November: The Bad

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When I was younger I read A Child Called It by Dave Pelzer. I was enthralled. I was fascinated by child abuse and couldn’t wrap my mind around how things like that could happen. Fast forward to now when I see child abuse regularly in the Children’s Hospital. November was one of the hardest months I’ve had yet, because of the tragic social situations children wind up in.

Neglect. Neglect is one of the worst forms of child abuse in my opinion. Not that you can rank them very well… But to me, not caring and being indifferent is in many ways worse than physically harming someone. At least with physical harm there’s some passion behind it. I’m not sure if that makes sense or if I’m communicating that well, but I just don’t understand it. I can understand other forms of abuse. Until you have a child, you can’t fully appreciate how difficult it is to be a parent. It’s difficult to lose your independence and have to change your day-to-day one hundred percent. It’s difficult to deal with the stress that having a child places on your relationship with your family and with your spouse and everyone around you. It’s difficult when your friends don’t understand why you can’t go out or be spontaneous anymore. It’s difficult when no one understands (or so it seems). I myself have had to find support through different Facebook groups of other moms going through exactly what I’m going through. I have learned that mommy guilt is a real thing, and mommy-shaming is made even worse these days with crafts and different competitive ways to measure how good of a mom you are… Mostly based on the number of crafts you do & the amount of time spent at home with them. And that’s just in my own socioeconomic class. The kids I’m taking care of often come from disadvantaged situations, so there is very little access to resources and education to prevent the tragedies that occur. I can’t imagine worrying about caring for a child while simultaneously worrying about where my next meal is coming from and if I can afford a winter coat and shoes.

But I just wish that people would consider another option. If they don’t want to be parents anymore or if they truly are indifferent, I wish that they would just drop their child off at the nearest Quiktrip or fire station or anywhere that has a safe place logo on it. I wish I could plead with them and reason with them and tell them I understand. I know it’s hard. I know what it is to be up all night and crying and exhausted & still have to go to work the next day and perform at a certain level. It is exhausting and horrible some days. And it isn’t all giggles and sunshine and cute chunky baby rolls. “I get it,” I want to tell them. I want them to know there are people out there that would take care of their baby if they thought they couldn’t do it any longer. I want them to know that there are resources in our community.
I want them to know that there are other options than neglect & abuse. Unfortunately, I don’t ever get the chance to voice that opinion until it’s far too late.

I worked the first weekend in December and after one particularly horrible social situation, I went home and found myself curled up in my bed, crying my eyes out while holding onto Adelaide. I’m not going to sit here and say that I understand on a different level now that I did it before I had kids (even though that’s really true, but I wouldn’t have believed you before I had her). But I will say having a baby the same age as a baby in the hospital that is at the hospital for injuries related to abuse rattles me to my core in a way that I hadn’t experienced before. It is so hard to go home and take care of my own baby when there are babies suffering at the hospital. It’s difficult to separate myself and not worry & stay up at night thinking of those other babies.

When I was a medical student, it was no different. I was equally enthralled by child abuse and fascinated at how things like that could happen. I wanted to know more about the social situations and more of the details. I didn’t understand why we weren’t allowed in the patient rooms where these stories were happening. I remember asking myself “wasn’t I here to learn? Wasn’t I here to gain from this experience? Why am I being barred from going in to those rooms?” Fast-forward to residency. Now I have no choice but to learn from these situations. And every single time, I wish I could go back to Med school. I wish I could go back to where I wasn’t allowed in the room. I wish I could go back to where my fragile emotions were protected by those that came before me. I wish I didn’t have to come home and bear the burden of the stories. I wish I didn’t have to look at my own baby and think “why did you get so lucky and they didn’t, simply because they were born in a different situation?” While everyone else is pointing the finger of blame and voicing anger directed at the parents/abusers,  I try to stop myself & think “how has our societal system failed them? Where were their family and friends to rally around them when times got tough? What could we have done as providers to prevent this from happening?”

I don’t have the answers. But I think routinely challenging & asking myself these questions, and allowing myself to be angry about these situations and emotionally moved is the only way to make real change. I sure hope there’s a solution and that it comes swiftly.

November: The good.

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First off the Cubs won the World Series!! We hosted most of my family at my house for the last 3 games, which was exhausting after working 13 hour days, but was definitely worth it. I wouldn’t trade the memories of watching those games with my family for the world! My fellow residents didn’t act too annoyed when I wore a Cubs shirt to the hospital instead of scrubs, and they even put up with me watching the entire Chicago parade after the big win, with tears welling up in my eyes.

November was my first month of inpatient peds. “Inpatient”= in the hospital. I work on the general floor, so basically if your kiddo goes to the ER and gets admitted to the hospital, I take care of them. If they go to their doctor & their doctor admits them to the hospital, I take care of them. If they go to another hospital in Oklahoma that isn’t equipped to care for them, they’re transferred to our children’s hospital, and I take care of them. Let me start by saying there’s just something special about working with only girls. I spent my month with 2 other girl interns and 2 senior residents.

One of my senior residents is a sister for the Catholic church. Another intern & I spent the better part of our month together grilling her on how she became part of the convent at our hospital. I was completely fascinated by the ins and outs of her daily life. Her & I bonded over our shared love of Advent (she had no idea Methodists celebrate it too!) and our love of bacon cheeseburgers.

An intern I worked with in the hospital had a baby in August. Having 2 breastfeeding moms on inpatient service for the month presented itself as a unique challenge for our teams, but it worked out beautifully. Our program is super supportive & allowed us to get our perfect rotation system down. We alternated times & got to use the call room freezer for our stash, and even got to use a secret stowed-away hospital grade pump! Even though this was her second child, we bonded over having new babies at home and the joys/struggles of everyday life. She’s hilarious & speaks her mind about everything, and is addicted to coffee to a slightly greater degree than I am. We took daily coffee breaks together & giggled about entirely inappropriate things.

The other intern on with me for the month happened to be my “residency bestie.” For whatever reason we got super close and just kinda clicked from day one of orientation. We met last year during my peds audition/interview for this program, but didn’t keep in close touch for the rest of 4th year. Anyway, we take turns babysitting the other’s kid from time to time and spent the month of November mourning the election results, watching Finding Dory, fueling our coffee addictions (with the other girl too!), and had a great time being sassy together.

My other senior resident in November is the epitome of classy attitude. She always has a witty comeback & a fresh view on a situation. She talks to herself, making for a constant stream of “huh? Oh, you’re not talking to me” comments throughout the day. She also loves Adelaide and calls herself Adelaide’s bestie because she can always seem to get her to smile. We bonded over selfies, lack of sleep as the month dragged on, our slap-happy goofiness, & our love of bacon in the mornings. (Cheers to you, caramel surprise!)

Our night team was awesome too- an intern & a senior, both who came in fresh every night with new jokes when we had tough days and funny stories from their crazy night shifts when we came back each morning for sign out. They were hilarious to work with, too, and sign out often went late because we were all laughing about some crazy event that had happened.

Since Thanksgiving fell in November again this year (ha), we had holiday hours. My residency splits holidays awesomely- we either get a week off for Christmas or a week of for thanksgiving. It flips every year so it’s fair. The holiday week you work is split fairly so that everyone only works 4-ish shifts. So, instead of working Monday-Friday, I only had 4 shifts. On thanksgiving day, we wore turkey & pilgrim hats during rounds and the kids & families loved it. And because our patient list was so small on thanksgiving day, I got to go home early! (which is unheard of in most residency programs!) I got home in time to critique David’s cooking of the bird & add my 2¢ on how everything should be set up, and got to host a wonderful dinner with my family & in-laws.

Seriously, the residents I worked with in November were such a fun group of people to work 12-13 hour days. We were constantly laughing from sign out in the morning to sign out in the evening.

Our attendings were amazing too. One brought us peppernut cookies which were delicious. 2 others were cool enough to dress up for thanksgiving with the rest of us with our turkey hats & pilgrim hats. We were able to have 2 separate birthday parties for our attendings & sister. I made a funfetti cake & an apple pie cake (link: http://www.bakeyourday.net/apple-pie-layer-cake/). We decorated the call room with balloons & streamers two days in a row & everyone enjoyed the desserts I made! We also had a running list of hashtags/inside jokes such as #isabella #watchgameonfleek #icanteven and my personal favorite… #VSSAF. One of our attendings constantly used the phrase “struggle bus” and “womp womp” and “I can’t/I can’t even” which all quickly became part of my daily vocab. We had so many laugh-til-you-cry moments that I lost track!

Pediatricians have been accused of being the fluffiest and happiest of specialties which is mostly true- but my goodness, I challenge you to find a more sassy, aggressive-in-a-good-way, and sarcastic group of residents than the people in my program. I seriously doubt you can!  image

 

The humbling act of parenting: my built-in ego manager

image.jpegI’m now several months in to residency and finally feel like I’m getting the hang of things. For starters, the computer system no long eludes me most days! Dr. Beeson is growing on me. I’m adjusting to my new identity slowly but steadily. The casual glance down at my badge & a subtle straightening of the spine instills a certain confidence.

I feel like I knew what I was “buying” when I started residency. 2 of my close friends in other residencies have asked me if I regret this line of work because they do. I really don’t. For the most part I am enjoying residency, despite the long hours and tough social situations I see daily.

I was on pediatric surgery in September. It was a good rotation because it showed me as a general pediatrician when to refer to surgery urgently and when something could wait. Having my history with anesthesiology, I was thrilled to be in the operating room again. I missed it, but every day was reminded in subtle ways that I made the right decision for me, choosing peds over anesthesia. I liked seeing the pediatric surgeries, but I didn’t get to do much hands on learning, which is what I prefer. They had enough people in the OR without me being there, so I often felt I was in the way. I joked with my family that I didn’t think I had narcolepsy until I started this rotation, because standing in a warm operating room and not doing much with your hands can make for some sleepy mornings! I tried to read every night on the most common pediatric surgery cases and tried to be interested in the lab values and testing our patients had. Mostly I just kept my head down and enjoyed the good hours and the extra time I got to spend with Adelaide when I had the occasional half day.

October was my clinic month. Our resident-run clinic sees a very underserved patient population. Truly the “least of these.” I know I said I wanted to serve the underserved in my interviews and even back in my Med school application, but in real life it’s tough. The question I’ve most struggled with is how do I go home and leave my baggage at the door? There’s no way anyone from my day-to-day life can handle the burden of knowing these patients’ stories, and patient privacy laws make it so that I often can’t share much detail of any patient story. It makes it very difficult to deal with, keeping them to myself and never being able to talk through them with my support system. So I make light of them. I joke about it. Because how else can I cope?

Another thing I noticed on my clinic month: my experience being a mom myself is making me a way better pediatrician. I’m not sure why I thought I had to keep my private life out of my clinical practice. For the first few months of residency, I hardly ever mentioned Adelaide to my patients because I didn’t want to make it “about me.” But I have found since I’ve started sharing my own parenting experiences I have connected with so many more patients. It’s really awesome to connect with families over shared parenting experiences, especially with families who come from totally different backgrounds than I do. One example is that I showed up to clinic two weeks ago with spit up all down the back of my shirt. I had no idea until my Attending mentioned it. I was mortified, but laughed it off & told my next patient about it & was able to connect over how our kids humble us when we think we have it all together! Plus there’s just something humbling about going home and wiping another person’s butt- if it was ever a question, these things definitely keep my ego in check. I have patients that now request to see me because of the connections we’ve made over shared parenting joys & downfalls. It’s a truly wonderful feeling! I have more to write about my November month of inpatient hospital pediatrics, but for now, this will have to do!