From med school to SAHM, MD

I think I'm finally getting over the overwhelming urge to try for baby #3. For the past year or so, not a single day has gone by that I haven't utterly obsessed over having a third child. I've discussed it on here a couple of times. I have thought about it several times a day. I've listed all the pros and cons and, of course, the cons win overwhelmingly. The higher risks of autism due to family history, genetic disorders due to advanced maternal age, pre-term labor, pre-eclampsia, and gestational diabetes in prior pregnancies. The very real risks that I could have another child significantly more disabled than my older son. The financial considerations. The reduced time available to help my older son.
I tried and tried and tried to tell myself this. Then, every time I looked at my perfect younger son, I felt an overwhelming urge to cast aside all rational thinking and try for another baby. Another baby just like him: happy, social, madly in love with me. To make things worse, it seemed like everyone around me was having a third child- some planned, others unplanned. I constantly felt this big huge empty vacuum where a 3rd child should have been.
Add to that the fact that I basically grew up an only child and always wanted my kids to have the big family I never had. Especially if, God forbid, something were to ever happen to one of them.
But the last thing I would ever want to do is burden either of my children with a disabled child. I felt this same guilt when my younger son was born, because at that point, it wasn't at all clear how my older son would turn out. Today, I have hope that, with continuing proper intervention, he'll be ok someday.
Today was the first day in over a year I haven't woken up wishing for another baby. It stems from a talk I had with my aunt yesterday. She had 4 kids, my cousins, who were my best friends growing up. My childhood was quite miserable by most people's standards, but the joy of my childhood was the time I spent with my cousins. I used to spend the night at their house all summer long. We spent our summer days doing all the fun kid stuff that I never got to do otherwise. Growing up, I was always so envious not so much of their material possessions, but mostly of the close relationships they had with each other. They seemed like the perfect family.
As they got older, I saw them less and less and lost touch with them completely for awhile. I know their oldest son had some problems with drugs and alcohol, but he seemed to have gotten through it ok in the end.
Last night, my aunt told me the whole story of the horrors she and her family went through in dealing with Chad. The details aren't important here- they're basically the same as you'll hear with any young man who gets in with the wrong crowd, gets addicted to drugs and/or alcohol, behaves irresponsibly and gets a girl pregnant, etc. "He would have been dead a long time ago", she tells me. Through continued Herculean efforts on her part and at tremendous expense to her and her husband, they managed to get him over it. He's been clean for almost a decade and is now married with kids. He never did get through college, but he does holds down a job. However, he still gets significant financial support from his parents, mostly because of the grandkids.
I asked my aunt "Why? Your other 3 kids were pretty close to perfect. What went wrong with Chad?" She tells me it's partially because her husband was never around. He worked all the time and was a really good provider in terms of money, but he was never there to help her with the kids. He never developed close relationships with them. With 4 kids, there was just no way she could stay on top of what all 4 of them were doing all the time. Fortunately, with the younger children, they learned from their mistakes, he got more involved, and they all got through adolescence without any major calamities.
So, really, it's that simple. Hearing this story- from what I once thought was basically a perfect family- has done for me what no amount of rational thinking has been able to do. The bottom line is there just isn't enough of me to go around. I have 2 children, 1 of whom requires every ounce of attention I am able to give him. Could he make do with less attention from me? Sure! Even now, he would be content to play quietly by himself all day. Would it be in his best interest to do so? NO! At the same time, I can't neglect my younger child, either. And since we don't have much of a family support network, my husband and I are on our own. Right now, we are both at our limits in terms of ability to provide nurturing and sustenance. We're giving them all we've got and I think both kids are getting what they need, though it's come at a huge personal price for us. It's working for us, barely. It wouldn't work if we had a 3rd child. Even if that child were born perfectly normal, like my cousin Chad.
Well, this has been a rather long rant that may be utterly uninteresting to anyone other than myself. But for me, personally, it brings a sense of closure. I will never have the big family of my dreams. But I do have 2 beautiful sons and I will do everything in my power to help both my sons become happy, well-adjusted adults someday. One of the ways I will help them do this is by NOT having a 3rd child so I can devote all my resources to helping them however they need me.
Perhaps a part of me will always wish for that 3rd child, but that's just something I'll have to live with. There are lots of women with fertility issues who would give anything to have even ONE child. To someone struggling with infertility, I'm sure this whole post sounds utterly ridiculous. Gee, I guess we're back to the analogy of the man with no shoes yet AGAIN...OK, I'm going to hit "post" before I end up deleting this entire post!

Aw, shucks, guys Thanks so much for the messages of support. They couldn't have come at a better time. I've been feeling really down today- my son had a huge meltdown that kept me up most of last night and I'm in the midst of a really stressful time preparing my students for their final...so I'm utterly exhausted and depressed to boot.
I'm off to teach my class now, but just wanted to say THANK YOU! You guys truly brighten my day! I'll try to update more later.

Well, we're almost done with summer semester here. My students have their final on Tuesday evening- then I have just a few hours to grade their exams, as final grades are due first thing Wednesday morning, no exceptions! I hate that, especially since my son's school is having a kindergarten round-up that evening and now I can't go!!! I really, really wanted to go to meet his teacher and the other parents and kids in his class. My DH will take the kids, but it's just not the same. I guess I'll just ask him to set up a meeting between me and the teacher later in the week, though it would have been soooo nice if it could have worked out.

No more meltdowns since that memorable Wednesday evening, thank God! I suppose I should be grateful that these meltdowns are increasingly rare- maybe just once or twice a month when they used to occur several times a day. And I am thankful, of course, but for some reason I really let this last one get me down. I guess I just have this illusion that everything's going to be fine, that my son is doing great - which he IS! But then this meltdown happens, inexplicably, for no apparent reason, and it all comes crashing down again. The next day, I pulled up MomMD and saw a couple of new PM's as well as Kris' message and that really brightened my day. Thanks, guys! You really helped me through a difficult time- you can't even imagine how much that meant to me!

Things improved. The other day, we went out to eat at a friend's restaurant and got lots of compliments on how well-behaved my kids were. Yesterday, we went to a birthday party and, again, received lots of compliments on how good the kids were. So...I suppose everything *IS* ok! Just a temporary setback to remind me that my son is, after all, still on the autistic spectrum, even though he does really well most of the time.

Kindergarten starts in a week and I AM A NERVOUS WRECK!! I am SOOOO worried that my son is going to be overwhelmed and his behavior start to regress. So I plan to stay close by, for as long as necessary. I can't go in the classroom with my 2-year-old, but I will plan to sit in the hall outside and quietly read him books while my older son is in class. I want him to know that I am nearby and always available if he has a problem. Hopefully the school won't have a problem with me staying nearby, because this is what I know my son needs right now. Maybe, over time, as he is better able to communicate with his aide and his teachers, I might re-think that strategy, but for now, I am staying put. He will only be attending for 2 hours a day anyway, so it will actually be easier for me to stay in the school for now. And if it doesn't work out...well, homeschool, here we come!

I received an interesting PM that has given me a lot of food for thought over the last couple of days. A woman contemplating med school wrote and posed a number of questions that have really got me thinking. So I'm going to post my response here, because I think it might be interesting to others.

Without divulging too many specifics, here are the questions:

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I am wondering if you would ever recommend medical school to any of your students?

In your situation, is there some comfort in knowing that you do have your MD, which you set out to get, and THEN found that it was not the right path for you, given your circumstances?

Would YOU go to med school again, if given the chance?

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The person who asked me these questions has been struggling for many years with the decision of whether or not to go to medical school. Of course, we each have to come to our own decisions, but I'm going to try to answer these questions for myself as well as I can.

As I've noted before, I too struggled with the decision of whether or not to go to med school. After getting rejected the first time, I took some time off to really reassess what I wanted to do. After meeting so many miserable people in medicine, I tried my best to talk myself out of it. I discovered that I had lots of other interests- foreign languages, travel, computers- and I took the time to pursue all of those. I'm SOOO glad that I did, especially the time DH and I spent travelling while in the Park Service. Yet, despite earning two Master's degrees in other fields, I never felt truly fulfilled in my career. That yearning for medical school never did disappear, no matter what I did. It took me seven years to realize that medical school was, indeed, where I belonged.

As I've noted before, I had to apply a total of three times before I finally got in. And my first two years of medical school were some of the happiest of my life, despite having a difficult pregnancy 1st year and an even more difficult newborn baby during 2nd year. Somehow, I just *knew* that medical school was were I was destined to be. I finally felt at peace with myself and with who I was.

All that changed as 3rd year approached. This was about the time my 1-year-old son was diagnosed with autism. For a while, we strongly considered having me quit to stay home after 2nd year. At that time, I was only $20K in debt and my DH had a great job in a great town with good benefits. The reason I didn't quit: because I just couldn't handle my son's autism. I just couldn't handle the guilt and it was affecting the way I was interacting with my son. My husband, on the other hand, was all gung-ho about staying home and helping our son, so he ended up quitting his job and we all moved for med school. The rest, as they say, is history.

So... what if I had the opportunity to go back and quit after 2nd year, when I was only $20K in debt instead of $155K? Would I do it? Or what if I could turn down my acceptance altogether, knowing then what I know now? Now THAT is a difficult question.

It's tough to say. I think if I'm being really honest with myself, I'd have to say that part of me would be angry or resentful if I had not pursued my MD degree. Even though I'm not practicing medicine in any form, there is a certain level of accomplishment that those 2 initials after your name conveys. I know that sounds superficial, but I guess I'm human, like everyone else, and I do like to be appreciated and I can tell that my students have a lot of respect and appreciation for me.

But if I had known in advance that I would have a child with autism, I would not have pursued medical school. 3rd year, in particular, took a huge toll on our entire family and we all suffered tremendously. Had I not had kids, I think 3rd year would have been loads of fun, even with all the hard work and long hours. But having kids- especially a child with special needs- changed everything.

So, no, I would not have pursued medical school, at least not at this time in my life. Maybe I could have gone back someday when my kids were grown.

However, I'm not saying this would have necessarily been the right decision. It's possible that I would have harbored a lot of anger and resentment towards my son if I felt that I could not go to medical school because of him. Right now, I am CHOOSING to stay home because I WANT to. But if I had been FORCED to stay home- well, that might be a different scenario altogether. It's conceivable I could be utterly miserable as a SAHM who really felt like she should have been in med school. Because the fact is, SAHM's, as a rule, do NOT get much respect. Many people assume that SAHM's are just not intelligent or motivated enough to pursue a meaningful career. In my case, because of my degree, few people think that I'm not intelligent enough. Some people think I'm crazy, of course, for turning down all the money I could be making. But most people who learn all the details behind my decision are very supportive and many are impressed that I would turn down a lucrative, challenging career to be a SAHM to my special needs son (not that I do this to impress people, of course...but it DOES feel good to have your decisions validated by others.)

So...no easy answers. In my heart of hearts, I'm comfortable with whom I am right now. I wish I didn't have all this debt, but I'm still grateful that I had the opportunity to go to medical school. I think it's given me a personal sense of accomplishment that no amount of adversity can take away entirely.

So, my FINAL ANSWERS...

NO, I would not go to medical school if I had it to do over.

YES, there is comfort in knowing that I have my MD and later found out it was not the right path, given my circumstances.

And YES, there are times I would recommend medical school to my students, as long as they went into it with their eyes wide open. I do know some happy people in medicine- in particular, many of the family medicine faculty at my medical school.

As for specific advice for the original poster, I'm not sure if this is helpful, but I guess the bottom line is to research all your options. Look into other areas of health care such as nurse practitioner, PA, pharmacy school. In my case, I often wish I had become a pharmacist instead...but I must confess that a part of me would always want to be a physician, so go figure. It may be that you really are destined to be a physician and really wouldn't be happy doing anything else.

One caveat: if you do plan to have kids, I would try to have them before med school, if at all possible. You never know what kind of mom you're going to be until you actually are one. I never, ever, in a million years could have imagined myself as a SAHM, much less as one enjoying it. It may be that these decisions will fall in place for themselves once you know whether or not you want a family and how you feel as a mom.

Well, this has been a very lengthy reply, but hopefully it may be helpful to someone. Thanks to the original poster for sparking this discussion. I think you have helped me realize that, at least professionally, I'm happy with who I am right now-and that's saying a lot! Who knows what the future holds, but I'm grateful to be who I am today.

OK so I am royally bummed right now regarding the situation with my son's school. Last spring, we had a great IEP meeting in which we all agreed he would attend part-time regular Kindergarten with a one-on-one aide and everyone involved would get trained in using RDI techniques to facilitate remediating his autism.
Now, it turns out that they will not be providing a one-on-one aide, but rather a shared classroom assistant because there are several other special needs kids in the class. The assistant would be a classroom assistant who would look out for my son as well as the other special needs kids in the class. Well, against my better judgment and first-hand experience, I decided to give the shared aide a try. After the first day, my son came home in tears, perseverating on various negative things that had happened to him that day, including the fact that there was no one available to assist him with toileting. So...I tried in vain to talk with both the teacher and the classroom aide, who are both apparently so busy with their other duties that they don't have time to meet with me. I have a meeting scheduled for next week with the principal where I'll certainly do my best to advocate for him, but I'm saddened and frustrated that it's already not working out and no one seems to listen or care. Of course, an IEP is a legal document and they are legally obligated to provide a one-on-one if that's what the IEP says- but I don't see myself actually going to court over this. Besides, that would virtually guarantee bad blood between the school and me and I certainly don't want that for my son (or for his younger brother, if he ends up attending there someday).
Why oh why oh why does dealing with schools and IEPs have to be so maddeningly frustrating?? It is HARD ENOUGH to have a special needs child, much less have to deal with all these issues with the school. I can understand why so many parents choose to homeschool their special needs kids- it's a huge hassle to have to deal with all this. I had really hoped this was going to work. Last year, he attended PE and music classes at this same school with his therapists as his one-on-one aides and it went really well. He enjoyed it and I was able to touch base with his therapists on a daily basis to see how he was doing. Whenever something started to go wrong, we were able to quickly pinpoint and remediate the problem because we were in constant communication with one another. Now, he's dumped in a class with 18 kids, several with special needs, without a one-on-one and a teacher who doesn't even know him and doesn't have the time to get to know him. None of the teachers or aides have RDI training nor do they have time to pursue it. Obviously, this isn't going to work.
I am so saddened because my son was soooo looking forward to kindergarten! All summer long, we've been really building it up, reading books about starting school, buying school supplies together, talking about all the wonderful times he's going to have. Of course, it never occurred to me that he wouldn't be receiving the one-on-one aide that we had agreed upon. I guess I could just homeschool if all else fails, but since he WANTS to go to kindergarten, I really, really, really want to make this possible for him. I've even thought about volunteering to be his one-on-one myself, if only I had someone to watch his younger brother.
Oh well, guess I'll just have to wait and see what happens next week. Meanwhile, I am so stressed out I can't relax or anything. I had such high hopes for this school!

I had a meeting with the principal, which went well. She was sympathetic and agreed to set up another IEP meeting, but we weren't able to get it scheduled until mid-September.

However, the situation with the classroom teacher and aide have gone from bad to worse. My son is having a hard time, basically perseverative talk and crying fits when he gets home, but the teacher flat-out refuses to meet or discuss this with me. I get the feeling she wants me to put him in another teacher's class- which I will definitely ask to do. My son is a great kid and I definitely don't want him in her class if she doesn't want him there, period.

I am this close to pulling him out and homeschooling. After meeting the teacher, my husband is now of the same opinion. He said he has never met such a mean, cold-hearted person in his entire life. However, the principal is quite reasonable and all the other teachers I've ever met have all been warm and personable, so I suppose we need to try another teacher first. But I'm not waiting until mid-September, when my child's already fragile psyche will have been completely crushed. I'm calling the principal tomorrow to tell her that I will plan to keep him home until we can resolve these issues.

I haven't slept much in two weeks as I constantly am stressed about this school situation. It's eating every ounce of my energy. I should be getting ready for my first lecture of fall semester that I have to give later this week, but I can't concentrate on anything other than this evil, evil kindergarten teacher. How anyone like this woman is allowed around small children, much less special needs kids, is beyond me.