Sunday, February 21, 2010

There's a 95% chance I'm doing pediatrics

So, I haven't blogged in what appears to be over two months. Goodness, what will become of my avid readers? Who will comfort that hole in their lives, that hole that is the word weaving that is "Scribe for Life"? Well the answer, ladies, gentleman and hotties is a new entry. A new entry for a new year. BRACE YOURSELF

So let's recap pediatrics. I ended on two weeks of clinic . Clinic was fun, for the most part I hung out with my friend Kristy and we split patients between us, the awesome medical students and the residents. One of the most important things that we learned about was the importance of moisturizer, Curel. Eczema and dry skin is pretty much the plague of pediatrics. When the temperature goes down, the heat goes on and the skin dries up. Let's just say our attending is a BIG FAN of curel.
I also learned the importance of cleaning ear wax.





Now let's enter one of my mental/actual conversations after volunteering to irrigate an ear:


Robert (in head) : all right, let me go ahead and uh.. put this piece in the ear
Robert: you okay little man?
Robert: sprays the hear [kid starts getting angry]
Kid: ow ow ow
Robert : (in head) ooookay... a little longer.. HOLY CRAP WHAT IS THAT?
[sees a chunk of wax in the receptacle]
[looks in Ear with otoscope]
Robert: (in head) looks good... WHAT IN THE ... DID I JUST PERFORATE THE EAR DRUM? PLAY IT COOL ABDULLAH, PLAY IT COOL
Robert: ma'am , I'm gonna have to go and umm... grab the resident to see if we got all the wax we're gonna get
Robert to resident: Uhhhh I may or may not have blown a whole in this kid's ear drum, please come look and tell me I didn't
Resident: [checks it out], says it looks good.. assures me ear drum's fine
..... then we proceed to clean the other ear...... to a screaming kid.... all in a day's work....

Another life lesson: Everyone likes stickers.... kids most noticeably but I don't think I know any normal grown non-curmudgeon that doesn't like em:


Another lesson related to stickers and promises: Don't ever promise something you can't deliver:

Robert (to two brothers who are there with their sister) - Gentleman , would you like some stickers?
Kid 1: Yeah, can I have batman?
Kid 2: Superman?
Robert: Sure, I'll go get em
[Robert walks to room with stickers... awww damn.... just transformers... hmmm... ]
Robert: Here's the stickers guys
Kid 1 (speaking for both): I'll take both, Kid 2 doesn't want his... wait.. this isn't superman OR batman...
Robert: Yeah, sorry about that
{Kid isn't really bothered... BUT he could've been....}

LIFE LESSON: Some girls are crazy, like secretively bipolar, on the verge of exploding crazy.

LESSON: Steer clear of such girls or always prepare for the crazy to leak out (above picture is Dr. Jekyll/Mr. Hyde)


So even after all the crazy, I still love pediatrics. Interestingly, my first week on Internal/Eternal medicine I started with Infectious Disease. The ID Doc got to knowing that I enjoyed and more than likely will pursue pediatrics so I was able to work in the HIV/AIDS Pediatric clinic and round on a peds patient while on ADULT INTERNAL LAMENESS MEDICINE.. SNEAKY....

I ended up seeing a little guy who I actually met when I was on pediatrics . He was a Nec Kid (had necrotizing enterocolitis) and had short bowel syndrome from his resection but got a line infected resulting in a systemic fungus infection.

But he was fine, perhaps it was a contaminant or whatnot but this little blue eyed glove grabbing little man became my buddy. I also worked as a sort of consultant , in between the ID Docs and Peds GI. The Peds GI doc called me very "thorough" and thanked me which was awesome. Remember when you're a big bad attending, the littlest of things and compliments (when earned) makes a student's day.


So infectious disease was fun, got to see some unique cases, worked in the Peds HIV/AIDS clinic for half a day. Cards was fun, got to see an ablation done which if you ever get to see, do so. You basically map out the heard and use computers and EKG technology to pinpoint the area of fibrillation. Then you ablate it with some waves, being careful not to burn the adjacent esophagus.


But yet again, my favorite case was an ECHO of a little man who was being worked up for newly diagnosed sickle cell disease. My last two weeks were spent on clinic duty, helping out residents by seeing patients and in some cases, outright seeing the patients on my own and presenting to the attendings by myself. The problem is , I don't see myself keeping happy in 10-15 years working with / against/ futile attempts with chronic disease. Somewhere between trying to figure out which of their 20 meds needs refills and if they're taking their meds and not understanding why we have them on their medications ... I find myself growing weary already.

Oh and I got to pull a two fer on a patient presenting for back pain. I definitely gave her a pap smear and I and D'ed her abscess. That wasn't as awesome as it sounds. Not much else to clinic, I got to work with my bud who I shall refer affectionately as "Hermione Granger" which is a shame because we would have made a sick inpatient team combo but alas, I begin inpatient 1000a Monday morning with a call night to boot... so here goes nothing.. 8 weeks left... and then I'm 75% done with 3rd year.


So to recap:

Curel does wonders for the skin
Don't promise , if there's not a 99% chance you can't deliver
Everyone loves stickers except losers
Stay away from crazy girls if you can
Love till it hurts and even when it does, love some more
Make time or time will make you


What's left
8 weeks of internal medicine (inpatient team, on call every 4th night)
6 weeks left of psychiatry (snicker)
6 weeks left of ob/gyn (GROSS)
May 30, 2010 - The most awesomest person's birthday ever
August 14, 2010 - STEP 2 - CK
August 19, 2010 - STEP 2 - Clinical Skills











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