fifth first day

Last week I finished my pediatrics rotation. The first four weeks was spent on the medical ward at Children’s Hospital, and the last four at various outpatient clinics. The whole thing was my favourite.

As I wrote to my dear friend Fiona just after I finished the in-patient portion, my experience in pediatrics was my most challenging, exhausting, rewarding, emotional experience in medicine so far, and it is left me oh so confused about what I am going to do with the rest of my life. I really feel like it was close to the first time in my medical experiences that my heart and soul was interested in my work, and not just my brain. I loved the kids (obviously), but I also loved the challenge of working with their families, and all the social issues that accompany their little units (often far more important and substantial than the medical issues). I realized part way through that I actually LOVED all my patients and their families, not just "loved" working with them, but emotionally attached to them - which was incredibly exhausting, but ultimately made the work even more worthwhile.

On top of that, the medicine is more interesting because it is often the first presentation of symptoms, and you have to actually think about making a diagnosis, instead of adult medicine in which you are managing diagnoses that have been made 30-40 years ago. (Kyle and another classmate liken it to rearranging deck chairs on the titanic).

I had some of my happiest and saddest moments of the year so far. My fifth first day brought with it one that will stay with me forever. I met a lovely 12 year old girl who was doing very well despite the fact that her kidneys had stopped working. In the afternoon we talked about playing the piano, and in the early hours of the next morning I held her unconscious head, while, as we found out later, her brain was filling up with blood. She never regained consciousness, and eventually died from her massive brain injuries. I was OK that day until I got home, where I became a bawling mess of questions that don't have answers. I met lots amazing patients and families, and foster families, and friendship families who I will think about in the future. And, I was involved in lots of stories with happy little endings (and cute ones too). I also met many very good, very dedicated professionals.

All have left me with some big thinking to do.

almost

I am at home right now for a few moments. This morning I performed the OSCE (objective standardized clinical examination) for my pediatrics rotation, and in a couple hours I will be writing the NMBE (National Medical Board Exam). And then, as of 4:30 this afternoon, I will be half-way through my clerkship. I am getting pretty excited that I only have to contain my excitement for another 5 hours. It's ok if you can't contain yours, I'll understand.