Oh pediatrics

January 14, 2008 at 7:34 pm (Clinical rotations)

Over the past few weeks have been on the pediatrics rotation. I’ve written before that don’t really care for peds as a medical specialty. You see, I dislike working with children. Nothing compares to walking into a child’s room and saying, “Hi, good morning,” and then the kid immediately begins screaming and crying.

There is a stereotype that the field is dominated by women who want nothing more than to play the role of an overeducated babysitter. And while there is some great research that goes into the field, many of the practitioners do fill a bit of those stereotypes. I’ve met quite a few female residents who say they want nothing more than to get married, raise their children as a stay-at-home mom, and then work part time as a pediatrician.

A few days ago, my team needed to meet with our intern before we could check out for the afternoon. We called her to find out where she was, and she replied, “We’re playing with the babies at the nurses station.” I thought she was just kidding. But when we found her, sure enough, every resident and gone into a patient’s room, grabbed a baby, and was found at the nurses station rocking them and playing with them. Now I’m not scared of babies, but I was a little put off when one of my teammates came to me and handed me a six-month-old to hold.

She said, “Talk to him. He needs stimulation.”

“What should I say?”

She replied, “It doesn’t matter. He’s deaf.”

“Then why should I say anything at all? Especially if he can’t hear me?”

“But you never know, he could regain his hearing.”

And now you know what I’ve been working with. My whole team is filled with women who want to go into the specialty. I’m the only one who wants to practice on adults. While most of the kids are fairly benign, I ran across one child earlier this week whose parents had used screaming, profanity, and threats of violence as a way to discipline their child. My assigned three-year-old picked up many of their bad habits. I sat outside his room copying down vital signs when I heard, “Shit shit shit shit.”

I thought to myself, there’s no way he was just saying that.

Then I heard it again: “Shit shit shit shit.”

I walked into his room and introduced myself by saying, “Hi there, Arnold. My name is Half M.D. I’m going to be taking care of you while you’re here in the hospital.”

He replied, “Shut your mouth. I’m going to beat your ass you son of a bitch.”

To the outside observer a cursing three-year-old might seem pretty funny. However, I had to be the one to deal with this mess. I asked the mother where he had learned such words. She said, “Not from me. Sit down, child! I’m going to slap you!”

The kid then raised a royal tantrum and started throwing things. I managed to calm him down for a bit so I could go through the physical exam. I gave him my reflex hammer and told him he was supposed to hit a spot on the bed when I told him to, and then stand absolutely straight after hitting that spot. I found that for many children, letting them play with my reflex hammer and turning it into a game is the best way to calm them down. I’ve also discovered that for children who have a phobia of stethoscopes, if I let them listen to my heart first, they’ll usually let me listen to theirs next.

When the exam was over, I needed to take back my reflex hammer. As expected, he started screaming. I then said, “Goodbye, Arnold. I’ll see you a little bit later.” He responded by spitting at me and saying, “I’m going to beat your ass.” I think that the child is going to be in prison by age 12.

I was growing pretty worried during rounds because I was scheduled to present my case last. I was wondering how I was going to tell everyone, “This is a three-year-old child who presents with cough and fever of two days’ duration. Social history is remarkable for a lot of profanity.” Luckily for me, while we were standing in the hallway outside of a patient’s room, Arnold walked by with his mother saying, “Bitch bitch bitch bitch…” and there went my patient.

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9 Comments

  1. Tea said,

    Half, I have more than five kids. I got to college full time, but I am doing liberal arts. I come home feeling like a wilted flower. I still have to make dinner and play with the kids then do homework till 2AM. I have friends who are teachers who go home with nothing, no energy for their families. I don’t know how you do residency and have energy for whatever you do at the end of your days.

    What are parents like who teach their children to be like Master Arnold? Are they barely functioning above an amoeba? Does it make you not want to have children? Can you educate them at all or are they beyond reaching?

    I think the first post I read in Hell (MSH) was about Hoover’s time in OB and the woman who’d never seen an OB was having her baby, “Ah want da best for ma baby!” That sticks out in my mind. How do you all keep going with it? People drain you, you see terrible parents who don’t comprehend the responsibility they have to raise the next generation, what is left for you to like?

  2. MSG said,

    I’ve seen that and worse. One of the kids I saw while on Peds who was being abused by his mother was killed a month later by her. I hate Peds for that reason – I can’t stand abusive parents and think they should all be beat down by someone who can fight back. Having my daughter completely changed my perspective on this specialty.

    Agree completely with the residents bit. All of mine, ALL OF THEM, were women who had a very benign nature and loved kids. They always held babies during nursery rounds and a bunch were pregnant.

  3. REO SpeedDealer said,

    Pediatrics = Veterinary Medicine.

    They scream and fight during physical exam and won’t tell you what is wrong with them.

  4. Tea said,

    Assuming that gender entrance is 50-50, should they admit more males who plan to stay in the field?

    I’ve had nurses who worked for OBs tell me that they became OB office nurses because they wanted a schedule to stay home with their families and “make good money.” I wish they’d have said, “I chose to become a nurse to provide some of the best health care you can ever get.”

  5. halfmd said,

    The kids annoy me, particular in the emergency department when I’m trying to figure just what in the world is wrong with them. That’s why I want to go in to adult medicine. If my patient is screaming and crying, it had better be a heroine addict who is scared of a tetanus shot.

  6. Half Addict said,

    “If my patient is screaming and crying, it had better be a heroine addict who is scared of a tetanus shot.” This is why I love your blog. Damn, you’re funny.

  7. REO SpeedDealer said,

    Agree with Half Addict. Hilarious line. When I was an ER bitch in med school and residency, I would just have the IV drug users draw their own labs with a butterfly. They knew their veins better than anybody. Never had one even argue.

  8. How to Control Unruly Patients « Medliorate said,

    [...] Oh Pediatrics [Half MD] [...]

  9. jj said,

    hey halfmd, i know you dislike working with the kids but what you did to calm them down i s sooo cute. i luv that and especially when you let the kids who are afraid of your stethoscope listen to you heart first .–>thats so friggin sweet LOL

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