Monday, November 02, 2009

evals and f$&@ RSV!!!

so i believe i have caught a delightful case of is the season, after all. first it started off as the "feeling of impending doom", and then a slight sore throat, then after all sorts of halloween party exposures over the weekend, the doo-doo hit the fan and BAM i was sick. i was on call sunday and you know you're sick when every time you sit down you fall asleep if not otherwise occupied with important M3-like duties. today is better...i have more energy, but the sickness has evolved into the more classic upper respiratory gunky sinus one nostril is plugged at any given time phase. i am also sneezing. and coughing. i live for those brief moments where BOTH nares are PATENT! yes. also, it sucks to have to climb up and down stairs...the children's hospital elevators are the major suck so it's quicker to just climb 4-5 flights of stairs than wait. so i've been getting my gym on at school. this is also my last week of wards, and i'm kind of excited. because that means moving on to clinic. which means no more wards. which means no CALL. which means i am happy.

peds so far has been a double edged sword in a way...i enjoy being with the kids, i really do. i like the babies, even if they make me sick. however, it really saddens me to see the abused kids, and the ex-preemies who are now trach'ed and feeding tubed and whatnot living out some sort of strange existence. i know, these kids are someone's child and they are loved and have their purpose in this world, but at the same time, on some level it just seems almost wrong. i don't want to start an ideological/philosophical war, because i have never had children or suffered through horrible chronic diseases, etc, but it just seems wrong to try and "beat nature" or surpass "God's will" and prolong life when it seems that the most humane thing would just be to let nature take its course. i have had a couple of ex-preemie kids (like extreme 23 weekers) who have such severe neurological devastation (so they are functional vegetables), they have a tracheostomy (so they breathe through a tube, most of the time there is oxygen being pumped into the tube as well), they have feeding tubes (so they are fed through a tube that goes into their stomach or intestines) just really makes me sad. these folks are in and out of hospitals for seizures, pneumonias, you name it. i have no idea what that family has gone through, or the decisions they have had to make, but i can't help and think that for me and my future family, i don't know if i'd want to "do everything possible to make life happen" if i happened to deliver a child at extreme prematurity. call me selfish, but i just don't see how that is humane to that child to keep them living when there is really nothing to live for. maybe they do have hopes and dreams, but it's hard to imagine that they do when they can't even interact with the world around them.

just some thoughts i've been having on that topic.

it's kind of hard to not wrestle with those tough topics when you see the patients every day. are we really doing good? for example...kid has some crazy something going on. they can't feed by mouth for whatever reason. ok, well, they need to eat. how will they eat? let's stick in a feeding tube. that tube goes in through the abdominal wall into the stomach. uh the hole in which the tube is inserted is leaking. oh, it's leaking stomach acid. now there's a ginormous hole in the abdominal wall and all the skin around it is disintegrating because of the acid. how do we fix it? also, how does the kid get nutrition? we got to stick more holes in the body to get to a vein to give some IV fluid nutrition, but that doesn't help out too much in the long run. then all those veins get clogged, and now you have clots that are threatening to go into the heart and lungs and cause some major damage. and you still have the ginormous acid hole in the abdomen...

another example...a kid who is deaf and blind and has a whole host of other neurological problems. why is the kid that way? mom had some sort of infection while she was pregnant, and the infection crossed over the placenta into the baby and now the kid is just a living vegetable. i guess the kid only knows if people are there because of touch. what kind of existence is that? no speaking capacity, can't even move, or see or's just tough to wrestle in my mind sometimes...

ok, let's move on to something else.

i just checked out my last set of evals from ob/gyn, and i got the nicest, most uplifting evaluations from that rotation. things that said "would make a great house officer" (a.k.a. kickass resident). "above average student". "worked well with others". "hard worker". i guess it's just wonderful and incredibly validating to do your best and for your work to be acknowledged by others in a positive way. when i read some of those comments, it really gave me a good self-esteem boost, because i sure feel like i'm dragging now, and surgery is yet to be done! and i know i'm not the smartest person...i certainly get a lot of questions wrong, which sucks, and i don't know what's supposed to happen next 99% of the time, but at least i'm learning from my mistakes and people recognize that i'm a good worker. that makes me feel good about myself, and sometimes that is hard to come by when everyday in medical school is just another reminder of what you're doing wrong and of how much you just don't know and need to learn. i know, what a fatalistic way to approach life, but that's kind of how it is nowadays.

ok, i think having RSV is making me a bit too philosophical. and it's time to make dinner, which will be pancakes, eggs, and sausage because dammit, breakfast for dinner is awesome!


chasingzebras said...

Sorry you're sick, but congrats on the good evals - that's AMAZING!!!

OleMissBabyDoc said...

Haha - I've never heard of an adult having RSV. Kids did it to ya ;)
Congrats on the OB/GYN evals. I'll need a good OB one day and I'd be proud to call you mine.