Monday, November 21, 2011

Land of the Little People

"Children are not just little adults." That's what the pediatricians would have us believe. And the converse is what other physicians assert. "Pediatrics is just veterinary medicine." That's what the surgeons say. All of this has some element of truth.

Kids are very different developmentally and metabolically compared to adults. Every age is marked with milestones, knowing and utilizing those milestones are key when "finessing" a peds patient to cooperate. And a lot of the patient history is obtained through the parent/caregiver, so in a sense it is like veterinary medicine.

I can't believe this is my 4th (and last) week of inpatient peds this year, and I still have SO MUCH MORE to learn!! Hopefully I learn a lot of that while I'm on my outpatient month coming up next. In some ways it's such a different world from that of adults, and in other respects way too similar. Like all the rotations before, there are things I like and dislike about this rotation. I LOVE my patients, sometimes I linger a bit too long in their rooms. But my team isn't as efficient as I'd like and I wish the residents had a bit more time to teach us.

So I've come to realize that I don't particularly care for hospital medicine (that is, only treating acutely ill patients in the hospital). I like a mix of inpatient and outpatient care. Peds certainly hasn't fallen on my list of things I want to go into, but this rotation hasn't reinforced it as much as I thought (or hoped). But the reasons why I'd choose peds over medicine remain true.

But that's for another post, as it's getting late and I have to be in at 6am. This month is almost like working surgery hours, ugh.

Thursday, November 17, 2011

Tribute to Life

It's been almost 3 weeks since I began my pediatrics rotation, wow! I had been debating what the "final" post for surgery should be - either a collection of quotes I've obtained on surgery, or something more meaningful. I decided to go with the latter.

A few days ago, I saw the following vid on the blog Chronically Lost in Thought.

My Friend Jason. from Shot at The Dark on Vimeo.

It's an interesting vid for me to watch, as it presents the same hard decision but from a different perspective - a family member's. The decision to let someone die isn't an easy one, but sometimes it's the "right" one.

On the doctor-side of things we reflect end-of-life decisions back to the patient and/or their family member(s). Our goal at this point in a patient's life is to ease suffering or at least prevent prolonging suffering. We don't consciously, however, consider that the family member's agony in losing someone personal, and with them, lose all possibilities of creating new memories and tying up loose ends of the past.

So just something to muse on before I proceed to the much happier world of peds.