On confidence through repetition

I have spent the past two weeks in the acute care pediatric clinic. Not terribly acute, because if the kids were truly ill and needed immediate care, then they would’ve presented to the ER. More sick than a well-visit, so instead of a question list with prepared topics of discussion, I have something to check-out and assess.

Two weeks of snotty noses, wet coughs, fevers, and rashes. Lots of flu, viral upper respiratory infections, and occasionally something intriguing like pertussis or slapped cheek. I’m no pediatrician, but I’m comfortable talking to families and discussing plans. Far more so than at any point during this year of clinical clerkships.

I’ve gotten into a good rhythm with my interview and physical. I know the important questions to ask for the most common presentations of cough and fever. I know what to check in the ears and to hear in the chest. Because their symptoms are so similar, I know when something unusual comes my way and what deserves a further line of questioning.

During my Internal Medicine rotation, I’d try to gather as much information as I can, so that the attending can sift through my pile of data and come to their conclusion. Now, I can manage a good chunk of the cases myself with the attendings confirming my assessment & plan and making the necessary orders. I can tell which kids have a viral upper respiratory infection that is already on the mend and will resolve by the weekend. I can tell which ones needs to be looked at a set of experienced eyes.

The relative monotony also helps me to appreciate the curveballs. A 5yo boy presenting for significant weight loss since starting his amphetamine salt medication. Poking through his chart, I found that he had been admitted to child psych for aggressive behavior three months prior.

I appreciated how anxious the mother felt, seeing the weight drop off her son. I reveled in the chance to soothe her fears that his health was in danger and her frustrations with his psychiatrist. And the attending appreciated the groundwork that I laid down before he walked in the room.

Overall, I am looking forward to another week of this. I know what to expect and I know my limits. I have both a sense of contribution to the clinical team as well as the freedom to utilize my idle time with studying. I think I will look back fondly on this time, in this clinic, with low stakes and good company.

Emotionally, I am well. Reuniting with Mackenzi as her week of nights came to an end felt so wonderful. Absence makes the heart grow fonder, and the first days of my Mackenzi-fast were spent productively. Then, I fell ill with a virus from the sick children in clinic, and all I wanted was to cuddle and annoy her. I missed her dearly.
Spiritually, I felt like the Mackenzi-fast allowed me to reflect on how I spend my time. I had the opportunity to see what does Eugene want to do, especially when compared to single Eugene living alone in Tampa. I learned that I watch far less television and movies when alone. Next weekend, I will be camping out with friends in the woods of NY. It will be a chance to both disconnect and reconnect.
Physically, I feel good. Good movement through the week when I felt up to it. The virus never laid me out, just kept me sniffling all week. Feel like I’m mostly over it. Will resume more movement as I fully mend.
Relationally, I feel strong. I have done some good reaching out, sending some messages and bringing people together. I feel like the spring will be good to me.

Emotional – 5/5
Spiritual – 5/5
Physical – 4/5
Relational – 5/5

Total – 19/20
3wk running total52/60

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