Traumatic

After working 19 straight days, I finally have a day off! Actually two! Things may be looking up (though we have our pediatric surgery exam Monday morning). Overall I've had a great time, and nothing too emotionally traumatic has occurred...none of the babies we care for directly have died. However, for some of them the long term prognosis is rather grim. I've certainly toyed with the idea of becoming a neonatologist, I'm really interesting in developmental biology and it's kind of part of my history, but at least from a objective standpoint I've never completely been able to convince myself that saving a 22 week old baby who's going to be on ventilators and intravenous feeds for years and then likely have long term health problems is always the right thing to do. Of course it is if they survive and have a happy life, I'm sure as hell glad no one gave up on me, and we're constantly pushing the limits so I'm sure that soon their survival outlooks will improve greatly.

However, so far the hardest thing I've experienced on this rotation was a Care Conference where a bunch of doctors, nurses and social workers all met together with the parents of a little 4 month old boy I've been following. His twin died at birth, he has microcephally, his liver is already enlarged from being on TPN his whole life, he had fungus growing in his brain for a while, and while he's getting over his repiratory issues his intestines are still no where near functional. Essentially the doctor had to sit there for an hour and explain to the parents their sons long term prognosis best as he could predict. And it was not good. The parents love their little boy so much, but still after 4 months of problems they had to readjust their expectations. I don't know if I could handle those kind of conversations every day.

Compared to that conversation, my over night trauma calls have been nothing. I saw a women with suspected necrotizing fasciitis, but it turned out to just be a boring abscess. In contrast we've been taking care of a 14 year old girl who was bitten by a brown recluse spider and ultimately had to have her leg amputated above the knee. Just yesterday we had two babies come in, one with Necrotizing Enterocolitis Totalis who died before they could ever operate and another baby who was shaken by the boyfriend and is now brain dead. That's hard to deal with. On Trauma call at Methodist we also had a 15 year old come in who had collided with another kid while playing baseball and was bleeding from his spleen. Sounds exciting! Trauma 1! Not totally, he came in fully conscious but kind of pale and ultimately went to Interventional Radiology (a really cool specialty) and they solved his bleeding without ever cutting him open. It sounds horrible to say that I hope people experience some sort of trauma, and I certainly don't really mean it, but it if they have to get in an accident it would have been great if it had happened while I was in the ER! The most traumatic part of trauma calls was staying up all night.

In good news, I got my Board score back and I passed! 246! Yay! Seriously, what a relief. But then I called to tell my parents and they had just found out that the parents and daughter of one of their friends had all died in a horrible car accident. Things can all change so fast.