Ups and Downs in Pediatrics

From my own picture collection, taken in Collosseum, Italy.
Siblings playing with their parents' video camera.

It has just been two weeks since my first day in Pediatrics rotation, and I can't help being in this kind of love-hate relationship with my daily job. Our daily schedule is tight, we have to be present in the hospital around 6 am and start making daily subjective and objective examination to all the patients in the ward. There are 29 co-assistant in total so we will have several patients we will examine daily. Then we have to write it all down in the patient status, including the diagnostic and therapy planning. It is a very effective way to learn about clinical medicine, thou. Then, most of our days will be spent helping the residents observing the patients ( every 3 or one hour, depends on the diagnosis), assisting in some clinical procedure, or participating in group discussion. Everything will be ended around 3 in the afternoon and on some days we have night shifts, mean doing almost the same job we do during daytime, only during the whole night.



On my first week I worked in hematology-oncology department. That was not the very cheerful department of all. Some of the patients there are very vulnerable because of the chemotherapy. They are easily get infected by microbes, bruised by harmless pressure, or getting weaker because of poor feeding. Some are very young children with rare kind of cancer, like retinoblastoma, Wilm's Tumor, or teratoma.

These children may look uglier than the healthy children, they lost their hair because of the chemotherapy, they look weaker and pale, and some types of tumor are cleary visible. But I found this children are just like every other child, only stronger. They are more needle-friendly and they don't fear us, white-coated annoying creatures. They still play everyday, talk about honest and innocent things, hold on their mother's arms. Sometimes, during midnights, some cried in their night dream. I wonder what were they dreaming about.

The most heart-breaking moment was when one day, one of the 7-year-old patient I have been obsereved for almost a week died. He appeared quite well days before, even we talked a bit about his favorite TV shows. One day, he had massive bleeding. He couldn't make it.

It was a wake up call that no matter how sophisticated the technology we have developed, modern drugs to fight cancer are discovered, all the protocols have been made in order to ensure the survival of kids with cancer, there are times when we lose the battle. No doctors are powerful enough, no scientist are clever enough to make all those kids survive. Makes me wonder if at some point, the suffering of chemotherapy might should be avoided from the beginning if in the end it wouldn't make any big difference on prognosis. Makes me also consider the other choice of palliative.

Anyway, there are so much sweet occassion I have experienced with these kids. I love how some kids smiled when I smiled at them. One little girl told me that she wanted to be a doctor one day. Another boy said he wanted to be a Superman. A mother asked me if I was tired and thanked me for some of my simple advices. How the love of their mom and daddy are so powerful that they spend sleepless nights in the hospital, making sure they are always there for their child, possessing of what seems to be endless energy.

I began this Pediatrics rotation feeling burdened, feared about what worst might happened.

But I think I start loving it.