paediatrics

The great thing about time is that it keeps going. The terrible thing about time is that it keeps going.

Robyn, , , , 2 Comments

Welcome to Paediatrics, the roughest rotation of intern year. When the head of department begins her speech with “I’m sure you’ve all heard the rumours, and they’re all true” you know you’re not in Kansas any more.

Everything from gaining intravenous access to giving chemotherapy is  a thousand times harder in children. They’re definitely not little adults. The entire frustrating process is complicated even more by the precision of doses, by the fact that doctor have to give all IV medications and by the constant presence of scared and angry parents.

“The parents are not your enemy,” our head of department advised. “Once you talk to them about what’s going on, they’ll be more likely to step back and let you do your job.”

But the actual job is so goddamn hard. Just getting blood from a baby for a haematology sample can be a Herculean struggle. The need for constant attention to detail keeps me up for 36 straight hours on every emergency duty. Having to calculate the neonatal dose of crystallized penicillin for a baby with ?sepsis feels like something I should not be doing at 2am after 18 straight hours on my feet. And yet.

I’m always counting down the weeks, the days, the hours. My first duty was so horrible (I was so unprepared) that as I walked from the lab where I had just dropped off some samples to the elevator that would take me back to the 6th floor  I said to myself, “I just survived 30 more seconds of this battle”.

I do what I can to keep myself sane. (It doesn’t always work).

As much as I want time to speed up when I’m on duty I want it to slow right down for the moments when I’m not at the hospital.

I want time to stop entirely when I’m having an epic literary discussion with triciatallen over a Burger King lunch. I want time to slow to a crawl when I’ve gone out to dinner with the Todd and our medical students (because they were absolute lifesavers these last two weeks). Hell, I even want time to pause when I’m having dinner at home, despite the complaints and arguments that frequent our family time.

But it never does.

It only keeps moving inexorably forward, dragging me along to the end of Paediatrics, the end of internship and maybe, just maybe, to the beginning of a career path that might actually make me happy. Whatever that is.

Paediatric Medicine

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I am holding down a screaming baby – boy – while the goodly intern (who can’t stand children) tries gently to insert a catheter.  I say baby but the child is in fact older than two (hence the catheter) and he puts up a good fight. We try to get it in before he relieves himself all over the makeshift sterile field.

Alternately, I am holding down a screaming baby – girl – while the capable intern (who isn’t terribly good at these procedures) tries unsuccessfully to do a lumbar puncture. The sterilizing Betadine (traitorously) seeps into the fabric of my white jacket as I attempt to pin her wriggling hips with my shoulder. For my efforts and hers, I am rewarded with a brown stain the size of a cheeseburger while she is rewarded with a firmer grip and a few more needle sticks.

Again, I am holding the hand of a boy who screams bloody murder before the needle goes in, but quiets down once we’re taking the sample. “He’s a good boy,” his father tells us. “He’ll carry on, but he’ll settle down in the end.” Thanks, kid.

Or, I’m stroking the arm of a girl whose veins the intern can’t seem to find, but who covers her mouth so politely when she coughs unlike every other patient who’s traipsed through this treatment room spreading aerosol droplets of infection from pharyngeal aspirations. I’m sorry, darling, but we’ll have to stick you again.

There I am collecting blood from a calmly quiescent eleven year old while an intern guides my shaking hand.

There I am listening to the scariest murmur I’ve ever heard from the heart of my favourite nine year old ward resident with chronic kidney disease. (I only have one wish for him – to live longer, and happier, than me).

There, poring over dockets thick as Bibles. There, running behind the Consultant peepeecluckcluck. There, stumped trying to answer a question. There, bumbling through an X-ray.

Also, learning. All over the place learning. Learning more in four weeks than (dare I say it) I have in the last two and a half years.

It’s official: I love clinic.