Some real oddities in the doctor-sister letter:

1. "Caity" is the made up name for the sister? Usually the pseudonym is a common spelling of some kind. Why not spell it "Katie"? Makes me think Caity might actually be the sister's real name. Either that or the doctor thought about it WAY too long.

2. Little sister in her upper 20s is "considering" becoming a doctor? This implies she's not even in med school yet. Assuming she can even get in, she still wouldn't be a doctor until she was pushing 40, by which time big sister will have had her practice established for over a decade.

3. "Changing careers at this point is not a realistic option" for big sister? Who in their right mind would abandon being a doctor? Moving to a different city doesn't come to her mind? And speaking of changing careers, if little sister has always been so much smarter and more talented, why exactly is she ditching her current career? Apparently everything hasn't come up roses for her, else she'd be enjoying her professional success too much to consider going back to school and trying something else.

4. The doctor decides writing Prudie is the best option? Therapy never came into her mind?