The Ending of Peds

Readers - If you're reading this blog, I congratulate you on your everlasting determination in checking this blog for the rare updates I give.

So the pediatric rotation is closing its final chapter this week. I had my last day of clinic today, I get tomorrow "off" to study all day, and then take the board exam on Friday. It has been a wonderful experience. I have reaffirmed that I do, in fact, love working with kids. Despite this passion, I would never want to be a pediatrician. Aside from a period when the child is 7-9 months old through the age of three or so (it's at this age that kids realize strangers truly are strange and there is no comfort like being in the arms of someone familiar), kids will do what you ask of them since they look up to you. It's always the mean nurse who gives the shot, not the doctor with the toys in his pocket. The parents - now there's a different story. Disclaimer: Working at state funded hospitals such as UAMS and ACH provides us a skewed population. These are people who are often uneducated, uninsured, and many are just downright trashy. In private practice and for-profit hospitals, it's a completely different story. The parent's can't always tell their left foot from right, one father of their children from another, or much less Tylenol from Motrin. OK, so the last is an exaggeration, but you would be surprised how many folks I see don't seem to know how many people fathered their three to eight kids. They don't seem to understand viruses can cause fever, even when you attempt to instruct them using influenza as a perfect example: viral infection = fever. They often look at me, question my age and place and life, and then don't believe anything I say, followed by an attending physician who repeats everything I said. If I had a dime for every time someone questioned my age. . .

I start surgery on Monday. I don't yet know where I will be working, what kind of surgery I will be going to, etc. I hope we find out something soon.

I walked into the hospital the other day and the scent of french toast filled the air. I suddenly realized how long it has been since I ate such a thing.

I started training for the marathon last week. I have been running at least once or twice a week ever since the race last year, but never more than four miles a day. I up and ran six miles last Saturday without any problems. I wasn't ever sore afterwards, and I didn't even stretch before or afterwards. I hope this is a good sign. This weekend I will go seven miles - further than I've ever gone.

That is all I have to say for now. I thought I would have more, but I guess I don't.

Out in the Clinic

I, for the first time ever, and getting a real amount of clinic work under my belt. For the first twelve weeks of my third year, I worked only on wards - seeing the same patients, day after day, and writing about their progress in a chart which tended to grow exponentially the longer they were admitted. See, you would expect a linear growth, or perhaps a decreased rate of growth over time. This isn't the case - but I won't dwell on this for too much time for those not inclined to care for one second about mathematical relationships.

Clinic is. . .different. In clinic, I see different patients throughout the day, each one with a different history I have to learn in a few short minutes. I do a focused history and physical in the specialty clinics, taking much less time than a new hospital admit. I am now at the end of two weeks of subspecialty clinics - a different clinic each day, sometimes a different clinic between AM and PM. This means a new attending each day, and each one gives me a Pass, Fail, or Honors rating. Thus far, I have received all honors sans the one clinic I have yet to do. But this really isn't a true honor as most attendings hand out such ratings like they do stickers. I just don't feel as special as the five year old with a new Scooby Doo sticker. My first clinic was the immunolgy/allergy clinic. What a way to start - a bunch of little ones with runny noses and autism. That's another thing - every mom thinks her child has autism, which isn't the case. Perhaps more on this later, perhaps not. I have also worked in the adolescent clinic (which, mind you, I escaped without having to do a single teen STD/pelvic exam!), cardiovascular clinic, hypertension and nephrology clinics, genetics clinic, hematology/oncology clinic, the ER, and tomorrow is my last day on subspecialties, spent in the neurology clinic. They've all been pretty fun - some more than others. Working in the ER almost had me switched to emergency medicine, or pediatrics in the very least. Then I remembered that as long as our country's healthcare reimbursement/insurance system is set up as it is, common civilians will continue to be forced to misuse the ER. Oh well, ophthalmology it is. You may ask which clinic I enjoyed the most - but I don't have an answer. It varies too much say, depending on your attending, patient loads/types, nursing staff, etc. Most had their advantages and disadvantages all in the same experience. For instance, Dr. Kahler in the genetics clinic is a great teacher and a very interesting person to talk to, but he often talks TOO LONG.

Next week is when I start the nursery. I will be there for one week, and hopefully "catch" some babies. I won't be delivering them - that's reserved for the L&D rotation later on. Catching them simply means I take them after they've been born, clean them up, get them stimulated and crying, and make sure they're OK. We only do this with babies that don't appear as though anything will be wrong - if any problems are likely to happen, they are usually delivered in a much more closed and controlled environment without amateur medical students around to muck things up. But the nursery, much like the ER, is a hit or miss experience. Some people catch a lot of babies within the first few days. Some, like the students there now, are around very few deliveries and between the three of them, have caught maybe five babies since Monday. I hope a full moon pops up next week and draws the pregnant ladies out of the woodwork. The good Lord doesn't need to know that all I want to do is rub some babies clean.

I have a grill. It kicks arse. I got a good deal on it. I like to grill. Beef is good.

I don't have much else to report for now. I sold my truck, by the way. I keep saying I need to call Kyle to make sure he has a backup groom's man just in case I won't be able to make it. I have an exam tomorrow and my mind is therefore not in the mood to recount experiences over the past several weeks or rant over some aspect of medicine about which none of my readers will really care. And oh yeah, lastly but not leastly, Rachel is the best!