Three key lessons from Pediatrics
…which can be applied to your life as well.
Wow, it’s been ages!
Well, I’m doing great and I am having a wonderful time in medical school so far. I finished my senior clerkship in Pediatrics about three weeks ago and somehow, I miss it already. I miss seeing those cute babies at the Special Care Baby Unit (SCBU) who look too lovely for sick babies. I had the opportunity of clerking various cases: severe acute malnutrition (now I can rattle the WHO Ten Step Management of severe acute malnutrition); acute tonsilitis (which made me swore to never forget to examine any child’s throat); osteogenesis imperfecta (I was fascinated by their bluish sclera); croup, a.k.a. laryngotracheobronchitis (whew, that’s a mouthful); to Potter syndrome (which I had never heard of before so then I learnt something new).
As part of our clerkship, we had the opportunity of presenting our histories (that’s patient’s health information collected during a hospital consult…if you didn’t know) to various pediatricians who pointed out our errors, polished and corrected our mistakes, so that we would keep getting better at it. Even after the eight-week clerkship was over, our histories are nowhere perfect, but at least it’s good enough to help make a decent diagnosis and draft a plan for the patient.
During this clerkship, I got to understand a lot of things about medicine which I would try to condense into three:
1. Treat the patient, not the disease.
It may sound weird to you if you're hearing (rather, reading) this for the first time. Remember that every disease has its own way or method or manner of managing them, but when you put the peculiar health parameters of the patient (for example, presence of a chronic disease, hemoglobin level, into perspective, you would realize that no two patients are the same. Even if they are the same biologically, their response to treatment and how the treatment is provided to them or even the social, cultural and environmental aspects of their help wouldn’t permit them to be treated the exact same way. Therefore, I have learnt the importance of putting the patient as whole into perspective whenever I am asked to decide on the best management plan for them.
This lesson can be applied in our lives too. It is easy to simply copy others without considering our own uniqueness and peculiar circumstances or even preferences. Always know that life’s choices are not a one-size-that-fits-all, so it’s up to you to know what’s good for you and what’s not.
2. When it comes to children, you need to be thorough when assessing and managing them.
A baby’s only mode of communication is crying. When they’re hungry, they cry; when they have wet nappies, they cry; when it’s cold, they cry; when it’s too warm, they cry…to the many other things they love to cry about! Therefore, when dealing with such a patient there would obviously be a huge communication barrier…even their caregivers have a hard time understanding them, not to talk of a stranger in a white coat!
In this case, you have to examine them from head to toe without missing any part of the body so that you will be able to pick up every abnormality you need to give a proper diagnosis, when added to the usually nonspecific and sometimes scanty history of illness that their caregivers present. For example, a baby can be brought to the hospital just because he/she has been crying all night and wouldn't stop no matter what mom does in her attempts to alleviate any discomfort her baby is experiencing, only to see a bulge at the groin (in examining the baby) which reduces in size during the short periods in between the baby’s cries. Then voila, you can think of an inguinal hernia (which is more common in males) and then treat accordingly!
The need to be thorough is also extended to toddlers, children and teenagers too. In pediatrics, detail is key.
One lesson here too is that though it’s good to look at the bigger picture, sometimes, details matter the most. Therefore, it is good to cultivate an eye for detail and to learn when and how to use it in various situations.
3. There’s so much to learn in pediatrics!
Pediatrics is so detail-oriented that many health parameters such as heart rate, weight, blood pressure, hemoglobin level and many others have different normal ranges for the various age groups: newborns, infants, children and adolescents; these age groups also have subclassifications that have corresponding accepted ranges for some of these health parameters too. Guess what, medical students need to know them all!
The idea of saving the life of a cute little one can feel good and fulfilling, but the huge volume of information one is expected to imbibe can make senior clerkship in pediatrics an arduous one. However, no matter how tiring it gets, it is so much worth it as long as it will save the lives of the most vulnerable group of people among us.
The lesson here is, usually the things that are worth the most are not easy (or cheap).
Well, I deserve a pat on the back for condensing my key lessons into these three…though I feel there’s more I didn’t mention; maybe that will come later. In the meantime, do well to digest these lessons as you ponder the ones you too have learnt recently.
Feel free to comment, like and share this post, thanks a lot!
Signed, Richeal.
