A Day In The Life: Pediatric GI Service Edition

On Monday night, during my volunteer shift, I ran into KayTar's GI doctor. She greeted me and struck up a conversation about volunteering/school/so forth. I'm still not entirely convinced that she didn't have me confused with someone else, as we only see her 1-2 times a year. Regardless of whether she actually recognized me or not, I half-jokingly asked her how I could get on shadowing her and she said "What are you doing this week? I'm not on service again until this summer." She gave me her email address, so after making sure I had a sitter, we set it up for Friday!

I arrived at the hospital at 6:45 and spent about 30 minutes trying to get in touch with the fellow to find out where to meet the team, so I finally just email the attending again to find out where to go. After that, it was smooth sailing. I had a very interesting day! I pre-rounded on a couple of new admits with the fellow, then went to grand rounds with the interns. The speaker was KayTar's ex-neurologist and while I didn't care for him in that capacity, he was pretty entertaining! The subject was orthostatic intolerance (Can You Withstand Standing.). There was food and coffee. :) After grand rounds, we started morning rounds. I saw a lot of new-to-me cases:

-A few short-gut kids
-Rhett syndrome
-intestinal lymphangiectasis
-Langerhans cell histiocytosis
-newly diagnosed CF in a preschooler
-ulcerative colitis
-Megacystis-microcolon-intestinal hypoperistalsis syndrome

It was a lot more variety than I expected to see on GI service, honestly. A couple of hours into rounds, the OR called to say they were ready for one of our patients to be scoped, so I had to go change into scrubs and head to the OR. GI procedures are non-sterile, so I didn't have to scrub or anything...just don scrubs and a hat. I got to handle the endoscope and fidget with the controls before the procedure. The interns were the ones who asked if we could play with it, so I guess it was new to them, too. They seemed pretty excited about it. I got to watch the procedure up close and the attending explained what we were looking at while the fellow did the actual scoping/biopsying. It was cool, even though the GI tract was completely normal as far as we could tell. After that, we went back rounding, it kind of took forever! We didn't finish "morning" rounds until after 4pm. Around 2:30, the fellow and I split off and he sent me for lunch. I appreciated it and ate as quickly as I could and met up with him again...I don't think I even missed a patient! Shortly after, we were pulled into a family conference with a translator for the CF kiddo, that was interesting! It was a complex situation and I hope it all works out in the end. Not everyone is equipped to deal with chronic medical conditions.

They let me go around 4:30 or so, I could have stayed longer...but they said it was fine for me to go and I got the feeling they wanted to move a bit quicker for the rest of the afternoon and I didn't want to interfere. I had a wonderful day, it was very interesting and the fellow said I had seen more than most med students get to! I'd love to do it again sometime. I still prefer the primary pediatrics clinic, though. I love the patient contact and there wasn't much of that in the hospital...at least on this service. We spent a lot of time charting...I don't know if that is typical or has more to do with the new EMR system...but for every 2 minutes spent in a patient room, there was probably 10 minutes spent in the hall making notes. I like the pace in the primary clinic better, even though I know the charting still has to get done sometime! I'm glad I got the opportunity to see so many new things and get a glimpse into how things run at the hospital. It was nice being on the OTHER side of those early morning rounds for a change!


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