When LaVina Miller Weaver chose to leave her Amish community at 17, it wasn't a frivolous decision borne of teenage angst.
She desperately wanted to please her parents and stay true to her faith by marrying an Amish man and having seven or eight children. But she simply couldn't ignore a tremendous desire to do something else with her life.
"I just went to them crying, 'This is what I have to do,' " she said. "I wanted so much to have their blessing."
Their reaction reflects the beliefs of a faith steeped in three centuries of tradition and teachings that admonish individuals to place community before themselves and preserve family values.
Her parents didn't agree with her decision but respected her choice. An aunt was less understanding, refusing to eat at the same table with her.
Today, about 10% of all Amish teenagers choose to leave their communities -- a small minority compared to 50 years ago when as many as 50% were leaving, sociologists say.
Weaver and her husband, a doctor who also left the Amish church, offer a unique perspective as former members of the faith who are valued, paradoxically, for the worldly knowledge that they could not have gained if they were still part of the church.
Leaving opened Weaver up to new freedoms.
She worked as a nurse at a mission in Haiti, got her bachelor's degree in nursing from Goshen College in Indiana, married and earned a master's in pastoral counseling from Ashland Theological Seminary in Ohio. She works today as a nurse and mental health therapist who counts among her patients Amish women who suffer from depression and anxiety.
"I'm sort of in a bit of awe that I returned to work with my own people in a capacity I never could have before I left," said Weaver, 52.
She recalled the rigors of college classes and the aloofness of the students being a challenge, but said her first chemistry test brought her to tears -- when it came back with an "A."
"I couldn't believe that I could do this," she said. "From that time on, I became a bit of an academic.... The world opened up to me."
That's the sentiment expressed by others who have left, Weaver's husband among them.
"No one came to me and tapped me on the shoulder. It was more wanting to see what's out there," Dr. Wayne Weaver said.
At 26, with a pregnant wife (his first) and three children, he felt that he had to leave. His father would have preferred that he didn't. The local bishop tried to get him to change his mind.
But he uprooted his family and hoped for the best.
Minister David Kline, a member of the Amish community in Holmes County, said leaders didn't scare people into believing in church teachings but he understood that some young people wanted something other than what the Amish lifestyle offers.
"It's bound to happen. They feel stifled," Kline said.
With a high school equivalency diploma (an Amish education ends after eighth grade), Wayne Weaver made the leap to college and medical school. He did volunteer work in Honduras and Liberia, then started a private practice in Virginia.
Weaver said he never would have considered becoming a doctor until he spent time working in a hospital. "It was still a little bit of a sissy job in my mind," he said, noting that he was raised to believe that physical labor was real work.
After his first wife died of cancer, he returned to Holmes County, where he met LaVina Miller. She'd also come back to the northeast Ohio county where she was raised to help care for her sick father.
Wayne Weaver, 66, now serves the Amish community in a way that he never could have had he remained a part of it. He works in the emergency room of Pomerene Hospital in Millersburg, where many of his patients are Amish.
The paradox of having to leave the Amish to serve them as a doctor isn't lost on Weaver.
"You can't have it both ways," he said.
Emanuel Hershberger, 80, understands the value of having a doctor with such close ties to his Amish community. He calls Weaver his handyman because his family can go to him with problems. Weaver understands the Amish way, he said, and was the first person Hershberger called when his wife had heart trouble.
Weaver is reluctant to acknowledge his value to the community, a reflection of his Amish upbringing and its teachings against vanity. But it's clear that he tries to protect them from over-doctoring and unnecessary, costly medical procedures.
The Amish pool their money and pay cash for their own healthcare, a practice that makes Weaver more likely to advise a $500 ambulance trip over a $6,000 helicopter transfer -- unless it's absolutely necessary.
The Weavers, who are Mennonites, live on a hill in the countryside in a two-story home filled with photos of the doctor's children and grandchildren, whom his wife has adopted as her own.
Over the years, they have seen changes in the Amish community, such as a departure from farming, which have forced fathers to take jobs outside the home, creating more stress for their wives by leaving them to do more of the child rearing.
This is where LaVina Weaver can help as a therapist who herself came from a large extended Amish family. She exudes a calmness that reflects the temperance of her Amish roots. Her steady manner doesn't go unnoticed by co-workers in the hectic hospital environment.
"There's Amishness oozing out of me in ways that I don't even know," she said.
She is aware that some Amish fear that because she can speak to the women in their native tongue, Pennsylvania German, she could put subversive ideas in their heads. But for the most part, she believes that the Amish value her and her husband for their worldly experience.
"They'll call us on the phone about medical issues or even political sorts of things that go on in the community, or concerns they have, just to get our perspective because we see it from both worlds," she said.
The Weavers have never regretted leaving the Amish church. They never second-guessed themselves. But they're thankful that the Amish principles that place importance on family, faith and the value of a hard day's work have made them who they are.
"Our value system still reflects our Amish heritage," LaVina Weaver said. "We so appreciate and value and honor what we received from that culture."