Finally, more paediatrics!

The following are a few excerpts taken from my iPhone, written in the past 6-7 weeks. A packed schedule meant that I didn’t really have the time to actually sit down and write on my laptop. Pardon the spelling and grammar, as microsoft word wasn't there to guise my decreasing leengueestick abilities. Enjoy.

The new partner

A new rotation also meant that I was assigned a new partner. Admittedly she was very enthusiastic and upbeat about seeing babies, up to the point it was almost an obsession.

Each day classes would start at 9.30am. We often ended up arriving at 8 to see patients in advance!

I wasn’t overly surprised to be dealing with a typical Type A Med Student personality. However, it became increasingly clear that I was holding her back with my lackadaisical attitude toward ward duties.

I was also taken aback with her OCD-ish obsession with washing hands. Not only did she make sure that she thoroughly washed her hands every other 10 minutes, she made sure I did too!

Palliative Care

Palliation and paediatrics are two words that simply do not belong together. Baby Nathan is 6 months and was diagnosed with a complex lysosomal disorder. He probably won’t survive past two years.

It hit me there and then when the palliative care team were contacted to make sure that the ‘end of life care’ pathway protocol was initiated. The fact that the little guy was oblivious to it all made it even worse.

As a general rule, babies do not belong in the hospital. They belong in their parents’ arms happily feeding away.

Professor Gill wisely compared babies to little animals. They are (initially) simple beings with simple needs. They cry for only a limited amount of reasons; hunger, pain and poo.

Communication

Explaining a disease with the aid of Mr Snuffles the bear really challenges one's ability to convey a simplified explanation of a complicated surgery. Yes, a child deserves to know everything about the treatment even though he is too young to consent to it.

Establishing trust is also a whole of a different matter. One cannot expect to earn the trust of a child by simply dressing up and looking like a doctor. It often involves sinking down to the child's level, interacting in his language and engaging his interest by playing with him (and his toys)

“Becca, what happened to you?” I asked, even though I knew she had swallowed a coin.

Becca remained silent. She hugged her Elmo even tighter, signalling that she didn’t want to be disturbed

I tried something else

“Hi Elmo! I’m a doctor here to make Becca better. Can you tell me why she is so sad?”

Becca started to pay attention

I continued making conversation with Elmo.

It worked.

Becca admitted that she swallowed a copper coin, much to her Dad’s relief. Anything bigger than that and she might’ve required more invasive tests and monitoring.

We sent her home.

Elmo saved the day. (see how modest I am?)

Paediatric reflection

After 6 weeks of almost being in another world of medicine, my paediatric rotation ended.

The whole rotation served to affirm my attraction towards the ‘happier’ side of medicine. Ward rounds involved messing around with toys, when in truth its really part of a disguised neurological exam, gauging the child’s response and movements. All in all it was a great experience, and thankfully doesn’t end up in the ever growing list of rotations I will never even consider pursuing in the future.

VIVA VOCE

I’m writing this as I wait in the office for my turn. Yup, it's exam day. And to good effect the enormous workload has rendered me emotionless...

20 minutes later...

"So hereditary pancreatitis is associated with a mutation in the SPINK and PRSS1 gene. The patient is more likely to develop chronic pancreatitis at an early age. He would also require close follow up with a yearly MRI to detect pancreatic cancer as there is an increased risk associated with HP."

Anne looked impressed. Then she said, "That was impressive..."

And, for the encore performance, I had the "carrot trick" (click for explanation) up my sleeves.

"I saw a baby with a tracheostomy because she had, errr, errr..( pause for good effect) P-p-pierre Robin syndrome" I said while scrunching my eyebrows (note the purposeful stammer)

They took the bait.

"So tell me, what's Pierre Robin syndrome?"

I tried to hide my excitement.

"Pierre Robin syndrome is..."

In other words, I knocked it outta the ballpark...alhamdulillah

On to the next rotation, Obstetric and gynaecology. The worst rotation in Medical School. More on that in the next post.

Cheerio