Since this is a medical blog, I thought I’d better mention my patients a little bit. Yesterday I picked up a new patient, a 4month old little girl with cystic fibrosis and failure to thrive, just diagnosed. She’s so pathetic: Her head is huge, and her arms and legs are just sticks, no muscle even. She lies quite still, not crying, just tearing up when she starts hacking. Her eyes are blue, and her skin is almost as white as her sclerae. Every morning when I come in she’s sleeping, and when she feels my stethoscope she opens her eyes and looks up at me curiously. This morning I talked to her when she woke up, and she started smiling and waving her tiny hands at me. She weighs as much as a healthy newborn, but she has most of the neurological development of a 4month old. Disconcerting. Then she started coughing, and looking at me for help (maybe I’m attributing too much intelligence/personality to her; but her eyes are so big), and her mother was sound asleep. So I put my stethoscope down and picked her up and patted her back for a few minutes till she stopped coughing. I can’t begin to imagine what this diagnosis must mean to her parents. It’s like her life just took a huge detour, and who knows if she’ll ever find the road back to semi-normal.

Which of course completely messed up my careful schedule for seeing three patients before Grand Rounds. The other patients were new to me, so I had to find their charts and read the H&P first. (It’s both embarassing and irresponsible to walk into a room knowing only the two word chief complaint on the assignment list; like when I read “asthma,” and it turned out the kid actually had febrile seizures. Mom and I talked at cross-purposes for quite a while.) And the attending, and the nurse, and the resident, and the billing lady all wanted the charts too; guess who loses? MS3. So I was half an hour late to rounds. Moral, not to talk to the pretty babies during morning rounds! Also to beat the billing lady to the charts.

Yesterday, instead of lecturing for an hour, the chief resident produced a game of Pediatric Jeopardy. We played in teams, as we’re assigned on the wards. The guy who wants to be an orthopedic surgeon is on my team. Now that he’s around, I realize how much of a gunner I must be usually. Between the two of us, we just pounded the other team. For once I appreciated that guy. Now we’re working on restoring a speaking relationship with the other team. . .

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