Thursday, January 08, 2009

A bad day

I'm finishing up my pediatrics rotation and feeling ready to reflect (and have a weekend off!). I have really surprised myself with how little emotion I feel when I'm working at the hospital. I always care about my patients but somehow it doesn't translate to an emotion. This changed when I started pediatrics- everything started to affect me. Before I describe today's bad day, I want to remember that there have been some really special moments in this rotation. I've witnessed and participated in more than 60 deliveries of an infant before starting peds- sure I thought it was awesome and special, but it wasn't until I was on the pediatrics side and when I was the person responsible for this seconds old new person that I realized how special it really was. And another patient I met in the hospital, an adorable 2 year old with some bad luck... I spent 2 weeks seeing her and when she was finally healthy enough to go home, her family left me a heartfelt note describing how much I helped them through a hard ordeal. I liked being able to appreciate how special those moments were.

Today was a day I wished that I could turn off my emotions and not let things affect me. One of my patients, a previously healthy 13 month old came to the hospital for a bad ear infection and today we had to tell the family that their only has a very severe form of leukemia. I overheard mom calling her parents saying, "Mom, pull over the car... are you pulled over? It's leukemia. It's bad. We are going to be the hospital for at least 6 months." I talked to dad who kept saying "He's all we have. Our lives revolve around him. He has to get through this." And after hearing all this, I learned from my attending that this form of leukemia has the most intense chemotherapy and very few kids are able to make it. Today would be a good day to be numb.

More sadness today- a 12 year old healthy child with complaints of diarrhea developed pancreatitis, then we diagnosed a severe inflammatory bowel disease, only to find that he had a cancer that no one in the history of medicine has survived; a baby born premature and with lots of complications is now 8 months old and ready to play but has had no visitors in the hospital so he just stares at the ceiling above his hospital crib; an 18 year old fighting cancer for several years, excited to go to prom this year, learning that her cancer is back and its back for good this time. Although I recognize that today is a particularly sad day, I can't but help thinking that this is too difficult to do everyday for the rest of my life. Although I am glad that I am not numb to sadness, I don't like that I come home and feel numb, so drained. It makes talking to friends and family difficult- how can I chat about what's new in my life when all I can think about are the experiences that have influenced my day? So basically, even though I've had some unbelievably positive experiences in peds, the few bads ones make me cross it off the list of career choices for me.