First Day

Way back when I was in Summer Scholars prior to medical school, a wise older student said "get comfortable being uncomfortable". Medicine forces you to do that because if you don't you will be a ball of stress rocking back and forth in the fetal positions whimpering "why me". Today was my first day in the clinic. It was amazing and a little overwhelming to be the pediatrician. Then I realized most of this stuff is universal kids stuff and that there are other docs around to assist if I'm stumped. I was supposed to get an orientation but no one was available to do it so I just decided to start seeing patients. I made a few faux pas's like ordering a medicine that per the pharmacist that called me quite perturbed "hasn't been seen on the island in months!" (cephalexin), though my orientation guide stated that it was available, it must not have been updated lol. Also I don't "write" perscriptions anymore (magical computer land) and so writing them was hilarity. Thank goodness the pharmacists that work next door were patient (unlike the one from above). i forgot to put the patients name on one, forgot the dose on another, dispensed a tube size that doesn't exist a different time. LOL. Again, just like nurses, these pharmacists saved my butt and I'm so grateful.

I got an "urgent" consult from the ED equivalent {accident and emergency} and it was a girl that was really not so bad. I thought, part of the beauty of being a pediatrician is not over treating children. I met a few kids with asthma today who have no albuterol at home. nothing. parents aren't even taught how to do a treatment. sooooooo yeah. I made them go to the pharmacy (right next door) pick up the albuterol, bring it back and teach how to do the inhalations. It took a few tries but we worked it. spacers are hard to get but I'm thinking of how to use water bottles.

Just when I was ready to move in I realized why I am thankful to have my training in the US. There are a few pediatric sub specialies that dont exist at my hospital and I just send my patients on across the river or to private docs out of our system. Here, there are no peds hem-onc, peds ID, etc. I have a pt that really needed a specialist and can't get it and will literally have to go to another country ASAP to get life saving, long haul treatment. Her mother is ready to go all in, but the expense is going to be enormous. I'm looking into how to get her to Cuba since that is probably the most cost effective option but I'm exploring any and everywhere. I still may move somewhere but I gotta get over the anger I feel at the gross inequity involved with being a poor kid. You think, working in Camden, I'd stop getting all worked up about it, but no. Still makes my blood boil.

Despite this and my mistakes it was pure joy taking care of these kids. toddlers still toddlering (ughhhh toddlers! we all know I loves the toddlers). pre-teens still refusing to eat vegetables or take medicines. babies still cute as ever. I'm just sad i don't see over 13. Eventually I will try to schmooze and convince the GP's to give me the teens as well. We'll see. The waiting room was full of adults so they may gladly hand them over.