Life in a Children's Hospital

Somewhere in Texas

Finally the rotation I've been waiting for!  Pediatrics!  I'm doing my pediatric rotation in Driscoll Children's Hospital in Corpus Christi, Texas.  Rocky Vista sends two students down at a time and another classmate was heading to San Antonio so we decided to car pool...all 18 hours.  But it was fun seeing New Mexico and Texas.  The hospital provides students with housing and there are several students rotating through at a time.  So I moved into a house with 4 other lovely ladies that is located across the street from the hospital.  Most of the other students are natives to Texas so they've been showing me around and teaching me all about Texas.

Dr. Tooth Fairy

The first week was spent on inpatient at the hospital.  This was my first time working in a teaching hospital with a residency program.  It is very different from the other rotations I've been on.  Also the most routine I've had in my days.  Every morning starts with Morning Report at 7am.  All the residents and medical students are there.  This is where those on call through the night report the patients they admitted.  The teaching attendings are there also and they elaborate on the cases when need be.  Then a teaching topic is presented by one of the interns.  At 8am you head to the floors.  For my first week, I was on the floor that had all the renal and neuro patients.  My second week I was on the cardio and heme/onc floor.  I would follow a resident around while they rounded on their patients.  Then I'd try to get all my notes in the computer before the attendings came and we'd all round again and present the patients to them.  This would take until lunch time.  Lunch was eaten while in Noon Conference.  A research presentation or Journal article were presented during this time.  Then back to the floor where we discharged or admitted patients all afternoon.  Check out occurred at 4:30pm.  The head resident would present all the patients on the floor to the head resident that was on call for the night.  This could be really short or take forever depending on how full the floors are.  Halloween occurred during my first week.  The hospital goes full out.  I went as the Tooth Fairy.  We were all encouraged to dress up and participate in the Pumpkin Parade.  All the children got to parade to every floor of the hospital and were given goodie bags that were full of everything but candy.

During my first weekend, we took full advantage of our time off.  Corpus Christi is right on the gulf coast and the weather makes it feel like summer.  So of course we went to the beach.  I tried surfing for the first time.  It is really hard!  People make it look so easy but I had the hardest time maintaining my balance.  But in the end I got a good photo op and a salt water sinus rinse :-)  We ended the perfect day by the water with some delicious fish and chips while watching the sunset.  It was a great day.  On Sunday it was time for brunch.  To continue with my Texas education I had chicken and waffles.  Interesting combination that actually tastes really good together.  Some other fun things we did as a med school family was take the Ghost Roll Sushi Challenge.  It was a mistake!  After one piece each we were all in tears!  I actually think I burned away some of my stomach lining.  Even after that, none of us can think back on that night without laughing.

Week 2 began with me back on the floors and then onto the PICU (pediatric intensive care unit).  This week was a little more frustrating for me.  I had some difficult patients that really made me ask some serious questions about medicine in general.  One infant had minimal brain function and was on a respirator.  This child has no quality of life and yet everything medically is being done to keep this child alive.  He has been through multiple surgeries and will definitely have more in his future.  When is enough enough?  When does mercy step in and medicine step back?  I admit that I am coming into the picture late and I never had the privilege of seeing this child really alive and thriving.  I am not a mother and so cannot speak with the opinion of one.  I never held him in my arms, have never seen him open his eyes.  Maybe with the hope of having that child back is what keeps this family fighting... I honestly don't know.  I have only seen him sick and what looks like suffering to me and it breaks my heart.  In a situation like this there are no right or wrong answers but it really makes me think.

Another difficult situation I came across was a teenager post kidney transplant.  This child had been given an incredible gift several years ago.  They were given a second chance.  Why were they in the hospital you ask?  Because they were in kidney failure due to rejection and all because they didn't take their anti-rejection meds.  Again, I can't speak from experience and I can image having to take drugs twice daily for the rest of your life can be annoying but really isn't that better than being back in kidney failure?  I was shocked to learn that noncompliance with anti-rejection meds is a huge problem in the teenage population.  Statistics show the highest risk for organ failure due to noncompliance is having an 18th birthday within 3 years of your transplant.  Some physicians are arguing to make teenagers be on dialysis, just to show them how much it sucks, before receiving a new kidney in the hopes of raising compliance rates.  If that isn't a big enough ethical question for you, then how about this.  Do patients who go into organ failure due to noncompliance get the same priority for a second transplant as those on the list for the first time?  Do they get a third chance?  I don't have the answers and I do not envy any member on the ethics committee.

           
 In the PICU I got to care for a lot of congenital heart disease.  There are so many different defects that a heart can be born with and the surgeries to repair them all are pretty amazing.  It's awesome seeing a baby looking really sick before surgery and within 12 hours post surgery they are awake, being held, eating, and smiling.  I was really surprised at how fast these kids recover.  And the babies are all so cute!  They are also a puzzle.  You can't ask a baby what's wrong and how are they feeling.  You have to discover it all for yourself by using clues and your observational skills.  It's a mystery waiting to be solved by me.  It's fun and exciting most of the times.  Sometimes it's frustrating.  Like knowing when a baby is just fussy or fussy because they're in pain.

I have one week left here in Corpus.  And I spend it doing heme/onc.  It's the moment of truth.  As some of you may know I've been telling people since I was 6 years old that I was going to be a pediatric oncologist.  Now we will find out if it's everything I think it is.  Wish me luck!