Friday, June 26, 2009

Reflections on New Intern Week

It is new intern week in teaching hospitals all over the country. The bright, shiny faces of brand new doctors who have their degree but only limited practical experience enter into the world of their real medical education and in some cases indentured servitude. The past week I have watched the new interns being toured around my hospital, appearing in the cafeteria en masse all tanned and relaxed appearing. New intern week doesn't effect me too much because we don't let the interns anywhere near our unit. Still seeing them around reminds me of that time 12 years ago when I was one of those bright, smiling faces in a different hospital, but the same deal.

I did a pediatric residency, because I wanted to be a neonatologist. I am unusual like that. I didn't much like general peds, but it was a necessary step. Anyway, as I knew what I wanted to do, I wasn't too scared when I got my schedule and saw that I would start in the NICU. My two colleagues were petrified. I was excited. Even more so because I'd be on call that very first night as an intern. We got oriented, we did our work. We had almost no idea how to do anything, but our chief resident and fellow were very helpful and supportive. We all got through the day, my new friends left, and I stayed behind to take my first call. A very brief time later, I attended my first ever delivery of a 25 week, 500 something gram baby. My fellow did most of the work, but she taught me what needed to be done and how to do several new (to me) procedures that night. That little boy became my patient, my teacher. He taught me so many of the fundamentals that I still use today. I followed him all month and then when he was ready to go home, I became his general pediatrician. He actually made it through his course of being a 25 weeker without any signfiicant complications and by the time, I left residency he was 3 and doing remarkably well. He was the last patient I ever saw in a general pediatric clinic.  I still get letters from his mom every so often. I will think of him celebrating his 12th birthday this week. I hope he is well.

This morning watching the new interns at breakfast, I was reminded of that long ago night, and that little boy. I was also reminded of who I was all those years ago. I hope that I haven't totally lost the amazement that I felt in caring for this little tiny baby. Certainly, I know what I'm doing now, and I have been to hundreds of deliveries like his, but he is special to me still. Also, I hope that I will never lose the drive that brought me into this career and that makes it more than just a job. 

Tuesday, June 16, 2009

My dog has brain damage

 I am convinced my dog, Sadie, has brain damage.

Last night, I was eating with a friend outside, when all of a sudden Sadie is facing a  low lying brick planter wall with her hackles raised, growling.  My generally sweet tempered dog was clearly incensed.  The growling continued and escalated, her ears and tails were down as she pawed at the ground, and then started barking.  As we tried to control our laughter at my dogs stalking of a wall, I went over to asses the danger.  She became frantic that her foe would hurt me.  Turns out the "foe" was a small FEATHER.  Yep, my brain damaged dog thought I was going to be attacked by a feather.

I certainly sleep better at night knowing what a  good guard dog lives in my house.

Who me, I didn't do anything.

Thursday, June 11, 2009

Destination: The Far East

I've done my share of travelling. I've done my share of medical volunteer work, locally and abroad. I've been to Nicaragua several times and had to cancel a trip when I got sick. Ever since then, I've been searching for opportunitites to get back in touch with that side of me that is fueled by being involved in something so much bigger than yourself. I have had many opportunities presented to me over the last year, but for one reason or another none worked out. However, a few weeks ago I was contacted to join CHLA's trip to Mongolia as they wanted to focus on some more maternal- fetal- neonatal health issues this trip. The trip works with my schedule, works with my plans and so I'm in. Plane tickets are reserved and will be paid for by the end of the day. I've never been to Asia, I'm a little nervous, but I'm really excited.

One of the big issues with this kind of work is to find a way to make sustainable differences in the healthcare in developing nations.  This is a huge topic and used to be a source of much dialogue amongst the Nicaraguan group.  Certainly they need supplies, but also standards and education.  The thing I really like about the approach of the CHLA Mongolia mission is their appreciation of those issues and the dedication to going there in order to provide not only education and support during the time that we are there, but also working with the health ministry to establish some standards for continuing education for physicians in Mongolia. Also, there is some effort being spent on extablishing internet based education and support materials for the doctors and nurses there.  I had lunch with the organizers yesterday, and got quite excited about what they're doing.  So now I'm trying to convince a few others to join me. Either way it is a great opportunity.

After spending a little over a week in Mongolia, I am going to continue on to Bali for some vacation while I am on the other side of the world.  I can't wait.  More to follow...