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This was written in post because I missed writing the day of.

During outpatient, we have to spend a day working in the Newborn Nursery and NICU. I was looking forward to this experience because it was something we never really saw much of during OB/GYN, and also having volunteered in the NICU before I was excited to what the LAC-USC NICU was like.

Overall, it was a lot slower than I imagined. We only saw and examined one newborn in the morning, which itself was a good learning experience, but was just — lonely if that makes sense. We then did a quick morning “rounds” with the attending where we went into all the potential causes of poor feeding and failure to thrive, which was also a good learning experience on its own.

That said it seems like the residents and staff didn’t really know what to do with us. In the afternoon we were supposed to be in NICU with one of the clerkship directors, so I was hoping we’d get a little more direction, but it turns out she wasn’t coming in today. One of the attendings did send us over to this empty NICU unit to watch a training on neonatal resuscitation. That was interesting and we got to practice some stuff like CPR and intubation on neonates. The residents decided to let us out early which was nice.

Afterwards I busted a mission back home for a concert which I forgot I had tickets for until this past weekend when Audrey reminded me. I was a good time.

Every time I talk about being in my pediatrics rotation, the conversation always somehow shifts to how sad it must be. And of course, over the course of this rotation I’ve encountered a lot of sad situations. The thing is though, at least for me, when you actually meet these kids, often the last thing you think about is how sad it all is that they’re sick.

In my very, very limited experience, think one of the worst mistakes you can make when working in pediatrics is assuming the patient is sad because they are in the clinic, or in the hospital, or because of the situation. Actually, that maybe applies to all medicine, but maybe especially with kids. A lot of the kids I’ve worked with are happy, normal kids. Nurse, doctors, hospitals, medicine, for some of them that’s the only life they’ve known, and sure you may think that’s sad because you think they are missing out on some part of life that you got to experience, but just because that’s how you see their life, doesn’t mean that’s how they see their life.

I’m not denying that any illness, regardless of severity, can be associated with sadness, depression, anxiety, stress. When bad things happen to kids, it’s especially sad, but that’s why it feels all the more special when you get a chance to be a part of their joy, to maybe let them feel “normal,” or to help them get better.

This one was written in post, since I missed writing the day of.

Was just another morning in the allergy clinic. It’s really interesting seeing the differences between doctors of different specialties in terms of personality and behaviors. I think it’s definitely something to take into account when deciding for myself. The attendings I worked with here are really great, though I don’t know if I really enjoyed the kinds of cases, we were seeing in this clinic.

It was a short day today in the allergy clinic. I had the afternoon off as study time. The allergy clinic isn’t exclusively for kids though, so I did see one adult. It was all asthma and possible allergic reactions. One of the doctors I worked with was really exceptional. She was very good at talking with patient and just had this very calm, wise, air about her. There was also another case of twins which is always interesting.

Working with kids in the clinics and in the hospitals makes the news from yesterday hit just a bit closer to home.

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.