Learning from the kids

Days like today make me realize a couple of things. First, they're a reminder of why I chose to go into medicine in the first place, and why it's important to study hard, to learn well. Being in the ED makes it all real. C. diff isn't just an abstract bug anymore; it's what's currently living in the bowels of the little kid scrunched up on the bed whimpering that's causing everything that enters one end to make a rapid exit out the other. And then micro comes rushing back, and you remember that C. diff can be treated either with IV metronidazole or oral vancomycin (since vanc isn't well absorbed orally so it goes right through the GI tract taking care of the problem as it goes). But this is real life, and more specifically, this is the pediatric ED. Oral vanc tastes FOUL, and there is no way on God's green earth that this poor little kid is going to swallow enough of it to make a difference. You see kids come in with pilocytic astrocytomas, or in status epilepticus; you get really excited about recognizing the tumor on the CT before suddenly remembering exactly what that means for the family. All of a sudden, the world of medicine is right there in front of you, not in color-coded drawings or dry textbooks, but a living, breathing person. We don't do medicine because of the theories. We do medicine because of the people we heal. We do medicine because of the lives we touch.

The other lesson that I learn -- repeatedly -- when I spend time at CHP or Presby, I'm constantly reminded of just how blessed I am. It's only by the grace of God that I'm able to be on this side of the hospital visit. Sometimes it's really easy to get bogged down in all of life's stresses. There's so much to do, and only a very limited amount of time in which to do it. It's easy to obsess over grades, over research, over crushes, over what to have for dinner tonight. Being in the ED makes you take a step back from all that and reorient yourself. Spending time in the ED gives clarity and focus to the things that really matter. Those of us capable of helping the patients who show up...well, we've been blessed. And no matter how stupid, how frustrating, how petty, how obtuse these patients (and at CHP, their parents) are, and as hard as it may be, I need to try to remember that I have been blessed and that my job now is to be a blessing to them, to be the instrument of God in touching their lives.

One other quick side commentary for future physicians: if you are in the ED and you are NOT an ED attending (say, a critical care fellow), please, for the love of God, DON'T contradict the ED attending, and DEFINITELY don't contradict her in front of other ED staff, and ESPECIALLY don't contradict her in front of the patient's family. PARTICULARLY when you're wrong. You'll seriously irritate said attending, earn the ill will of basically the entire emergency department staff, and leave the MS-II standing in the corner watching the whole thing shaking his head in disgust at the absolute lack of professionalism. What you do in the ICU is your business, but what the emergency docs do in the ED is theirs. This has been a public service announcement.

Anyhow, that's all from me for tonight. At some point I'll have to blog about my experience in the OR, but for now all I'll say is that it was both worthwhile and eye-opening. Stay tuned...

Peace and God bless!