Reflections on Pediatrics I

I’m still super behind on my reflections on clinical rotations, so I actually finished this rotation up back in…early February. (I’m catching up, slowly but surely!)

I loved this rotation! The learning environment was super welcoming and laidback. My preceptor would ask me questions, but would never make me feel terrible about not knowing the answer–he just genuinely wanted me to learn. He’d also think out loud, which actually really helped me a lot in terms of knowing what to do, and what questions to ask.

Although I definitely wouldn’t have minded staying longer hours here, he didn’t keep me there when there was nothing to learn/do, I was super sad to have to leave this rotation. :[ But on the bright side, he said he’d be happy to write me a letter of rec! :D!

Reflections on Pediatrics I

1. How much you like your preceptor makes a huge difference on how much you enjoy your rotation.
   This is probably a no-brainer, but I’m surprised at how much of a difference it makes. My preceptor for this rotation has definitely been one of my favorites (if not my absolute favorite) for the entire year! This was one of my favorite rotations, and it was largely because of how awesome my preceptor was.

   I’m probably honest to a fault, so he knew from the start that I’m fairly introverted and that I actually much prefer animals to children. He revealed to me that he’s actually very much an introvert/a major animal-lover as well, and that he has a different persona while working because that’s what the kids respond to better. (This is probably why we got along so well! :O )

2. The care you want to provide often isn’t up to the kids–it’s up to the parent(s) or caretaker(s).
   This is the part that I find the most frustrating, and the #1 reason why I do not want to go into pediatrics–even if you want to help the kids, sometimes there’s nothing you can do because the parents see nothing wrong with how they’re bringing up their kids (e.g. anti-vaxxers, super-unhealthy living/dietary habits, etc.).

   If you recall, the area I live in is the most obese part of the entire country. I’m currently working with a county health program to recruit obese kids to the APPLE Program (Appalachian Partnership for Positive Living & Eating Program), which provides the kids (and their families) with activity and exercise programs, meal prep tips, nutritional counseling, etc.–all free of charge. This even covers things like free bikes, and taking them to the grocery store to show them how to save money while buying healthier foods. The kids would be excited about this, and would ask whether or not they could participate…and I’d shot down by their caretakers. (Why!?!)

3. You need to be okay with being peed/pooped/puked on.
   We got puked on by a newborn on my first [and as it turns out, only] day at the hospital. I did actually manage to avoid getting peed or pooped on though! Twas a miracle of sorts!
4. It’s pretty awesome that it’s socially acceptable to act like a kid again.
   I’m not gonna lie. It was great getting to play with kids and watch Tangled and/or Frozen all day long! :P The kids were a lot of fun, and the well-behaved ones were super sweet. I held and/or tickled a bunch of babies, looked for monsters in a whole lot of ears, and talked to the kids the way I talk to my foster kitty/the animals I take care of at the shelter. (When you consider the fact that my pets are basically my preferred choice of “children,” this actually works out really well.)
5. You need to have a lot of patience.
   As my preceptor said, you cannot be “a man of little patience (patients–har har).” You need patience with the kids and for the parents (sometimes especially for the parents). When the same family brings in their kids for the 11th week in a row because the “kids are still coughing and should be better now,” and you ask them whether or not they’re still smoking in the house and they respond, “Yes,” it can be pretty difficult to not throw something at them.

Cutest nebulizers ever! <3

Memorable Cases

• Lots of super rare diseases/conditions that I’ll likely never see elsewhere (e.g. mosaic Trisomy 13, grade 5 vesiculoureteral reflux, Towns-Brock syndrome, severe tracheomalacia, Smith-Lenti-Opitz syndrome,  ketogenic hypoglycemia…)
• A little girl who got a feather stuck in her ear(?!)
• A little girl whose previous foster family dunked her in ice cold water because she had an accident :[
• …there were two kids at his practice that I’m really hoping will never remember my face or my name, because we’re somewhat convinced that they will later grow up to be serial killers :[
• Teenager who wanted to kill himself :[

Remember my discussion on unique baby names?

Notable Quotes/Conversations

• I actually don’t have all that many quotes/conversations from here because…most of my patients couldn’t talk yet! For the most part, they just babbled at me, so instead, I’ll refer you to the really weird unique names parents have chosen to name their children.
• “4-month-old’s are everyone’s friend. 9 month olds are nobody’s friend. They get stranger anxiety, and it peaks again at 18 months.”
• “I feel like I’m abusing you or something. I should probably send you home! I’ve kept you here for too long!”

Resources

• Pediatrics – A Competency-Based Companion, by Maureen C. McMahon & Glenn R. Stryjewski
• Underground Clinical Vignettes Step 2: Pediatrics, by Sandra I. Kim MD PhD & Todd A. Swanson M.D. Ph. D
• Pediatrics PreTest Self-Assessment & Review, by Robert Yetman
• UpToDate

Read about my other rotations here!