1. Newborn nursery: A great week indeed. My team consisted of an attending physician, one intern and three medical students. By mid-week the nursery was booming and that meant we med students actually got to do useful work, filling out new charts for the babies and scanning their mother's charts for pertinent prenatal information, examining our tiny patients, and giving parent talks (anticipatory guidance for new parents, signs of dangerous infections in an infant, and newborn safety information). This was actually a great experience: carrying up to 6 patients, using translator phones to speak to patients, and gaining some confidence in my physical exam skills.
2. Night float: This was an easy rotation to start the new year on since I trained myself to stay up late the week prior. I had a great time working with a small team of residents and would follow them to see any interesting cases that came in overnight. I was assigned to one of the general medicine teams so I also interviewed and examined patients we admitted to my team and I presented them to the day-team on rounds the next morning. The best part was chasing around the intern assigned to the newborn nursery. One night an infant was crashing because his blood sugar was less than 10 (normally we keep our blood sugar level between 80-100) and I got to participate in his resuscitation! Saving lives, people!
3. Heme/onc: My teammate and I started heme/onc on an unusually slow week for that service, so we initially spent our time following patients who were just chilling, for lack of a more appropriate medical term. Later in the week things picked up and we took part in a new diagnosis of leukemia including the bone marrow biopsy and enrolling the patient in a clinical trial. The moment that stuck with me was when my patient and her mom told me her hair had started to fall out one day so they decided to braid a section of hair and cut it off so they would remember what it looked like. Through the course of their treatments, these kids go through hell, but typically they do quite well.
4. Inpatient pediatrics: I lucked out during these weeks and got to follow two very interesting patients. One was in a traumatic accident and had suffered every possible complication thereafter. The other was being evaluated for a rare cancer syndrome. Though I can't say I developed a great relationship with the patients themselves (who can blame them, I was part of the team of strangers who was inflicting a great deal of their pain), I did enjoy working with their parents more than I thought I would. For the first time I understood what everyone has been saying all along, that we med students have more time than the rest of the team and we can really make a difference in patient care. I spent hours walking the halls with one patient who suffered a terrible drug reaction that caused widespread edema (fluid in her tissues) and I was able to participate in a great deal of the other patient's care including a family meeting to discuss his diagnosis and helping to create a family tree for genetic analysis.
Overall, I found I ended up enjoying pediatrics. Though I still don't think it will make my list of considered specialties, I learned a great deal and I feel more prepared for the coming months of internal medicine.
Speaking of, this was my first week on internal medicine (which means adult medicine). I am starting on outpatient medicine with 2 weeks in a primary care clinic and 2 weeks in the Veteran's hospital emergency department. More on that to come.
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