Freakin' Kids (or, Dr. J crosses Pediatrics off his residency list)

The BBQ Pit
1

So I just finished my wonderful Psychiatry block, and I have moved on to the world of Outpatient Pediatrics. I have never wanted to be back among the suicidal and psychotic more in my life. There are certain qualities that one must have to enjoy working regularly with children; apparently, I lack all of them.

How do I hate Peds? Let me count the ways:

–Typical dialogue when checking out a patient with a pediatrics attending:
“Sounds like you did a good exam, and I agree with your assessment. There are a few other etiologies we might consider for this presentation, and we can talk about those later, but your thinking is certainly the most likely possibility. Let’s go see him.”

<enter exam room>

“Oh, LOOK AT YOU! You’re so CUTE! Yes, you’re just the CUTEST THING! Yes you are! YES YOU ARE! You’re a big boy, aren’t ya? Yes you are! Oh, look at those little toes! They are SO CUTE! Oh, no ouchies, baby, I promise, no ouchies! Those little cheeks are just the CUTEST…what the…hell… <slump>*”

  • Dr. J gets them from behind with 100 mg sux

I’m all for relating to one’s patients, but this ability to be a wonderful, competent, intelligent person outside the exam room and a drooling idiot at the first sighting of an infant drives me up the wall. Particularly one attending, who in addition to being the worst of the baby-talkers is also the loudest; we call her the Sam Kinison of baby talk. (“OHHHHH! YOU’RE SO CUTE! OHHHHH!”)

–Children scream. I know that, and I don’t blame them for it. Yes, I screamed when I was a kid at the doctor’s office. That doesn’t mean I want to hear it. With eight exam rooms and blood-curdling screaming coming from at least three of them at any given time, I feel like I’m in a hallway in Hell. And when it’s my patient? Sheesh. Holding down kids to look in their ears makes me want to start giving them all a little Versed as soon as they walk in the door. (When the aforementioned Dr. Kinison was examining a screaming infant, and thus elevating the volume of her baby talk appropriately, I wanted the same Versed for myself, plus some bourbon.)

–Older kids, however, I don’t have as many allowances for. Is it too much to ask to be able to behave for five minutes while I’m talking to your mom? More often than not, it isn’t the patient who is being a hellion, but the older sibling (4-5 years old) running around like a Bonobo chimp on crank because he can’t stand not being the center of attention for the five minutes it takes me to examine his little sister. Oh, and Mom? I know you’re adept at tuning out your little bundle of joy when he does this, but you could at least tell him to stop banging that ophthalmoscope against the side of the exam table–those are expensive, you know. Plus, if you keep letting him put things in his mouth, don’t come crying to us when he becomes a Petri dish on legs in a few days.

Sigh. Seven more weeks…
Dr. J

2

I can’t stand this (you’re so cute!) when people are doing it to human babies. I have to admit, though, that I will do it to cats, particularly kittens. I’m a sucker for kittens.

3

I’m sure the Pediatric world will muddle along fine without your presence, Dr J. :slight_smile:

4

re the inane comments: It’s all part of my canned drone to lull the kid into compliance. The best is to use a pleasant and reassuring voice to say outrageous things to the real little ones, like “Well, look at you, I bet you’ve got a genetic predisposition towards lycanthropy! Let’s see if your canines are coming in yet!” They smile, mom smiles, I feel like I’ve vented.

Anyway, before your next peds patient, you try taking the Versed.

5

Pediatrics is about making the parent comfortable since the kid usually doesn’t have anything seriously wrong. If this involves grotesqueries like loud baby talk, so be it. But the better class of pediatrician just relies on the popsicle and sticker bribe and doesn’t sweat the saccharine.

6

My dad just retired last year after 30 years as a pediatrician. When he retired, someting like 1000 patients showed up at a reception just to say thanks for being a such a good Doc. Any time I met one of his patients, I was in for 5 minutes of “Oh, you’re Dr. Ron’s son? Your dad is the best…etc…” What follows are tips I picked up over the years. Understand, I’m not a Doc myself.

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90% of your job is dealing with the parents, NOT the kids. Look them in the eye, use english, not medicalese. “Bellyache” is far preferable to “Adominal distension” or “gastritis”.

Come up with a gimmic. My dad would talk like Donald Duck. The first time it goggled the kid, and later they learned to expect it. It destracted them from the fact that they were in the Docs Office.

Have the nurses give the shots

Learn to do your routine exams in a manner that is playing to the child. Find out how they are reacting w/o them necessarily knowing they’re being examined.

Never wear good ties. ( technicolor burps )

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Hope that helps! Good luck!

7

Ahhh, the memories…

I didn’t mind the kiddies during the peds rotations*. It was the parents who were hard to take. Such as the mom whose stocky, pre-Jesse Ventura toddler I was ill-fated to examine and whose punching and kicking resulted in Mommy getting mad at me for inflicting such savagery on her Widdle Boy.

Have you considered Neonatal Intensive Care as a specialty? The patients generally lie still and are very quiet.
*except for the endless series of viral infections I caught from them. Haven’t gotten sick yet? Just wait.

8

Ah, Weirddave, you brought back memories of MY pediatrician. He talked like Donald Duck too, made balloon animals, and told silly stories and jokes. I was never afraid of going to see him, even for shots. He would get you all wrapped up in some story, and you wouldn’t even notice he was getting the needle ready. He has since passed away but when HE retired there was a big affair for him too.

One poem of his I remember that we little kids LAUGHED at:

Old Mother Hubbard
Went to the cupboard
To get her poor girl a dress.
When she got there
The cupboard was bare
And so was the girl I guess!.