Pediatrics

Pediatrics floor month.

Since pediatrics was my very first rotation as a third year medical student, and it has now been (thinking...) nearly three years since that time, I'm due for some review. Yes, I already worked a month in the pediatric ER, but it's hard to really get a sense of "sick vs. not sick" if you don't see what sick kids really look like. And since H1N1 already hit (the peak was 3 weeks ago, maybe?), and we're at the near-peak of bronchiolitis season, I have to put on the additional "contact precautions" attire for nearly every patient I see during the day. I've done a few LPs during this month, mostly since I've done more of them recently than most of the other interns. Otherwise, lots of parental counseling regarding home antibiotic regimens, warning signs of more serious illness, etc. One parent was particularly hyper-vigilant. Her daughter had thankfully survived a bout of septic shock precipitated by a community acquired pneumonia, and she was terrified about bringing her home again. We explained the mechanism of septic shock over and over, and said that after 3 weeks in the hospital, she was back to her regular healthy self. I had to review the child's full set of labs, including some of the esoteric results we get from the lab that none of us really use (e.g., mean platelet volume), and explain to the mother that not every single value has to be perfectly normal before discharge (or that, in the average healthy person, not every value will be perfectly normal all the time).

Anyway, the pediatrics residents were generally nice and fun to work with. Overall, a good month.