My time allotted up at MidHudson has ended. The branches lining the Taconic were finally covered with new green by the time I commuted for the last time. I have now transitioned to the Pediatric Surgery service and will remain there until the end. I purposefully maneuvered my rotations. It's not by chance that I get to ride out of Westchester in the world of cute little kids. Awesome pathology, amazing surgeries, and the best patients.
It's been as busy as ever. I had two interns assigned to my team, and I started the rotation by informing them both I no longer would treat them as interns. It's close enough to everyone's transition, and the bar, is raised. Time to step up and fill the role of a PGY2. And quite honestly, they are doing just that.
As much as I enjoy pediatric surgery, my sick babies have been more sick with sadder stories thus far. Just last week I had two different babies require chest compressions in the OR. This week, one is now extubated and tolerating her formula like the amazing person she is. The second one, stable, but deciding to take his own sweet time before he trusts adults again.
My cutest baby right now, is also the saddest story, in my opinion. He's a tiny little guy about 2months old, first presented a month ago concern for his constant vomiting. Pediatric Surgery was consulted then for pyloric stenosis. I read the notes of the previous team; they argued their reasons, and the family was sent home from the ED to follow up with their Pediatrician. They immediately called and made the soonest possible appointment. For the next three weeks they had multiple appointments with their Pediatrician, who suggested multiple formula changes. They followed instructions exactly as directed all the while their son continued vomiting. They have two older children, they knew something was wrong, and confessed that they basically haven't slept the past month due to worry for their son. After weeks of recommended formula changes with no improvement, they were trying home remedies, really anything, to save their son who had now lost a bit of weight. They had started mixing cornstarch with water to feed their son. And finally Mom suggested to the Pediatrician that they repeat the imaging, which lead them back to the hospital. By that time, after a month of vomiting and being fed cornstarch and water, the baby's electrolytes were dangerously deranged. He was resuscitated, rehydrated and ultimately taken to the operating room for his pyloric stenosis. Now, fast-forwarding a few days, we made the decision to take the baby back to the operating room for a second surgery. I stood in their room for almost an hour this afternoon explaining the surgery and the situation, but mostly just letting them vent and answering their questions. You see.... someone (and thankfully I don't know who) had contacted CPS about the case. Here are loving, caring parents, incredibly worried about their son. Brought him to the hospital initially, and were turned away. Yet continued to persistently seek out help for their son, and then when that failed resorted to cultural remedies. This is a situation of poor decisions by healthcare workers, this family suffering as a result.... and then they get blamed for it?!?! The whole situation makes me so angry, the lack of understanding and making of assumptions against this family was unjust. So I stood there, trying my best to admit fault without casting blame, despite how much I wanted to. Emphasizing frequently that it is not their fault, it's actually because of them that their son is finally getting help, will recover, and grow to be a happy and healthy adult. Extra prayers for this little guy's second surgery. For some good news for this tortured family.
Love and prayers.
