My First 10 Days as an Intern

So since graduation, I've spent 2 weeks in Spain, a week moving, 2 weeks of orientation/moving and last Wednesday I started on the inpatient floors at Helen DeVos Children's. And the way my schedule fell, today is my first day off! It felt amazing just to sleep in until the Pooplet alarm went off.

Internship's gotten off to an encouraging start. It's overwhelming to start any new job, let alone one where your performance and picking things up quickly effects other families so much. But it's gone really well. My 2 nights of call were at opposite sides of the spectrum with 2 admits and 3 hours sleep one night and 4 admits and no sleep the other. Ack!

I'll work on posting some Spain pics next.

Isabella & GR Update

It's been a couple months now since we stayed overnight at the epilepsy monitoring unit at Children's and got our diagnosis of Benign Paroxysmal Torticollis squared away. Since then, Isabella's development has been nothing but normal. She hasn't had any more seizures and hasn't worried Mommy and Daddy with any new symptoms. She continues to have BPT spells occasionally where she'll drop her head to the side and fuss a little just like before, which only strengthens my confidence in that diagnosis. I get the sense that she's perhaps dizzy or nauseous when she has her spells and she seems to have some mild trouble with balance and coordination during those times but between episodes she's progressing right on target with her motor milestones, if not a little advanced in some areas. She's saying "mama" and "dada" and sometimes seems to use them correctly depending on who she's with but she's still saying them pretty nonspecifically at this point. But that doesn't make it any less exciting of course. :)

After our news of the match in GR, our focus has shifted toward real estate hunting and planning our spring/early summer with internship activities starting on June 15 and the real action (first real day on the job) starting July 1. April will be my last rotation in medical school, pediatric infectious disease, here at Vanderbilt and then it's off to a couple weddings, moving, graduation, Isabella's first birthday (yeah, already!) and a 2 week honeymoon in Spain. Caramba!

Matched

Pediatrics in Grand Rapids!

The Vaccination Debate

Those who cannot remember the past, are condemned to repeat it.
-- George Santayana

I know there's a lot of information flooding the news about childhood vaccinations and the risks associated with them, namely the fear that they could cause autism in some susceptible children. I cringe a bit when I hear the disjointed bits of information that most parents (and parents to be) are able to glean from the news stories being presented on this. And it's not their fault at all. Much of the information that's out there isn't misinformation so much as it is incomplete and limited in scope. And what results is a blind fear that parents don't quite know what to do with. They're scared to vaccinate and they're scared to not vaccinate. It can also shake their trust in the medical community and make them wonder why docs insist on these shots if they have the potential to hurt their children.

For me, this is a non-issue. The diseases we're preventing through the administration of these vaccines are that potentially life-altering or deadly for children that I could never risk my child's health or life by refusing to vaccinate. But because we don't hear of children getting these diseases in our country, we don't have a natural fear of them. And this contributes to parents' consideration of non-vaccination as an alternative to worrying about side effects. So what we really need to do is reintroduce a bit of that fear through education.

The CDC happens to publish a free Parents' Guide to Childhood Immunizations, available either in print or downloadable form. It's full of helpful but unsettling reminders about what it means to be infected with these diseases and why choosing not to prevent them would be such a mistake. We've made so much progress as a country in eradicating childhood infectious diseases. It'd be one of the biggest tragedies imaginable to take steps backward now.

And the question of association with autism? Trusting the research that says there's no association may not be at all reassuring for parents, but it's all we've got. We're left with a strong, evidence-based case for vaccination and not much to the contrary, save for some anecdotal evidence. Dr. Steven Parker, a Boston pediatrician, writes a great article for WebMD that appeals to parents' sense of logic rather than spouting volumes of medical information they can't mentally assemble in a meaningful way. It's not an elegant piece, but it's direct and it puts the most recent media coverage into perspective.

When I Grow Up

After each clerkship is finished, I usually have to reassess my thoughts on just where it is I'm headed on this medical map. After nearly 7 weeks spent in the crazy, bloody world of general (and this week trauma) surgery, my feelings need some sorting through. Rather unexpectely, I really enjoyed surgery. I wouldn't say I thrived in it (yet), it felt like a constant uphill trek. But I liked it. I loved the challenge and I loved the hands-on healing aspect. And I got some good feedback from residents and attendings that let me know I'm at least not too clearly ill-suited for a career in surgery. Last week, I even dared to check out some prospective surgery residencies at Vandy online for giggles. Problems I have with surgery? Very demanding residency, leaving little time for my new family and my kid(s). Difficult to be pregnant as a surgery resident, as I most likely will be again if not a few times during the next 7 years. So for those reasons, it falls a distant second to peds at this point, but I can't rule it out either. Next up, ob/gyn and babies, babies, babies!

Missing Peds

Well, the time has come to move on to the next clerkship but my heart's still in peds. I misses the kiddies! Yes, I'll see some in family for sure. But it's definitely not the same as being able to see all kiddos. Some of the parents made me want to pull my hair out but the kids themselves are darlings. I sometimes wished I could take one home with me. :) Scary, their parents probably would've taken me up on that.

Goodness Me!

So few posts lately. Well, things should be picking up again here on the Daily Dose. As occasionally happens with Mistress Angela, life gets in the way of the more fun distractions. Peds is clipping along at a feverish pace and will be finishing up this coming Friday with the shelf exam. So far I've spent 4 weeks with hospitalized patients, 2 weeks split between newborn nursery and resident clinic, and last week was spent on the peds hematology/oncology service. This last week will be spent at my very own former pediatrician's office, Kent Pediatrics on West River Drive, where I was a patient of Dr. Kokx until I was 18 and where my dream of becoming a doctor was born. So the story comes full circle.

Peds Kickoff

It's only the first week of my pediatric clerkship but I already love it. My early impression is that it's a better fit for me than internal. But it is very early, with seven weeks to go. I probably won't be posting as much here during the week because my daytimes are actually longer on inpatient pediatrics than they were on medicine. I have to be at the hospital a full hour earlier, which means I actually have to go to bed at a decent time. Plus I'm adding another commitment during the week in addition to dancing (a religion course), which between the 2 will eat up 5+ hours on their own. And I have to steal time in there somewhere for reading. At least I get to go to Tennessee in 2 weeks!