Goldilocks and the Three Kiddos on Pedi

Time flies when you are having fun, and my Pediatrics (or as they like to say, Pedi, pronounced "P.D.") rotation was over before I knew it.

I had a blast on Pedi. Most memorable patients included:

A 9-year-old girl who was born with her heart on the wrong side of her chest who had a mysterious blood infection, either from her heart or her ankles. The treatment was the same regardless, so I guess we will never know. We wrote secret messages to each other on the chalkboard on the floor. She also gave me this notebook (see photo). 

A 5-year-old girl with adorable glasses and pneumonia. She refused to take her medicines, so I made her an offer she could not refuse. I let her squirt soda at me using a syringe that she used to drink her antibiotics. Luckily, she was contagious so I was protected by a plastic gown. To help her get air into her lungs, we had her blow bubbles all day. 

A 20-year-old Spanish-speaking girl with Down Syndrome who was newly diagnosed with diabetes and loved to shake my hand every time I entered or exited her room. I spent a lot of time trying to find her something to drink that wasn't so sugary...

One of my Pedi attendings kept referring to Goldilocks and the Three Bears, warning me not to do too little or too much, but to do JUUUUST the right amount of medicine to make my little "kiddos" get well again.

(On Pedi, all the patients, ages zero through 22, are Kiddos. One of my classmates postulated that they were all Kiddos because the residents couldn't remember their patient's names. Or for the babies, because nobody knew if the Kiddo was a He Kiddo or a She Kiddo... I hope it's just because a Kiddo is obviously better than any other type of patient.)

All of medicine is playing Goldilocks and the Three Bears, not just in Pedi. We had a lecture on big bad Medical Malpractice last Wednesday. I have seen some Malpractice in my time at Baystate, and it looks a lot like doing too little, or doing too much. But it is not easy to do JUUUUST the right amount of medicine. It seems pretty impossible to me.

When a patient (or Kiddo) shows up in the Emergency Department with some vague complaint, the doc asks a bunch of questions and then runs a bunch of tests. In some cases, the doc starts a bunch of treatments, too, even before they have the diagnosis. The tests have risks. The treatments have risks. Just being in the hospital for too long, without us even doing anything, has risk. But not doing the tests and the treatments could have worse and sometimes fatal consequences. Doctors base their decisions on the most common and the most dangerous things that someone could have based on their story and physical exam. They try to do JUUUST the right amount of medicine.

That is what I am learning as a third year. Medical management. How to make these doctor-y decisions. Luckily, on Pedi, Goldilocks and the Three Bears usually meant something a lot less intimidating, and involved porridge and tucking a Kiddo into bed.