Questions answered

February 4, 2008 at 1:01 am (Clinical rotations)

I finally wrapped up pediatrics this weekend. Throughout the previous two months I’ve seen and done things I’ve never thought possible. I’ve also learned quite a bit about children, mostly in the form of questioning the bizarre behavior that I saw around me. I would like to take this opportunity to share some of those questions and their answers with my reading audience.

Question: When I was in the neonatal ICU I noticed that all of the doctors and nurses were wearing gloves when handling the infants. While I understand that hand washing is good for reducing the spread of infections, why are gloves also necessary?

Answer: the purpose of the gloves is not to reduce the spread of infection; it’s to prevent the scent on your hands from being transferred to the infant. If the mother smells the scent of another creature on her baby, she will immediately kill and eat her child. It happens all the time in nature. Since were trying to prevent this from ever occurring, it’s necessary that all doctors and nurses wear gloves when handling babies.

Question: What are our responsibilities on pediatrics? What happens when we don’t fulfill those responsibilities?

Answer: As Pandabear is fond of saying, you have no true responsibilities as a medical student. However, the university will certainly try to give you many pretend responsibilities. I had to take call every fourth night to admit patients and to help the residents with their work. On two separate occasions I had forgotten that I was on call, gone home, and taken a nap. Each time I woke up, realized that I was supposed to be in the hospital, and then ran back to the wards. On both occasions, despite being late by several hours, the residents took no notice of my absence. In one case, the resident even said, “I didn’t even know med students took call.” The good news is that I’m on the psychiatry as my next rotation. I figure that if I’m ever late, I’ll tell the patient, “You had better tell everyone that I was here at 2 p.m.” If he ever squeals and tells my attending that I showed up at six, I’ll reply, “He’s crazy! Obviously he doesn’t know what time I arrived.”

Question: I watched a doctor give a lecture via PowerPoint today. He seemed not to know how the computer worked. He had the presentation in “edit” mode and went through the entire lecture with the screen at only half size. Why is it that doctors don’t know much about technology?

Answer: Nothing scares me more than physicians who don’t understand computers. Doctors are supposed to be the best and brightest of our nation; however, many of them can’t figure out how to use a microwave if their life depended on it. I’m constantly amazed at how we have many medical advances such as lasers being used in surgery, molecular mapping of the human genome, and nano robots that can deliver drugs to pinpoint target. Despite all these advances in technology, many physicians are scared of using anything technologically-related. Many of the premeds who used to shun physics, math, and engineering courses as undergraduates eventually progressed into becoming physicians who also shun applied physics, applied mathematics, and applied engineering. I’m extremely annoyed that we continue to use paper-based charts for all of our patients. My hospital has tried to go into a quasi-computer method of charting patients. We use electronic medical records to house data such as x-rays and laboratory results. However, we continue to use paper charts for admission notes and record-keeping. Once the patient is discharged and returns to clinic a week later, we no longer have access to the paper charts. Therefore, we have no idea why the patient is coming for a follow-up appointment. And forget about the patient ever knowing why they’re there. Most of them will merely reply, “I got a letter in the mail telling me to show up today.”

Question: Why do pediatricians talk to everyone (including adults) like children?

Answer: Doctors only understand what they practice—and pediatricians are no exception. One of my many great annoyances from this past rotation—and believe me, there were a lot—included pediatricians to like to talk to me as if I were a five-year-old. Nothing is worse than having a resident who is younger than me adopt a high-pitched voice and then say, “Do you think you can get that done for us?” Lord, I can’t imagine what their consults are like.

Since I’m starting psychiatry tomorrow, I’m sure I’ll have lots of new stories to begin posting on this blog. I’m sure many of them will begin with, “You won’t believe the shit I saw today!”

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