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.

One Day in the Clinic

The doctor carefully explained about the medication prescribed. Haloperidol, Folic Acid, Clobazam.  None of them were familiar to the mother. She stared to a space that did not exist. Her ears were listening to the doctor's words, every single word. But her mind was spread into several thoughts at the same time.
She might need to stay for a month, or maybe more, in this city, 4 hours away from her home. She didn't have any place to stay, yet. Her husband might have to work harder than before. She would look for all the therapies, anything that could fix the problems. She might will have to leave her younger daughter at home. Her son might will never able to enter regular school, be a regular child.
Who will afford all the medication and medication fee, anyway?

And just moments ago, she discovered that her son was diagnosed with mental retardation.

Fiets in The Netherlands

the bike racks

Bicycles are not uncommon in every region of the world. But there is something special about bicycles in The Netherlands. They are not a one-moment trend. Neither a stylish accessories about what's in and what's not. Bike is a need. It is cheap, healthy, and fast. People ride bikes anytime, to any destination. Even you can find some men in neat suit going to workplace daily on bike. Students, the older ones, professors, professionals, anyone. People can choose an expensive multi-geared bike with fancy model or they can basically opt for an old--but fast one.

It is common for little children to start with 3-wheels bike, then usually children in school age will learn to ride bikes with foot-brake, the ones without hand-brake and you need to turn the pedal backwards to brake. I have tried them once, and it was not easy, as I did not usually ride bike in Indonesia, where I came from. There are also special bikes designed for people with disability. Usually they are three-wheeled, with different models and size depends on their disabled limbs. Some children with special needs also use custom made bikes to stimulate their movement, strength, and coordination. Another extra benefits of bikes. 

The Art of Letting Go

03.00 am, almost dawn. It was my first time facing death. Many stories about doctors who resuscitate their near-dead patients and managed to bring them back to life. But I didn't. It was my first time performing resuscitation on real patient but I didn't succeed.

Previously, a senior of mine calmly informed the family about the patient's worsening condition. That we had given all our best, all the medication and medical procedures we had known to save the patient's life. And after she had gone, it was my senior who calmly explain about the possible cause of death, about his deep condolences to the family, and that he will be there if any of the family need help on anything regarding the late patient. I was near speechless. Maybe it was my emotion, I was overwhelmed by disappointment and grief. It was more than a death to me.

Idealistically Realist

the north coast of Java island, taken during my last week trip to Central Java

"Do you know what's the secret of being a popular doctor?" my father asked, just recently.

"What is it?" I shrugged.

"Give your patient the most potent medicine. Once they know the drugs work well, they'll know that you're doing your job."

Patients : People or Cases?

This month has been overwhelming by school schedules, reading catch-up, and extracurricular activities I have. Last 3 weeks I joined gym and tried to spend 3 times a week having workout session. On one side it has made me feel good about my body, I feel much more healthier and less tiresome, I have better mood, and it is a good way to relieve some stress too (yes, the gym guys are good looking! :p). On the other side, I go home after workout feeling tired and can't stand reading handouts for more than one hour. So I try to do a major catch up on weekends, but then I always use weekends as my excuse to hang out and have fun, so basically I am doing a very slow progress here. I have postponed my plan to take a diving course this month until all the exams are over and it turns out to be the smartest decision I've made so far.

Being so tiresome and sleepy in class make me want to post some tricks (some work, some not) I use to do when I can't stand to sleep during a long class, either it is a morning one or an afternoon one. Still on process on making that post, though. But tonight when I was reading surgery handouts, some case images of oral cancer have disturbed me.

When a Med Stud Watch A Movie

I know that this thing happens to almost all of my friends in med school and I have been experiencing this since my first year: we can't stop our mind (and/or mouth) from any medical-related scene on anything we are watching.

Last Thursday I watched a Chinese movie, entitled "Shaolin". It was a good movie, indeed. Good humors, some touchy scenes,nice effects, and some complicated kungfu moves. The greatest thing is that two senior, tallented Chinese actors and singers, Andy Lau and Jackie Chan, also act in this movie. Both as the good heroic character. But there are some scenes which annoyed me because I keep on relating it to the medical theories I have learned so far.

1.  There were several scenes which actors/actresses bleed through their mouth. My thought: "Which organ trauma could cause this bleeding?"

2.  When an actor got deeply stabbed more than one time by a blade directly to the upper left area of his chest (right where the heart lies), he was still able to performed some kungfu moves and fight the bad guys about 10 minutes. My thought : "Isn't he supposed to be death by now? To be stabbed right on your heart will have the same impact with cardiac arrest, right?"

3.   When a cute little girl died after some physical trauma and a senior monk had sticked an acupuncture needle on her neck and the little girl bleed through her mouth. My thought "What could be the cause of her death? Does the acupuncture needle on her neck really help?"

I'm glad that I can keep my mouth shut during the movie. Or else, those who sit next to me in the cinema won't be able to stand my critics and I might end up watch all movies without any companion. Except my med school friends, perhaps.

*Anyway, there is a cute actor acted as a monk in the movie. Anyone has idea who he is?