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Published: January 24th 2018
Peds WardA Week on Peds
The patients on the peds ward are definitely cuter than those on the adult medicine ward
There are several reasons why I am not going into pediatrics: the patients can’t tell you their symptoms, they squirm and cry when you try to examine them, and there is too much math involved when dosing medications. I am in the mindset of treating pediatric patients as though they are just tiny adults, which they are not. Thus, I am eternally grateful for those (like my beautiful wife) who have chosen to dedicate themselves to this field.
This being said, I have enjoyed my three days on the pediatric ward. My kiddos had things ranging from run-of-the-mill pneumonia to meningitis to pigbel. (As an aside, pigbel is a severe form of necrotizing enteritis that is only seen in the Highlands of New Guinea. It occurs after eating contaminated meat, usually pork, and is exacerbated by the staple sweet potato diet which inhibits protein breakdown in the child’s intestines. The bacteria then causes necrosis of the bowels in severe cases, leading to perforations and sepsis. Obviously antibiotics are a mainstay of treatments and surgery is sometimes needed, depending on the severity of the case. If caught early, kids do fine, but too often delayed
On a walkabout through the Waghi Valley with my friend John
presentation yields poor outcomes. This hospital sees too many kids die every year from pigbel.)
Other interesting things I got to do included lumbar punctures (aka “spinal taps”) on several kids to check for meningitis. With lumbar punctures, there’s a tradeoff in performing the procedure relative to the age of the patient: the older they are, the more they squirm and are harder to hold, but when they are younger and easier to hold, your target of hitting the sac with spinal fluid is much smaller. I’ve had my share of misses before finally getting a couple.
After pediatric rounds each day I went back to the craziness of outpatient department. Monday was hectic, as seemingly half of my patients in the afternoon required admission to the hospital. One was a four year old boy with dysentery and a very high fever who had a seizure on the bed in front of me.
One of the less acute and more fun cases that day was a rugby player who had dislocated his ring finger the week before. With fractures and dislocations, time is not your friend. The more time that has elapsed since the trauma, the more
difficult it will be to reposition. With this particular guy, I anesthetized his finger and then Dr. Nathan and I pulled and pulled, but were unable to relocate the finger. We then found Dr. Bill. Besides being the go-to guy for any medical question, Dr. Bill is also the guy to go to for help with many procedures. Dr. Bill pulled and pulled, grunting all the while, but was also unable to relocate the finger. Then, across the ER, we spied Alex. Alex is Dr. Mel’s husband and is a surgery resident himself. In another life, Alex could have played for the NFL – he is built like a tank. He came over and in less than 30 seconds, with seemingly no effort, popped our patient’s finger back into place.
Tuesday was also a little crazy. In outpatient alone I saw 18 patients on my own. My first patient of the day was a 12 year old girl who had fallen and hurt her hip, making her unable to walk. An x-ray revealed severe osteomyelitis (bone infection) of the entire hip. This infection clearly predated the girl’s fall and the question was whether the infection was TB or another
bacterium. I sedated her with ketamine in the ER and performed a bone biopsy of the hip. She was started on TB treatment and we will wait for the pathology to come back.
Today (Wednesday) was a little more routine with things like follow-ups for blood pressure, osteoarthritis, pneumonia, school physicals, and chronic pains. I got a chest X-ray on one patient who had a history concerning for TB, but also symptoms of acute pneumonia. Turns out he had both so I put him on antibiotics for his pneumonia and sent him to the TB clinic for medications for his TB.
Today was also a bittersweet day because it was my last day. I fly out tomorrow at 10:00 am. I spent much of my day and evening saying goodbye to my friends and colleagues inside and outside of the hospital. The Call
As some of you will know, since college I have always wanted to pursue overseas missions as a career. This comes not so much as a career choice but as a calling. This calling came during a time in which I was struggling in deciding whether to use my biology degree
to pursue a career in ecology/conservation biology or medicine – both things that I loved. I wrestled with this for months before my first trip to PNG in May of 2012. I hoped that trip would make my choice for me, but it only served to muddy the waters – while I had seen many fascinating medical things on that trip, I was also captivated by the amazing flora and fauna of this country. Two days after I returned from that trip, I finally gave over my decision to God and immediately felt an overwhelming sense of peace. There was no big flash of light, no still small voice. Just an overwhelming peace that called me to medicine. More specifically it called me to full-time overseas missions. I had never considered missions are a career before. I thought of it more as a side gig; go overseas and practice medicine for a few weeks each year and feel good about myself while not sacrificing the American dream lifestyle. But as soon as I received that calling, any desires of money and a complacent lifestyle were gone.
During the ups and downs of medical school, I have questioned that calling,
Me and John Opa
I first met John Opa back in 2012 on my first trip to PNG. Since then, he has been my guide to secret caves way up in the jungle and a good friend.
sometimes daily. I have even questioned whether I wanted to do medicine at all or find another career path. But during my time here in PNG, I have undergone such a period of affirmation. Never before have I enjoyed going to the hospital each day like I do here. Never before have I delighted in taking ownership of the needs of patients and in running around the hospital to track down supplies, medication, or a second opinion for them. I have looked forward to going to work, learning, helping people, and serving people every single day during my time here. Never before have I felt such joy in the field of medicine. I know that God has placed this calling on my life and I would never be satisfied unless I follow His leading. Abigail and I may end up here or somewhere else – the location isn’t important, following and serving is. I’m excited for the future.
This concludes another trip to PNG. Hopefully not my last. Dr. Bill told me that if I come back, I have to stay.
Thanks for reading my blog and sharing in my journey!
Until next time,
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