what I wish I'd known before residency

17 December 2014

You like that ominously somber and cliché title? I thought you might. I got the following email {edited a bit and author's name withheld!!} earlier this week and it wasn't unlike a lot of similar emails I've gotten so in the event that any other residency-esque emails are in the future works ... I thought I'd type this out since Simon is currently on a decent rotation and I won't be irrationally tempted to write a scathing diatribe about the past 3.5 years.

My husband is interviewing currently and we match in March and I am stressing out and am unsure how to handle this entire process. I am extremely close with my parents and all of the programs we are considering are minimum 6 hours away. I'm terrified of moving but happy that he is even getting interviewed at these incredible programs and knowing that someone would be proud to take him. We're considering children soon and I feel lost about leaving and having kids away from our families and any support system. I was hoping that you could give me some insight or advice on this roller coaster ride that we are about to embark on. 


*Grace again! before I answer I have to give a disclaimer like the funion that I am ...

I realize that my situation could be a lot more difficult. I could be a single mom, Simon could be deployed, Simon could be unemployed, and the list goes on and on. On the totem pole of difficult situations - ours ranks pretty low. I know that. If I sound like an ungrateful b, that's perfectly understandable and I could keep my mouth shut (or my keyboard untouched, polite laugh) but I've read a few "it's totally fine!" accounts of residency experiences from the wife's perspective and I felt a lot a bit duped. Simon is at a great program that does a phenomenal job of giving as many two day weekends off as possible and it is absolutely the best fit for him and our family for countless reasons. I just don't think there's any escaping a lot of the necessary realities of medical training.

With that disclaimed ... I'm probably the worst person to talk about this because I can't truthfully paint the rosy picture that some spouses might. I'm sure there are some couples that have been genuinely and pleasantly surprised by their residency experience because they were expecting much worse or the resident went into a relatively "easy" (in quotes because I don't really think there are any easy programs out there) field - as far as hours go or they have more optimistic temperaments than I do. We are not one of those couples. I think Simon had a much better idea than I did because as a med student he shadowed residents and knew how many hours they logged at that hospital and he encouraged me to talk to residency wives to learn what I should expect but I said I was sure I got it because "how much worse than med school could it BE?!" and I could handle it. Laugh laugh LAUGH. 

Let's break it down.


brace your lonely nerves: July of 2011 was a bit of a shock to my system as I found myself staring at a baby Julia while both of us sat on the kitchen floor in a new house in a new city mindlessly snacking on cereal straight from the box at what felt like 5pm but no, how could be a mere 10:00 in the am?! Day after day after day. No matter the residency (OB, Family Medicine, Surgery, Internal Medicine etc.) the hours are always going to be really long on some rotations. The nature of the medical beast is generally unpredictable and emergencies tend to arise at the end of shifts and patients always take priority over getting home for dinner - as they should. I'm not sure I necessarily understood that when Simon was "on call" he would be at work on the weekends for a minimum of 24 hours and not at home with a pager or at work getting sleep. Depending on if he worked overnight - when he got home he would need to sleep. This was a tough pill to swallow because I was so lonely and ready to interact with a human that could talk in sentences but eventually the shock wears off and it just becomes a fact of (temporary!) life.


the first year is the worst year: I can't speak for all residencies but I think getting acclimated to the rigor of the hours makes intern year the most difficult for both the resident and the spouse. After the first year, there's a better idea of what to expect during each rotation and I learned to set my expectations bar SUPER low during certain months to occasionally be pleasantly surprised. The interns are at the very bottom of the food chain and are learning a whole lot in a very small window of time. They tend to do a lot of the busier grunt work (so it seems) so second year seemed to be a little less of a grind for Simon as his autonomy and responsibilities changed for the better. 

holidays are hard: Unless you live near family and are able to travel to be with them ... odds are good that you'll spend a Christmas and Thanksgiving or two or three alone. The first Christmas Simon was working and Julia was throwing up and I was still in a bit of a postpartum haze after Sebastian so I think that set the bar pretty high for future and subsequent Christmases have been so much better. Simon's second year he was working a 24 on Thanksgiving and it was a beautiful day outside so I took my 32 (? I think) week pregnant self and the two older kids for a walk and saw countless families in our neighborhood walking into homes bearing casseroles and smiles and my baditude hit a real sour note. We tried to visit Simon who was busy (again, understandable! he was at work!) and I gained a huge appreciation for this past Thanksgiving when Simon was very much not at the hospital. 

expect no paternity leave: It's just not in the cards for most programs (although! I did hear something about some sort of mythical Psych program that gave three weeks of paternity leave .... say que?!) which is understandable but difficult when baby arrival times are unpredictable and you don't live near family. No one was able to come after Phoebe was born (although my wonderful friend Caitlin came a week later while Simon flew to an interview because she's an angel) and 7.5 months later I'm still feeling a little bit mentally fragile which is probably the most pathetic thing you've read all day, I know.

but having kids is totally doable: I would never discourage anyone from having kids during residency because having babies is always an adjustment and there's never a good or easy time to have them. The kids are mostly clueless that Simon is gone on some weekends and holidays and think it's totally normal that he sleeps "in his bedroom" at the hospital some nights and they LOVE visiting him. 




I think (?) most programs have pretty good health insurance so the cost is feasible and I would imagine after surviving the newborn phase during a tough rotation (hello night float!) ... any future newborn periods will feel relatively easy and breezy. 

it's not mission impossible: There will be some rotations with a light call schedule and decent exit times and you'll wonder why you ever thought residency was tough, you big baby!! And those months will save your sanity and keep you chugging along. It's tough for me to remember that eventually allllllll the med school loans WILL be paid off and that Simon will be able to take pager call on the weekends and there won't always be a month of nights looming in the near future. We've learned to really appreciate the weekends that Simon has off because they feel like such a luxury sometimes and I'm really thankful for that. 



it's important to be kind and gentle: with yourself and your spouse and remember that you're on the same team. It's easy to default to frustration with each other when there's snag in the schedule or weekends are anything but a breather in between rough weeks but it's not productive. It's perfectly acceptable to slip yourself straight into super survival mode on the more difficult months and turning your parenting blinders to level: HIGH so that you don't start comparing your survival tactics to other families who might be more on the thriving end of the spectrum for that particular season of life. 

it's a marathon, not a sprint: gross, I hate that phrase - I'm sorry! Julia was nine months old when Simon started his intern year and she'll be seven and a half when he is completely finished with his training. It's been vital for me to take it a rotation (four weeks) at a time. Yeah, yeah, "the days are long but the years are short!!" (I hate that saying even more) but the days can feel e-t-e-r-n-a-l and even though the years do pass at a relatively decent clip, it's not helpful to dwell on how many more night shifts you have to go because, it's just not (but 30 - I broke down and counted like the immature toddler that I am). 

it will all be worth it: Or so I've been told. Jury's still out. ;)

Reading this back - it makes it sound like I think I'm the one working the crazytown hours under lots of stress and little sleep. I don't! Simon is the true hero here and I know that. I think I get the lonelier side of things which is mostly my fault for not branching out more.


And also! I think the title is stupid because I think I had to experience all of these things to know and learn them for myself. It's like thinking if someone had (maybe they did!) sat you down and wagged their finger and outlined exactly how sleep deprived you would be post-baby ... it would actually prepare you for your new and enlightened fatigue but of course it wouldn't! I think every spouse would write something different (although I talked to a residency husband the other night who seemed to share a lot of my same thoughts and I appreciated the solidarity so much) so take this novella with a grain of iodized (or sea - if that's your poison).  

49 comments:

  1. Yes, it is all worth it but life outside residency brings its challenges too! :) I actually miss the simplicity of our life in St. Louis but then again...I only had 2 kids! :) Hope you guys are doing well and Merry Christmas.

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    1. haha fair enough :) I'm just dreaming about a life without night float - I spend the other 5 months catching up on sleep from that month ha!!

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  2. Thanks for keeping it real! I wish I had gotten the good, the bad, and the ugly before my husband started this journey. Because it is a journey, not only for your spouse, but for the entire family. I'm holding my breath for when he is practicing, I hope it's worth it? Epitome of positivity, that's me!

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  3. This is all so true and a good realistic picture of residency or fellowship. My husband is now an attending, but we're military so completing training = deployment(s). Wheee, great trade! To your list, I'd add a couple of things. My husband and I are also very close to our families, but someone once mentioned to me that living away from your families early in your marriage can be a great, rich thing for your marriage and family. We really found this to be true. We got married and immediately began life a 20+ hour drive from family. Rather than running to our parents for help immediately when issues occurred or we were stressed, we were forced to turn to one another and God and build our teamwork and patience with one another at a much deeper and faster rate. Six years later we're still living far from family (the military doesn't have any hospitals near our families). We miss them and look forward to their visits and eventually moving back when we get out of the military, but we're also glad we'll be moving back as a married couple and a well-established family in our own right, rather than just being "the kids". We miss having any family around to help with our small kids (three two and under with number four on the way) but have also built good systems as a household and developed rich friendships in our church and community.

    I also agree that holidays the first couple of years were SO hard for me. Holidays were not a big deal in my husband's family growing up so he didn't mind as much, but holidays growing up in my family were really special with many traditions. I also had many pity parties (wistfully sitting alone on the 4th of July with a high fever and no friends, fireworks, or barbeques *sniffle*, Christmas alone with screaming infant twins and leftovers for dinner *sniffle*, birthdays never celebrated *sniffle*). Now that my husband is an attending, he still works A LOT of holidays - three of the last four Christmases, which leaves the one unworked Christmas ridiculously stressful as every branch of the family fights for our attention. One thing we've learned that really really helps is not to try to cram in celebrations and special events on top of call or a rough rotation just because that's the official date they occurred on. I began our relationship with a "WE WILL CELEBRATE SO HELP ME!" attitude which resulted in us blearily scraping through Thanksgiving dinner at 10:00pm on a call night, or blearily trying to come up with conversation at a special birthday celebration as we both slumped lower in our chairs after four hours sleep, or blearily....you catch the theme. Life became so much more pleasant when we started planning to celebrate on a good date. Who cares if he's on call Thanksgiving Day? Now we just have a family feast on Monday when he's finally off call, and actually really enjoy our "secret" holiday. Our nicest Thanksgiving ever was actually just a dinner of gumbo and a run-down bar in the backwoods of Louisiana. I flew down to join him at his field training location for two days before he deployed for half a year and we really savored the meal because we knew we'd have no time together for many months. Likewise, birthdays are more fun when we just look at the calendar and pick a clear day (preferably two days post-call because otherwise he just keeps falling asleep) to celebrate rather than pacing and muttering as the special birthday meal burns to a crisp after a Five O'Clock Special gets wheeled onto the floor and keeps him another six hours just as he was about to leave. I won't say there isn't occasional sadness on actual holidays, but not stressing over getting "The" day just right and planning together so we know a celebration will actually happen has really helped. The good news is that life really gets better after training!

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  4. We're in the middle of intern year and my baby girl just turned one today. I feel a lot of what you described here but what is hardest for me is the amount of time that my husband gets to spend with our daughter (not much). On long call days he doesn't see her at all. On short call days, if he actually gets out early, he will come back and help me give her dinner and a bath and put her to sleep but sometimes I just feel that she doesn't even realize he lives here. She gets excited when (he's home on weekends) I take her to our bed and she sees him sleeping because he's never here in the mornings. And right now he had to run an errand and she is standing at the door saying "abbababa" (abba is dad in Hebrew). Anyway, I know it will get better. And he's in internal medicine so it's not nearly as bad as some other rotations. You just don't get those years back, you know?

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  5. I hate that guilt I feel sometimes that it's also my fault for being lonely because I just don't put myself out there, so I'm calling your bluff on that one--totally not your fault, just preach it and know that fellow moms of four, even those without the excuse of a med school husband are nodding their heads. Love your blog!

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    1. Haha. That's good to read!! I blame my super fun personality (hermit) but I'm so happy im not alone!!

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  6. When I was a nanny for two years, I worked for an ER doctor and his also-doctor wife. It was a good intro for me to see what life will be like once Will is out of residency - and as the Dad told me, Sure - what doctors do is tough. But they are in the zone while they are at work, and the hours just fly by -- vs. at home, where life is a different pace and the responsibilities are different. This isn't saying life at home is boring, but after hours and hours and hours of kitchen! laundry! naps! I just cleaned up this mess! more food! ... there is a reason two parents are important to the equation!!!!! I function way way way way way better when Will is home for longer than 2 hours a day. I love how Will always asks me about my day, and tells me that I'm doing a great job. I need that reminder too: our work *is* so important - raising the little ones, feeding and clothing - the job that never ends!

    And yes, I just asked my mom to come in March when Will is in the SICU vs. end of February, when the bebe deux is due, because he's in the ED and can take a vacation day or two. Survival is the name of the game. :)

    Thanks, as always, for writing!

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  7. Love it! My mother-in-law warned me that being a physician's wife is hard but I agree with you- it's necessary to live this out to fully understand. I hope you all have a great Christmas this year-hopefully Simon isn't working!

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  8. Phil just had his defense on Monday and during his presentation, I felt like I relived the last 7 years and every single challenge and setback along the way. It was almost painful and left me feeling tired and a little depressed. I know residency isn't the same as grad school, but it does have some parallels.

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  9. Yes to all the above!
    BTW, the 'first year is the toughest' held true for fellowship ~ at least in pediatrics.

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  10. I don't have a husband in residency, but I have a LEO husband. It is nice to know I am not alone in the long hours. My husband recently switched from 12 hour shifts to 10 hour shifts. Which I was so excited about, but it is a joke because I am pretty sure he has gotten off on time twice in the last 4 months. It is hard to have little kids and a husband that leaves for work before they wake up and gets home after they are asleep most days.
    I think the hardest part is not being upset when they have to work late or can't take a phone call. It is so frustrating, but they are at work. He is saving someones life and that is hard to see when I am up to my elbows in baby and toddler.
    Luckily he does get AMAZING paternity leave. He took 6 weeks off with our daughter and 4 weeks off with our son. I don't know how you do the beginning without that.

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  11. Grace, having four children as young as yours is absolutely a full-time job! And as rewarding as it is, as someone currently without children I am fully aware of how hard and lonely it would be at times. I work full-time and am in awe of all that you do! You do all this while maintaining an awesome blog that is a delight to read. And as the daughter of a doctor (I was born when my dad was in residency) I can say that I am so grateful to my mom for staying home with us and I treasure the memories of all that time with her! It will definitely get better. :-)

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  12. If it is available, take a place in family housing! It has saved my sanity to be living next door to other people (mostly women, some men) in the same boat, especially with a toddler and another on the way. I know not everywhere has the option, but it's awesome if it's there. Holidays aren't quite so lonely if there are 4 other families in the same boat.

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    1. Doesn't exist here but would be nice for sure!! :)

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  13. Grace, my husband is in law enforcement, and believe it or not I deal with a lot of the same issues! Working on holidays, midnight shifts (gosh I hate those), lonely weekends and having "top priority" jobs. Reading your blog has really helped me deal with a lot of my issues, as I see that I am not the only wife out there struggling. You do a great job of keeping perspective...something that I am continuously working on! Thanks for sharing your story! Merry Christmas!

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  14. You and Simon can both be real heroes! The work that you both do is super important!

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  15. I really like the way you describe these years! As a current fellow married to a fellow (and previously we were residents together) I think we actually have it easier than my friends who are home with the circus while the hours fly by for us at work. Medicine is such a social profession that I truly feel for spouses at home alone or with the little ones. Keep up the hard work...We have a toddler with a little one on the way so we'll see how this round goes!

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  16. Military wife over here. When my husband is deployed, it's survival mode for sure! Once he gets home, it's like I get to lift my head and breathe for the first time in months. One deployment, he left when our 4th was two weeks old, although thankfully my oldest was 13 at the time, so I had another pair of hands. And you're right - you can't tell anyone what it's really like, because everyone thinks their version will be "better". Just keep thinking about Florida....! :)

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  17. My husband is a second yr attending..but I remember when he was on night float in residency..and my daughter was up all night every night! What a nightmare!

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  18. Great post! My husband and I work overseas and sometimes we have similar issues especially the holidays, loneliness and just plane ole isolation. Everyone's experience is different but it's encouraging to know there are others out there and we are all just trying to make it through the day at times :) Have a Merry Christmas!

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  19. I can 100% relate to this. I mean obviously we are not a medical family but we are a military one. Is that like apples to oranges here? But I had NO idea what I was getting myself into, even though Chris and I dated while he was in. But between the schools, deployments, and normal 15 hour days, I am sometimes left sitting here like what? But I do like your perspective on it all, and I love that you said to not wait to have kids. I tell people that all the time...if you base it around the Army's schedule you will never have a child. Don't be afraid to give birth without your spouse, I had to do it ;) But as always thanks for keepin it real mama!

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  20. You nailed this post! Great perspective and tips on surviving residency. We have baby #4 on the way and she will be our first residency baby, so it will be interesting to see the difference of having a baby now instead of in medical school.

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  21. No way! YOU ARE THE TRUE HERO HERE!!!!!!! I mean I love Simon (I mean, not like that. I've never met Simon, but in the way that you can love another woman's husband who you've never met in a totally appropriate and not weird way - I love Simon), but still..... YOU are the Hero! Simon, back me up here! (www.athingcalledloveblog.com)

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  22. Oh gosh I am certain that Simon works exceptionally hard and has an impossible task of trying to balance everything, but you, work harder, without a doubt in anyone's mind. There was a 6 month period when my little was a newborn that my husband wasn't home before 2am every night and working weekends and I only had the one baby to care for and felt like I was sinking. We too live away from family and my gosh it is isolating. So add three more babies into the mix and I cannot imagine the strength and self-assurance required to not only get through each day, but to do it with a smile on your face (sarcastic smiles totally count!) . Simon needs to guest post about this from his perspective, in his spare time! Rounding out the cliche sayings, but show me a successful man and we can all see the woman responsible for his success. xx

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    1. aw thanks, Meg!! I will tell him .... I would for him to guest post on anything!! You are so sweet - life with the first baby is TOUGH and going it alone had to be so trying!

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  23. arg my comment vanished, the gist of it- our home schedule can be a little crazy too with us both working full time and my husband coaching too (which basically means you have about 20 guys who see you as their coach, their therapist, best friend etc. and you get people texting at 2 in the morning) - brief moaning session, but makes you realize there are people (namely Grace) who tough it out through way worse:) First baby on the way and feel slightly less nervous about balancing it all. Had one of those vivid pregnancy dreams the other day where I hadn't taken my maternity leave and was trying to manage a new born and work and this had led to bottle feeding (shock horror) and when I went to feed this tiny baby it looked up at me and said " Really? I mean really" in a condescending tone- I think when new borns start talking to you in your dreams it means you're over stressing? yes? hahaha

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    1. definitely not way worse! I think coaching sounds a lot more consuming than residency!!

      And cracking up at that dream! All our kids have been partly/mostly bottle fed .... and look how great they've turned out? ;) (wink - of course!!!!)

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  24. You amaze me. Truly.

    The comparison game is not fair, but when I compare you to me, you win each time. I am d-y-i-n-g right now with the arrival of our third child and my husband is not a doctor. He works a pretty standard job and every day he comes home and I hand the baby to him and walk to the room and lie on the bed not talking or even thinking for a while. Last night I got in the car and drove to KFC to buy myself nuggets for dinner while he fed the kids. It was delightful. What sort of woman have I become?!

    Anyway. As previously stated - you amaze me.

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    1. no - no comparing!! it's all hard!! I had a hard time with Simon's med school hours when Julia was an infant ... one baby is tough and lonely!!!

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  25. I have 2 under 2 and my husband ends up missing bedtime because of work sometimes. That is the worst time of day solo. All you can think about is showering and a book or uninterrupted tv time! You are amazing! :)

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  26. Great to hear some realistic advice. My husband is in 2nd year, so I'll try to soak up the good times while I've got them!

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  27. "I'm the one working the crazytown hours under lots of stress and little sleep" ...you are, though! Your work is "just" at home but that doesn't make it any less work!

    I really admire you, Grace... I'll be honest, back when I was in the midst of infertility and my husband's residency, and you were struggling and having kid #3 or something, I didn't get it and I couldn't read your blog. But now that I'm sitting here *hoping* (unrealistically) that my 6-month-old naps for more than 35 minutes because she's been fussy almost since she got up at 6am and her dad was already gone and won't be home until 6pm and its going to be a long long day, and I'm still trying to pick up the pieces after (only two weeks of) night float ended on Monday... I get it. Residency is hard, being married to a resident is hard. Only 194 days to go... (And then we're doing residency number 2 which we just matched into today(!), BUT I think you may be wrong about there being no easy residencies because the first year of my husband's occupational medicine residency will be him taking classes for a master's in occupational medicine, and working one full or half day a week in clinic!!)

    Anyway, great post. I especially liked your points about enjoying the easier rotations (my husband hates internal medicine outpatient clinic but I love it!) and being kind and gentle with each other (something I really need to work on!)

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    1. oh, although I've never fully experienced it firsthand - I think the pain of infertility trumps all of the struggles that come with raising children (I know some people might disagree) and I'm so sorry if my blog does a poor job of reflecting that!

      And - what?? where was that residency four years ago when Simon was looking into all the different fields?! I hope it's as great as it sounds!!! :)

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    2. Oh, no, I hope I didn't make you feel bad... I stopped following a lot of mom blogs those days. And yes, the pain of infertility was worse than anything--but being a mom definitely has its challenges and struggles too, as I'm now discovering. I just couldn't appreciate that then, obviously.

      By the way... I met your brother last month. (He's in high school with my brother-in-law. My husband is an alumni of the old school.) (I hope that doesn't make me sound creepy...)

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  28. For what it's worth, you ARE working crazytown hours (24/7, actually) and you ARE under lots of stress with little sleep, so both you and Simon are rather impressive.

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  29. Oh I love your blog so much! My husband is in year 5 of his ENT residency and it has been TOUGH! These years have taken a toll on us and our 3 kiddos.

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  30. Hey, I love your blog, just curious if you guys are going to have more kids. We have four and are considering one more.

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  31. I am scared to death to have kids! (mostly the whole pain of childbirth thing...im a wuss obviously) & you make me want to have them! You are an amazing mother!

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  32. This was a good post. My husband works night shift full-time and farms with his dad so he's either sleeping or gone at work or the farm which means taking care of our 4 kidlets is all my responsibility 95% of the time. It's hard, but I've learned to deal with it. When other moms complain to me about their husband being gone once in a while during bedtime, I just chuckle...I can't remember the last time I had help juggling four kids for bedtime. The baby is tube fed and always needs a feeding at bedtime so it's pretty tricky. I was gone one night a few weeks ago and my mom babysat. She was completely frazzled when I came back, lol. Our situations may be different, but they're pretty similar!

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  33. Hello! First time to your blog today and found my way to this post and I just wanted to comment and tell you how much I appreciated your honesty. My husband is a Pilot and the travel, the constantly changing schedule, the on-call, and the weather delays, and what it all boils down to: the time away from home. I know our situations are a bit different, but I feel ya! And when I look back to four years ago, I had absolutely no clue!! I love my husband and I'm committed to him and nothing would change that, but wow I had a rough few years breaking into this! And now we are at this point where we both want to have a family, but we feel overwhelmed by the idea of it. So thank you for your honesty and your encouragement. I look at your story and I see so many similarities and it makes me think, if you can handle four kids I could certainly manage one little one :)

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  34. New to your blog and glad I found it! My fiancé is a surgeon and has been with his practice for 10 years. About three years ago, two of the four docs left. It has been very tough and lonely. My fiancé and his partner have been running their private practice day in and day out....Full office, surgery, on call every other night, every other weekend. On the weekend he is not on call his daughter is at our house. Hopefully Spring will bring good news and they will be joining our local hospital/healthcare system. Good to know that someone out there "gets it". I'm met with a lot of "what do you have to complain about, you're life must be great, you are marrying a doctor" Pleeaasssse. Time and loved ones is what's important, not money folks. Keep bringing the good stuff Grace and thanks for keeping it real.

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  35. Oh thank you for this! Your humor and your wisdom. My husband starts (well, hopefully!) residency this year and I am oh so nervous. Glad to see you all made it out alive ;)

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  36. Trying to enjoy every minute of med school because residency has me shaking in my boots.

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