Pediatric Ponderings

Today was my first day in inpatient pediatrics. My love for pediatrics was reconfirmed, as I enjoyed all of the patients, was able to handle the parents, and preferred the illnesses/chief complaints over those of the usual adult inpatient setting. With this being said, here are the extremely important, life-changing points that I am left pondering at the end of the day:

1. If I have a stuffed animal wrapped around my stethoscope, at what age is it inappropriate to have the patient guess what animal it is or name the color? I think seven could be a good cut off (obviously taking development into consideration). Pretty sure the eight-year-old thought it was lame.

2. What kind of stuffed animal am I going to buy for my stethoscope!? Tigers are my favorite. But, a monkey could be cute. (Sidenote: I hope you can tell I am writing this with sarcastic tones... mostly...)

3. Do I have to ask patients if there are "monkeys in their bellies" or "potatoes in their ears"? I like the monkey idea... maybe... but, I am pretty sure half of the kids under three didn't know what a potato was yet. Could be a problem. Maybe I'll say "cookie."

Adorbs!!! http://swell247.com/baby-doctor-gift-set.html

4. Apparently, I need to borrow my friends' kids and practice changing their clothes. Did not realize I'd have to do that... very awkward, need some skills.

5. Definitely will enjoy a subspecialty over general peds. Something a little more hands on... and when a parent asks what my job is, I don't want to respond with "I'm here to monitor how much your kid eats, pees, and poops." Gen peds is great for being the hub of information and consultation, but I want my daily skills set to go beyond the basic physical exam. Also, I prefer what's going down inside the body, as opposed to what's coming out of the body.

6. I think physicians are either drawn towards peds or drawn towards adults, and there is only a select few that can thoroughly enjoy both categories. Yesterday, an elderly patient was hacking up a storm and I was legitimately scared - had to make a conscious effort not to slowly back out of the room. Lots of things flashed through my mind... getting puked on, dentures falling out, patient falling out of bed, patient dying. None of these are good things (May I point out that I excel at stating the obvious?). In comparison, today, a pediatric patient was hacking up a storm and I was legitimately in doctor mode, immediately consoling the patient and helping him through the fit. Who cares if I get puked on? It will be a smaller amount. The bed is three times the size of this kid, and the kid isn't obese... not gonna fall out of bed.

For some reason, I see kids as more resilient than adults. I appreciate their innocence and potential, and I have more internal faith and belief in them, which is probably the main reason I'm drawn towards peds. Interestingly, my fellow med student friend feels exactly the opposite. She's terrified of kids, I'm terrified of old people. She views pediatric patients as fragile and scary, I tip toe around everyone over 65. She prefers adult puke, I prefer kid puke (again... smaller quantity, yo!). She prefers black and white, I prefer colors and animation.

Edinburg Children's Hospital in Texas. Seriously!?!?! How could you not be happy working here!?!?

7. If I have nightmares tonight, I know exactly who to blame. I've seen students/interns/residents get yelled at and reemed out by attendings before, but only on TV. Today, I witnessed an attending open the gates of hell and unleash 1,000 furies on an intern, and for literally NO REASON! She was walking by as he was explaining why a particular patient was unable to receive oral medication to me. The attending heard only the words  "use oral meds" and flipped out on the intern, telling him how he was "only a first year resident and knows nothing and shouldn't be telling people information that you have no clue about." She then went on to yell how it was "inappropriate for this patient to be on oral medication, so why are you talking about using oral meds? That's wrong. You are wrong." Which, as you can see, he was not wrong, as this was exactly the point he was trying to make, that this patient shouldn't be on oral meds. He literally had to chase her down the hall and try to politely interrupt her rant to defend himself, and then report back to his attending and tell her about the misunderstanding. I literally feared for my life and I was just standing there. Can't wait until it's my turn!