02 April 2012

Second week on neonatology

Babies. Very small babies. I come in the morning, and they're all wrapped like little burritos with their heads sticking out. Wrapped - three blankets, each tucked in three different ways, as if you wanted to ensure they could never ever get out of their burrito-blankets if they wanted to.

So you approach the crib, very cautiously. Like a ninja. Survey your territory. Where's the nurse to give you disapproving looks while you're taking apart the burrito-blanket? Not around? Excellent.

Then you look at your little masterpiece. Boy or girl? Doesn't matterSurvey your territory. Find out where those corners are. You've got less than 10 minutes to unravel the burrito and listen to the heart. Like a bomb. More importantly, mess up the unraveling with sudden or improper movements and you will unleash the fury of a thousand dragons.

Slowly, you start to tug at the corners of layer 1 of the burrito. Sometimes you realize you have to turn the baby. Can't arch its back at all, else it'll wake up. You then do some complex calculations in your head, find out where to provide pressure points and roll that burrito like a plane banking into a turn. Boom, blanket corner out.

Rinse and repeat. Do your exam. Finally, very quickly wrap that baby up as fast as possible while still maintaining movements around its principal axes. Often, the baby will wake up. All you need to do is rub its back while making clicking noises from your palate - tk tk tk tk tk tk tk tk tk tk - and it calms down.

Leave the poorly wrapped burrito in its half awakened state and rain down some burrito destruction elsewhere.

Sometimes, it'll wake up completely and start crying. You have to pick it up and hold it (support its neck!).

In that moment, right after it stops crying, it fidgets. It fidgets like never before. He's fed, consoled, hydrated, warm, evacuated* and ready. Its sole purpose in life is to get away from you. It knows nothing else. It puts 100% of all of its energy and every underdeveloped neuron it has into strategizing ways to remove himself from your vicinity/arms. And your job? To employ some Red Queen Hypothesis business to keep three steps ahead, and not provide any kind of feedback but a firm grip. Turn into the human Cesar Millan and show him who's boss. Do it right and he becomes terrified at your sense of control and awe-struck at the show of confidence.

*No. 1 and No. 2

27 March 2012

Outpatient paediatrics

I spent 2 weeks on the mobile clinic, which... is kind of cool? Two fully equipped exam rooms, refrigerated medications, a mini crash cart, two nurses, two doctors, one med student and that goal to get every kid in Houston immunized.

Ridiculously cool.
After a while, you learn how to give vaccinations. The giving part is not nearly as bad as the consoling part, and every age group needs their own system.
  • Babies - no prep required. Snap your fingers in two different directions, flash your penlight so they reach for it, and the moment their hands go up - Bam! right in the Vastus lateralis. 
  • Little boys - little boys cry* far too much, almost more so than the girls. Just do it. They'll realize it wasn't so bad.
  • Little girls - less crying**, but it's more dramatic. Minimal prep required, although they will need consoling afterwards. Stickers, pencils, hugs, what have you. 
  • Older (7-10 y/o) boys need reminding of how macho they are. Usually come in with slick gelled up hair. Dude you can't have hair like that and be afraid of this needle? Right? Jab.
  • Older girls are a bit more mature than the older boys. Usually not problematic.
These schools we visited were much nicer than the one I went to, but I'm not so sure about the teachers. They also all ate fried crap for lunch so naturally there were kids that weighed more than me - > 165lbs. 

Also, taco trucks and mexican bakeries galore. So cheap.

*: This type of cry being "my god this is going to hurt"
**: This type of cry being "I have accepted death as my fate"

22 December 2011

I haven't posted in a while

And the end of the year is approaching, which means I'll probably take a trip through my really really old posts.

You might, too.

Pretty much. 

18 November 2011

Shelf exam over

Guilt free TNG
Watched delightfully by D
As he drinks green tea

23 October 2011