Tuesday, March 02, 2010

take only what you need from it

There have been a lot of questions swirling around in my head, but no space or time to find any of the answers.

Two of the rotations I was dreading most in medical school were Obstetrics and Pediatrics. Really, more people should dread Obstetrics than do- fear the placenta, I say, for there is nothing particularly appealing about that part of childbirth conveniently left out of the likes of Knocked Up. I was also dreading (forgive me, XX's of the world) the idea of working in a female-dominated area. In the past, in groups of women, I've always floundered a bit. There's a hierarchy and code that I somehow missed by being too much of a tomboy when I was a kid and hanging out with way too many teenage boys when I was a bit older. And even though I got better at it as I got older, I still always felt more comfortable hanging with cowboys as compared to sororities. Pediatrics, I feared for less rational reasons- I thought of children as little alien beings who make a lot of noise at Target, and I worried about dealing with anxious parents.

In the end, both of the rotations went surprisingly better than I could have hoped. While I happily leave the delivery of babies to those more interested in that sort of thing, I liked how focused the field is. You can figure it out and become fairly competent at it, and, as a medical student, that's always an attractive quality. Moreover, I got to spend some time in the OR, resecting ovarian tumors, and that felt like a once-in-a-lifetime opportunity. I'd reconciled by then that I have a fondness for surgery, but no aspirations to pursue it. But in some ways that made it more interesting, as I could just allow myself to be fascinated. The patients were so interesting, facing an uphill battle that can sometimes feel much like Sisyphus, but most of them were ready for the fight.

While I was justified in thinking of children as aliens- after all, they did infect me with their foreign pathogens and render me half alive for a solid 2.5 weeks of an 8 week rotation- Pediatrics was also one of my favorite rotations of medical school.

For one thing, it bridged a gap for me. There was a young, idealistic version of me that was once interested in medicine. But that was a long time ago. It wasn't until much later that my interest in medicine experienced a rebirth, and this later, more measured, eyes wide open version of me decided this was the right thing for me to do with my life. Amusingly (to me), the earlier version of me was keen on Pediatrics. When I was young, I had this connection to children that seemed like a secret power. At family parties, I was always handed little babies and toddlers. I liked them even. They seemed to just know whether your intentions were pure, and I loved that they couldn't be fooled.

But all of that seems like ancient history, and most people who know me these days wouldn't even believe any of what I just wrote was even true. It's annoying though, the pressure to be consistent. So it was nice not to be. I'm sure my fellow classmates concluded it was some kind of act. But it was actually nice to be around some of the children (I can still do without the monosyllabic adolescents, though, when you finally get them to talk, you feel as though you just cured Polio).

And there's something else too, which I could not have predicted at all, having never worked with children in the hospital. Kids are often extremists. They usually present as previously healthy little dudes who were minding their own business, or they come to you with a whole host of issues. The latter is both complicated and difficult to bear. But the former makes pediatric medicine much more attractive than treating a 55-year old. A 55-year old comes to the hospital with poorly controlled diabetes, hypertension, and COPD secondary to smoking, and wants you to figure out why he has a stomach ache. Your head proceeds to spin off its axis, as you can amass a list into the next day of all the possibilities. A 5-year old comes in with a stomach ache, it's a completely different game- the list still has to be generated, but it's a shorter and cleaner one. You can come up with a diagnosis, run the right tests, figure out what is going on. And kids, of course, rebound better than your average 55-year old, which makes treating them, in many ways, more satisfying.

When I write that down, I realize it could come across as though I am considering a future as a pediatrician. It's strange, because I keep getting pulled in every direction except the one that I want to be pulled in. But I think that has more to do with the external rather than the internal. I've gotten a lot closer to be being certain of what is best for me to do. I just wish I could figure out why it took being told that I should be an obstetrician and/or a pediatrician to get to this point.


pied piper said...

Just make sure it's eastbound, whatever it is.

B said...


Looks like I'll be landing in either Worcester or Baltimore over the summer and an anklebiter is arriving in mid August to boot. Would be lovely to have Auntie Brimful nearby!

karrvakarela said...

Prior to my rotation in adolescent medicine, I used to have a difficult time communicating with teenagers and even now it's not always easy. But having spent a month exclusively talking to and taking care of teenagers, I find that they are some of the most amazing people around. Smart, vulnerable, funny, sensitive, curious. It's a privilege to be let into their worlds.

Whatever you decide, I'm sure you'll be an excellent physician. Good luck with making the choice!