Celia's Uber Late Post of the Week

Monday was my last day in PEDS. I walked into PICU, straight into a patient that was coding. She’s this 5 month-old who has been in PICU for the past three weeks. Dr. Monroy informed me that she might not make it much longer because of her pulmonary hypertension from her congenital heart defect. Sadly, she died the next day at four in the morning. Of the initial five patients when I started PICU, three has died. It’s just so heartbreaking to realize that these kids are just so sick and that there really isn’t much you can do for them, here or anywhere. I also found out about another death, that of a Down’s child who was in the CRIN (where the malnourished children are). We were all saddened because just the Friday before, we were playing and feeding him and he seemed fine. I’m reminded that life is precarious that way and we’re so lucky to enjoy our sound bodies and minds. The PEDS-ER was not as busy Monday but Andy and I stayed to watch a couple of surgeries with Dr. Amaya in the adult OR and explore the ER before going home. The next day Jen was feeling better so we all made it to the hospital for our new rotations. I was in the burn clinic and I played with a few kids before surgery. The first two surgeries were debridements and just general cleaning and removing of dead skin. The last surgery was a full thickness skin graft of the area between the little boy’s second and third digit. Dr. Ramero removed skin from the pelvic area and grafted it on there with several stitches, even a little bit for the tip of the boy’s finger. I was in the burn clinic again today and Andy and I watched a debridement. Andy even got to scrub in and help Dr. Ramero. The last two surgeries were pushed back though they would have been cool ones. One was to close the hole in Eva’s scalp which resulted from a car accident. We also could have seen an expander removed but an infection had developed and they had to postpone that surgery as well. So Andy and I played with the kids, including a very intense game of Go Fish with Jhoselin before making our way to lunch and back home.

6-22-09
Today was my last day in the burn center. We got there at 8:00 and I changed in one of the back rooms in to scrubs and a coat. I said hello to the kids sitting in the hallway and then I walked into the patient rooms where rounds were beginning for the day. I didn’t know this at the time, and the resident turned around and explained to me that rounds started promptly at 8:00 and that I was now late. I think it was a case of mistaken identity, as I think she thought I was a local medical student, blond hair and all. Not wanting to argue with her authority, I apologized and fell in line, and watched as she chewed out every medical student or random volunteer to walk in the door from that point on. It was really very entertaining. Surgery started late this morning, at about 10o’clock. The first case was just the debridement of a little girl’s foot that went off quickly. The second surgery was the debridement of a little boys severely burned hand. In this case they attempted to put a catheter in the femoral vein of the four year old boy, but they accidently cathed the artery instead, which had enough pressure to run the I.V. backwards. It took them almost an hour to repair the artery and snake a catheter up the vein. The hand was covered in huge blisters, but the debridement went very smoothly, and only took a fraction of the time that putting the I.V. in took.
We went to get lunch, and after lunch, Celia and I returned to the hospital to meet Dr. Amaya in the O.R. We got there about 2:00 and saw the end of one appendectomy and the entirety of another. Dr. Amarya didn’t speak any English, but humored us as we tried to speak to him in Spanish, telling us about his daughter and other kids, and asking a million questions about how hard school was in the United States. After the surgery, Dr. Amaya took us down stairs to the ER. We saw only one case there, a bad case of hemorrhoids in a 70 year old woman, but we talked to a number of residents. Apparently, there is some local scandal where several of the residents have flunked out, but they are refusing to leave. The new residents who wish to take their spots are also upset. It was a very eventful day, and a long one at that, as we didn’t leave the hospital until nearly 6.