I remember you mentioned you have a PhD acceptance - I was about to apply MD/PhD in 2020 when I got an acceptance to a DBA program (long story that makes sense for anyone who cares to listen to it, haha). I was struggling on whether I should accept the invite or continue toward MD/PhD when the director of pre-professional advising on my campus (who was writing a LoR for me) said, "Hey, you're wanting to do research in health systems... take this doctorate and do that research you've been wanting to do for years. Med school will still be here when you're done." Although the DBA is a slightly different experience than the PhD, it was an amazing experience for me and I'm certain yours will be, too. If you're still interested in practicing medicine like I am, in a few short years you'll be a stronger candidate and you can apply again. Either way, I'm hoping for the best for you and your loved ones and am rooting for your professional and personal successes.