(This was originally a post I made on Facebook on November 30th, 2015.  I’m adding it to the blog to help preserve it, and to make it more available for those who are not FB friends…)

Carina all dressed up for her first residency interview

Carina all dressed up for her first residency interview

Every now and then, life (or God, or Fate, which ever you chose to believe) has a way of throwing you a curve ball.  Recently, in our family’s journey of Carina becoming an M.D., we had one of these curve balls thrown our way, and it has significantly altered our future path.

Those of you who know Carina personally may recall that it has always been her goal to help people who are fighting cancer.  In fact, this desire has been the most singular driving force behind her decision to go into medicine and become a physician, and is rooted in the experiences of her younger sister Amy, who died of cancer when they were both children.

At the end of November, 2015, Carina finished medical school. Phew!  What an accomplishment!  It’s been a long, adventurous, challenging four years!  Andi, Tanner, Piper and I are all proud of her!  After medical school comes residency, a three to four year training program that all physicians must complete in their chosen area of expertise.

Finding a residency, however, is not an easy process.  It used to be that there were more residency spots than med school graduates who wanted them.  But that isn’t the case anymore.  There are now more young, budding M.D.’s who are looking for a residency then there are positions to accept them all. As a result, it’s not uncommon for graduates to apply to a LOT of residency programs all over the country in multiple areas of expertise.  Some of Carina’s preceding class mates applied to more than 100 residency positions.

After submitting all the applications, you hope to receive invitations for interviews from the hospitals who wish to consider you for their residency program.  It’s not uncommon to only receive interview invitations from a small handful of the programs to which you apply.

After all the interviews are completed, each applicant then ranks all the places they interviewed.  Their top choice is number one, second choice is number two, etc.  Likewise, all of the program directors rank all the candidates who they interviewed in a similar fashion. Then, in March of each year, there is a giant process called “The Match”, in which a computer simply runs down the ranked lists of the programs and the candidates, and matches them all up.  And of course, because there are always more applicants than positions, not everyone gets a match.

So, back to Carina.

A few months ago, she submitted applications to various programs around the country, but focusing on Michigan, where the kids are entrenched in school and sports and new friends and don’t want to leave. Her plan was to seek a residency in Internal Medicine (IM).  This is an intense, 80-hour per week, three year program, which she would then follow up with a two year fellowship in Oncology.  At that point, the plan was, she would be a practicing Oncologist and be able to fulfill her goal and dream of treating people with cancer.

As a back-up plan, she also applied to a few Family Practice residency programs on the off-chance she didn’t match in any of the IM programs.   As per the norm, not all of the programs to which she applied invited her to interview.  But enough did that we were not worried.  And a few weeks ago, she began the interviewing process.

Now… finally… we get to the part where life threw us a curve ball.

Not long ago, shortly after completing an interview at one of the Family Practice programs to which she had applied as a backup, she received a phone call from the program director.  He told her that they had never been so impressed with a candidate, and that the reviews which came back from all the attending and residents who interviewed her were absolutely glowing.  They had recently had a first year resident drop out of their program for health reasons, and they needed to fill that spot as soon as possible.  They wanted to know if she would be willing to take this open spot, and if she could start January 1st.

In essence, they were offering her an opportunity to completely by-pass the entire Match process next March, to start her residency six months early, and by doing so, also finish it six months early at the other end.  The program making the offer was Beaumont, a world-class and highly respected medical system.  And while this was an incredibly honorable and fantastic offer, there was only one problem:

It wasn’t Internal Medicine.

Decision time.

We held a family council.  We talked.  We made lists of pro’s and con’s.  Carina called and talked to people in the medical profession who she knew and trusted, and asked for their advice.  We asked ourselves some tough questions.  Carina asked herself some tough questions.  And foremost on her mind was this:  I am a MOTHER first, and a DOCTOR second.  While treating people with cancer is a fine goal, it would come at the expense of being out of the home and away from children for huge amounts of time for the next five years.  And even then, the life of an oncologist isn’t always easy.  Lots of on-call, weekend, evening, and holiday hours.  But yet, this was her GOAL and her DREAM!  Helping people with cancer was THE desire that drove her through med school and kept her going when things got hard!  (Not to mention that Family Med would represent a significant cut in pay.)

My dad used to teach a class at BYU called “Decision Making”.  I know.  Seems like an odd topic on which to teach an entire class.  That is, right up until you are faced with a decision like the one that was now before us.  Suddenly, we felt like we could really use a full semester class on how to make decisions.

One of the principles he taught in that class is this:

Sometimes in life we are faced with making a choice between two good things, and although we may really want both for different reasons, we can only have one.  And when we finally make the choice, it is perfectly okay, and even necessary, to mourn the loss of the one you didn’t pick. It’s okay to cry for it, and to literally, honestly, mourn for its loss.

We knew this was going to be a hard decision between two good choices.

One of the phone calls Carina made when seeking advice about this offer was a cardiologist at Southfield Hospital with whom she had rotated, and with whom she had forged a strong bond of friendship and trust.  Cardiology, like Oncology, requires an IM residency, followed by a two year fellowship. Before calling, Carina expected, and even wanted him to talk her out of taking the Family Practice offer from Beaumont.

You need to understand, this cardiologist was also the director of all medicine at the hospital where Carina had done almost all of her rotations, and he had spent time helping her forge relationships, making sure that just the right people knew who she was, introducing her to colleagues in influential positions, and assuring that she was fully on the radar of the people who selected residents for the IM program. When Carina explained to him the dilemma she was facing, he immediately said, “You need to take that offer!”

“But” said Carina, “You know that my desire is to work with cancer.”

“Yes” he said. “But Carina.  Listen.  I am at the top of my career.  I am a respected cardiologist.  I make a lot of money.  But, it has come at a great cost.  In the process of getting here, I lost my family.  My wife divorced me and my children lived with her.  You would make a fantastic oncologist.  We all know that. But I also know that you love your children more than you love the idea of treating people with cancer.  Beaumont is a world class hospital system, FAR FAR better than Southfield. This offer they have extended to you is an incredible honor.  The options for Family Doctors are expanding. Their lifestyle is ideal. You will see your kids!  You really should take their offer.”

Earlier today, Carina received the official offer and the contract.  She signed it.

It’s official.  She will not become an oncologist.  She will become a Family Practice doctor.  And she will do it through the Beaumont Health System.  And she will start in January of 2016… in a few weeks!

On Saturday morning I was in our basement, looking over all the books on our bookshelf, and I happened to spot all of the books Carina has read and collected on cancer.  There are a lot of them.  A sadness hit me.  And for the first time I understood what my dad meant about mourning the loss of the choice you don’t pick.

But then I think about the lifestyle Carina will enjoy over the next three years as a resident, and about the lifestyle she will enjoy as a family med doctor, how much more time she’ll spend with the kids.  She is, after all, a mother first.

Yes, it’s true.  Every now and then, life has a way of throwing you a curve ball.  We never saw this coming.  But now that’s it’s here, it feels like the right decision.

I love Carina, and she will be a GREAT family doctor who will rise to the top of her career.  But more importantly, she will also get to be a great mom.

I saw this little sign in a store right after Carina decided to take this residency. It has a double meaning for us... She chose Family Medicine because her family is more important than her career.

I saw this little sign in a store right after Carina decided to take this residency. It has a double meaning for us… She chose Family Medicine because her family is more important than her career.


Follow up:

It’s now March of 2016, four months after I posted the above thoughts on Facebook.  Carina started her Family Med residency two months ago, and she is loving it!

I’ve had a few AUC students ask me for blog posts about rotations and the residency application process, and I’m working on another post that will share some insights.

Life is good!

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    Emily Taylor commented

    This was such a great post. I found myself getting teary eyed for Cari, I felt like I was mourning for her. We had the exact same situation with Jaren getting into law school that it was uncanny to read about your experience. I can look back on it now and realize how it wasn’t just coincedence but truly the hand of God literally leading us to where we needed to be. I have no doubt after reading your post it will be the same way for you guys and Cari. So good to read about how well things are going for you guys.

    March 11, 2016 at 7:26 am
      Casey Crookston commented

      When we are in Utah, remind me to ask you about the story of Jaren getting into law school. Sounds like a good story.

      March 11, 2016 at 2:17 pm

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