falling in love

Yes, Its true. I've fallen in love.... with a 6 year old boy with the sweetest smile. LOL don't worry I'm not gettin all Mariah Carey on ya, I saw this boy in clinc the other day and he just wowed me. He has a chronic illness. He could tell me why he was coming, and could name his problem. He was initally shy but became very chatty. Like many boys his age, he was asking all kinds of questions and kept practing saying the word stethescope. His grandmother was as sweet as can be too, asking me if I would see him again when they come back for follow up. I assured her that she would see another pediatrician but she kept asking if it would be me. I felt really honored that she wanted me to see him again and then got a little sad knowing that I wouldnt. I got excited that I'll be seeing my kids from home again soon but then I remembered that I only have 3 months left of residency and all the kids I've fallen in love with up to now I will have to give to another doctor.

I'm really privledged to have a job that I love, where its OK to love my patients (in that non-creepy don't sue me kinda way of course!), where I feel truly fullfilled. When I first chose medicine, I chose it because I saw the need for medical personnell in the world first hand. Though I consider that as real a reason as any, I was not any less nieve about what it meant to be a physician than any average budding med student. I thought my mere presence would save lives! LOL. I would have this fantasy that I am driving and there is an accident before my eyes. I would spring from my vehicle and magically by my mere presence the mangled would get up and be healed I thought I would save the world. As the meaning of doctoring has gone from being fantasy, to tangible, to my real daily existence I have gone through many changes. Primary care has become my passion. But what does it mean? I realized that what I like about my time here with Issa Trust most is that it is very similar to a clinic month back home. I see them, assess as many things as I have time to, introduce interventions, help them navigate the system, see them back. As I would at home I am essentially trying to build some trust and provide the best care I know how to. Im doing that, mostly from the clinic, because I believe in prevention, monitoring for occult disease so it may not cause more significant illness or premature death later in life, and mostly (to be honest about my personal intentions), so that these young folks can have the best quality of life with fewer days of illness or complications. Primary peds is not sexy. Diagnosing a 3 yr old with a urinary tract anomaly and providing interventions to prevent long term kidney damage is not going to wow your grandparents at the dinner table. Preventing a case of rheumatic heart disease by treating a strept throat, or treating a teenager with chlamydia to decrease her odds of having complications that might involve her ability to conceive later in life… those things are not ‘your favorite doctor show exciting’ but they are vital. As I reflect on them it reminds me of why what we do matters and why offering pediatricans to a place where there are so few, is a significant contribution to this and any population where access to a pediatrician is limited.  The icing is that loving and caring for your patients makes you better at your job and leads to the kind of relationship that, though short term and minimial in the grand scheme of all the relationships people have, is still in some way significant.

Dont get me wrong sometimes it is like an episode of ER. A mom deliveries a baby thats very sick, significant interventions have to be done to help that baby breath, keep enough blood circulating to keep the heart pumping and treat whatever infections may have been brewing. This happened last week at one of the hospitals. I wanted one of the awesome pediatricians as she resusitated and stabalized a baby in prep for transport to a hospital that has a ventilator (which they do not at Annatto Bay). They team took turns bagging the baby and safely delivered her to a higher level of care. At home that would be the realm of the neonatologist. Here, where specialists are so few, the pediatricians do as much as they can and deliver the babies to one of the few neonatologists when they don't have the right equipment or it is beyond their expertise.

Overall though the thing I love most about my job are the patients. I snuck in an 18 year old the other day and she was so great and made me miss the teens. I've seen a 14 and 15 year old here and there and they just fill me up with joy. The babies are so beautiful (most of them lol!) the children so fun (except when they really don't feel good and then they're likely cranky. You look around in the world and you realize that some have nothing that brings them joy. They hate their jobs, they live alone, they aren't close with their families. They struggle to make it, they work 7 days all day because they have to to eat (met a man like that last week). I like the whole "first world problems" joke thats going around. You know the " i had to wait 3 min for that webpage to load" lol.  My patients here wait all day to see me on clinic days. They get a number at around 9 am and if there are many patients I may not see them until 2 or 3 pm. I apologize for their wait and they are still so friendly and patient and glad a pediatrician is seeing their kid. I get first world annoyed just as much (maybe almost as much) as any American, but I'm always glad to gain some perspective.