Dr. Vicki Engel steps into the examination room, and before she even takes out her stethoscope, she has a pretty good idea what's going on with her patient, a working mother like herself. "I can spot them right away," says Vicki, a part-time family physician in Kingston, NY. "I'll ask them how they're doing and I'll get 'the look'—that happy-tired smile that says, I love my life, but I'm so exhausted." Vicki suggests vitamin supplements, stress-reduction exercises and offers nutrition tips. She hopes the doctor-patient relationship they've built over the years will inspire her patient to take better care of her own health—so she can keep caring for her family.

As much as they need medication and therapy, patients of Drs. Weeks and Engel Family Medicine—who range in age from infancy to 104—need understanding and compassion from their primary care physician, says Vicki. A love of science led Vicki to pursue a career as a family doctor specializing in osteopathic medicine, which concentrates on treating the whole patient. But becoming a mother three years ago, when she and her husband, Nils, adopted a boy and a girl from an orphanage in Kazakhstan, brought her to a whole new level of caring. "I'm a better mom because I work," says Vicki, who graduated from the Philadelphia College of Osteopathic Medicine and keeps part-time hours at the clinic she runs with a partner. "It allows me to appreciate the time I have with my children. I'm also a better doctor because being a mother continues to teach me deeper, more meaningful ways to care for someone."

Married ten years ago while she was in medical school, Vicki and Nils always looked forward to starting a family. They began trying in late 2000, as Vicki neared completion of her residency at the Mid-Hudson Family Health Institute in Kingston. Three years later, she still wasn't pregnant. After a failed round of in-vitro fertilization, "we decided that the infertility roller coaster was not for us," she says. "We wanted to be parents. There were children who needed parents. We decided that adoption was how it was meant to happen for us."

Vicki, whose ancestors are Russian, felt drawn to that region of the world. Her research led her to the Children at Heart Adoption Services agency in Mechanicville, NY, which specializes in international adoptions from the Republic of Kazakhstan, a country that stretches over a vast expanse of northern and central Eurasia and shares borders with Russia and China.

The couple traveled halfway around the world in February 2004 to visit a rural orphanage. There, child welfare officials presented them with 26 different children from whom to choose. They had 20 minutes. "I wish I could say that there was a magical moment the first time I saw Alex and Julia, but the whole experience was very surreal and overwhelming," Vicki reveals. "Fortunately, my husband was drawn to the same little boy and little girl that I was. Now, three years later, I am deeply in love with them, but it was a journey, not a moment, for me."

Vicki and Nils originally planned to adopt one child, until a social worker told them that the average life expectancy for people who grow up in Eurasian orphanages is only 30 years. They decided to adopt an 8-month-old girl and a 10-month-old boy. The process, from when they started their paperwork to when they brought home their children, took—ironically—nine months. "Our hearts were in the right place," Vicki says, but she laughs at her "total ignorance" about how much work lay ahead.

Within a month of returning home, both Alex and Julia started walking—usually in different directions. "For the first year, it was just survive until the next day," Vicki says. "I remember thinking, How am I going to make it so that I'm never alone with these two?" Vicki, who worked 80-hour weeks during her medical residency, recalls feeling that nothing was as hard as parenting. It took a good year, she says, before she felt comfortable and "like I knew what I was doing."

Now 3, Alex and Julia are thriving. Vicki and Nils, a full-time software salesman, share child-care tasks like getting the kids ready for preschool. "Nils is 100 percent with me in raising our children," Vicki says, "but we joke that we don't want them to outnumber us."

The couple found a big source of help in raising their kids when Vicki's parents, now retired, accepted an invitation to move into the couple's home in New Paltz, NY. Her mother cares for Alex and Julia three days a week when Vicki sees patients at the clinic and does her hospital rounds.

Her mother also offered much-needed perspective during Vicki's first months as a mom. "Early one day, my mom said good morning and I burst into tears. I felt so overwhelmed," Vicki recalls. "My mom just said, 'Sometimes moms have these days. Why don't you take a shower.' I did—and felt so much better."

Because of student loans, Vicki says, not working was never an option. But she also has discovered that being a full-time stay-at-home mom doesn't fit her personality. "When I'm at work, I get the adult stimulation I need to feel challenged and energized," she says. "This allows me to enjoy playing with Alex and Julia and stay engaged when I'm with them."

On the days Vicki works, she tries to be home by 5:00 p.m. so she can prepare dinner. Evenings are a blur of activity. While her husband does the dishes, Vicki has bath and bedtime duties. After the kids are tucked in, she tries to catch up on episodes of The Oprah Winfrey Show stored on TiVo.

The hardest part of being a new mom was giving up the illusion of being in control. No matter how organized she tries to be, Vicki has accepted the reality of living with 3-year-olds: Anything can go haywire at any moment. There was the time Julia gave herself a mullet haircut with a pair of child safety scissors, and there are those moments when the world must stop because Alex needs help dressing Cookie the frog in a bumblebee suit. "Three-year-olds have their own schedule," Vicki says. "I was used to being prepared. Now I have to be completely flexible. It was a huge lesson."At work, Vicki's staff is careful not to overbook her. The reason is twofold: She must honor her commitment not only to her children but also to the patients with whom she has bonded. "There's always at least one patient who needs that little bit of extra TLC," Vicki says, "and I need to be there for her."Spotlight on Vickie

GREATEST CHALLENGE Living in the moment. I have to remind myself that if I don't complete a chore this very minute, the world won't come to a halt. Childhood flies by, and I don't want to wake up one day and feel like I missed it because I was cleaning.

BEST SOLUTION I have to physically stop what I'm doing, sit with my little ones and talk to them. It might only be 15 minutes, but I feel better because that was one moment that didn't get away.