The last week of peds was much more exciting than the previous ones. The fun parts included the intern we worked with, our attending, and the ridiculous moms we dealt with. All week we rounded with the Dr. C, the doctor that I originally hated/feared from the outpatient clinic. She pretty much shows no emotion except for a random joke every once in a while. But even so, she is easy to work with because she goes fast and gets done early.

The last week of newborn nursery we had a lot of mom’s who used drugs in the past or during pregnancy, a ton of teen moms and some other pts who were in jail at the time of giving birth. Each one of these patients is not allowed to leave the hospital until a social worker clears them for discharge.

The most extraordinary case of the week was a 32yo G24P6 female. Let me break that down...this 32 year old woman had been pregnant 24 times [Gravida 24] but only given birth 6 times [Paridy 6]. Go ahead and let that sink in for a minute....

I was the one to see the baby and present the case to the attending and i was looking forward to subtly add that into the history and seeing what her reaction was... When we got to my patient during rounds it went something like this, “ In room X we have Mrs X who gave birth to a full term AGA male last night via NSVD. Mom admits to alcohol use and 1 pack every 4 days of tobacco use during pregnancy. Mom is G24P6 and her labs were all negative except for GBS which was positive and 3 doses of antibiotics were given during labor.” Then I stopped after this sentence and looked up and Dr. C just looked at me with a puzzled face. “G what?” We all sneakered and after I repeated myself we went on to have a conversation about if this was really possible or not. We all agreed it probably was if she got pregnant twice a year since the age of 15 or so....that or she just lost count because really, who keeps track of their pregnancies, abortions, and miscarriages...

This week we had a lot of sick kids in the nursery, not sick enough to be in the NICU but enough to make rounds last a lot longer than usual. At a certain point during rounds this week Dr. C said “ok, any healthy normal babies here right now? i guess they dont make that model anymore, most have discontinued it.”

On Tuesday we had a set of twins born via C Section, a boy and a girl, and then Wednesday we had another set of twins. Ron got to go into the delivery on Tuesday and then on Wednesday we were on rounds and the intern’s pager went off [its actually a little speaker that they use in the OR to inform everyone that needs to be there. A nurse is heard over a little speaker the pediatric intern has on their scrubs saying “Pediatric and OB teams please come to OR number X for a twin delivery..[etc]” its pretty cool. I heard the speaker go off and i immediately got excited and asked if i could go into the C section...only problem was that my patients were next and i had to present them to the attending. i was so freakin bummed when the intern said, “no you should probably stay here and present your patients and then if your done you can come after.” I was so antsy and finally after rushing through my patients Dr. C said “go, go to your C section,” i couldnt tell if she was mad or really didnt care [again, she shows no emotion] so at first i was very hesitant but then Torey [another medical student] encouraged me to go so I did and i am very glad i did. I ran down the hall to get to the OB department and after putting on my hair net and surgical mask i walked into the OR to find at least 14 people in there-- 3 on the anesthesia team, 3 on the OB team operating, and the rest were nurses, respiratory therapists and the pediatric intern, NICU attending, and some others. The babies had just been born before i came so i didnt get to see them come out but I did get to see them get worked on. Both were very small and needed help breathing for the first few minutes of life. Right after birth they were wrapped up in what looked like a plastic bag to keep them warm and after they were stabilized and swaddled up, the intern took one baby at a time to go visit mom for a second and then there were both taken to the NICU in their baby warmers. I found out in the NICU that the mom was actually carrying triplets but one of them had died in utero about 1 month prior and the mom had been in the hospital for the month before this delivery. The fetal demise was born third and right after birth was taken out of the OR where it would go to the morgue to get an autopsy. The other two babies ended up being fine and later did i find out the mother had a history of meth use....

Two other interesting cases happened at the end of the week. One was a baby that was born and about an hour after delivery we were doing the newborn exam on her and she seemed to be fine. Her physical exam and vitals were unremarkable but yet she was totally unconsolable in the nursery. She just wouldnt stop crying. I remember this baby because I was studying in the nursery and mom called me asking me how my day was going and she could hear the baby in the background crying and said, “something is wrong, babies dont cry unless there is something wrong.” I laughed at this saying she was just being fussy and that she was fine. Then when I came in the next day we learned from the overnight intern that the baby was with her parents but still was being fussy and wouldnt stop crying. I thought it was pretty ironic that mom was right but it ended up that the baby was fine. We did a work up for a couple different problems that we thought she might have but everything ended up being fine. So thats good even though we never figured out why she cried so much....hope she lets her parents sleep at home.

Lastly, I will end pediatrics with this pearl of a story. I dont know too much about the mom and baby because she wasnt my patient but i heard about her during rounds from the staff. Ron had a newborn born to a mom who was a little...off. He said he would ask her questions and she would just look around the room and talk about random things. He said he got an odd vibe from her and let the intern and attending know during rounds. Also, this mom was refusing for her baby to get a neonatal blood screen [a screen every baby gets in the first days of life to check for genetic diseases that can be fatal if not caught early...and if they do have one they can be harmless if given the proper medications/diets]. While talking about this patient, the charge nurse came up to use and said she needed to speak with us about her. She wanted to let us know that the mom was saving the babies diapers and expressed that she was doing so so that later she could smear the poop on her body because it is good luck. All of our jaws dropped and the only words out of the attendings mouth were “Psych consult.” It was hysterical. Social services had to get involved with this case also and I actually dont know what ended up happening with this mom because she was still in the hospital when i left on Friday.

So thats it, peds is done and I could not have been more wrong about my interest in it. I am glad i found out early on in my 3rd year rather than later on. I now know that I need something fast paced in my daily life and even though this will likely be more stressful and tiring, I have come to realize that even though i hate stress and being tired, its something that keeps me going. I am a fast paced and outgoing person and I need to be challenged and most importantly, I need to know that my work is important and making a difference. When i was on OB I saw a difference right there and then. Wether it was a delivery, a surgery, or just a clinic visit. I saw the work I was doing was making a difference. In pediatrics you dont see the ‘fruit of your labor’ sort of speak. It may sound shallow but i need to be reminded of the importance of my job since i have sacrificed so much to get to this point. Thus right now I am still considering going into OB/GYN and I am also thinking about going into Emergency Medicine. Who knows, maybe the years of watching ER has subconsciously persuaded me into the field.


The past week we had our didactic week that happens after every 12 week of rotations. We came back to campus to do our OSCE’s, take or shelf exams [which sucked] and then have ‘plenary’ session for the upcoming specialties we were rotating on. Basically, it was a stressful Mon-Wed and then 2 days of relaxing. Next up, I have 4 weeks of a well deserved vacation. I have not taken time off since last summer and I have never needed a mind break more. Going straight from second year to board studying to 12 weeks of a demanding rotation schedule, I am going to enjoy and relax as much as i can for the next 4 weeks. Then its off to Portland, Oregon for my elective. I will be working in an outpatient family practice clinic and living with a good friend of mine who is also doing a rotation up there.