Getting to know me, Real Medicine

Why I Paed

il_fullxfull.1060268322_b3xh_1b44cb32-38e5-43f0-83cd-e66691807124_grandeWhenever I talk about my love for child health, and my intention to pursue it as a career, I get this kind of response:

“Oh, I could never work with kids. It just breaks my heart to see them suffer!”

I don’t get it.

I mean, maybe I’m a cold-hearted bitch, but I don’t think so.

I hold children down and stick them with needles, because I know it’s necessary to make them better. I scrub burn wounds and I encourage parents to wait outside because I know they’ll cry and/or likely try to assault me for hurting their babies.

I also use topical anaesthetic cream liberally and question IV lines when I don’t think it is absolutely necessary. I’m liberal with analgesia prescriptions because pain is more harmful than useful in a hospital setting.

I see malnourished and abused children, and sometimes I bite my tongue raw to keep my temper.

I’ve told mothers that their children had cancer, and I’ve told them that their kids would be developmentally delayed for the rest of their lives. I’ve told them that their kids will live, but that they will be long-term patients.

(Thankfully rarely) I’ve informed parents that their baby was no longer alive.

* * * 

But I give more high-fives than I give pain.

I get gummy smiles and snotty laughter and the wide-based gait of children waddling around my legs.

I call in the social workers and the dieticians and we (try to) address systems, not just lapses in judgment.

I get to pick up a crying infant and feel it relax, because although human contact isn’t medicine, sometimes it’s just what you need in that moment. Both of you.

I get to discharge more patients than I ever have to declare demised.

When I tell a parent that their child is disabled, I get to tell them about disabled people who don’t only live, but THRIVE.

I get to admit a shocked child, and see her running around the ward two days later.

I get to witness the purity of the human spirit first-hand.

I tread among the future.

Paediatrics is the great success-story of 20th century medicine, and I rarely cry for it.

* * * 

Adult medicine? Oh I couldn’t. I’d cry all day.

Real Medicine

Working in the Land of Milk and Honey

By some kind of dumb luck, I am doing my Community Service posting at an incredible children’s hospital in Cape Town, rather than the archetypal middle-of-nowhere clinic post we all expect for ComServe.

And it’s incredible.

#lucky to work with this view; less lucky to be #oncall Friday and Sunday. #weekend #capetown

A post shared by Megz (@barefootmeds) on

This hospital is just something else. It’s public, but has so much private funding that it might as well be a private hospital. It gets a lot of private patients so clearly I’m not alone in my perception.

Some things that continue to blow my mind:

1. Pain management team

Absolutely essential, of course, but not something we had access to in the Eastern Cape. As part of pain management, our kiddies have access to aromatherapy and music therapy. How cool is that?!

2. Psycho-social services

When adults bring kids to hospital and they have witnessed violent events, the adults get debriefing practically before the kid even leaves the emergency unit. When a kid gets hit by a stray bullet, he gets trauma debriefing. There are support groups for kids with any number of conditions. All of these things should be a given, should’t they? But again, it’s something I’ve never seen.

3. Palliative Care Team

Last year, I often had to decide on my own whether a patient was for active resuscitation or not. It was a horrible responsibility, but not that I’ve learned just how much is involved within the practice of palliative care, I realise how WRONG it is for a clinician to have to make such decisions without an entire palliative care team.

My entire view of palliation has changed.

4. Gorgeous Operating Theaters

There are theaters with views of Table Mountain, and I just… wow. (The on-call room also has a view of the mountain.)

5. Clinicians who love their jobs

I can’t begin to tell you how amazing it is to be surrounded by senior doctors who are still passionate about their work. It gives me hope.

 * * *

One thing that is not available in the land of milk and honey is small-size theater scrubs. I still have to use a whole host of improvisations to prevent my pants from falling down when I scrub in for theater.

Oh well.

Getting to know me, Real Medicine

Not Waiting Anymore

A few months ago I did something on the spur of the moment. Something unlike me, something I was sure I’d regret.

I invited a colleague for a coffee/debriefing session after work.

I’m an introvert. Initiating a social event, even a small one, is unlike me.

I asked her because we bumped into each other at work, and had a quick chat about how downtrodden and hopeless we felt. (Internal Medicine is hard.)

I asked her, selfishly, because I needed it. But also because I realised that she needed it. Continue reading “Not Waiting Anymore”

Getting to know me, Real Medicine

Doctors and Piercings: Part 3

It’s been nearly five years since I decided to get a nose piercing. I mused about the decision on the blog both before and after the fact.

Since becoming a “real” doctor, I’ve never had a patient refer to my piercing. As mentioned before, it really isn’t that conspicuous. I’ve also noticed more and more doctors who have nose piercings, so it probably isn’t so strange in South African healthcare workers as it was in 2011.

This year, after working with a certain doctor for three months, he finally noticed the piercing. His response was, “Well that’s atypical,” then he laughed and we moved on with our ward round.

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You can see it, but just barely.

I removed my nose jewellery recently, and in many ways that decision was as difficult as getting it in the first place. Continue reading “Doctors and Piercings: Part 3”

Real Medicine

Abortion Care: Did I Provide My Best?

It’s funny how sometimes, long after the fact, you start questioning your levels of care and competence.

During my first rotation of internship (last year), which was Obstetrics and Gynaecology, I was one of the few interns willing to do pregnancy terminations. (For the purposes of this blog, the matter is not up for debate – I have been pro-choice for nearly half my life, and have thoroughly evaluated my own beliefs.)

Just recently I’ve found myself thinking back on those four months and wondering if I did everything I could, and if I was empathic enough. Continue reading “Abortion Care: Did I Provide My Best?”