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Why do we refuse to do anything? Why are we surprised that putting weapons of war in the hands of civilians results in the deaths of civilians? Why do we think putting more guns in schools will help anyone? Why is it so hard to understand that owning a gun, doesn’t make you any more or less of a “man” (whatever that means)? Why is it so hard to convince people that a child’s life should, AT THE VERY LEAST, be worth having to do extra paperwork?

Why do stare blankly at each other and cry and pray and send condolences, time after time after time, and wonder how shit like this could happen in our country, when so many other countries in the world have figured it out.

Yes, let’s address mental health! But that can only take us so far, and as far as preventative measures for this mass shootings go, I don’t think it’s really that great. I highly doubt that countries with lower rates of mass shooting simply have far superior mental health services. Maybe they do. Though if anything, it’s not the quality of mental healthcare in our country that is lacking, it’s access to it (and interestingly enough, many people who oppose gun control also seem to want to limit access to healthcare).

I’m not here to judge anyone for what they believe or how they conduct themselves. I am simply asking for a little more introspection about why guns are so goddamn important to the people who own them. I’m not going to pretend I know anything about owning or shooting a gun, or the reasons why different people feel they need one. If you oppose gun control, please, let’s talk about it. Let’s talk about what it means to own a gun, which I nothing about, but let’s also talk about studies and evidence, which I know a bit more about. I am genuinely curious about what you have to say and would like to see if we can find some common ground. Deep down I know we all want what is best for our children and we want to prevent as much senseless violence and death as we can. And if we refuse to do anything about guns, then what are we going to do, because sitting around arguing is unacceptable.

As part of this rotation, we have to do an interprofessional experience. I was assigned to spend the morning with a Child Life specialist. I took a course in Child Life during my gap years so I had some idea of what I would be doing (in addition to what I heard from my classmates who already did their day in Child Life). The general idea behind Child Life is recognizing the role that “play” has in the normal, healthy development of children and in helping children cope with and process significant medical events. Sooo I pretty much spent the whole morning playing.

The vast majority of my time was spent working with a 5-year-old patient. She only spoke Spanish, which made it a really great opportunity for me to put my 933 Duolingo streak to use. I faired pretty well and made it through few hours of coloring and pretending to be a customer at a restaurant without having to reference a translating app more than 3 times. I had a lot of fun and learned a few new Spanish words (at one point she was asking for Play-Doh and I brought her a toy banana, bonus point’s if you know what the Spanish words for both). It reminded me of my time working back at MOXI and of how much I love “teaching” (I use quotes because I mean teaching through playing) and working with kids.

Not sure if I mentioned this before, but for this rotation I’ve been trying to do a more business causal dress as my daily attire, so dress shirt and tie. We have the option of that or scrubs, and I wanted to try doing the former, partially inspired by a MD I used to work with when I volunteered in the NICU. Anyways, today was the first time this year I donned one of my bowties.

In the afternoon, I was back in neurology. Got to see a couple more interesting cases. I definitely need to pick-up on my studying though. With all the fun of working with this patient population, it’s easy to forget how much material is covered in Peds.

The theme of the day was specialty clinics. I started off in the morning in the pediatric nephrology clinic and then in the afternoon moved over to the pediatric neurology clinic. Both clinics had so many interesting cases, the kind that you think you may only see in question banks and the board exams. Personally, I thought the neuro cases were overall more interesting, but that said it was a small sample size so it’s hard to say which I would ultimately enjoy more.

The neurology clinic was interesting because, having had a whole week of learning developmental milestones and well-child exams, I got to see what it looked like when patients had appreciable delays, and the important role physical exam plays the work-up, especially in these cases. In one of them there was a very clear juxtaposition of two varying degrees of neurological deficits (apologies for being so vague, I just want to be extra careful when talking about this stuff).

I’m back in neuro clinic tomorrow afternoon, so we’ll see what’s in store for me then.

I haven’t talked about my food as much this rotation, mostly ’cause I haven’t been cooking as much, but this past weekend I went to my cousin’s baby shower and took home a shit-ton of leftovers which I will be making my way through this week.

Not much to report today. I had the morning off and just stayed in my room, then had Zoom didactics in the afternoon. It was more of like teaching sessions for the residents who were in-person, and we were just there. I will say that their lecture sessions are a lot more fun than the ones designed for medical students. Really makes you think…

I got to spend the morning in the pediatric cardiology clinic. Things definitely move a bit faster there in terms of the visits, or at least it felt like it. The encounters were relatively short, but the attending would also do echocardiograms on the kiddos which probably took the majority of the time. All the patients we had were babies, all very cute and pretty easy to work with. The idea of doing and reading echo’s is kinda cool, but I’m not sure if that’s just because of the novelty. It seems like a chill gig though. But also part of me was looking forward to going back to the regular clinic in the afternoon.

I’ve also been eating vegetarian-ish for a couple days, the only reason being that I’m trying not to spend money on lunch when I’m at the clinic. I get a $4.50 meal stipend from the school every day that doesn’t roll over so I get what I can to stay within that budget which usually includes vegetarian options. Plus the food I’ve made at home is also vegetarian. It’s been working out though, not complaints.

Anyways in the afternoon got to see 2 patients on my own. One was a 9-month-old, the other a 7-year-old. Definitely getting a better feel of these visits. I like the diversity and I like talking to the patients and families and then also learning more about putting together differentials from the residents and attendings. I also noticed there’s a lot more poop talk than in adult clinics. This was my last day in this general kinda clinic and then I’m mostly gonna be in specialty clinics in the coming weeks.

I had a bit of a rushed morning today, but luckily made it in time to catch the morning teaching session which we already went over the day before (different attending and different residents). In the morning I got to see 2 of my own patients, a 10-year-old and a 6-week-old. I think the variety of peds is something I could really get into. Not sure if I’ll get tired of seeing babies and the 10-year-old kept subtly roasting her mom which was pretty funny. I really liked working with the morning attending, she just had a very compassionate and wise aura. During one of the morning lulls, she said something that I liked when she asked about what I wanted to go into: “It’s good to try to be a leader, but when it comes to happiness, be a follower.” Follow happiness; such a simple concept, but so easy to forget or just ignore. Wasn’t like a revelatory moment, I just appreciated hearing it.

In the afternoon, the clinic was pretty busy again and one of the residents when home sick, so the others had to pick-up patients. I didn’t end up getting a chance to see any on my own in the afternoon, but I shadowed a couple. After a shadowed visit with an 18-year-old, I stuck around a bit after the resident left to probe a bit more about some of his issues. It was honestly really interesting and enjoyable to talk to him. There was definitely a subtle mentorship itch that was getting scratched during the conversation with some motivational interviewing. Whether he got anything out of it, I can’t say. What I can say is that I definitely am looking forward to working with more patients on my own in this rotation.

It was my first day in the outpatient pediatrics clinic at the county hospital. The day started off with some Zoom grand rounds about spinal muscular atrophy and muscular dystrophies. The morning was a bit of a struggle because I realized I really had no idea what to expect or what exactly was going to be expected of me when I got to the clinic. Plus, I was having some issues accessing the county electronic medical record and I also realized I didn’t quite know where I was going. Luckily, I remembered that the pediatrics clinic was in the same place as the pediatric cardiology clinic which I shadowed in earlier this year. I found the clinic and made my way to the provider lounge. Therre was only one other person in there at the time. I introduced myself and he introduced himself as an intern. He told me a little bit about his role and the set-up of the clinic. Eventually one of the attendings came in and gave me a bit more info.

I soon went with the attending to see our first patient of the morning, a baby here for his 6-month well child check. He was this very cute, chunky baby who was just waiting for us sitting upright on the exam table, cloaked in a blankies, his mom sitting in a chair next to the exam table. We went through all the normally questioning, did some physical exam then went on our way. The intern presented the case to the attending. The attending asked some questions, both genuine and pimping-type, and then with some that that the intern went back to relay some of what we discussed to the mom. That was really it for the morning as far as patients. All the rest were tele-med or converted to tele-med.

I was told to take a long lunch and had a chance to catch up with classmates who were also stationed at county but in different parts or on different rotations. When I go back things were still kind of quiet in the provider lounge. Slowly the residents who would be working in the afternoon started trickling in, as well as two different attendings (one of whom I was already decently well acquainted with as the head of the Intro to Clinical Medicine course). Things really picked up in the afternoon. People were running around everywhere. I shadowed one of the residents with 2 patients and then I got sent out to see my own patient. I was nervous, but also looking forward to finally being sent to see a patient on my own during a rotation. The patient was a 9-month-old being brought in for a well child check and some skin concerns. She was also very cute, though a bit more fussy (probably cause of some of her health stuff). I felt like I had a decent handle on asking appropriate questions for the patient’s age and I also did some physical exam, which I’ve never done on a baby before.

When I was finished I went to present the patient to the resident who she was scheduled to see, we went over some stuff, I wrote up a note, and then I presented to one of the attendings and we went over my note. From today I think I got a good feel for how things are supposed to go during these shifts. By the time I finished with that patient and got my note signed off, it was already time to leave, so I only got to see one patient on my own today, but overall it was a really good and informative experience. I also answered a pimping question correctly which always feels good. Tomorrow I hope to get to see more patients on my own, and hopefully streamline my note writing.

Today was orientation day for pediatrics, 7 am to 4 pm. We started learning about what was going to be expected of us, and while it was intimidating to hear how big a role we as students would be playing in individual patient care, it was also exciting. I’m a little concerned because I feel like my experience in Ob/Gyn didn’t really prepare me for inpatient pediatrics. Then again, I’m not sure what rotation would have really prepare me. The most similar would be Internal Medicine, but starting with that would be even more difficult. Luckily though I am starting with outpatient peds to kinda warm me up a bit more.

I really want to do well in this rotation, so I think I’m gonna need to kick my ass into gear a bit more than I did for the first one. Being back in LA may make this a bit harder. Actually that’s not a good attitude to come in it with. There’s a lot of things about being back here that may support me in doing well in this rotation. I’ll have more friends and peers to work with and study with. I’ll be able to fall into some of the good habits I’ve established in my LA environment. At the end of the day, whether or not I take this rotation seriously is going to be up to me, and I’m coming in determined.

Started off the day early with a C-section; my last one for a long time… maybe ever. Still didn’t go perfectly smooth. I forgot to grab my tag thingy and then when they reminded me and I spun to tie it, I dropped it. Turned out ok though. The patient, who I had seen before in clinic before was funny. As soon as the baby was out, she goes, “I want another one,” and kept alternating between sobs and laughter. After the surgery I ran home to hop into our Friday morning lecture on a very timely topic: professionalism and abortion. I won’t go too deep into it, but definitely had some thought-provoking conversations.

The lecture wrapped up and then I hit the kitchen. I told the clinic staff I would make lunch for everyone on my last day so I had to get cookin’. I had some food stuff to finish up so it kinda worked out, though I did have to pick up some ingredients from the store. I ended up making sinigang and adobo (and rice of course) and headed out to clinic. On one hand, sharing Filipino food with people who are not familiar is one of my great joys. On the other, I always get nervous when I do ’cause I’m not sure if people will like it. Everyone said it was good, but I feel like that’s just a courtesy thing, but people went back for seconds and some people packed to-go so I’ll take that and not think about it anymore.

Then after lunch was my last patient encounters of the rotation. Nothing too crazy. There was this one first time mother, who we had seen last week for her pregnancy test who came for her first prenatal visit with the father of the baby. They were both super excited which as cute to see, and the mom was funny, similar-ish vibes to the C-section patient from the morning, except she wasn’t on a boatload of pain meds. Once we were through all the patients (of course the last one didn’t want a student in the room as is only fitting) it was time to say goodbyes. Nothing too emotional, but I did want to get a picture with everyone. There were hugs and handshakes and well wishes. They told me to come visit if I was every in the area and I promised that whenever I go back to Sequioa that I would stop by and invite them.

Most of the emotions came as I was walking out that door towards my car for the last time. There weren’t any tears or anything (it was only 5 weeks for Christ’s sake I’m talking like I was there a year), but just the thought of this little adventure coming to an end made finding me way out the parking lot a teeny tiny bit harder.

I feel like I’ve been kinda saying the same stuff in these especially the last few days, or maybe weeks I’m not really tracking content. But I genuinely starting to get sad about leaving, not that I necessarily want to stay here, but I just the relationships I formed with the people I met here didn’t have to end or at least end so soon or end so definitively. Not sure if any of the people who work at the clinic feel the same, they have students constantly coming in and out, but I like to think I made some kind of impression there. At the end of the day though, I’m happy that I was able to have this experience and to have shared it with the people I did. I am also very excited to start my peds rotation, but also a little scared cause in-patient sounds intense from what people have said.

Tomorrow I have a C-section in the morning, probably my the last birth I’ll get to experience for a while, then some zoom lectures, and then clinic in the afternoon. Then time to say my goodbyes.