Pffffffffff

That's the sound of pressure being released.

Last February, when Henry was in the PICU, Jay had to leave to interview for two MSK (muskuloskeltal radiology) fellowship positions. At his interview in Denver, he interviewed with a well-known MSK expert who offered him a spot but hinted that she might be retiring and there was a chance that she would no longer be at the university when he came. We weighed the pros and cons and decided that the program there was a great program even without her and that the extra year of training would be good for his career. He accepted the fellowship position and for the last year, we have been planning on moving to Denver at the end of June.

About a month ago, the above mentioned radiologist sent Jay an email saying that she had, in fact, left Colorado and was working in Utah (part time at the University and part time at a textbook company) but that the situation she had left in Colorado was unfortunate. The department chair had left and as of yet, they had been unable to find a replacement. In essence, there was no one left there really qualified to teach Jay about MSK. Immediately after reading the email, we both knew that we would no longer be going to Denver.

In her email, she mentioned that she was attempting to work something out his behalf Jay at the University of Utah. It wouldn't be a full-time MSK fellowship because they had already filled their position (as had every other program about a year earlier) but that if he would be willing to fill in as Jr. faculty for body imaging, they could teach him MSK 50% of the time. We were both grateful for her concern for Jay's education and the strings she was willing to pull and thought Salt Lake would be a fun place to live for a year.

Several months ago, Jay asked me what I thought about living in Arizona. The radiology group that his residency is affiliated with (Inland Imaging) is opening a branch there this fall and they wondered if he was interested in going there after his fellowship. (Very unfortunately, they don't have any MSK openings here). I balked - rather loudly. It's hot there. I hate being hot. I think I burst his bubble a bit but you know when you get asked "So, where do you think you guys will end up?" about a million times during this medical journey - never did I consider anywhere outside of the mountain west. I have never been set on a particular place...but mountains, seasons, proximity to family were all included in my rosy picture.

When mention of this change of plans leaked to Inland, they started talking to him about going to work for them this fall in Arizona and doing a 4-6 month MSK training with them (they have never done this before and it wouldn't be a credited fellowship). I started to soften my position regarding Arizona because I could sense that it was an offer that appealed to Jay. And the more I softened, the more convinced I became that we could sincerely be happy there. Jay weighed both options and while he felt either choice placed an asterisk on his fellowship credentials, the Utah asterisk was probably the smaller one. After lots of praying, we both felt really good about going to Utah.

Then came another email from the program director from Utah saying that they had received a couple of applicants for the body imaging position so they would no longer be able to work something out with Jay. We both felt like the rug had been pulled out from under us...again, and wondered why we had felt so good about Salt Lake.

The talks intensified with the radiology group here and we were fairly certain that we were heading down to Arizona this fall. The idea that we were going to be done with being students, after all, was very attractive and my initial reluctance about living in the desert, away from any family and in a big city (all three pretty big strikes in my book) melted away. I actually felt really excited about it.

About two weeks ago, Jay received another email from Utah. They wanted Jay to come interview but they had worked out another way to fund Jay's fellowship. Now, he was going to get to do 100 % MSK (four days a week) and work as faculty at the VA one day a week. This offer was significantly better than the original one but mentally,we had shut that door and it was really hard to reopen. Why struggle financially through another year if Jay had a job that was great and where he'd be able to do what he wanted without a fellowship. We were both surprised that we weren't salivating at the offer. He agreed to an interview but we had decided that unless he LOVED it that we were going to Arizona.

He left last Sunday and interviewed Monday. He started his day going to a sarcoma conference and was impressed by the studies they showed. He got a glimpse of the kind of education he would get as a fellow and realized that a year there would put him at the next level of radiology. He'd get to train with this world-renowned radiologist that he wanted to train with in Denver but now in addition to her, there were four other really good MSK radiologists he'd be learning from. He came home and sheepishly told me that he really LIKED it. I have never been personally opposed to the fellowship anyway and really, what's one more year when you've already done nine?

Through all of this, Jay's nerves have been like a ticking bomb. He's a planner and his fellowship was taken care of a year ago! I felt so awful for him, to have to worry about this when his boards are coming up in June and also about how these changes affected our entire family. He hates feeling like he's just dragging us all around. And we both care more now with Seth in school than we ever thought we would. I get really sad when I think about leaving here and would love fewer transitions for him.

So, we had all of this pressure and I couldn't write about it! I couldn't even really talk that much about it (although I did with a few people because otherwise I would have exploded!) We are both very glad that the uncertainty for next year is over. I think this is the best choice for Jay and we have family in Utah so it will be great for me and our kids too. And after that, who knows? I think this makes Jay very competitive in his field. I think any group will be lucky to get him.