From med school to SAHM, MD

The title basically says it all: I just graduated from med school in June and am now a full-time SAHM with an MD after my name and a 6-figure debt to show for it. From reading some of the other posts on this board, it appears that it isn't all that uncommon for women physicians to leave practice to stay home, but I think I'm the only one here who decided to bail before even starting residency. I actually matched into my #1 choice of residency, but basically reneged on that agreement after moving here and fortunately the program was very understanding. I feel really bad for the program, but I'm sure they won't have any trouble filling my spot.
One sad fact of reality remains: My loan payments are $900 per month and my husband doesn't earn nearly enough to make that payment while supporting a family of 4.
So why did I do this? How did I get in this position? And, most importantly, what am I going to do with myself in the long-term?

Before I had kids, I knew there was nothing in the world that could make me as happy as being a doctor. I know because I tried everything else. I fought the desire to be a doctor over and over again. I told myself the hours were too long, the training too expensive, the sacrifices too great, the work environment too threatening. I listened to the dire warnings of miserable med students and miserable physicians.
But everytime I went back to volunteer at a local clinic for the uninsured, I knew they were wrong. My heart went out to these patients who all worked full-time jobs just to pay the bills, but didn't have health insurance. I saw a 54-year-old woman with Type II DM who couldn't afford her meds and was walking around with a HgA1C of 11.5. I met a 58 year old man who had waited three months for an appointment for shortness of breath-we slapped a pulse ox on him and he was satting in the 70's at rest. Despite his severe (undiagnosed) COPD, this guy had been dragging himself to his blue collar job every day, because he didn't get paid for sick days. I could go on and on, but you get the idea. I knew this clinic was where I needed to be. I knew they needed me to become a physician and come take care of these patients.
I can honestly state that I didn't give a flying hoot about money. I figured I would make enough to repay my loans and since I've never had much money in my life, I wouldn't miss it anyway.
I grew up in a working-class family myself. My dad was a blue-collar worker who got laid off from his job when I was in 6th grade, which is when we went on welfare, food stamps, and Medicaid. I worked at babysitting jobs until I was old enough to get a real job and then I worked mostly in restaurants. I served customers, prepared food, mopped floors, and cleaned bathrooms to pay my way through community college.
One of my fondest memories was one day when I was working the cash register at the local sub shoppe. In walk two gentlemen who are obviously professors- it's quite apparent from their demeanor. One guy is wearing a T-shirt with this equation on it:
They come up to my register, order their subs, and continue chatting with one another, mostly oblivious to me. You should have seen the guy's face when I asked him why in the world he was wearing a T-shirt with the Schroedinger equation of quantum mechanics on it. Priceless! I loved it- he obviously though I was some idiot blue-collar bimbo and he about fell to the floor when I said that.
OK, I have digressed. Let's suffice it to say that I worked my way through community college, then transferred to a state university and applied to med school. Since I had no source of income other than my measly restaurant jobs, I could only afford to apply to one school. I applied Early Decision to the closest school, was initially waitlisted, then ultimately rejected.

When I finally got rejected, a week after classes began, I was in shock. I guess it was naive of me to assume the school would ultimately accept me, but it never really occurred to me to come up with an alternative plan. So I wallowed around in depression and self-pity for a few months after that. Then I met yet another miserable bunch of third-year med students. One guy in particular exhorted me to find something else, anything else, to avoid medicine at all costs. When I asked him why he didn't just quit, he told me he had $25,000 in loans and a wife and two kids to support, so he was trapped.
I also realized that, other than the doctors I worked with at the clinic, I really didn't like doctors. They seemed so pompous, so high-and-mighty, so holier-than-thou. So I resolved to take the med student's advice and find something else. I went to graduate school, got a teaching assistantship, earned a Master's degree. Then my husband got a dream job that took us all over the country. He was a seasonal park ranger and actually got paid to take people hiking, wow! It was actually a ridiculously low salary- he started at $7 an hour and eventually worked his way up to $11 an hour with no benefits. But who cares? Who needs benefits when you're healthy, 20-something and get to live in the most beautiful places in America and go hiking every day of your life? I worked odd jobs- bookstores, gift shops- and followed him around the western parks for several years. After 5 years of this, he decided he had had enough and needed to settle down and get a decent job. We both returned to graduate school and he eventually got a decent-paying real job.
When I got back, the clinic was still there. Only it was even busier than before. I found myself wondering how I could ever have forgotten the medical dream. Truth is, I never really forgot it- I had just repressed it. My rejection from medical school had been so traumatic that I just couldn't deal with it. Like the proverbial fox and the grapes, I had told myself I didn't want that silly old med school anyway. But when I returned to my clinic after all those years, I knew I had been wrong.
So I retook the MCAT, did well, took some updated science classes, and reapplied. This time my husband was working, so I was able to afford the applications. I still only applied to 4 schools because I needed to stay close for my husband's job. I got one interview, at the same school I had been waitlisted at before. This time, I was rejected outright, no wait list.
Instead of getting discouraged, that second rejection made me more determined than ever to be a doctor. I started making tentative plans to study abroad if necessary and mounted a full-scale plan for reapplication. My husband said he'd move to the ends of the earth if that's what it took for me to go to med school. The third time, I applied to 20 schools, got 4 interviews, 3 acceptances, and 1 waitlist. I even got into a top-20 school, but turned them down for my state school, which I chose mainly for financial and geographic reasons, even though they had rejected me twice before.
The day my acceptance letter came was the happiest day of my life. Best of all, my husband was even more excited than me, if that was possible. It felt so wonderful to have him 100% behind me. I knew it wasn't going to be an easy road, but I knew I could do anything with his support.

During the six months between getting my acceptance letter and starting med school, strange feelings were stirring within me. Most women my age were having babies and I knew I wanted to have children too. I realized that med school and residency were going to take up at least the next 7 years of my life and that I would be nearly 40 before I was done. Around this time, I discovered MomMD and read some success stories of women who had had babies during med school. My husband was skeptical about my ability to handle it all, but he agreed that it would be tough to wait until after residency. He also agreed to quit his job and stay home for at least a year once the baby was born. We were both very good at saving money- even on his modest salary (in the 30's) we had been able to save enough to pay cash for a new car. And I had the first summer after medical school off, so that would give me three months to stay home with the baby. And 2nd year was still preclinical, so it wouldn't be quite as stressful as clinical rotations. By the time 3rd year started, the baby would be a toddler and easier to leave. It made sense, at least to my warped mind. So we decided to take the plunge.
I sat at my med school orientation charting out "o" (ovulation) and "m" (menstruation) dates for the next several months. Fortunately, it didn't take that long. I got pregnant two weeks into my first year of medical school.
I didn't believe it. I repeated the test. Then I repeated it again. Then I repeated it the next day, with a different brand. Then I went to Student Health and took another urine test there. Then I went to the local women's clinic and requested a serum HCG because it just didn't seem real. It was real. I was on Cloud Nine.

Once the initial elation wore off, nausea set in. I was sick all day and all night for 6 months. Somehow, I managed to pass all my classes and even honor a few. The only thing that helped my nausea was eating all the time, so I did. I gained a huge amount of weight- 55 pounds!
The baby was due 2 weeks before final exams, which posed a potential problem, but I met with the administration and they agreed to work with me.
The worst part was taking genetics and embryology during my 1st trimester. I developed anxiety so severe I was barely able to function. Worse, my AFP test came back slightly abnormal, but not abnormal enough to warrant an amnio since I was under 35. I anxiously waited out the rest of my pregnancy, praying fervently the baby would be ok.

He certainly seemed to be ok. He was a beautiful, robust 8-pounder who arrived promptly on his due date. He didn't have Down's. He didn't have a neural tube defect or Trisomy 18 or Trisomy 13 or any of the other horrible conditions we had studied in class. Thank God.
We brought him home and the crying started. He wouldn't sleep in his bassinet. He wouldn't sleep in his crib. He would only sleep in his infant swing and only if you kept it moving. So I would sit up at night and watch him in his swing while trying to study. My husband would take over for a a couple of hours around 4 AM prior to going to work so that I could sleep. Somehow, I managed to pass my 1st year exams, then had the summer off. After about 3 months, he finally started sleeping in his crib, but only for an hour or two at a time. He demanded to nurse every 2 hours all day and all night long. We took him to the pediatricians, who diagnosed reflux, but basically told us we needed to let him cry it out. We tried it one night, but just couldn't do it to our poor little baby. This went on for over a year.
Meanwhile, I had started 2nd year and determined that I could get by mostly by studying at home. So I skipped class, got the notes from friends, and stayed home except for the mandatory clinical and physical diagnosis classes. My husband took family leave when my schedule demanded it and we managed to make it through all of 2nd year without using daycare and with no family help. We planned for the baby to go to daycare during 3rd year so my husband could keep his job (his job had an on-site daycare). I actually honored all my classes that year and did really well on Step 1 (don't ask- I have no clue how!)
Despite the endless sleepless nights, things were looking good. Once we got over the hurdle of 3rd year, 4th year would be a cinch. Maybe we could have another baby then.
Our son grew more and more strikingly beautiful every day. He had a head full of curly hair, the bluest eyes you've ever seen, the most perfectly chiseled face you could ever imagine. Grown men would stop us on the street to stare at his beautiful face.
The strange thing was, he never stared back at them. In fact, he would act as if the people weren't even there. He would always look past them at the nearest bike or car or train.
My eyes are filling with tears as I get to this part, so I will have to pause for now.