Residency 1.8: PCC

Oh, the glorious last month I have spent in the PCC (Pediatric Care Clinic)--normal hours, weekends off, seeing lots of cute, healthy (compared to inpatient) kids. Since in our weekly continuity clinic, we mostly see checkups, this was a great month to see a little more of the typical outpatient kids. You know, the dozens of strep throats, colds, headaches, constipation, etc. I had a great month with my fellow residents and wonderful attendings, and learned a lot, especially how to delicately deal with parents.

It's funny, because most parents come to the doctor expecting an answer and a quick fix, and the reality is that we only prescribe medicine about 1/4 of the time, if that. In fact, I remember in medical school, I would go an entire afternoon at my preceptor's office without him writing a single prescription. It's not because we don't care. It's because most kids get better all on their own, and they don't need the medicine (or the side effects). It's part of what I love about pediatrics--how resilient their little bodies are. And, I'll let you in on a little secret (but you have to promise not to tell): we as doctors don't always know exactly what's going on and how to fix it. Shhhhh! The body is a mystery, and a complicated one at that. Often times things need time to either go away on their own, or develop a little more so we can identify what's going on. So please, don't hate your friendly pediatrician the next time they say, "It's probably just a virus" or "Well, why don't we watch it and have you come back in a month." And for my part, I'll try hard to remember how frustrating it is to hear those words.

The bright side

Inspired by 1000awesomethings.com (check it out, it's...well, awesome), and looking to brighten a kind of drab day, I present Laura's 8awesomethings from the last few days:

1. Making a new recipe and nothing goes wrong, and having enough for leftovers
2. Winning a freaking fondue set at Housestaff (and I never win ANYTHING)
3. NO traffic on the way to work because it's a "holiday" (and that was a serious one, not an "I'm bitter because I had to work and no one else did" one)
4. Having the attendings tell me, twice in one week, that I'm doing a good job
5. Getting to wake up without the alarm clock, make whatever I want for breakfast, and finish all the Sunday puzzles
6. Having time to read THREE books this weekend just because I could
7. Boulevard for the price of Bud Light (thanks, Kelly, my new favorite bartender)
8. Greek food for lunch! And Steak'n'Shake for dinner!

See, life's not so bad. Try it for yourself.

Stick your tongue out and say...

I'm dubbing today "Strep Throat Wednesday." The three of us in clinic this afternoon (plus some help from the attendings) cranked through 16 (16!) patients whose chief complaint was "fever, sore throat" (plus the rest of the kiddos). Actually, there was usually some variation in how the clerks entered it: "fever and throat hurts" or "possible strep throat" or "temp and sore throat" or my favorite, which showed that even they thought it was getting to be a little much for one afternoon: "ANOTHER STREP TEST".

We started making bets on everything: whose strep test would come back first, whether it would positive, and whether the mom would opt for the 10 day course of amoxicillin or the one-time penicillin shot. I was only 4/6 on whether mine would be positive, but 2/2 on choice of antibiotic route. Anything to pass the time waiting for that result to pop up in the computer.

I'm just glad those two kids who coughed straight in my face were the strep negative ones. So, just a reminder to all you germ-harboring mongrels out there--WASH YOUR HANDS (please?). And for Pete's sake, teach your kids to cover their mouths. Only YOU can prevent the spread of infection.

Until next time...

When it rains...

You would think that one broken appliance flooding the kitchen floor would be enough. You would be wrong. I guess it's a good thing I decided to run the dishwasher tonight instead of on my way out the door tomorrow so I was around when the water started pouring out. Also good thing that my complex recently decided to get the handy men a cell phone instead of a pager, cause then they get here faster. Also a good thing it was just a busted valve instead of a busted pipe. Still, it would be EVEN BETTER if the rest of my appliances decided to behave from now on...my kitchen floor would prefer to stay dry from now on.

Residency 1.7: Red Team

The end of another month. I must admit that I was not so much looking forward to this month. Part of that was the string of 30-hour calls at the beginning of the month which comprised my "Holiday Block"--okay, that was ROUGH. The body was not meant to work every other night overnight, and it took its toll by the end.

That part notwithstanding, this was still one of the busiest months so far. Bronchiolitis season hit in full force, and we were a revolving door of admissions (record belongs to Andie and Brian for 10 admissions and 10 discharges in one day; separate record belongs to me and Christina for admitting and discharging a patient all within 3 hours and 10 minutes).

This month I had many occasions to realize how blessed I am to be a part of this program. Laughing during lunches, happy hours, getting support in tough situations at work, good friends, awesome chiefs--if I've got to be slammed, I'd rather be slammed here. Though I will say, I am SO looking forward to PCC (clinic) next month, and rolling into work about 8:30. Hopefully I can also motivate myself to study for Step 3. Until next time...

Good deal, McNeal

Things I'll miss about Mimi...
-the freezer stocked with Gold Medal Ribbon
-all the green on St. Paddy's Day
-getting scolded for wearing socks on the wood floors
-messy sundaes
-sitting on the porch with a book and a glass of iced tea
-goulash, coffee cake, and brie cheese
-the candy drawer
-her laugh
-the way she always hung the IU ornament on the back of the tree
-the flowery birthday cards
-her impeccable taste
-sneaking Squeeze-its at the lake
-the way she looked at me the last time I saw her and she said, "tell your Dad hi, all you girls..."

All heaven sighs and angels dance

I found out over the New Year's block that one of my patients from last month had passed away. She had been very sick with a known fatal disease and our goal had been to keep her alive until the family could arrange hospice care and then get her well enough to go home. After a couple of sleepless nights worrying whether she was going to make it, and some tireless work on the part of the day team, we succeeded in getting her out just before Christmas. Her pediatrician called us last week to say that she had spent her last day out at the park with her parents and her sister in the gorgeous sunshine (what I'm sure was a freak weather day for KC in the middle of winter), and then they took her home and held her while she slipped away. Even though we knew it was coming, it still hit me, in a really good way. To know that however small, I played a part in getting her home to spend her last days with her family. And to know that, even though we run around necessarily detached at times, that it's still a beautiful thing to be able to celebrate a life and to feel a little grief as well. Go with God, baby girl.