Allison sat waiting for her turn to interview for medical school at UW. She hadn't done well at her other two, getting flustered when they questioned her commitment and ability to be a doctor and a mom.
"Allison Altman-Hunt," a woman called.
Allison stood and smoothed the skirt of her dress.
"I'm Dr Deol," the woman introduced herself.
"It's nice to meet you," Allison smiled shaking the woman's hand.
"I went to Harvard with a Grace Altman, any connection," Dr Deol said.
"My older sister," Allison replied.
"Is she still practising," Dr Deol asked.
"She is in Seattle," Allison replied.
"How is Grace doing," Dr Deol asked.
"Her and Josh are good," Allison said, "busy they have 4 kids."
"Josh," Dr Deol said, "she was super close to a guy named Josh Riggs in med school."
"Same one," Allison said, "I've known them both my whole life."
They walked into the room and Dr Deol introduced Allison to the second doctor doing her interview, "Allison Altman-Hunt this is Dr John Williams."
"It's nice to meet you," Allison smiled, shaking the man's hand.
"You as well," Dr Williams said, "let's get started."
"Of course," Allison said, taking a seat in the chair they had pointed to.
"I'm going to get right to it Allison," Dr Williams said, "there's a red flag on your file that makes me wonder if you can be successful in the program."
"Everly," Allison guessed.
"That you have a child," Dr Williams agreed, "with special needs. I read your essay. It's very compelling but I wonder about the time commitment."
"I have done my four year degree with Everly and maintained a 4.0 GPA," Allison replied, "it's not easy and there are times when Everly has required emergency surgery that I have missed classes. My daughter is the most important person in my life. But I am not alone, I'm engaged to her father and we will get married this summer, my parents are very involved in our lives and supportive. My sister and her husband are a big part of our lives as well. "
"Do you have reliable daycare," Dr Deol asked.
"I do," Allison replied, "Everly is currently in half day preschool 5 days a week at Parkside with two afternoons of early intervention for her CP working on mobility. In September she will be doing 4 full days and a half day on Friday. We will have one of my parents pick her up from school and bring her home. For Monday to Thursday we have before and after school care arranged through a daycare. Evening classes she will be with her dad."
"When you have to do hospital rotations those have odd and unpredictable hours," Dr Williams said, "have you thought of that?"
"Yes," Allison replied, "both of my parents and my sister are surgeons. I know the lifestyle. We have family who can help as needed. Her dad is an electrician and his work is predictable."
"In your essay you wrote that it was your daughter who drew you to medicine. Can you explain that," Dr Deol asked.
"Everly is the reason I am pursuing medicine," Allison said, "there were complications with her delivery, the umbilical cord was around her neck. She was born with hydrocephalus and at 5 months old had a VP shunt placed. She has a bicuspid aortic valve. She also has hemispheric spastic cerebal palsy affecting her legs. We have been working with an incredible team at Grey Sloan, Atticus Lincon, Amelia Shepherd, Jenna Silverman-McKellar and Kevin McKidd."
"Grace Altman is the peds cardio person there," Dr Williams said.
"Grace is my sister, she can't treat Everly," Allison replied, "she has been helpful and very supportive."
"Your daughter's medical needs," Dr Deol said.
"She's doing well," Allison replied, "we've had two surgeries now, a couple rounds of casting. What the doctors have done for her to be able to help her have a normal life is incredible. I'm interested most in paediatrics or orthopaedics. Seeing the work her surgeons have done how hip realignment surgery last spring made it so she can stand on her own. I want to be able to do that for another family."
"What else inspires you," Dr Williams asked, "that's a compelling reason but does anything else influence you?"
"My parents, aunt and uncle, my sister and brother in law," Allison said, "I grew up in a family of surgeons. I've seen the difference that they make. And I'm aware that it is a lifestyle and one that isn't always easy on a family. I used to say I would never be a doctor. Then events in my life lead me to change my perspective. I didn't choose medical school lightly. I thought I wanted to be a translator and work for the UN or a kindergarten teacher. But the more time I spent in a medical environment, the more time I spent learning and having a reason to learn it the more I wanted to know. My choice is not easy, I know that. I also know that being a doctor I will have an opportunity to work with families like mine, I can look another parent in the eye and truly mean it when I say I understand. I was that scared mom hearing that her 5 month old needs surgery in the next 24 hours. I was 18. If I can do that I can do this."
"Beyond paediatrics or orthopaedics, what interests you," Dr Williams asked.
"Neurology, neurosurgery, obstetrics," Allison said, "family medicine."
"So not sure yet," Dr Deol said, "anything you really don't want?"
"Pathology or research," Allison said, "I want to work with living people and be face to face with my patients, to see their faces."
"I understand that," Dr Williams said, "we've already talked about some of the challenges you've overcome and I think you've shown a lot of resilience. In ten years where do you see yourself?"
"Finishing up residency," Allison said, "working, spending time with Asher and Everly, Ev will be in highschool."
"Allison what is the best quality you would bring to our program," Dr Deol asked.
"I'm resilient and compassionate," Allison said, "things can get hard or scary but I always find a way to move forward and make things better. As a doctor this will only help my patients, because I've learned that there is always a way to help. With my daughter I've learned that if one way to soothe or calm her doesn't work there is always a way to, I just have to look further into why she's upset. I have to find the root of what is bothering her and change that."
"And an area that you need to grow in," Dr Williams asked.
Allison paused, "I think that my biggest weakness is that I do a lot of my work independently right now. I enjoy group work and loved it in highschool how ever I have not had the opportunity to engage in group study sessions or assignments beyond group projects for the past few years."
"Why is that," Dr Williams asked.
"Daycare," Allison admitted, "groups wanting to meet spur of the moment after class and I haven't had time to arrange alternate care for Everly. I love group work and am happy to host group project meetings, but I need to know the day before. I'm a planner, I try to lay out a week or two at a time for assignments and scheduling when tasks need to be completed and working backwards from due dates so everything gets the attention it needs and I can do my best work. I don't do my best last minute, I like time to plan and prepare. I know that isn't possible in a medical setting to know every detail ahead, however there are standards of care and diagnosis that help us to organise our thoughts."
"We have a couple scenarios for you," Dr Deol said, "you can ask for clarification at any time."
"I'm ready," Allison said.
"Okay scenario one," Dr Deol said, "you are an emergency room physician, a child is brought to you with bruising, a head injury and a broken arm what do you do?"
"Do we know how the injuries were sustained," Allison asked.
"Not for certain, the child and the parent's stories don't allign," Dr Deol said.
"Who brought the child in," Allison asked.
"The mother," Dr Deol read.
"Age and biological sex," Allison asked.
"Six and female," Dr Deol answered.
"Symptoms," Allison asked.
"You need to ask specific questions," Dr Williams said.
Allison paused, what did they do when Everly had been taken in.
"Are the pupils equal size and reactive," Allison asked.
"Pupils are un equal and slow," Dr Deol read.
"Has imaging been done on the arm," Allison asked.
"No," Dr Deol read.
"Which arm," Allison asked.
"Left," Dr Deol answered.
"Is there any swelling or deformity," Allison asked.
"Swelling and deformity," Dr Deol confirmed, pausing the young woman was good. She knew medicine and the process.
"Is the bone through the skin," Allison asked.
"No," Dr Deol replied, "I need you now to tell me how you would proceed."
"I would first speak to the mother and gather the child's medical history," Allison said, "then I would proceed with a physical exam noting the location, size and shape of the bruising and documenting them. As I am doing the exam I would get the child talking and ask how they got hurt, seeing if the story matched the mothers. I would then proceed to have labs drawn and doing a blood count and checking for anemias. Following that I would send the child for imaging a head CT to rule out a traumatic brain injury and then finsihing with an x-ray for the broken arm."
"Why the head CT," Dr Deol asked.
"To rule out a brain bleed or any trauma to the brain," Allison replied, "that would require immediate referral to the neuro surgeon and airway, circulation and neuro come first in a trauma."
"How did you learn that," Dr Williams asked.
"My dad is a trauma surgeon," Allison replied.
"Why when the chief complaint from the family was the arm did you pursue talking to the child and head injury."
"My experience as a parent," Allison said, "from the information you gave me something doesn't feel right."
"What do you mean," Dr Deol asked.
"I think there is some abuse going on," Allison said bluntly, "the parent and the child's story not aligning, the location of the bruising on the cards you gave me. While I was waiting for imaging I would be notifying CPS and paging the on call social worker to speak to the family. I can not investigate if abuse is happening or not, how ever I have to report it my suspicions and protect the child. The child must be protected, she is a six year old girl, she trusts and relies on the adults to care for and protect her."
"Do you have personal experience with this," Dr Williams asked seeing how passionately Allison was speaking.
"Unfortunately I do," Allison said, "recently with someone I thought we could trust harming my daughter at a Thanksgiving dinner. The matter is still with the police and the courts so I can't say much more about it."
"Your daughter," Dr Williams asked.
"Everly has made a full recovery, she's back to her happy chatty self," Allison replied, "and we don't have contact with my in-laws for now. The incident happened in their home and until they can support us in ensuring our daughter's safety we can't have them around. We have put distance between them and us to protect Everly."
"You spoke to almost all of the points," Dr Williams said, "can you complete the treatment plan."
"Getting the imaging back I would call for orthopaedics to set the broken arm and cast it," Allison said, "if there was something going on with the head CT I would call for neuro to take over and refer to the surgical department. I would not discharge until given the clear to do so and that it was safe for the child by the social worker."
They ran through a few more scenarios and a few more questions.
"Ms Hunt," Dr Deol said, "while we had some red flags at the beginning reading your file the maturity, thoughtfulness and thoroughness you've shown today, you've changed my mind."
"Thank you ma'am," Allison replied.
"I will be strongly recommending you for admission following this meeting," Dr Deol said.
"I agree," Dr Williams said, "Allison you're ready for this program. I would be very optimistic in your shoes."
Allison walked out of her interview and texted Leo, "so?"
Leo," just finished you?"
Allison, "nailed it. You?"
Leo, "Texas is feeling good. I blew Harvard."
Allison, "so did I. UW felt great."
Leo, "I still have to do Columbia, Oregon and my remote UW."
Allison, "Oregon, Columbia, remote Texas and I got a call for UBC for one of the few international spots."
Leo, "taking it?"
Allison, "the interview yes."
Leo, "Asher though?"
Allison, "west coast but he said if we have to move we'll make it work."
Leo, "if we go to the same school I'll help."
Allison, "we could get a three bedroom place and all be together."
Leo, "we can do this Allie."
Allison, "we can. Surgeons?"
Leo, "Trauma. You?"
Allison, "ortho."
Leo, "we can work together."
Allison, "you'll serve you owe time and will owe more when you finish med school."
Leo, "I do."
Allison, "you'll come home and tell us about all your adventures?"
Leo, "always. How's Ev?"
Allison, "she's good. I need to go get her from school. She misses you.
Leo, "I'm home for Christmas in 2 weeks."
Allison, "when your 3 that feels like forever."
Leo, "can I call her later?"
Allison, "you can story time?"
Leo, "yes before bed?"
Allison, "she's in bed at 7:30 we do story at 7:15."
Leo, "talk to you then."