Behavior and Development

In Developmental Pediatrics, we do lengthy assessments of children with possible developmental delay or suspected autism. A lot of it involves a box of toys, seeing how they play with toys, how they interact with us and their caregiver. I enjoy playing with toys. I also found it incredibly interesting how every child with autism is very different from other children with autism, yet there are core features they share in common. There are also a lot of questionnaires and scoring forms, but these are used as guides rather than as strict diagnostic tools.

Well baby nursery

I'm on call in the well nursery. Newborns are so sweet, and I've seen a few interesting diagnoses, from Down's Syndrome to polydactyly, and loads of hyperbilirubinemia. Unfortunately, birth has a lot of paperwork, and some pediatricians want to medicalize the whole process. I end up doing blood tests and ordering imaging when I really think that observation is more appropriate. Spiralling costs of healthcare, anyone? There's such a fear of being sued for missing something.

Backup call from home

This was my first weekend in a month where I was off for a 2nd day of the weekend, even though I wasn't fully off. My pager never left my side and I prayed that I wouldn't be called in, since I was on backup for 24 hours and it's flu/cold season. We had 2 people out last week due to exposure to Pertussis. I read, watched Star Trek: The Motion Picture, ate dim sum, and relaxed a bit. No bleeps!

Paging Dr McCoy!

I do not enjoy talking on the phone. It largely involves trying to convince other people to get up off their butt and do more of the work that *they* don't particularly want to do. Sadly, much of my day is spent taking phone calls, chasing lab results, getting scans arranged, talking with other doctors, making referrals and so I get to practice yet one more thing I don't like to do. I think that's a big part of residency, learning to just power through psychic pain and get on with it.

Tools of the trade

Working back on the general ward. Our hospital beds range from cribs to full size beds and my patients range from 20 days to 20 years old. This is RSV and asthma season, which also brings in a lot of sickle cell crises. I use my stethoscope, tendon hammer, torch light, and pen regularly. Also on hand is the PALS guide and an asthma booklet. All of these fit into my white coat, with all the other bits of paper I've accumulated and a list of all the patients under our care.

Step into my office...

I've been on an ambulatory rotation, which doesn't mean I just walk around. It means I'm rotating through different outpatient specialty clinics. It means bankers hours. It means a bit less stress. It also means I feel like "the doctor" with my room and exam table.

Playing around

During vacation, in addition to getting things accomplished, like signing up at the co-op, going to the eye doctor, and the dentist, I also spent some time with my family and played board games. Though I may look serious, I do have a fun side.

Medical conference in the Rockies

During vacation, I went to a medical conference (IDAA) that just happened to be at Keystone resort, in the Colorado Rocky Mountains. Beautiful scenery, nice resort, and great conference.

Call me. Call me any any any time.

One disadvantage of being a resident is the working pattern, and being on call frequently. 11-12+ hour days become the norm, overnight shifts here and there, days off few and far between. The hospital provides an on-call room with two twin beds, though I've yet to have time to nap or use them while on overnight. Instead, I'm spending a small fortune on coffee to keep me powered all the hours that Helios and Chronos send.

Dammit Jim, I'm a doctor not a typist!

I spend most of the day sitting at ergonomically disastrous computers, typing notes. I spend more time with a computer than patients, though still enjoy seeing patients when I get to. I look forward to ubiquitous computers which record the entire patient encounter and create the note using AI. I've had some really interesting patients, with a variety of diseases and conditions.

First day of really taking care of patients

Started on the wards today, taking a leap forward in responsibility. Everyone is still treating me very well, and it's great to be "Dr McCoy" looking after my own patients.

Pediatric Advanced Life Support

Learning how to recognize the seriously ill child, and identify who may need resuscitation.

This monitor/defibrillator is much bigger and has more buttons than a tricorder. But we mastered its use.

Picnic in the park

Pediatrics department picnic in the city park. I got a bit of sun, met a few new faces, chatted with fellow interns and their guests, ate too much food, then bought a new hat. Reminded me of company picnics as a child, where we'd play softball, badminton, and run around with the other kids. Except there were few kids, and no sporting activities.

Bag lunches and conference rooms

The last week has consisted of a lot of lectures and conferences, many of which were incredibly boring. The dullest was probably HIPAA, which is an important topic but not very exciting. Bag lunches provided by the hospital (perhaps in lieu of pay?) have been the staple of my diet, which is a major departure from my prior dining habits.

Commuting is so pedestrian

Until the transporter is approved for commuting purposes, I'm riding the extensive and efficient subway system. The next two weeks will be orientation, where there are mountains of paperwork to fill out, classes to attend, and a few free lunches to be eaten. On my commute, I'm studying for the multiple certifications I need to achieve by the end of next week.