Late in the academic year, I decided to seek a pediatric training program elsewhere in the city. Unfortunately, no position was available, and I was told that I would have to wait another year for an opening. Because our undergraduate loans required monthly payments, I had no choice but to find other work in the interim. I stumbled onto a public health residency training program offered by the New Jersey Department of Health.

The regular hours offered by this residency allowed us to start a family. We soon began the frantic search for quality, affordable child care and worried endlessly about our infant daughter while we were at work. Our life seemed torn apart, our loyalties divided, as we attempted to be with our daughter as much as possible while simultaneously trying to meet the academic demands placed on us. I vividly recall my daughter crying inconsolably for the first 3 months of her life. In retrospect, I believe that she did not suffer from colic; I'm convinced that she suffered from having an overly anxious mother. My fears that all I was doing was wrong were fueled by the neighbors' never-ending, freely dispensed advice. Compounding those fears was the tremendous sense of guilt I suffered every morning as I left the crying baby in the care of one in a long line of ever-changing child-care providers. Even my efforts to calm her while nursing must have been thwarted by the production of adrenaline-rich milk.

As I eased more comfortably into motherhood, I was able to concentrate on my residency and I found myself more enthusiastic about the work than I had initially believed possible. I became especially interested in the public health applications of epidemiology and applied to the Epidemic Intelligence Service (EIS) program at the Centers for Disease Control (CDC). At that point, I was a mother of a 15-month-old child and in the early stages of pregnancy with baby number two. This scenario created concern on the part of CDC about my suitability for acceptance to the incoming EIS class. A pregnant EIS recruit was an unknown entity, and as I interviewed for one potential assignment after the next, I could feel the cool reception as I entered each office. But the health officer in Maine was not afraid to give a pregnant recruit a chance, so an assignment to Maine was the ultimate outcome of the EIS match.

We arrived in Maine in early August, greeted by the rain, fog, and chill of what we were to learn was a typical summer day. I started work the following Monday, leaving my husband as temporary child-care provider. The moment I returned home at the end of the day, he would disappear into the far corners of our rambling 1796 house to renovate what was to become his office while I nursed my infant son and simultaneously balanced my young daughter on my lap. Our weekends were filled with looking for a suitable child-care provider, unpacking, and settling the family into the new home.

I had been continually instructed by my CDC mentors to go out and "find those outbreaks!" Find them I did, even on holidays and weekends. Trying to be a true shoe-leather epidemiologist, I had no recourse but to take the two young children with me on outbreak investigations after hours, when child care was especially difficult to arrange. A salmonellosis investigation over the July 4th weekend was especially memorable. I locked the two kids in the vehicle (fortunately, no one reported me to the Child Protective Unit of the Maine Department of Human Services) while I interviewed the manager, staff, and food handlers of a national fast-food chain restaurant. During the course of the investigation, I confiscated suspect food for laboratory testing and stashed it in the car. Later, while I was inside the local hospital reviewing the emergency department log for potential cases of salmonellosis, the two kids happily munched on the confiscated food. After thoroughly berating the poor kids for "eating Mommy's work," I rushed back to the implicated restaurant for more specimens. Neither of the kids became symptomatic, so I was able to enroll them as controls in my study.

Realizing that my training was still not adequate for a practicing epidemiologist and taking advantage of a depressed economy in Maine (where members of the state government workforce were encouraged to resign, retire early, or take an unpaid leave of absence), I decided to return to school to pursue a master's degree in public health. Now with four children, ages 11, 9, 7, and 4, I moved to Boston, leaving my husband behind to maintain his practice and financially support my academic pursuits. I found the return to the classroom gratifying and fulfilling. It also put me on an equal footing with my school-age children: We spent evenings commiserating over extensive reading assignments, unfair examinations, and unrealistic teachers. Long after I'd put them to bed, I sat in front of my newly acquired computer, struggling to meet assignment deadlines. Our weekends were spent commuting back and forth to Maine so that my 9-year-old could fill his lungs "with that clean Maine air." With the end of school and my return to work in Maine, my reward for pursuing further training was a cut in salary and increased responsibilities, the typical scenario for a public health practitioner.

My career as an epidemiologist has been a family affair. The kids have been influenced by my work over the years, as demonstrated by my son's show-and-tell in kindergarten, when he apparently provided an all-too-vivid description of Escherichia coli O157:H7 infection and bad hamburger. My career choices have been influenced by the various stages in development of my marriage and family; as a result, I have had the flexibility to respond to the needs of a growing family. My personal and professional life is very fulfilling and richer because my husband and four children have provided me with a broader perspective on life. My needs as a working mother have guided my public health efforts in Maine; hence, I have become involved in such issues as infectious disease threats in child-care settings, injury control, and promoting a safer food supply. I like to think that my work as a public health practitioner has been enhanced by my training and by the personal events, opportunities, and chance occurrences that have culminated in a rewarding career.