Life has changed quite a bit in the last two years. My husband and I have been blessed with a wonderful, healthy little boy, Willem James, and I can’t describe how much joy he brings to our lives with simple things like smiles and cooing. Life is in some ways simpler — as a family we are often reduced to the repetitive tasks of sleeping, eating, peeing, pooping. But the simplicity has moments of beauty mixed in, as when a crying child finally relaxes all his muscles and “gives in” to the sleep that has been beckoning him.

I am back at work now, and have been really struggling with whether or not to pursue a pediatric intensive care fellowship (another three more years after I finish this year of residency)…or be finished with residency and start general pediatrics. I sometimes wish I wasn’t drawn to the intensive care field. It is probably the most demanding fellowship in pediatrics, but I keep coming back to how much I love working in the intensive care unit.

Last summer I heard a sermon from a wise, respected pastor in Sioux Center, Iowa. With welcoming, simple demeanor, he said, “Seven days have passed since we last gathered in this sanctuary. For most of us, no life altering events have occurred… and perhaps we aren’t that changed from seven days ago. But for a few, these seven days have brought us near the experience of death.” Later in the prayer time, we prayed for a little child suddenly and unexpectedly admitted to a PICU (pediatric intensive care unit) with kidney failure. This family had experienced what the pastor was describing. For that family, the last seven days facing death were life-changing.

On the following Monday, I started my PICU rotation, and I loved it. I loved taking care of the really sick kids. There’s nothing like walking alongside a family when their child was once healthy, but some freak accident or pneumonia or diarrhea or whatever has brought their child to the valley of the shadow of death. Something about the PICU is raw and absolute; layers of pretension are stripped away and we all — patients, families, staff — have to deal with the life-altering issues at hand. I feel privileged to be alongside these children and their families for their “seven days.” And it’s very intellectually challenging. There is no “how-to manual” for most things that children come in with. The PICU brings together so many of the things I love about medicine.

But general pediatrics is incredibly valuable as well. You get to be there for the long haul, walking alongside families through health and disease (but mostly health). Hopefully, one has opportunities to play a role in things like preventing obesity, guiding teenagers through the rough years, celebrating with new parents the new life that they hold in their arms. And the lifestyle seems to be a bit more predictable, more family-friendly.

So back and forth I have gone, with feelings of guilt and passion and confusion. I have coveted the prayers of those who have been beside me in this, praying that God will again make his path clear, praying that he alone will be glorified in whatever we decide.

I had been praying for over a year for guidance about pursuing a fellowship, and there was never a clear day where I felt God leading me any specific direction. I was often jealous of those who said, “God told me to do….” But then, over the course of a couple of weeks, it became more clear that general pediatrics was where God was leading me and the family.

First of all, it was quite clear that I was tired! Being a mom and a resident is exhausting. I never regret having Willem when we did, but I don’t think another intense three years of a fellowship would be healthy for me or the family. More importantly, I realized in church one Sunday that I hadn’t been praying in faith that God would provide a fulfilling job in general pediatrics. Soon after, I met with my global health mentor who is also a strong believer. He encouraged me that God has brought me this far and he will continue to be faithful. He was sure that I would find a job (though perhaps not immediately) which combined my passions for caring for sick children, forming deep relationships with them, teaching medical students and residents, and serving the underserved, perhaps globally.

And so, the search begins for a general pediatric job. I’m excited about the possibilities!