Finding a specialty you love- Natalie Crawford, MD

I loved every rotation my 3rd year of medical school. Some rotations were certainly easier than others, but I found things fascinating in each field. I really did not know which specialty to pick. A mentor suggested I consider emergency medicine because you do a little of everything, become a jack of all trades, and think quick on your feet. You also make good money and have time off - so I thought it was perfect. I did a rotation and I thought it was great. So then after interviewing across the country I matched into my #1 EM residency pick at UT Southwestern in Dallas! I was thrilled.



Well, it wasn’t right for me. I loved the people I worked with, and I found the day to day job interesting. But something was missing. The schedule was exhausting (days and nights) and I felt like I knew a little about everything (instead of a lot about one thing). I did a lot of soul searching and realized the main problem was I missed the patient connection. I missed the continuity, the patient experience. I constantly wondered what happened to my patients. Luckily at UTSW we did some ob/gyn rotations as EM interns, and I just loved it. I loved the patient relationships, the combination of medicine and surgery, it was right for me. Looking back, I think I was nervous about ob/gyn as a medical student because of the notorious “difficult” lifestyle. I always knew I wanted a family, and a field that was known as demanding made me really (really) nervous. However, after doing something that I could feel was not right, I felt more committed that I should be spending my time in a specialty that inspired me. It was an extremely hard decision, but 100% the right one for me.

Ob/gyn residency is tough, but it's very humbling. When things are bad, they are bad. The 25 year old who dies from a cervical cancer only diagnosed because it grew as a mass out her c/s scar, the baby that doesn’t make it after an emergency c/s because of a placental abruption, the mom who dies from an amniotic fluid embolus. Man, those moments really suck. This is what makes it real. Some patients have such bad scenarios. I always remember that as a patient, you can never prepare for your worst day, because in reality, the hardest or worst things in life are the things that you can never imagine happening to you. As a physician, my job is to try to be prepared for those moments. Things in the OR are systematic for a reason – there is a huge trust when a patient allows you to operate on them. It is my job to be prepared. And no patient ever imagines or wants to come see me. I am an infertility physician – nobody ever thinks/expects/wants that to happen. So every patient walks in a door that they never want to have set foot in. My job is to educate them, sympathize with them (because infertility sucks), and help them make the plan that is right for them. And hopefully the end result is a healthy baby.

I often get asked about how I ended up becoming an infertility physician. Well, due to my EM experience, I knew that taking care of patients and having a bond with them was key to my happiness. I also was very interested in fellowship and being a true “expert” in a field. I decided in my 2nd year I wanted to do REI (Reproductive Endocrinology and Infertility), for a few different reasons. I love the physiology behind the endocrine system – so complex but it feedbacks so perfectly! I love the procedures. I love the surgeries. I love that infertility treatments are always pushing boundaries and evolving. But really, I love the patients. I love that this field requires a lot of trust and it is a very personal field. Patients are struggling, they often feel isolated, and being able to be there to help them through this time and understand what they are going through – those bonds mean the most.

It is again, another match, you apply at the end of 3rd year, and interview over the summer before 4th year. Match day is in October. I knew I wanted to do REI and I felt like I had prepared myself to the best I could, I worked in a basic science lab and presented at national meetings. REI is competitive. There were about 40 spots the year I applied. My approach to interviews: go everywhere I could. Seriously, I went to so many places, but I met amazing, inspiring people in the field, and I truly got a sense of what the places had to offer. Residency programs tend to be similar because there are so many requirements. Fellowship programs really differ. It was really tough making my match list. In the end, UNC was the right fit for me – I loved the location and the patient care focus to the program. As compared to some programs that have a lot of shadowing, UNC gives their fellows independent clinics and we practice like any other physician in the practice. It is amazing. I can’t even being to express the learning that happens when you are given the respect and autonomy to function independently.

What is work-life balance?

Balance. Balance is really hard. It is a constant goal and not always achieved. I think the key is to understand what is important to you and prioritize your life in this way to be present for those things which really matter. The truth is, regardless of how hard the training is – this is your life. In medicine, we too often delay gratification and are always planning/waiting for the next thing. I’ve had to learn to enjoy where I am in the moment.

In residency, it is hard. Your schedule varies rotation to rotation, which can be hard on loved ones to understand. This time was really hard for J and I because I would work long hours, be really tired, and neither of us made our relationship as big of a priority as it should have been. Balance took realizing that I needed to take care of myself and we needed to plan quality time alone into the schedule for when we could. I’m not going to lie, it was hard.

Balance is overall much easier as a fellow and out of training - but it is much harder as a mom. Generally, I try to give myself 100% to my patients when I’m at work, then I leave the first moment I can. I get home and we give 100% to the kids until bedtime. We eat dinner together, play, baths, bedtime, etc. Then J and I do the dishes, clean, pack lunches, get ready for the next day. I try to cuddle with my babes while they will still let me, and I just know they are growing so fast.

What is it like being a doctor and a mom?

Has being a mom changed me as a physician - YES. 100% YES. I know that my field is special and unique and I have always loved helping couples achieve their dreams of starting a family. But going through it all myself - the uncertainty and fear with infertility, the craziness of pregnancy, and the pure joy (and exhaustion) of being a mom, makes me view this process completely different. My littles have brought so much love and endless happiness to my life, more than I honestly knew possible. And I want this so much for each of my patients. I want each patient struggling with infertility to be able to see the lines on a positive pregnancy test, tell their partner and jump up and down with excitement, experience the first kicks, see your little peanut waving on a ultrasound, pick out the perfect baby name, experience the emotional roller coaster of birth, hold that sweet, sweet baby in your arms, and watch them turn into their own little person (which happens way too fast). I know how precious it all is. And it makes me want to work so hard, and do everything I can, to help every woman experience this. Being a mom has 100% changed me as a physician.

On the other hand, being a doctor mom is hard. When a patient of mine was trying to get pregnant at 40, who never thought she would want another child because she had 2 amazing kids. But her youngest died at 4 years old of cancer… man. hard. I certainly went home and held my kids really, really, really tight. And when my daughter had pneumonia, you can bet I sat by bed and watched her sleep, listening to her lungs and counting her respiratory rate. The truth is, being a physician and a mom are not just titles. They become who you are. People who say you can separate the work and home are crazy in my opinion. To be a physician, it invades your soul. It will always be a part of you and it will impact everything you do. Because you know how bad it can be, you know what the worst case scenario could be. Being a physician gives you perspective and it makes you cherish all the moments of your life.

What sacrifices have you made for your career?

Time. Anyone in medicine will sacrifice time. Time away from your friends/family, weddings you miss, baby showers you can’t attend, holidays at work, quality time with your partner, and tucking the kids in bed at night. You will miss things, it is a sacrifice, and at times it will hurt. But to be able to care for patients is a huge honor. And with it comes tremendous responsibility. Patients trust you to help them. The training is hard and demanding because there is a lot to learn. If the training were easier, you wouldn’t end up as such a great physician. There are fewer compromises as you progress through the training and into your career, but the sacrifices are real. Surround yourself with supportive people who love you. Shower them with your love and lean heavy on them. You can 100% do it all, you just can’t do it alone. Find your tribe.

 

Stay in touch with Natalie by following her Instagram & check out her website which is launching soon.