Thursday, June 26, 2008

An intern no more

WOW.....it's so hard to believe that it has been a year already, though on the other hand I didn't think this day would ever come. A year ago today, Ientered Children's Hospital in my fresh clean white coat with a bounce in my step and anxiety flowing in my veins. Upon graduation I had in one moment been transformed from "medical student" to "doctor".

The year in review:

July: Outpatient Pediatrics......felt like more of medical school. BOOOOOOOORRRRRING. And I caught the worst virus of my entire life. And personally learned what chills and cold sweats felt like.

August: NICU On call the first day of the rotation. I remember the first phone call from a nurse that required me to make a decision.

Nurse: "Baby Peanut had a 10 mL aspirate".

Me: "Ummmm.....ok, I'll come see the baby" (Internal dialogue, holy crap what's an aspirate?)

Me: {looks at baby, appearing all doctorly} To nurse: "You know I'm an intern"

Nurse: "Yup"

Me: "and you know it's August and let me add I did outpatient last month and learned nothing"

Nurse: "Yup"

Me: "OK, so well, what's an aspirate?"

Nurse explains that an aspirate in undigested formula pulled from the baby's stomach before the next meal is fed to these tiny baby's. Large aspirates can be a sign of serious intestinal infection in a preemie.

Me: "So, what are my choices"

I am presented with three choices and I choose one to which the nurse replies

"Hmmmmmmmmmm"

Me: "I see you don't like that choice, what would you do?"

And thus I made my first decision as a Dr. It' very funny now....not so much at the time.

I became very attached to my preemies...and as a matter of fact I still see 13 of them regularly in my clinic. I lost one baby that month which still brings tears to my eyes but I also witnessed a true miracle. Baby E came into this world weighing 1 lb 12 oz, blue and lifeless. I had to do chest compressions and bag this tiny thing. HIs changes of survival wre less than 20% and his chance of leading a normal life were minicule.

Meet Baby E at 9 months old

Just beautiful.

September: GREEN TEAM This is Adolescent Medicine/Pulmonary/Renal. I hated it, it was miserable. It is over. I have nothing esle to say.

October: Newborn Nursery What a truly happy rotation. I was the little dark thundercloud of doom though. I could bring all the pregnant women in the area into the hospital to give birth on my call nights. I hold the record for the most babies born on a single call day at 17. I also had a 14, 11, and 10. I still see several of these babies in my clinic as well.

November: I bought a house and moved in. Had a rotation of lectures and went on vacation.

December: RED TEAM I was disappointed that I didn't enjoy this more. This rotation was general inpatient pediatrics. Asthma, pneumonia, dehydration. I didn't particular bond with any patients and well I didn't like my senior resident.

January: ER. I had fun, learned alot and was sad to see it end.

February: Heme-Onc The greatest surprise of the year.....this was my favorite rotation. The disease process is interesting though sad. But you get to know your patients well. The relationships I made with these families still continue when I see them in the hospital. I'm returning to heme-onc in August to see if my love of this field is real.

March: Cardiology Not my favorite subject. But I did manage to not let die a 16 year old having a cocaine induced heart attack.....and the page to the cardiology fellw from me was classic "Patient X ont he floor, now complaining of crushing chest pain, ST changes on EKG, need help now" AMazing how fast things happen when something bad is happening. I couldn't find the drugs I needed on the computer eletronic order system so I called the pharmacy and was like I can't find it online but I needed it NOW and presto I had the meds. I recruited a baby to my clinic (see a trend?)

April: 2 weeks of my clinic (bliss) and vacation

May: Neuro.....loved it, bonded with my families. Was sad to see it end.

June: Red team again. Better this time but I don't like the rapid turnover of patient's. I like to get to know my families.

So now that I'm an all experienced 2nd year resident what changes other than I am not called an intern anymore.

Not much. I have fewer call months. (5-6 instead of 9). I'm the senior resident on the wards and have interns that answer to me for 2 months. My other call months are more difficult with sicker kids....surgery, ped ICU, NICU with sicker babies. I have the responsibility of doing more teaching to interns and medical students. And I have to figure out what I want to be when I grow up. I also have to take the boards and get my liscense.

So really, completing intern year though I. AM. SO. EXCITED. is just a hurdle in the process and I have 2 years to go.

Stephanie

Friday, June 6, 2008

In memory of Nicholas

This is what makes my job so hard......but makes me stronger for having known him. This is the first child that I have lost that I had direct long term patient care with. My heart was broken as I followed his condition. Privacy laws prevent me from saying much....but newspaper articles are public record.

Nicholas you were a beautiful child that brought joy to many. May you run free in the heavens and may the memory of your giggle be remembered by all that care for you.

http://news.nky.com/apps/pbcs.dll/article?AID=/AB/20080606/NEWS0104/806060391