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I make a liar of myself... - Nobody wears a white coat any more... — LiveJournal
...a tribute to becoming a doctor.
I make a liar of myself...
I have yet to be on time to the pediatrician's office. I always beat the doctors in. Yesterday morning, Dr. TD was at the hospital dealing with a patient in breathing difficulties. Dr. MD disappeared after talking to the intern for a bit. And for the next hour I just sat around looking confused, until T called over to me, telling me that Dr. TD had called from the hospital with something for me to learn about. So I looked it up. And then I waited, and finally Dr. TD came in and then we had to rush through the exams. So (gasp, choke) I just got to go in with him and look at the kids while he was talking to the parents instead of doing the whole thing and presenting the patients. But I still got to see them first, and if I talked fast I could present my findings to him before he did a physical.
At lunch, he took me aside and apologised to me for not letting me do enough. I wasn't offended. I completely understood. This has been one of the best clerkship experiences ever.
A quick survey of what I've seen recently:
An infant with a facial hemangiomata in the opthalmic region of the trigeminal nerve division. ishotkenney: what disorder are they concerned about? They don't know yet whether she's got it; the current concern is the bilirubin of 14. She's got a bili-blanket, which I want to see. What do they look like?
A little girl who has Osler-Weber-Rendu syndrome, an incidentally finding as she was being evaluated for a two-month history of fatigue and malaise. Apparently, her previous doctor just kept giving her antibiotics. Her mom is understandably miffed. Dr. MD thinks she has mono. Her blood tests show a malnutrition-based anaemia. I suggested parasitic infection. Possibly. I also asked, based on the rest of her history, whether she might have immunodeficiency. That's a good thought. He wrote: "Consider immune deficiency" on her chart.
Lots and lots of little kid ears. And noses and throats. Did you know that 25% of visits to paediatricians are for routine physicals? I've found several unsuspected ear infections, including the event today where I went in to do a followup visit on a little girl. "I think she has fluid behind her eardrum, which is normal following an ear infection, but it looks good to me. I'll have the doctor check." And then I went out and told Dr. TD that I thought she had fluid behind her eardrum, but that it looked good. And then I got pulled in to play "name that rash" with Dr. MD. More on that in a moment. When I came out, he was in the room. I popped my head in, and got a very wide grin from the normally ebullient Dr. TD. Good eye. She's got a resolving otitis media with effusion. A lot of people don't ever learn to pick that out.

More on "name that rash" tomorrow (later today?). I want to post, so I can sleep, so I can go to the BMV and get my licence address changed; get a new cell phone and better plan; spend more money. Wheefun.
Plans for the Gathering are beginning to progress. Also wheefun. Glad that Quinby is going to go with James to the housewarming; Aura and LC are so great.

And now, to bed.

now feeling:: chipper chipper

1 whisper echoes . o O ( ... ) O o . whisper a word
From: dr_bobbie Date: August 23rd, 2003 11:37 am (UTC) (etched in stone)


Well, I do know that port-wine stains that occur in the distribution of V1 are associated with Sturge-Weber syndrome. That was one of those things that was DRILLED into us in our Pathology class. ;)

And a biliblanket is nothing special to look at. The ones I saw in the nursery were small enough to be wrapped around the infants beneath thier onesies. They remind me of heating pads that glow. Neither the chief resident or the new neonatologist that I worked with think they are
nearly as effective at lowering bilirubin levels as a bililight. ::shrug::
1 whisper echoes . o O ( ... ) O o . whisper a word