Here's Looking At You, Kids

Coincidence: My first baby that I helped deliver... I am sort of taking care of him on pediatrics… he is in the pediatric ICU… I didn’t know it until Friday when my intern asked me to accompany a baby down to nuclear medicine (fancy x-ray) so he wouldn’t cry or freak out when getting his belly scanned… I didn’t recognize him because duh they all look the same when they come out, covered in gunk… it’s not like I walked into the room and said OH HEY BRO IT’S YOU… but I looked at his chart to see why he is in the hospital… he doesn’t even have a name on the hospital chart yet, he is still “Baby Boy A”... his mom was my patient, she’s 19, has three other kids, he was the fourth, but he has a heart condition and she can’t take care of him… so he’s an orphan now… sigh… when he was born I was so surprised to see a baby come out… I wanted to follow him to the baby table but he wasn’t my patient, his mom was…

I feel bad because when he was born I didn’t even see him as a person, just an ex-fetus. The endpoint of his mother’s pregnancy. I just wanted to see him get borned so I could take full advantage of my experience as a medical student on obstetrics. His mother was more of a person to me than he was. I knew that she smoked during her pregnancy and that’s probably why Baby Boy’s heart is messed up. I am usually not really judgmental of patients’ social histories, and I remember thinking that, oh, that kinda sucks for her baby that she smoked during her pregnancy… so when do I get to watch the delivery? Maybe it’s not that I’m impartial and nonjudgmental, because those sound like good things to be. Maybe I’m actually a coward and afraid of confrontation and afraid to potentially upset someone to tell them to quit smoking. At the time, she was my patient, and I tend to side with my patients, and I thought, well yes, she did smoke, which is not the best thing for the baby, but who am I to judge, she is not in the best social situation and certainly has a stressful life.

But now, I look at this eight-week-old baby with a million wires coming out of him and surgical scars on his chest from where they cut him open to try and fix his heart and his fuzzy head that looks like Mr T’s haircut and the feeding tube coming out of his nose and the fact that whenever I go in there he’s all alone because he doesn’t have a mom or a dad and the fact that he is 86 days old and has never been outside the hospital, and it makes me wish someone had cared enough about his mother to slap her whenever she tried to light a cigarette while she was pregnant.

Sigh.

Later that night I had to help a nurse hold Baby Boy down so we could get some of his blood. (I’m reminded of Demetri Martin’s ‘baby blood’ joke… it’s still funny, but after this experience, it’s painfully funny.) It probably took about an hour, and we couldn’t even get enough of it to run the labs because for whatever reason his arteries and veins were bad. Later we tried again for about an hour and a half. Again to no avail. We must have stuck him 10 or 15 times. It was pathetic (not him; us and our failed attempts); after awhile he didn’t even cry anymore. He would just whimper when the needle went in and lie still with his eyes closed tight as the resident poked around for the vessel.

That bothered me more than when he was screaming his head off.

I AM SAD.

Another patient on the floor is about the same age as Baby Boy. Two months. She’s here because she’s been throwing up more than usual. Pertinent to her past is that she’s been dropped on her head TWICE because her mother fell asleep while holding her in a chair. TWICE. Now, I am not a mother. I can not even begin to imagine the stress of being a parent. Parents make mistakes all the time. In my family’s baby books there are pictures of my sister, no older than nine months old, sitting ON TOP OF THE REFRIGERATOR and smiling, and on the coffee table with a huge cooking knife about three inches from her fat baby hands. She’s going to business school this autumn. The point is, parents make mistakes, and most of the time, the kids turn out fine. But this patient we have, this mother, she’s got a heroin dependence, and she’s in rehab. Yup. Baby girl lives in a methadone clinic with mama. Ugh. DCFS has already done an investigation and basically the conclusion is that yeah, maybe she’s a bad mother, but she’s not abusive, so… guess who gets custody of the kid. Old Butterfingers McGee over there. Great.

I think sometimes you have to say to hell with being culturally and socially sensitive and be like, THIS KID IS GOING TO BE DAIN BRAMAGED if somebody doesn’t at least give the mother an extremely stern talking-to. (And also, this is why social support is so important… can’t a family member take care of the baby while her mother gets clean? Can’t the state pay for 24-hour child care? Why isn’t the father around? It’s enough to make you a crazy left-wing feminist!)

Anyway… so I am going into pediatrics. No joke. I set up my schedule for next year and I’m doing all peds electives. I just set my career trajectory for the rest of my life; I’m doing this. Even though patients like Baby Boy make me cry. Even though mothers like methadone mama make me scream. Even though I ruled it out a long time ago. That must really just be a hilarious joke that the universe is playing on me, because I remember when I was six years old I said I wanted to be a pediatrician when I grew up. Which was a goal I abandoned by the time I was six and a half years old. Because every child at some point says s/he wants to be a doctor… and then I didn’t even want to be a doctor for a long time, (I’m still not even 100% totally completely wholly entirely sure I REALLY do, but there’s something about having spent $200,000 you don’t have, towards an education in a certain field, that makes you try pretty fucking hard to like it), until about five years ago, and even then I was DEFINITELY SURE I did NOT want to work with children, but shit, those little fuckers won me right the hell over.

(I am sure my patients’ parents will love it when I tell them that.)

Next time I will tell you, in excruciating detail, WHY I want to go into pediatrics, but I’ve said more than enough for now (and, let’s be honest, it’s just going to be another extremely convoluted and long-winded entry in which I essentially say I LIKES CHILDREN).

One more thing though. My sister called me tonight, and I told her I was concerned that I wouldn’t be able to get a residency (the next step in my training that I have to apply for) because my board score was low and my grades aren’t stellar, and she said, don’t worry, it’s easy to get, it’s not like the best and the brightest go into peds.

My first thought was, whew. (I probably should have been offended, but seriously, even though you people think I’m smart or something because I have glasses and I was a mathlete in high school, the reality is, I am painfully average, and in med school, I am below average.) My second thought was, well, that’s a bummer — why ISN’T it that the most intelligent minds go into taking care of our children?

I guess it’s because (1) kids don’t give a shit what you got on some standardized test, and (2) pediatrics isn’t exactly lucrative. Which works out for me, because (1) I test poorly and (2) I don’t really care about making a bajillion dollars a year and having a diamond-encrusted Mercedes-Benz.

(Gold-plated will do just fine.)

Anyway, I’ll leave you with a happy thought, one of the moments where I realized I might want to be a pediatrician for a living: Last month I was working in the suburbs with a pediatrician, this grizzled old man who’d been practicing for probably fifty years and still had no intention of retiring who was a veritable wealth of knowledge regarding children’s health and all the latest literature on evidence-based pediatric medicine (and had even published major research in the core journals himself) and whatnot, and someone I definitely learned a lot from. It was a particularly busy day; we’d seen probably twenty patients just before lunch alone. We were considerably behind in terms of time, as most doctors in primary care are. So anyway, we go in to see a patient. The doctor does his usual schtick, gets the history from the mom, does the exam on the kid, prescribes some antibiotics or whatever. Then, out of nowhere, he takes this pink rubber ball out of his pocket (okay, not out of nowhere, ‘cos a pocket is a somewhere) and bounces it at the kid, who catches it, smiles, and bounces it back. They do this back and forth a few times, and then the doctor and I say ‘take care’ and excuse ourselves. In the hallway, the doctor turns to me with a serious face and says, ‘Now the point of that—’ and here I’m thinking he’s going to spout off the latest research in the clinical effects of spontaneous ball-throwing at children under the age of 9 years as evidenced by a prospective randomized multicenter double-blinded placebo-controlled trial published in the journal of the American Academy of Pediatrics or something ’—is to enjoy the day.’