Nearly half a decade ago, I was a nephrology fellow simultaneously enrolled in graduate school while pregnant with my third child.

Nearly half a decade ago, I was a nephrology fellow simultaneously enrolled in graduate school while pregnant with my third child. When I wasn’t on service, I’d go to bed at 8:30pm, wake up 11pm, do homework until 3am, and wake up at 6am for clinic or class. Yet I was still able to remodel my home, go out to eat with friends, and enjoy 4 weeks of vacation a year. I did not believe it when my attending told me that life would only get busier. She was right.

As a physician, it's important to exude and project an image of confidence, knowledge, and decisiveness. After all, the eyes of patients, families, nursing staff, ancillary staff, and trainees are on you. There is no room to question or doubt yourself in the public eye.

Without a doubt, the hardest part of practicing any type of pediatric medicine is delivering bad news to the parents. It is very common for me to inform parents that their child has renal failure, needs dialysis, and a kidney transplant. There are a lot of tears, but with reassurance, there is comfort in hope for the future.

Like most physicians, I could write a book about hard cases. Many of them bring back memories purposely suppressed only slightly below our subconscious. Cases of severe multi-organ trauma, child abuse, social discord, DIC with uncontrollable hemorrhage, complicated zebras, etc. Regardless of the complexity of the cases, difficult cases come with difficult decisions.