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It was not one thing, but one final one that tipped the balance.

Qia is a doctor and a good one. They have two children, she and her husband. He is an interventional cardiologist, doing cardiac catheterizations, putting stents, saving lives.

Qia is a neprhrologist. She argues with her husband about blood pressure. She agrees with the new guidelines, check the blood pressure standing up in anyone over 65 and don't drop it below a systolic of 150. "You die without kidney function." she says. However, you die a lot slower than the drop on the floor death of the heart patient.

The last straw is a dental appointment. She's set them up for the kids. She tells him because he will be off and be the one who takes the younger child, who is two. "When was your last appointment?" she asks, curious.

He shrugs.

She eyes him.

"Whenever you made my last appointment." he says.

She has not made him a dentist appointment ever.

There is a short silence, a pregnant silence. He leaves for work, kissing the air by her cheek. She sits. She feels very very tired. There is a shift, a pregnant shift, in her hormones. The male fetus is only two weeks along, but the testosterone level shifts down.

Interventional cardiologists and trial attorneys, when they are male, have a higher than average testosterone level. Their third child will become an interventional cardiologist, but only after the sex change is complete.....



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