the vascular surgeon, the millimetric precision of the neurosurgeon – and he had to be fast, too[...]There was no other surgery in which precision combined with speed mattered so much. Add to that the need for imagination, and the bar began to seem almost insurmountably high." This was exciting stuff!

As a fourth year medical student, I completed an elective in pediatric cardiovascular surgery. I was fascinated by the embryologic development of congenital heart lesions, the ingenious corrective operations devised to treat them, and the perioperative management of mixing physiology. And although the helicopter flight over Lake Michigan with the donor heart was fun, to this day, I am still transfixed every time I look into the chest and watch the transplanted heart start to beat. But then...I had five years to wait before returning to the cardiothoracic OR!

Throughout my general surgery residency, I kept an open mind about the other surgical specialties, and approached each rotation as if it was my chosen field. A number of faculty members even attempted to dissuade me from becoming a cardiothoracic surgeon, citing declining case volumes, decreasing reimbursement, and long work hours. However, while remembering the advice of Dr. Fullerton, "There will always be a need for a great cardiothoracic surgeon," I ambitiously pursued my dream.

Training in cardiothoracic surgery is a stressful and arduous process. It requires the endurance of a marathon runner, the manual dexterity a pianist, the sharp intellect of a scholar, the ingenuity of an engineer, and the selflessness of a new parent. There are 16-hour operations, unstable patients, sleepless nights, emergency surgeries, bedside vigils and board exams. And with that, there are missed dinners, reunions, camping trips, birthdays and first steps. The training takes time and patience, and can be frustrating. As Norman Shumway, the father of cardiac transplantation remarked, "The hardest thing about cardiac surgery is getting to perform the operation." It is also a rewarding time during which many accomplishments and lasting friendships are made.

With a lot of hard work and a little serendipity, I am blessed, as a pediatric cardiac surgeon, to wake up every morning excited to go to work. Receiving the annual family holiday card from the parents of a child who would have died of hypoplastic left heart syndrome 30 years ago outshines the many sacrifices.

Traditionally, the practice of TH requires a passage through an Internal Medicine residency (three years), then a GI/Hepatology fellowship (three years), and finally a secondary fellowship in TH (one year). Notably, with evolving national policies, this final year may in the future be fully integrated into the traditional fellowship.

Some sense for the intellectual allure of this specialty, beyond the intrinsic merits of deciphering and managing its myriad functions, can be gained by expounding upon its inter-disciplinary nature. In the setting of advanced liver disease, the TH specialist must pay attention to and collaboratively manage complications that arise in the heart (e.g., heart failure), lung (e.g., pulmonary hypertension), kidneys (e.g., electrolyte and volume disorders) and intestinal tract (e.g., bleeding). As the liver disease worsens and the patient requires evaluation and implementation of a LT, further specialties are also engaged, e.g., transplant surgery (anatomic issues), immunology (vaccinations, medications), and infectious disease (opportunistic infections). Less obvious, but no less essential, is the engagement with social workers, psychiatrists, dietitians and physical therapists to collaboratively capture the appropriateness of the patient for (and ensure their success through) surgery and the post-operative state (days, months, years).

Moreover, given the training towards TH, the specialist continues in the use of procedural techniques for both diagnosis and treatment of primary liver (e.g. liver biopsies) and inter-related GI disorders (endoscopies for both upper and lower GI tract problems). These procedures require their own set of unique skills and mechanical artistry.

The day-to-day practice of TH, given the nature of pre- and post-LT care, takes place at an academic medical center. Therein, clinical care, education and research are intertwined in combinations befitting the particular interests of the specialist. Personally, my focus is clinical care (clinic, in-patient primary service and consultation) and education (teaching medical students, residents and fellows in the classroom and/or wards). These efforts are undertaken in the daily atmosphere of inter-disciplinary rounds and conferences.

On a more personal note, I would strongly attest to the influence of charismatic mentors. Whether found intentionally or by accident, mentors can reveal and crystallize the specialization of interest to the eager and open-minded student. In my case, key individuals, through word and deed, took the time to share with me their vision of excellence in TH. They treated me not merely as a transient worker passing through a rotation, but as a junior colleague with expectations, guidance, correction and care consistently given – even to the present time – in cultivating my own vision. Their interest in my professional (and personal) well-being had a profound influence upon me: re-directing me, during my initial fellowship, from a career of GI and “some” Hepatology towards TH entirely.

On the whole, I would submit that our careers are the summation of many events, some planned with most efficient strategy, while others, meandering with real-time adjustments, and finally, through mechanisms unknown and/or uncontrollable at the time. My narration of these contributions is at times a romantic one, reflecting upon modest successes while minimizing failures, all the while quite sure that I have been helped by so many people and fortuitous events along the way. I count myself most fortunate to continue along this pathway: to experience, share and improve upon patient care and medical education in an intense and collaborative environment.

While I enjoy working with people, I found that at the end of the day I always wanted to know the final answer. I didn’t want to look at an irregular nodularity in the lung on a screen (like a radiologist) or a gross lesion in the colon (like a gastroenterologist who sees a mass while doing a colonoscopy). I wanted to know what the shadowy lucency or mass lesion was. Pathology was the best fit.

So that’s basically my job, giving the mysterious lumps and bumps that are found on imaging or palpated grossly a name. Let’s go back to the mass in the colon. My job, once the lesion is biopsied by the gastroenterologist or removed by the colorectal surgeon, is to figure out exactly what it is. Once the tissue arrives in the lab, it is processed and ultimately ends up on glass slides that I examine under the microscope. By looking at the morphologic features of the lesion and characteristics, like if it’s invading surrounding benign tissue or has spread to regional lymph nodes, I can come to a diagnosis and appropriately stage the tumor. Let’s say in this case, it’s colon cancer. The next step is to perform ancillary studies to determine prognosis and likelihood of response to certain chemotherapeutic agents via immunohistochemistry and/or molecular testing. Once that is all done, we can generate a complete report that not only identifies the mass as malignant but will give the oncologist an idea of the necessary next steps to take to best treat the patient. This is probably why they call us the doctor’s doctor and why I truly enjoy what I do. It’s patient care from behind the scenes, but we still are an important part of the patient care team.

There was a giant two-story walk-through model of the heart. The passage was narrow enough that you could only walk through one way. My sister and I would still try to walk backwards though. I felt pretty sure about cardiology after the first year of medical school. At that time I liked it because everything made sense to me. There was little to memorize, but lots to understand. The physiology appealed to my undergraduate background in engineering. As I have continued in my career, many other aspects of cardiology fascinate me. I like the diagnostic reasoning. Integrating the history, the physical, the ECG and imaging studies to formulate a plan never gets old. On the research side, I like the idea that my work on HDL metabolism and coronary disease applies to a broad swath of the population. And teaching cardiology is just a lot of fun. I learn so much from students and from revisiting the fundamentals each year.

However, one of the wonderful aspects of medical education is that you are forced to explore all aspects of medicine and sometimes what you might have considered the most unlikely career choice actually becomes your destination. I decided I liked surgery initially because I enjoyed the idea of developing a technical skill that, when combined with the physician’s knowledge base, could immediately affect a solution to a discrete clinical problem. I gravitated to thoracic surgery because I thought that the interplay between anatomy and physiology was incredibly interesting in both the lung and the esophagus. Thoracic surgery offered the opportunity to treat both benign and malignant conditions and to perform both big, open operations and minimally invasive and robotic surgery.

What do we actually do as thoracic surgeons? We treat diseases of the chest such as lung cancer (a big chunk of our routine practice), pneumothorax, complex chest infections, and chest trauma and tumors of the mediastinum. We treat esophageal cancer and also benign esophageal disease such as gastroesophageal reflux disease and achalasia. While the majority of our operations involve a resection of some sort, a significant portion of what we do in the operating room is functional reconstructive surgery. This requires a good understanding of the relationship between structure and function and provides an opportunity for creative problem solving. Many thoracic surgeons are also involved in lung transplantation, the ultimate intersection of a significant operative and medical management challenge. One of the unique aspects of thoracic surgery is that it retains a distinct diagnostic component. We are viewed as chest physicians, not just chest technicians. This means that a good portion of our time in the clinical setting is spent managing the early phases of the diagnostic evaluation for patients with conditions such as a pulmonary nodule. While many of these patients may need an operation, we also will follow a number of them over time. We are also primarily oncologists and work closely with medical oncologists, radiation oncologists, pulmonologists, gastroenterologists and radiologists in multidisciplinary teams. This opportunity to work with a diverse group of professional colleagues is one of the truly fun parts of this job.

There are two primary roads to a career in thoracic surgery. In the so-called traditional pathway, surgeons do a five-year general surgery residency and then match into a two-to three-year thoracic surgery fellowship program, where they are trained in both thoracic and cardiac surgery. Alternatively, surgeons can match directly into a six-year integrated thoracic surgery program directly from medical school, where their experience is tailored to early training in thoracic and cardiac surgery. Our board examinations cover both cardiac and thoracic surgery, so the training programs cover both areas. While most academic surgeons choose to practice either general thoracic surgery or cardiac surgery exclusively, some surgeons in the community maintain active practices in both specialties. The training is a bit long, but the quality of life of a thoracic surgeon is quite good. General thoracic surgery is largely elective, with few true operative emergencies that cannot be managed with placement of a chest tube and conversion to a planned procedure. This means you can gain some control over your schedule and life outside the hospital. The field is also well compensated compared to many other surgical disciplines, which allows you financial flexibility to pursue interests such as research without significant financial trade-offs.

I’ve found this career to be truly rewarding as every day is a little different and I have the opportunity to work with a great group of physicians and to develop longitudinal relationships with patients. If any of you are potentially interested and want to learn more about a career in thoracic surgery, I’m happy to talk.

To this day, I remember sitting in a human physiology course and being introduced to cardiac physiology. It seemed fairly simple, yet fascinating how this four-chambered structure that sat in the center of the mediastinum was responsible for supplying the oxygen necessary for the other organs to function. I had barely scratched the surface of the field of cardiology, but I was enamored by my understanding to date.

When I matriculated into medical school, the seemingly simple structure that relaxed and contracted became more complex — so much more complex that it was almost overwhelming, from the embryologic development of the cardiovascular system to the cellular components that lead to energy production and ultimately cardiac contraction. We were taught the targets of pharmacologic agents, and ultimately cardiac pathophysiology. Certainly this was daunting, and in some instances overwhelming. However, I knew it was sticking when I could identify fallacies portrayed on television medical shows. It is a process, and a tremendously rewarding one.

I subspecialize in advanced heart failure transplant cardiology because it is the one field in cardiology that applies all the cardiovascular foundation acquired during medical school. The field is constantly evolving. For instance, in the 1950s, heart failure was a certain death sentence. The first heart transplant was performed in 1967, and the 1980s led to the development of new classes of medications. In the early 2000s, we entered the next generation with left ventricular assist devices, and now we are understanding the role of genes in the manifestation of cardiomyopathies. I am part of a team that manages patients ranging from those with asymptomatic left ventricular dysfunction to those who are extremely sick in cardiogenic shock. There is no greater feeling than telling a patient who you have been caring for over several months that they are going to receive a heart transplant and a new lease on life. Simply stated, I chose cardiology because we fix broken hearts.

For me, I knew I wanted to take care of children. I’m not sure how I came to that decision, other than interacting with children was personally satisfying and being around them made me happy. I enjoyed having the child as a patient but also the parent as "co-patients," and I recognized from the beginning that you are often taking care of the family unit in pediatrics. I also knew instinctually that I wanted to take care of sick children, with a significant amount of time spent in the hospital setting. The part of pediatrics that I found most fulfilling was to be a member of the care team during those vulnerable times for families. I found that I thrived in acute settings, and I was good at distilling complex material into understandable concepts for families.

Surgical versus medical was a more difficult decision, but somehow I determined that a more medical approach to patient care better suited my personality. Therefore, my career choices at this point included a pediatric subspecialty such as PICU, NICU, hematology/oncology or cardiology. I wanted variety in my daily practice that included seeing patients in an inpatient setting, following them through their hospitalization to the outpatient setting and throughout their childhood. I also wanted to focus on a single organ specialty. Pediatric cardiology met all of these requirements. More importantly, I was hooked once I started learning about congenital heart disease and cardiac physiology. Cardiac physiology is fascinating to me in a structurally normal heart, let alone one that is missing a ventricle or valve, or has anomalous return of vessels.

After completing a three-year residency in pediatrics and a one-year chief year in pediatrics, I did a three-year pediatric cardiology fellowship. As the field has advanced, it has become more subspecialized, with many (especially in academic settings) choosing to subspecialize. I decided to take this route and specialize with an additional training year in imaging, specifically echocardiography and fetal echo. This allows me to read echocardiograms, perform complex studies, participate in surgical cases by performing transesophageal echocardiograms in the OR, and do fetal echocardiograms and counsel women during their pregnancy. In addition, I see patients on an outpatient basis. This makes my typical week varied, interesting and sometimes challenging. Being in an academic setting allows me to pursue outcomes-based research, imaging research, and think about policy and ethical issues in pediatric cardiology. Medical and surgical strides have led to significant improvement in morbidity and mortality, and there are now more adults living with congenital heart disease than children. The dynamic nature of pediatric cardiology keeps me motivated, excited and happy to come to work every day.

I paired this academic work with attending clinics and observing many endoscopies to better understand the patient population as well as the field of GI. After working with an inspiring mentor and seeing the impact of GI disorders on patients, I knew the field of gastroenterology would be a good fit for me and a field where I could make a difference in patients' lives.

As a gastroenterologist, I am privileged to not only see a patient in clinic and develop a differential and diagnostic plan, but also enact that plan by personally forming the diagnostic procedure, often an upper endoscopy or colonoscopy. To have this ability is so rewarding and a reason why I feel lucky to be a gastroenterologist. The field of GI also allows for variety to my day and week, which I enjoy. Gastroenterologists care for patients in both the outpatient and inpatient setting, perform procedures and see conditions of varied acuity – from reflux disease to brisk GI bleeds, all while working with medical students, residents and fellows. Additionally, as I'm sure you may guess from the subject matter, the field of GI often attracts people with a good sense of humor. Gastroenterology has allowed me to find the right balance of providing care to a diverse group of patients in a variety of settings, performing interventions, and remaining engaged in medical education and the development of trainees.

Without any significant past medical history, he had presented with a two-week history of rapid weight gain. A physical exam revealed massive edema and a bedside urine dipstick test confirmed he was spilling large amounts of protein into his urine. He was admitted to the nephrology inpatient ward and underwent a kidney biopsy. The biopsy showed focal segmental glomerulosclerosis (FSGS). Despite powerful immunosuppressive therapy, the proteinuria persisted, and he developed a number of life-threatening extra-renal complications of the nephrotic syndrome, including multiple pulmonary emboli. The decision was made to "medically ablate" both of his kidneys by injecting 100% ethanol into both renal arteries; this approach was needed to save his life but sentenced him to dialysis. One year later, he was re-admitted to the nephrology service to receive a living-related kidney transplant from his father. Minutes following the anastomosis of donor and recipient vessels, the new kidney began to leak large amounts of protein. The kidney graft failed, and he needed to reinitiate dialysis. In 1988 (the year I was an intern), we knew that podocytes, cells of the glomerular filtration barrier, are the target of injury in FSGS. We also suspected that our patient and others like him had a circulating factor in the bloodstream that had attacked his native kidneys and then the transplanted kidney from his father. However, at that time, we had no idea about the genes or molecules that are expressed by podocytes, which might be the target of the mysterious circulating factor. It was during this first clinical rotation as an intern that I decided to pursue nephrology. Without question, it was the patients and their individual stories that determined my path and who have continued to inspire me in the clinic and in the lab for almost 30 years. Within the past decade, more than 50 gene mutations have been identified that lead to glomerular disease (including FSGS) and other kidney diseases, which has allowed rapid development of targeted therapies and diagnostics. Together with advances in stem cell-based kidney organoids, bioengineered and "wearable" kidneys, nephrology is a subspecialty with tremendous opportunity for physicians and physician-scientists to make a major impact in the lives of patients. However, despite these incredible advances, the search for the mysterious circulating factor continues. Setting itself apart from many other medical specialties, nephrology provides a unique opportunity for physicians to take care of diverse and fascinating clinical disorders, develop long-term relationships with patients, acquire a deep understanding of physiology, and master procedure-based technical skills (including lines, vascular access, catheters and biopsies).

Most people are lulled into this false sense that it is our right to have these basic skills in life. That is why many of us take them for granted, and we often forget that at one point in our lives we all spend a considerable part of our time and energy learning to perfect these skills to the point that they become the routine and the mundane. Now imagine when the slate of your learned abilities, which you now consider a part of your identity, is wiped clean and you have to start over again. Where or whom do you turn to for help with this? The field of medicine that addresses this issue is physical medicine and rehabilitation (PM&R).

I will admit prior to medical school at Northwestern, I had never heard of a Physiatrist before and I didn’t know that PM&R as a field of medicine existed. I applied to medical school with a very specific idea of what I wanted to do with my life and the type of patients I wanted to treat. When I went on my clinical rotations as a third-year medical student, I realized that the specifics of what I wanted to do with my life did not quite fit the field of medicine that I had focused my sights on. I recognized in myself that I was truly interested in how people can return to their desired level of functional ability. Across all my clinical clerkships, I found myself coming back to this theme. We would improve the creatinine of a patient on the general medicine service who would be ready for discharge and I found myself wondering how this person was going to walk up the flight of stairs at home after a prolonged hospitalization. We would diagnose and optimize the medications of a patient with a recent stroke and I would wonder how this patient was eventually going to get back to their job or if that was even possible. We would see the patient with knee pain in ortho clinic who did not need surgery and I would wonder how this person was going to progress back to running. Functional recovery was at the heart of my curiosity and passion in medicine.

I consider myself lucky to have been a medical student at Northwestern for many reasons, but one of the greatest reasons is its academic affiliation with the Shirley Ryan AbilityLab, formerly the Rehabilitation Institute of Chicago (RIC). In the midst of this great realization that I was interested the most in the functional recovery of patients, I went to an open house at RIC for students interested in PM&R. This is where I found that there is a field of medicine that fulfills what I wanted my career path to take – I just didn’t know until that moment that it was called PM&R.

As you may already be aware, the field of PM&R is not the most well-known specialty. I have always thought that if there were just one character on Grey’s Anatomy who was a physiatrist, we would be recognized by a wider audience. Physiatry has an identity crisis because the field is broad and covers so many areas of medicine – it is often difficult for people within medicine to define it. PM&R addresses the functional recovery of patients with spinal cord injury, traumatic brain injury, stroke, cancer, degenerative neurological diseases, cardiac complications, amputees, low back pain, musculoskeletal pain, and chronic pain - just to name a few. Furthermore, PM&R does not “own” one body part. (i.e., the cardiologist “owns” the heart, the dermatologist “owns” the skin, the nephrologist “owns” the kidney.) If I had to describe what a physiatrist “owns” – I would say that we own “function.” Return to function can come in a lot of different forms. It can be a stroke survivor learning to put his socks back on, the teenage spinal cord injury survivor developing the fine motor skills to eat cereal again, the concert pianist trying to get their 4th digit to strike the keys better after a fracture, or the collegiate basketball player with patellar tendinopathy trying to improve their vertical in time for the NBA draft.

I chose to sub-specialize within PM&R and completed a one-year Sports Medicine fellowship after my residency was completed. There are many sub-specialties within PM&R such as: Brain Injury Medicine, Hospice and Palliative Medicine, Neuromuscular Medicine, Pain Medicine, Pediatric Rehabilitation Medicine, Spinal Cord Injury Medicine and Sports Medicine. As a former athlete myself, I had always been interested in evaluating biomechanics of musculoskeletal movement to address injuries and potentially prevent recurrence of injuries. Since I finished my training, I have thoroughly enjoyed my job as a Sports Medicine physiatrist – even though many of my patients still view me as a non-operative orthopaedic doctor and don’t necessarily know the term “physiatrist.” When I chose to be a physiatrist, I knew I was taking the road less traveled to become a Sports Medicine physician. For the last two years I have been the team physician for the U.S. Women’s National Soccer team, which has taken me to an international stage that I never anticipated I would reach in my career. This summer as I stood in a sold-out soccer stadium in Lyon, France, next to the most elite female athletes in the world, hoisting the World Cup trophy above their heads, I reflected upon how grateful I am that this road less traveled through PM&R lead me to be a part of that moment in sports history. I have had the opportunity to work for the NFL to evaluate retiring players; participate as a medical aid station captain at the Chicago marathon; cover the Big Ten Basketball tournament; provide medical care to the performing artists at Ravinia (ranging from Lady Gaga to Itzhak Perlman); serve as the medical director of the Joffrey Ballet; and represent our country as the team physician for the Men’s Paralympic Soccer Team at the 2016 Rio Paralympics. I enjoy having the opportunity to take care of people at all levels of functional ability to work on their goals and become a little bit better at what they do. It is a supremely fulfilling job.

I oftentimes think that if I had not gone to medical school at Northwestern, I would have never found PM&R and would likely be in a job that I didn’t truly love. I am one of those fortunate people who loves going to work every day and strongly feels that I am making a difference in people’s lives. Life doesn’t owe us happiness at our jobs. It is up to you to know yourself and be open to unfamiliar territory. If I didn’t take the opportunity to go to the open house for the Department of PM&R 15 years ago, I’m not sure if I would have ever learned the lesson that “Life doesn’t owe us anything.”

Quite honestly, I anticipated my career in medicine during medical school markedly different from what it has become. The new reality is a result of keeping an open mind during medical school, seizing opportunities as they came along and having some amazing mentors throughout the process.

During the first half of medical school I had a pretty good idea of what I would do for the rest of my life. However, I found that there were too many aspects of all of the different courses and clerkships that I really enjoyed. In particular, I was most intrigued and engaged with the initial management and stabilization of all types of patients. During my fourth year required clerkship in emergency medicine, my future potential specialty was solidified. I really appreciated the opportunity to care for any type of patient with any type of illness at any time of the day or year. I was drawn to the integration of procedures and complex medical decision making. I embraced the challenge of never knowing what types of patients I might care for during any given shift as well as becoming a physician that could provide the immediate resuscitative steps to safe a patient's life.

In addition to the clinical aspect of my career, throughout medical school and through residency I was always interested in medical education. Starting with review panels, joining the curriculum committee, and eventually teaching in a variety of courses during the fourth year, I knew that teaching was something that I wanted to ensure would become a central part of my career. As residency continued, this desire to teach garnered traction and expanded to include ideas of how we might be able to do a better job of teaching. I became intrigued by the concept of simulation-based medical education as it was an instructional methodology that fit with my learning styles — hands on, practical and engaging.

After residency, I decided to pursue additional classwork to obtain a Master’s Degree in Education to provide the foundational framework necessary to understand how to effectively take steps to innovate curricula. Since completing residency, I have been lucky enough to collaborate with some great people to rethink and redesign the way that educational content is delivered to be much more active and engaging. Both sides of my career end up making the other even more rewarding. The clinical side provides the real-life experiences to make the educational content more realistic and the education side encourages me to think through potential challenges and opportunities in patient management so when similar patients present in the real world I have prepared for and thought about how to provide excellent care. Together the two will hopefully provide the foundation for a satisfying and life-long career in medicine.

Ultimately, I decided to try general surgery. It was through surgery that I got my first real exposure to IR. As an intern, many of my tasks were to review patients within the IR department. As the year progressed, I noticed a recurring theme: Nearly every surgical specialty I rotated on utilized the IR department. The more I saw IR, the more I found myself lingering a little longer in the IR department, just to see what else they were doing. Before long I was hooked. Even before the year was up, I had applied to a radiology residency and never looked back. (Ok, I did need to spend one more year in surgery before I started, but that’s neither here nor there!)

Now, diagnostic radiology was a completely different experience from surgery. The people, personalities, and overall culture were almost the exact opposite of what I had experienced the prior two years. However, what radiology seemed to lack in day-to-day activity, it more than made up for in intellectual stimulation. You have to know so much about the human body and disease processes, literally from head to toe. But as interesting as the diagnostic element of this field was, my primary goal was to become an interventional radiologist. On the very first day, I found my way to the IR department and introduced myself to the staff there and let them know I was extremely interested in IR.

Subsequently, I found myself spending all my free time during the day, as well as after my diagnostic work was done, in the IR suites, watching and participating in cases in any way I could. As I said, I never looked back. If I did, I would see that I was lucky to find an exciting field like IR and thank the stars that I found my way here. We work at one of the best IR departments in the country and not a day goes by where I don’t think, “They actually pay me to do this?!”

For students today, a lot has changed. The training pathway for IR is changing from a fellowship following a diagnostic radiology residency to a dedicated residency direct from medical school. The integrated residency training starts with an intern year, followed by three years of diagnostic radiology followed by two years of IR. Although the training starts in radiology, there will be much more attention paid to the clinical aspects of the field in addition to the technical aspects. Medical students can sign up for elective rotations in IR during their clinical years and there are IR interest groups that welcome medical students at all levels of education. It was a happy accident that I found IR the way that I did, but now the increased awareness students have to IR will ensure that you don’t need chance to find your way to this exciting field.

They remind me always to be kind, sometimes to be silly and to see things from their perspective. Their parents remind me to be humble, especially since becoming a parent myself.

I always knew I would practice pediatric medicine, though I changed my mind a few times about what aspect. I found the fast-paced environment of the pediatric ED was a natural fit for me. I am drawn to the variety of disease pathology, illness acuity and diverse patient population in the ED. You never know what is going to come through the door, and our job is to see and treat everything and anything that does. There is never a dull moment. I love that on a single shift, I get to counsel a parent who is concerned about their infant’s fever, remove a bead from a child’s nose, resuscitate a teen with respiratory failure and get the first crack at making a diagnosis for an ill patient. Most of us in the ED thrive in this “controlled chaos” and have a knack for multitasking. We perform technical procedures, such as lumbar punctures, suturing and splinting. Many kids come to us with injuries we can fix, and leave us with smiles on their faces and popsicles in hand. At other times, we need to have difficult conversations about a newly found brain tumor or a new diagnosis of diabetes. Luckily, we do all of this as a team. I am surrounded by outstanding colleagues: nurses, residents, paramedics and other staff. And the ER is a place rich with hands-on educational opportunities. From educating parents, to supervising trainees, to learning from consultants, I get to teach and learn every day.

When people ask what my schedule is like, my usual response is “it is different every week.” Working in the ER means working shifts on evenings, overnights and weekends. Working late hours can be hard (being a night owl helps), but it leaves me time during the day to accomplish other tasks. One day I may be going to meetings, teaching medical students, working on the curriculum or research projects, and other days I take my kids to school, go for a long run or run errands. I enjoy the variety and flexibility of the schedule, and the opportunity it gives me to pursue my passion for teaching and make time for my personal life. While I am always searching for that perfect “balance,” the challenging career I have in pediatric emergency medicine and medical education comes pretty close.

The weight of the decision appeared to increase each day. It was as if this choice would somehow define not only my career but my personality as well. Friends, family, faculty and advisors all tended to start each conversation with the same question: “Have you decided on a specialty yet?” I loved what I was doing on each rotation and deciding to narrow my career choice into one specific specialty seemed daunting. Perhaps I was indecisive, overwhelmed, naive. Most likely, I was a bit of all three. One day, I had a great conversion with an upper level resident. We discussed how I enjoyed the problem-solving skills of medicine, the joy of pediatrics and the intensity of surgery. Then, he rather nonchalantly said, “This is easy — you need to be an otolaryngologist!”

I guess, at first, I was a bit relieved that this decision about my career was apparently so easy. However, my anxiety quickly returned when I realized that I had no idea what an otolaryngologist was. I spent time meeting with ENT residents, fellows and faculty and quickly set up elective rotations in Otolaryngology - Head and Neck Surgery. I enjoyed the opportunity to be part of a care team that helped people of all ages deal with a variety of medical problems. Some of the patients suffered from very morbid and complicated problems that involved coordinated medical and surgical multi-specialty care. However, many patients had relatively common medical issues that could be treated in the outpatient setting.

It is very rewarding to positively impact a person’s life. The variety of the of pathology seen by an otolaryngologist provides physical and mental challenges each and every day. I loved the surgical aspect of the field as well. There are complex surgical procedures and relatively straightforward rapid-fire procedures. As an otolaryngologist you often find yourself operating under a microscope, operating through an endoscope and operating on soft tissue all in the same day. Now, 18 years after starting my residency training in Otolaryngology, I still love what I do. I am challenged every day. I continuously learn new things. I work with wonderful happy people every day and I consider it a privilege to provide care for the patients who seek my help.

I have watched the people of my tribe in Somalia treat musculoskeletal injuries with limited experience, knowledge and resources. They have worked with refugees and displaced people who arrived on the shores of Kenya. Unable to ever forget these early experiences, I returned to Kenya during the summer prior to entering medical school. I returned as a translator, traveling with general and orthopedic surgeons, and I personally witnessed the impact and importance of reconstructive surgery as a treatment modality. The treatment for these injuries drastically improved the livelihood of our patients since their jobs, as field laborers, depended upon their physical capabilities. Observing trained orthopedic surgeons from all over the world as they treated old and recent musculoskeletal injuries was inspiring. Even more inspiring to me was the time these surgeons spent teaching the local physicians and surgeons to properly manage these injuries.

The field of joint replacement surgery is continually refined through ongoing scientific pursuit. Advancements in implant design, surgical technique and postoperative protocols is what initially drew me towards arthroplasty surgery. Orthopaedic surgery truly encompasses all aspects of medicine and serves ALL people and is one of the few specialties where our implant design and surgical techniques are continuously changing. More importantly, I have personally seen the functional impact hip and knee reconstruction and replacement has provided to both young and elderly patients.

Read about Linda Suleiman's recent study on the representation of women in orthopaedic surgery here.

You should choose a specialty based on how much you like the people you work with.” The physicians who chose pediatrics seemed to be compassionate, endearing and, above all, patient! Psychiatry was fascinating and also appeared to involve a high degree of patience. Obstetrics would allow one to care for happy and healthy patients during an amazing transition in their lives. Surgery would provide the opportunity to save lives and potentially fix what’s broken. Internal medicine and family medicine are the backbone of our profession as a whole. There you can create enduring, dependable relationships with appreciative patients and endless opportunities for patient education.

Luckily, I stumbled into anesthesia towards the end of my third year. I soon discovered it was perfect for my personality. I appreciate how this specialty kindles immediate rapport with a stranger who may be completely terrified and vulnerable and the opportunity to use knowledge of physiology and pharmacology to choose the perfect recipe among thousands in my repertoire to safely navigate the medical comorbidities and surgical waters for any individual patient. It’s also the only medical specialty that allows you to personally administer medications that yield near immediate physiologic responses. I also like getting to use my hands to accomplish a wide array of procedural tasks, so that I have minimal reliance on other hospital staff in order to care for patients; assisting with a medical emergency in a public forum; and the flexibility to be mobile and leave one city to lay roots in another, relatively seamlessly. I don’t have a practice to maintain. I don’t have to manage chronic conditions. I don’t have to plead with my patients to adhere to various recommendations to improve their long-term health. And for the most part, each day I am able to leave my work at the hospital and balance a rewarding career with a nice lifestyle. In this profession, I’m very fortunate that I have the opportunity to make a significant difference in patients’ lives every day.

I tell my patients that I will take excellent care of them throughout this supremely vulnerable time. I view myself as the ultimate patient advocate, a gatekeeper of sorts, protecting my patient from all aspects of harm while under my care. Although some days can be very stressful, seem endless and detrimentally affect my own health from time to time, I’m proud to have a highly skilled job in which I spend every moment keeping patients alive and well during their surgical experience.

The only thing I remembered about a lumbar puncture was that if you do it wrong, you can paralyze the patient. I declined. I was in Kenya at Moi University in the western part of this East African nation the summer between my first and second year of medical school back when we had a true “summer break.” Most of my classmates had started medical school straight out of undergrad. I had come from nine years in litigation consulting and the last few years fulfilling my premed requirements. I was 30 years old upon entering medical school and thought I finally knew what I wanted to do with my life — to become a pediatrician. After that early experience the first day in the hospital in Eldoret, Kenya, and several weeks on every ward in the hospital, I realized how desperately I wanted to communicate directly with my patients.

Heading back into my second year of medical school, I was going to be an OB-GYN. I spent the next year shadowing a gynecologist in her office every week. Her partner had just “retired” due to her frustration with the changes in the insurance providers in the late 1990s. I realized I would be 40 years old being called into the hospital at all hours of the day and night to deliver babies. I was hoping to also have a life and maybe family outside of the hospital. After that year, OB-GYN was out too.

Surgery and medicine were now the residencies I was deciding between, as I had ruled out a few other specialties for various reasons. I loved surgery, but again looked at the residents and attendings and in the long run decided the lifestyle was not for me.

Internal medicine had fascinated me with the diversity of the patient population and the ability to provide continuity of care for my patients. After starting my residency in internal medicine, I met some of the most amazing role models, which solidified my decision to practice general internal medicine. I truly enjoyed each subspecialty and decided that a career in internal medicine would allow me the diversity to practice all areas of medicine while fulfilling my desire to provide continuity of care.

I believe I am one of the luckiest people in the world because I love my career and feel honored to be able to care for people and attempt to make a positive difference in their lives. I also love educating my patients so they can better care for themselves and their families.

I tried to keep an open mind during my experience, giving every field a fair shot. During that time, an unlikely family member ended up influencing my decision.

My grandfather was a proud man who never asked for help from anyone. At age 16, he joined the Navy and was deployed to the Pacific during World War II. He was always someone with incredible stories and someone I admired and respected. However, when I was in high school, he was diagnosed with Parkinson’s disease. While nothing seemed to change during the early years of the illness, he began to find it increasingly difficult to get around. In spite of this, he remained adamant about doing things himself. During my second year of medical school, he could no longer function at home and stopped responding to the medications. When he became bound to a wheelchair and unable to care for himself, my grandmother was forced to put him into a nursing home at the local VA medical center. I continued to visit him and witnessed how a once strong man, who never asked for help, had become dependent on his family and nursing staff to care for his every need. As time passed, more friends and staff began to dismiss him as another needy old man on his way out of this life. Everyone gave up on him at a time when he needed us the most. It was then that I realized why I needed to be a neurologist.

Many neurological diseases do not yet have a cure, and they are diseases that drastically change individuals’ lives forever. These patients need a physician who will be there to care for them, regardless of the prognosis. The field of neurology is a continual learning environment capable of substantial improvements in both therapies and outcomes. It is also intensely and inherently longitudinal: both in relationships fostered with patients, but also with advances and changes in both treatment and prognosis of neurologic diseases. With these factors in mind, at this point in my career, I cannot imagine choosing any other field.

Family medicine doctors pride themselves in providing great continuity of care, to not just one patient, but the entire family. By treating the entire family, I now have the privilege of not only learning about a patient's illness and symptoms, but about their life, their joys and their stressors. In knowing each patient's story, I am able to direct and tailor care to their individual needs.

The variety within the specialty was another key reason I chose family medicine. During my third-year rotations, I enjoyed aspects of many specialties, but choosing just one felt confining. It was not until I discovered family medicine that I realized I could continue to see a wide variety of patients and thus, diagnoses. The breadth of knowledge within the specialty makes family medicine intellectually challenging and keeps you on your toes each day. I love that, for the most part, I am my patients' first point of contact when they have a health concern. This can range from nervous first time parents, to a smoker with a chronic cough, to a marathon runner with knee pain. Family medicine physicians are also trained in a multitude of office procedures, including IUD placement and joint injections. This ensures that as family physicians we can treat our patients to the fullest extent possible.

The community of family medicine physicians is vibrant and diverse. I would encourage any student interested in a career in family medicine to complete the primary care rotation with a family medicine physician.

Throughout the first year, I connected with and learned from most of the children I encountered but found that children with diseases that involved multiple organ systems and required a thoughtful systematic approach were the most interesting to me. I found myself checking up on those children after I left the hospital for the day or when I changed services. The PICU was a place where I didn’t have to leave any of those patients —I could still care for the former NICU babies and the children with cancer and short gut. It is really general pediatrics at a more intensive level.

Additionally, critical care is a team effort, which I really appreciate. In order to care for these complex children, I rely on the expertise of others — organ-specific specialists, nutritionists, pharmacists, nurses, respiratory therapists and more. It’s incredibly rewarding to work with a team of people all focused on achieving the best outcome for a child. While we don’t always win, it’s great to come to work in a place filled with that motivation. And children remain resilient and engaging, and good outcomes for them make it all worth it. So really, I chose pediatric critical care because I couldn’t choose one organ system or patient population and because I wanted to work with a team of people consistently trying to better the care we provide to children.

I had entered college as an art major intending to become a medical illustrator, and poor microscope skills aside, I ended up really enjoying my science courses. I redirected my course from art to biology and medicine. In my medical school histology course, with a much higher quality microscope, I truly saw cells for the first time, and it was beautiful. When I was studying, I always saved histology and pathology for last because those were the topics I enjoyed the most.

I entered my third year of medical school interested in pathology but still leaning towards pediatrics or family medicine. My first clinical rotation was surgery, and a 16-year-old boy presented with constipation. Imaging revealed the constipation was secondary to a large mass, and during one of the first surgeries I had ever scrubbed into, we realized it was a widely spread tumor. The endless waiting of the family for the pathology results was so hard. It was over a week before they received the final diagnosis of an undifferentiated small round cell tumor. I felt the helplessness of not knowing the diagnosis, and all I wanted was to be on the other side of the process, to be part of the team trying to find the answer. That was when I knew with certainty that I wanted to be a pathologist. After I took some time to get a PhD in immunology and returned to clerkships, my first pathology rotation was four weeks on hematopathology due to scheduling reasons. My immunology experience gave me a solid understanding of all the CD markers and lymphocyte biology, and hematopathology was a perfect fit.

If I am honest, my career choices have been predominantly based on following the path of what I enjoy the most. Happily, this has now led me to teaching, which I have discovered is my greatest passion of all.

In college, I had the opportunity to focus on women’s health and feminist studies, human rights issues and anthropology/sociology. I worked on breast and ovarian cancer lab research, studied young women’s sexuality for my college thesis and had summer experiences as an abortion counselor/advocate. In the year between college and medical school, I worked full time as an abortion counselor and Planned Parenthood clinic assistant, while taking nighttime public health classes on global women’s health. All this to say I came to Northwestern thinking OB-GYN was “meant to be”! As a first- and second-year student, I found myself attracted to the idea of taking care of the sickest patients, and loved complex pathophysiology. My husband jokes that I loved the lungs and kidneys so much that he thought I would defect to pulmonary or nephrology! I worried early on whether there would be a way to combine those internal medicine interests with my surgical and women’s health interests, but that worry was quickly allayed when I became a senior student. On the wards, I loved every clerkship, but it was something different about each that captured me — and by the end of my third year, I saw the common thread. On neurology stroke service, I have memories of being given feedback that I should focus more on stroke care and less on talking to patients about the complex contraceptive needs of the reproductive-aged women we saw. On urology, I loved the pelvic anatomy, and on surgical oncology, I cared for several pregnant or reproductive-age women with cancer. On pediatrics, I enjoyed learning about social determinants of health — including how maternal health affected pediatric well-being — and I really loved adolescent health. On infectious diseases, I got to be a part of the perinatal HIV clinic, and on psychiatry, I enjoyed taking care of women with perinatal mental health disorders more than the non-reproductive age patients. Every rotation served to confirm that OB-GYN was where I was meant to be. Alongside the clerkships, advocacy and social justice were a major reason for choosing OB-GYN. For my MPH field experience, I spent a summer in Vietnam evaluating the country’s comprehensive abortion safety program via a major international NGO. I did my MPH thesis on postpartum contraception needs of underserved Chicago women. And I helped with student organizations that focused on women’s health. Through all of this, I learned that this was a field where I felt I could make a real difference in the world. I could put my MPH skills to work, both as an advocate and as a researcher. I could also develop a set of core skills that could save women’s lives — contraception provision, abortion provision and safe obstetric care. I believed (and still do) that while OB-GYN is an opportunity to provide compassionate healthcare to individual women, it also opens the door to a unique perspective on the world and a chance to “do good” for communities. While I love individual patient care, I also see medicine as an avenue for social justice and, to me, focusing on women’s health was my way of carrying out that focus. Last but not least, in terms of reconciling my internal medicine interests with my surgical interests — that turned out to be an obvious answer once I discovered the subspecialty of maternal-fetal medicine! Now, every day I get to think about complex perinatal physiology and pathophysiology, and I’ve learned how to take care of sick patients while also getting to use my surgical, research and advocacy skills. I can’t think of a better way to combine those interests.

1) Maintain order: Admiral William H. McCraven said in his inspiring Commencement Address to the University of Texas, Austin, “If you want to change the world, start off by making your bed.” In obstetrics, I have little control of how a scenario will unfold or the amount of chaos that will bombard the day. But if I can start my morning with order, routine and a sense of discipline, the rest feels manageable.

2) Never fall asleep with medicine: I put something in my head before I fall asleep that is not related to my job. Whether it is a poem, a book or a magazine article, even if I am too exhausted to get beyond the first line, my life is a little less consumed by my job if I can sneak something outside of it into my brain.

3) Allow yourself to grieve: Obstetrics is filled with tremendous joy. But, as joyful as it can be, it is also devastating. For me, compartmentalizing the pain is possible and sometimes necessary but not sustaining. Sadness stems from loss. I believe the women I care for during the most intimate moments in their lives deserve to have someone share their loss, witness their pain and be present in the midst of that pain. Pushing away my own emotions distances myself from those patients and sacrifices the meaning I find in my job.

4) Make friends with your colleagues: I took a position at Northwestern because it was a phenomenal opportunity. But, in truth, there are many academic programs in the country that could offer a fulfilling and inspiring career path. What brought me to my current job is the people. My division is my family. We take care of each other, we spend time together, we celebrate together, we mourn together, we hug and we laugh.

5) Move: I love to run, practice yoga and spend time outside with my kids. These activities require my entire body to participate in an activity separate from my job. They also require play. Who doesn’t find wellness in play?

6) Love what you do: In the end, I went through years of school and years of training to practice obstetrics. If I could not do that –– if I could not work –– those years would be an incredible loss. I spent hours in a library. I spent long days in a hospital. I spent holidays away from my family. I spent nights in call rooms. I experienced grueling exhaustion. I experienced fear of failure, and failure humbled me. After enduring all of that, I see it as a privilege to practice medicine. It was my dream to be a doctor, and now I get to live that dream. What a unique and coveted gift.