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Monday, March 9, 2009

Pediatrics... Uh-Oh!

I've been wanting to write this for a while now but it's just been a hectic couple of weeks what with the classes, both skipped and attended, the exams, both near misses and lucky escapes.
So here's another foray into the earliest clinical experiences and their impact on a confused med student shopping for a marginally successful career.

I've always struggled to understand kids. I'm only consoled by the mutuality of this feeling when it comes to my younger brother and sister, my younger cousins etc... There's always been animosity and for a reason. I don't seem to get them. Trouble inexorably ensued!! For me, as far as kids are concerned, no one could have said it better than the late Bernie Mac: "...Oh shit come help me babysit these m*****f******s..."! I know that to the baby lovers and kid huggers among you I'm gonna sound like a Neanderthal but I'm banking on an outside chance of a few of you feeling about the same way that I do; so I'm out on a limb I guess...

10:15 am - Visit # 1 - The Regular Checkup for the Obnoxious Fat Boy
Phase 1 - 5 year-old kid walks in with his mom. A 2-minute dialogue between the physician and the kid's mom about diet, playtime habits, and vaccines follows.
Phase 2 - Physician invites kid and mom into exam room.
Phase 3 - Kid enters battle mode and seems to latch on to his mother's leg in a grip worthy of the most intractable centipede dead-locks!
Phase 4 - Kid is now on the exam table - don't ask how that happened - screaming his little butt off while physician desperately tries to hear something in between the groans and moans with the stethoscope, as the kid gasps for breath.
Phase 5 - Physical complete. Physician calls for the nurse with the vaccines (I named her the Shoot'em'up lady).
Phase 6 - Shoot'em'up lady comes in, tray in hand, with 2 shots worth of vaccines. "One in each arm please", says physician.
Phase 7 - All hell breaks loose as Shoot'em'up lady pricks the kid once and another time. Me watching, worried that the little demon's gonna fidget one time too many and break the needle off in his flesh with dire consequences. Shoot'em'up lady's job? Not for the faint hearted!
Phase 8 - Shoot'em'up lady in the sweetest of voices: "there all done! That was not that bad now was it?" Me in the corner, trying not to puke.
Phase 9 - Physician declares the session over, gives the kid a lollipop. On to the next one!

10:35 am - Visit # 2 - The Regular Checkup for the Demonic little girl
Same as above. Please replace "5-year old" with "4-year old", "mom" with "dad", "his, he, him..." with "her, she, her...", and "all hell breaks loose" with "My eardrums burst" and that's about it, all the rest is essentially unchanged.

10:50 am - Visit # 3 - The Regular Checkup for the Sweetest Thing that Has Ever Existed (now that's a change of pace!)
A 2 month-old baby girl with the face of an angel. Brought in by her mom and grandmother. Onto the exam table after the formalities of phases 1 and 2, she lay silent, her fists clenched and her tiny arms and legs twitching from time to time. Her big grey eyes desperately looking for something to focus on apart from the bright overhead light. The physician examined her, looked at me and said suggestively: "she has a very faint murmur you should hear." Even her guardians were nice and joked around, and actually acknowledged my presence, something no other parent/guardian managed to pull off, the physician's failure to introduce me as his apprentice notwithstanding, talk about professionalism! Would it be too much of an effort to say this is R., He's going to be learning with us today, please don't be freaked out by his curious eyes... but I digress... So here I was, awestruck, in front of a silent pediatrics patient, until, you guessed it, Shoot'em'up lady came in and screwed everything up with one little prick.

11:05 am - Visit # 4 - The Regular Checkup for the 2 Girls From Hell
This one was a bit funny, I have to admit. The older of the two went first. After a typical phase 1, phase 2, and phase 3, came a rather peculiar phase 4:
-Physician: "Let's see what's in your ears now all right?"
-Little girl, tears in her eyes, pouts and answers: "no. there's nothing there I checked!" I cracked a smile.
After going through phases 1 through 8, with the ruckus and the rivers of tears I had now adapted to, she looked at her sister (now in phase 4, the worst) who was screaming so hard that I was afraid her eyes were going to pop out. And then, in a condescending tone, one that flaunted her newly acquired wisdom to her sister, she quipped: "khalas! ma 3am ya3mellik shi! lesh 3am tebke??" translation: "Stop crying! what's the problem they're not doing anything to you!" I couldn't help but laugh, look at the Dad and say "oh, now she's wise!". The dad nodded, threw a fake smile my way and went on to talk to the doctor.

That visit ended at around 11:45. Another short uneventful visit (uneventful only meaning not any more eventful than the other visits, because you may imagine that there is no such thing as an uneventful visit to the pediatrician's!) and it was time for me to head out. And as I was getting ready to do so, the attending, having noticed my expressions of boredom and anguish, smiled and said: "It's a lot of repetition, this specialty." So I smiled back and said nothing. What could I say? "Yeah Doc it was nice watching you play and toss your stethoscope up and down while the nurse did all the real work" ? hehe no, I don't think so.

For me, it was an interesting experience, to be honest. Sure, for the most part all I could do is think about the best ways to shut the kids up, and these included hammers, fists, screaming in anger, but also, I have to admit that a nice strawberry lollipop and a reassuring kiss on the forehead went a long way sometimes. So what am I saying here? Hold on... I'm not so sure anymore! I mean when I started concocting this thing you're reading I imagined it ending very differently. Somewhere along the lines of "Kill the bastards", or "Fucking kids!" or... you get the drift... But as it turns out, I am just realizing now, as I'm typing, maybe I don't hate the little buggers as much as I used to... Maybe I did think that the little wise-ass girl was funny and cute, or that the helpless silent baby girl was just to die for... I must be growing up. Go figure. Well some of my closest friends would say: "it's about time"...


poshlemon said...

I enjoyed this ;) mainly because it started with a tone of loathing, which I share with you... but, how disappointing. The sloppy mushiness emerges towards the end ;) hehe.

Well, kids can be okay. I have a 7 year old cousin I adore. He and I have to see one another every day. He is my love. On the other hand, I don't feel remotely that way about his 5 year old brother.

But, if you were to get involved in pediatrics, I guess you must have an opinion that is a bit more fitting than just 'kids can be okay'.

Le colleague said...

Hate to have disappointed you. Alternate endings available on demand ;) In one of those I even kill one!! Nahh... What you see is what you get i guess...

I really didn't see it coming though. I have nothing but younger cousins ages 1 and up (I have quite a few!) and here's where i stand. I hate the ones that can talk, and love the ones that can do nothing but feed. Of those who CAN talk, only very very few get my nod. so pediatrics? not for me...

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