It’s Such a Good Feeling

3 06 2012

For those of you unfamiliar with the reference, this is a line from the song that Mr. Rogers sang at the close of each of the later episodes of his show.  As I am “leaving the neighborhood” of pediatrics, so to speak, I found this title fitting.

The clerkship is over, and I still feel as drawn to the specialty as I did that second week.  I’ve already done a good bit of reflecting on the clerkship itself, so to cap it off, here are some snippets of the most interesting/fun/indescribable encounters that I had in the past couple of months.

  1. I was blessed enough to see only one child abuse case, and it was a case of neglect.  This kiddo followed the statistics; she is under a year old, suffered neglect at the hand of her mother, and is a special-needs child (profound mental and growth retardation and required a feeding tube).  She had been admitted to the hospital so many times for failure to thrive (not gaining enough weight) they eventually had to call social work.  The mother, it turned out, had gotten so sick of all the extra care that her child’s feeding tube required that she’d   stopped using it altogether.  The good news: when I met this kiddo, she was with a foster parent experienced in kids with special needs, she had gained weight, and she is doing so much better.
  2. A mother threw a fit in the clinic one day to the extent that we almost had to call security.  The reason?  She refused to vaccinate her kid with the 12-month shot set (specifically, the MMR and Varicella) and as a result, that child was discharged from the practice.  The mother was fit to be  tied because her two older kids—who were vaccinated—could remain at the clinic.  Some clinics have this policy, one that requires vaccination to remain as patients, and for good reason: if you have a tiny baby too young for the DTap, you want the herd immunity to be strong enough that the kiddo doesn’t contract pertussis in your waiting room.  Same reason why most public school systems require it.

3.    I was never seen as a med student to my patients or their families.  It didn’t matter that I wore a short white coat (many of the nursing students wore them too), it didn’t matter that I didn’t do what the nurses did, it didn’t matter that I introduced myself as a medical student or was presenting the patient at bedside rounds every morning with the residents and attendings and other students.  Everyone thought I was a nurse.   I was annoyed about this, partly because my name badge said MEDICAL STUDENT in bold letters, and partly because when they asked me and I explained that I was a medical student, they still referred to me as a nurse.  This, of course, meant that they expected me to be able to do all of the nursing things, like mix or warm up their formula or change the baby’s diaper.  Which I could do, but to be honest, I have a very specific set of responsibilities to do.  At the risk of sounding conceited, change your own kid’s diaper.

4.  One parent brought her kid into the clinic a few weeks back; he’d been bitten by one of his little playmates (another 2-year-old).  The bite looked unconcerning, but the mother was panicking because the other child wasn’t up to date on his shots.  No further commentary is necessary here.

5.   Last week, I had to tell a 15-year-old girl that she was pregnant.  She really didn’t react to the news at all –though her mother was nearly in hysterics.  She just kept reading her Disney princesses seek-and-find book; but then freaked out when I told her she needed to have blood drawn.  That poor girl… I wonder how long it will take for the gravity of the situation to really sink in for her.

6.   A mom brought her kids in for lice.  As my hand was on the doorway to leave the room, she speaks up and says “oh, by the way, their uncle has hep C, and one of them got stuck with his needle a couple of days ago.”  I’m sure that my eyebrows were through the roof at that point.

7.   WIC (Women, Infants, and Children) is supposed to be a supplemental program.  How many of the patients I see use it as a supplemental program?  None.  They all assume it’s supposed to completely cover adequate nutrition for them and their kids.  So because it isn’t supposed to cover the food costs, it doesn’t.  This leads to desperate mothers doing things like diluting their kids’ formula and switching their 5-month-old babies from formula to cow’s milk (BAD idea).  It’s not necessarily the mother’s fault, and it’s not the WIC program’s fault, but it’s no shocker that these kids come into the office with growth failure and severe anemia.

8.   Nobody breastfeeds—that’s the conclusion I’ve come to this month.  By nobody, of course, I mean a slim minority.  In this patient population—which is generally low-income—I estimate maybe 10% of the moms breastfeed their babies.  And even those have almost been within the small pocket of Russian immigrants in the area.  This is all I’ll say for now, as I’d really like to do a separate post devoted to this issue.

It’s been a great 2 months, all things considered.

Now, on to surgery!




One response

12 06 2012

Hi! I love reading about your experiences. Thanks for writing this blog!

So, what do you think?

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: