Sunday, November 22, 2009

Crunching Leaves

Autumn is here. Getting away from San Francisco reminded me about the seasons and the leaves with all their color changes--yellow, red, orange, brown.

As I ran around my neighborhood, I crunched the leaves that had fallen and blanketed the side walk. It took me back to the days of childhood. When I was younger, I would help my dad rake the leaves into nice neat piles before jumping on the piles and recreating the mess we had just cleaned. The good old days.

I had my first extended vacation of third year over the last two weeks. During the first week, I made a trip to Chicago for my brother's wedding. After the wedding, I came back to Davis to spend a week with my family.

It was so refreshing to get away from the medical world with all its differentials and histories for a short time to spend time with family and friends.

It's very simple to get completely consumed and to forget your human world. I had an amazing time at the wedding; it was so nice to be leave the medical student role behind temporarily to live life as a daughter, sister, friend and photographer.

As the old saying goes, "all good things comes to an end." And so too, does my vacation.

Despite having to give up unstructured days and three square meals, I am ready to return after a short hiatus. Being away has made me realize how much purpose I have as a medical student. There certainly are days when you feel inadequate and wonder if you will ever move forward. There is so much learning to be done, but you realize that you have come so far and and are moving ahead, albeit with small steps.

And each day is a gift that gets you a little closer...

I return to San Francisco today and the world of pediatrics. I move from the world of urgent care to the pediatric wards. There are four more weeks left in the rotation.

Hopefully, there will be time to crunch leaves during the next couple of weeks.

Monday, November 2, 2009

Halloween & Hand, Foot Mouth Disease

I was reminded of how much fun Halloween can be last week during the costume contest on the wards. The day before, our chief resident made an announcement during noon conference to remind us to dress up for the kids. I was a gypsy, which was not nearly as creative as the Mickey Mouse, pirates, fairies, cowboys, Pippy Long stockings, and other characters. As we walked around the wards, it was uplifting to see some of the patients dressed up and getting to Trick-or-Treat at different places on the floor.

Post-Halloween, I spent my day in the ED during a day shift.

When I spoke with a kid with a possible wrist fracture, I asked him why he waited to come to the ED (he had sustained the injury the day before) and he had the most adorable response.

"I would have come on Saturday, but I wanted to go Trick-or-Treating."

Now, there is a kid with his priorities straight.


For the first time, there is something in medicine that is appropriately named- hand, foot and mouth disease.

During urgent care clinic today, I met a very cute four year old boy, who was been feeling awful over the last weeks with fevers, diarrhea, mouth ulcers, and diarrhea. He also had some interesting rashes on his palms and soles. As I listened to the story from his grandma, I started to put two and two together; he has problems with his hands and feet (rashes) and mouth (ulcers) in the setting of an infectious process (fever and diarrhea).

Like a simple math equation, it all added up to one thing- hand, foot and mouth disease, which is a coxsackie virus infection. Treatment is mostly supportive (fluids, rest, and Motrin) and the symptoms will likely resolve with time. Poor kid.


My days in urgent care have been a mix of evaluating upper respiratory infections (mostly coughs, runny noses and fevers) and some other interesting things, including jaundiced newborns, kids who have been vomiting, kids with diarrhea and strep throat.

On my call days in the Emergency department, I took care of a six year old boy, who sustained a wrist injury while dribbling a ball in a soccer match. I was the first to sign his cast with my signature sparkly Sponge Bob stickers. I also saw a toddler with gastroenteritis and a 16 y/o with vomiting.

In my one week of experience, I am really enjoying working with the kiddos and am beginning to see the "bread and butter" of pediatrics, which is still very novel to me during my second week of pediatrics.