Internship: Second Rotation Begins (Week Nine Reflections)

Hello Pediatric Intensive Care (PICU)!

This week flew by as I oriented to the new hospital, new floor, new mentor . . .  and all new ways of doing things!  I am, once again, a little fish in a big sea.  But with so much sea to see!  Though I doubt this revelation will surprise anyone -- the PICU is a pretty intense floor. Most of our patients come to us through the Emergency Department with either trauma (sudden injury like a car crash) or acute illness (like pneumonia).  In my first week I've seen a lot and learned a ton.  Each day I come home with a list of new diagnosis I've never heard of before.  My task is to learn the basics of each, and be able to describe them in one sentence, that a 5th grader can understand.  For fun, I'm keeping a running list, to see how many there are by the end of the rotation.  Maybe I'll make it a guessing game, with a prize for the winner?  Hmm . . . .  lemme think about that!

Here are a few examples:

"Osteogenisis imperfecta" -- This means that your bones aren't very strong, so they break easily, or sometimes bend.  (Made famous in the movie Unbreakable.)

"Hirschsprungs": -- The nerves in part of your colon don't work right, so it makes it difficult, or even impossible, for you to poop!  The doctors can fix it with surgery.

"Ondine's Curse" -- (yes, someone actually named a children's disease "curse."  Not really sure what they were thinking!)  When you fall asleep, your body forgets how to keep breathing, so you need to be hooked up to a ventilator when you go to bed.

"Subglottic Stenosis" -- The smallest part of your airway is too narrow, making it really hard for you to breath.  This is the one of the most common reasons that babies get a "trach" (a special tube in your throat that you can breath thru.)  Sometimes, the doctors can fix this with surgery.

And many many more.  Some of the things I see are really neat and interesting from a medical and Child Life perspective (like Toxic Shock Syndrom, Duchenne's, and Pelizaeus Merzbacher disease).  But, it's really hard to see a family standing around their intubated child while the doctor explains to them that he will probably die.  On the other hand, to be able to help that family, to provide support to a sibling who is frightened and confused, feels pretty good.

My High:  catching on fast to all the new medical jargon, and learning about all the new diagnosis.

My Low:  The hardest things to deal with have been the kids hit by cars, the suicide attempts, and the shaken babies.