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.

Current Affairs, Real Medicine

Patients Don’t Want Exhausted Doctors

Before you read what I have to say, you should read Dr Nikki Stamp’s post: How tired is too tired?

One day, I’d like to have a study to prove the post title. But for now, we’ll have to settle for another anecdote:

tired doctor Continue reading “Patients Don’t Want Exhausted Doctors”

Getting to know me, Real Medicine

One Year On

Exactly one year ago, I started Internship. Hard to believe that the terrifying days just kept coming, until one day they weren’t so terrifying anymore.

Today marks the beginning of my second year of Internship, as the new interns arrive. I am excited for them, mostly. I also have quite a few friends coming!

I’ll be on call today on the surgical service. I anticipate a busy busy 24 hours; because with great celebration comes great trauma, unfortunately.

One year from now, if all goes well, I’ll be starting my community service year – in a different province, different hospital.

I don’t really know what to expect for the year ahead. To be honest, I haven’t even had time to make goals or plans. But I trust it will be a year of great learning and experiencing.

What a time to practise medicine, indeed.

Getting to know me, Real Medicine

Working the Festive Season

Christmas and New Year’s is such a fun time in South Africa. It’s the middle of Summer. The weather is gorgeous, perfect for swimming and braaing, spending time with family, and reading.

It’s my first festive season of working full-time.

nurse-working-christmas Continue reading “Working the Festive Season”