Med-bubble floats to the Reservation

Today I spent the day with a family doctor at an Algonquin federal reservation, seeing all the pediatrics cases. Now normally, we know I am not the biggest peds fan, but I absolutely loved working with this family doctor (she is so amazing), I got to actually do so much independently (she was not re-checking my histories and physicals in great detail, unless I told her I wasn't sure about something, which really gives one so much confidence!) and I loved working in that small, intimate setting, seeing this patient-population in their own community.

Everything was so open, people were very friendly and the people working at the clinic were just so positive and motivated / passionate about working there and working with the Native population, without any condescension, judgment, etc. that unfortunately is much more prevalent in the city-centre hospital, even if only subconsciously. For example, I actually saw one of my previous hospitalized babies at the reserve clinic today and I noticed that my own ideas about the patient, the patient's parents, etc... was so different. The love and empathy for the baby was always the same, of course. But today, I was much more sympathetic and caring about the parents too, and much less tainted by the opinions of other staff and their disdain for this unfamiliar style of parenting (some of which, I will admit, is probably valid, but there are such complex social, cultural and economic issues at play when it comes to all of that, so you have to take it into consideration... alcoholism, suicide, substance abuse, boredom, lack of motivation, lack of education and employment... these are the real problems that are not solved by throwing money at them... so anyway, of course teenage mothers and drunken fathers with too many kids are not going to be the best parents in the world, but that would be the case, regardless of whether or not they are white, black, yellow, red, or blue!) And basically, by working on the reserve itself, it's so much easier to maintain this balanced perspective when dealing with these difficult cases, which is so important if you want to actually help anyone and learn anything from them.

So that is my schpiel for the day. But yet another baby with seizures -my goodness, the poor darling! Really, as my little cousin says "I feel bichari for them!" (bichari means "poor thing" in kutchi / gujarati and is usually used as a response / exclamation to witnessing something like a little baby having a spastic seizure). I love newborn babies, I really do. I could easily spend the rest of my life being a doctor of little neonates... except the lifestyle thing for neonatologists really is scary too.

Shorter Reflections: Kids love 'em rollercoasters

Today was a better peds day: I saw a kid with croup who was getting better, happy, sweet, playful and cooperative. I saw a baby with herpes on its face (poor thing really -what jerk with a cold sore goes around kissing babies' faces!) and I saw a case of mesenteric adenitis / questionable Gilbert's syndrome. Our lecture was on adolescent cases, which was a welcome, far-more interesting change (and an unfortunate rarity). I was present for a delivery in which a healthy baby was born -we did not even have to suction, her cry was so good. All in all, a very non-typical day in pediatrics. Of course, it helped that I am finally getting over this viral infection and I could actually show my face at work today after staying home, sick for two whole days.

The roughest was the psych case a few days ago -cute little kid with behavioural problems, ADHD, tics, oppositional defiance, self-mutilation, tantrums, hypersensitive to touch, possible absence seizures, has been overdosed on meds by accident because a family member was taking the same drugs in a higher dose, does not distinguish between strangers and family / friends, has trouble with social interaction and play (autism spectrum disorder suspected). Now there are the challenges in medicine that one loves, and then there are... these. It's awful. It's unfair. Why. She's just a kid -couldn't the evolutionary gods spare her and her family all this suffering? It's not a case of autism. This is comorbid to the power of a billion. That was a heartbreaking day.

But today was a better one. So this is what it's like in this little med-world of mine -up, down, up, down, up... sigh. As my neonatology supervisor's 7 year-old kid said, "I work very hard at school. It's enough, [Mommy]! I need a vacation!"

So that is what Harvard-Yale will be for me, in a couple weeks -a much needed vacation before getting started on the rotation that may or may not determine the rest of my career path -Ob/Gyn!