Pediatrician

***Note: I'm making up names and sex for all the docs I shadow to protect their privacy. All docs will be assigned a letter and will be referred to as "she" because I'm tired of "he". ***

So I started shadowing a pediatrician last week. Let the record state that I've never had an interest in kids. They drool, they make messes, and they get sick. As in the words of one of my professors, they're little walking disease bags. Hence, I've never thought about being a pediatrician. But do you know what?
Kids are so damned cute.
Kids don't usually have much to complain about, occasional tummy or ear ache here and there and it's pretty much taken care of. Then they go back to doing whatever cute thing they were doing before. I haven't given it much thought, but I find it fascinating how humans develop at that age. They are starting to develop their own immune systems, their bodies are developing, and all their systems are starting to gear up. It's also a very fragile time in life. Any foods ingested at the wrong time could result in an allergy or hyper sensitivity at a critical development time. That would worry the crap out of me constantly if I were a parent. Knowing what I know now, I'd probably be pretty germaphobic with my kids. So parents, I have to hand it to you.

Another aspect about being a pediatrician that the doctor brought to my attention. People will also make appoints even though the kids aren't sick? What? I mean isn't that what a doctor is there for? Not to a pediatrician. For those of you that aren't already parents, well-child visits are appoints you make with the pediatrician every couple of months/years to make sure your kid is developing properly and make they have all their shots. Dr. P loves these visits. In addition to the usual shots and physical, she believes that it is the perfect time to communicate with parents about how to raise kids. You know what? I agree. I mean there are parenting classes but those are rare. New parents already have the time sucked out of them by adjusting to a new person in their lives. How else are parents supposed to know at what age to start potty training their kids or what foods to feed them? I think that it is important that parents ask these critical questions because how else are they going to get credible information?
I've never seen this side of pediatrics and I find it extremely interesting. I like having knowledge and I love spreading it to benefit others. I find that this specialty is more about teaching as well as healing. Very cool.

There is a growing concern that Dr. P did bring up. She works for a big hospital and her boss told her to cut down on these well-child visits and see more sick patients. They get paid the same whether it be a 30 minute well-child visit to discuss development or 15 minute check for an ear ache. She grows increasingly tired of the bureaucracy and she told me to keep an eye out since it's starting to really affect how doctors operate and even deliver health care from when she first started practicing.
While I understand that concern, I never really knew how it was "back in the day" so all the regulations and red-tape will already be apart of my medical training. The thing that I do raise concerns about is if indeed getting through bureaucracy does affect the care of the patient, are current and future doctors providing less care for their patients than the old doctors?

My First Observation

Note: This post is backdated from 21 Jan 09 but I feel like it was an important event in my medical career so I'm posting.


With nothing planned but making welcome packets for the day, I bunkered down and got started. No sooner than I started when the doc, who was in surgery when I got there, walked by. Normally I'm quiet and reserved. I don't think there is anything wrong with it, but from what I've seen, that won't get you anywhere. One thing you must do is be assertive and just go. Worst they can say is no.
I walk up to the doc and asked if I could tag along to whatever she was doing. She agreed and I tagged along.

Shadowing her after a couple of patients, she mentioned she was going to do another lapcoly. What the heck is that? I didn't know but she asked if I want to observe. HELL. YES.
I've never observed live surgery before, sure on discovery health they had those shows, but LIVE surgery? Never.
I followed her to the patient and she did the formalities. I introduced myself and thanked the patient for giving me the opportunity to observe. Hint to any people shadowing. When dealing with patients, always, I mean always give a genuine appreciation.
-These people are not just another case, if you give them a genuine thank you, that develops patient/healthcare professional relationship.
-This gives doctors insight into your bedside manner. If you're giving a timid and shy thank you, it doesn't give mentors any material to work with when writing a letter of recommendation. Remember, you are there for only a couple hours out of the week, you don't have a lot of time to show these people what you can do.

surgery was amazing. It was one of those procedure with the endoscope to minimize on healing time. They first cut incisions into the patient.
*disclaimer, this may or may not be the actual procedure but only from my observation. Do not reference this as any source of medical credibility.
1. incision
2. insert plastic valves to keep the incision open so they can stick instruments through it. Kind of looks like those things they put in cows that allows scientists direct access to the insides.
3. insert gas into the patient to open the cavity up.
4. use tools through the plastic channels to locate, cut, cauterize, and remove the gall bladder

This has got to be one of the coolest things I've ever seen in my life.
Things I've learned today:
-A lapcoly is a procedure to remove the gall bladder
-Surgery is awesome. I'll seriously consider it if I ever get into med school.

Small Towns

I get asked often about where I'm going to to school. I tell them the same small town where I got my bachelor's degree. Most give me a puzzled look. Really? Of all the places you could be, you chose a pit-stop* town. [*Pit-stop town - a town between two cities that one only stops by to get gas at. ] While I sometimes miss the bustling and life of a larger city, going back to this small town is very beneficial for me: Volunteering.

Let me give you an example. Tomorrow I'm going to be going in hopefully (assuming the patient gives me permission) observe a gall bladder removal. One of the doctors I normally shadow will be performing the procedure and it's very easy for me to get this experience. For those of you thinking it would be fun to practice medicine this is the tried and true method to tell if you can stomach seeing the guts. I was worried my first observation too. "Would I get dizzy?" "What if I feel like I have to throw up?" You'll have to find this out for yourself. For me, when they cut into the patient I was like "dude, awesome. Let's see more of that!"
I guess it's another reaffirming sign that I made a good decision.

But I digress, reasons for going to a small town to volunteer at a hospital.

1. Less paperwork/Less Redtape
Let me tell you about how I started volunteering at the hospital. I walked in one day and asked the gift shop lady if I could.
Me: I want to do something more hands on.
Gift shop: oh, we only have volunteers that want to sell flowers and comfort guests while they're waiting in the lobby. Let me send you to the nurses station.
After five minutes of waiting I'm talking to the HR person.
HR: I'm going to take your picture.
Me: Umm... for what?
HR: A badge. You'll need a badge if you're going to be volunteering.
Me: Sweet.

I got a badge and a task to do. I made welcome packets for the inpatients. I volunteered 3-4 days out of the week and got to know the staff pretty well. Afterwards, I started shadowing doctors and now I get to observe surgeries. One of the surgeons told me that one time he wanted to observe a surgery in the city because they were using a new method. He told me he was treated like a criminal when he asked because they were suspicious and wanted documentation and paperwork and a whole other assortment of things. In a small town, it's pretty easy to bypass that.

2. Less people to get to know
I hate meeting new people. In a city, the medical field is very compartmentalized. A heart surgeon here, a podiatrist there. To get experience in all those areas, you'd have to meet people. Another round of introductions, another round of ass kissing. In a rural area, they don't have the luxuries of compartmentalization. They have to do more and this is where the person shadowing gets benefit from that. Like I said earlier, one of the doctors I follow will be performing this procedure. In addition to that, I know pretty much everyone in several departments so I can hop around if I get bored. This is fantastic.

People told me that these volunteer experiences are crucial into getting into medical school. While I'm still debating how much it actually factors in, I'm covering my ass and volunteering regardless. And you know what? I actually enjoy it.