Archive | September, 2012

cake for breakfast

11 Sep

I equate the provision of the occasional cake for breakfast with good motherhood.  I’ve mentioned before that my mother was a terrific cook.  Her kitchen was quintessential healthy Mediterranean long before it became “a thing” (an almost fad diet) in the states, before Mireille Guiliano’s French Women Don’t Get Fat (the concept that someone would even write this book would probably elicit an eye-roll or several from the foreign-born matriarch of the house).  Everything in moderation…including moderation.  Which meant that we never denied ourselves our piece of chocolate, our glass of red wine, our parmigiano reggiano.  It also meant that for one day a year, on my birthday, I could eat cake for breakfast.  (During the rare moments when my mom actually felt the need to justify this parenting decision, she would state that her homemade cake was at least as healthy as the pop tarts with which other parents sent their kids to school.)

Well, Friday was not my birthday, but I indulged anyway…and I think my mom would have approved, as this gluten-free girl has gone without cake for the last several birthdays.  It was the day after another anatomy team-extended potluck, turned into informal baby shower.  We had the best feast.  Apparently, my friends were in cahoots with the hubby, asking him about dinner menu.  I can honestly say it was the best dinner I’ve had in months, and this has been a summer of fabulous eating: sparkling cider; caprese salad with extra basil; fennel and citrus salad; make-your-own personal gluten-free (with homemade cauliflower crust!) pizza; chocolate-covered raspberries and strawberries; best-of-summer fruit salad; soy vanilla ice cream; and flour-less chocolate almond cake.  Thank God the meal was plentiful and the cake was rich, so there were leftovers for me to sneak home to be consumed a mere seven hours later!  I just wish I had snapped pictures of this exceptional spread and the chefs that created it.

But I did get a picture of the baby-shower related game that, despite my concern for all things competitive (I get mean when I “play”), I actually enjoyed considerably.  Hint: it was very med-school-y, and it involved blindfolds:

Just stating the obvious: I love my friends.  Very, very much.

 

outpatient pediatrics

7 Sep

After three weeks of caring for some seriously sick kiddos, this past week of mostly well visits has been a welcome reprieve.  While I think I’m more of an inpatient kind of girl, a month of clinic every now and then, or an afternoon or two a week of outpatient is a sweet deal.

First of all, the schedule is simply lovely: arrive at the office at 8:30; take 30 minutes for lunch; leave by 5:30 at the latest…and that’s a busy day.  (This is definitely not to say that all outpatient pediatric experiences are like this…to the contrary, most attendings in private practice are feverishly swamped.  But, as a student, things are a lot cushier.)  As I enter my 35th week of pregnancy, I’m overwhelmingly appreciative of the extra time allotted for sleep and study–oh God, I’m horribly behind on studying.

Two: at a tertiary care center, it’s easy to forget that rare diseases are rare, that not every child has a catastrophic  illness or injury.  Not all children who have asthma have to be admitted to the pediatric intensive care unit for days in order to make sure they oxygenate their blood.  Not all children who have a fever have bacterial meningitis.  For me personally (and somewhat selfishly), it’s nice to be reminded that there are so many healthy, happy children out there.

Finally, outpatient peds is a fairly unique environment for providing true preventative care.  Parents love their children and, for the most part, they’re pretty amenable to changing behaviors, considering suggestions, and making some hard parenting decisions if it means their kids will be better off.  Sure, we’ve all seen parents who refuse to get their kids vaccinated, who could care less what and how much food their kids consume but, although they’re a loud minority, they still are very much the minority.  The challenge is much more a battle of resources.  It’s hard to argue with the fact that cheap foods are often not the healthy ones.  And it sucks when you and mom are in agreement that her child needs to get outside more for stimulation and exercise, but the neighborhood is far too dangerous to allow for it.  So, in the mean time, we have things like WIC to provide healthy supplemental foods, and Brighter Futures to provide (among other things) a book to take home for every child who comes in for a well child visit.  It’s something.

Oh, and this is funny: I think I’m starting to develop age preferences.  Right now, I’m totally digging 4-month-olds and teenagers.  4-month-olds will smile responsively and make all sort of fun vowel sounds.  Teenagers will, sometimes, talk shockingly openly about their sex lives and their completely untempered, borderline lofty life/career goals.  Love it.

a magical place

1 Sep

I just finished my three weeks of inpatient pediatrics on the Heme/General Peds service at the Children’s Hospital of Philadelphia, affectionately called “CHOP.”  There’s just something about a children’s hospital…it does something to people.  John once remarked that even the assholes he knew peripherally during residency would morph into not only tolerable , but kind and accommodating people while on their peds rotation at Boston Children’s.  One of my senior residents, when describing her love of CHOP, commented that the attitude was even written into the HR agreements–all staff understand that it’s their duty, which they feel compelled to uphold, to be as generous to their patients and fellow workers as possible.  She sees it in the night janitorial staff, for example, who will often go out of their way if they notice something in a patient’s room that’s at all possibly disconcerting.

As a student, I’ve been blown away by the residents.  I can’t imagine how busy and stressed they must be.  Yet they are the only residents with whom I’ve worked who I have literally never heard complain or be negative, and they somehow still always find the time to go over presentations with me or provide me with teaching points.  They’re not saccharine, they’re just nice.  It’s part of the pediatrics culture, and it’s heavily engrained in the CHOP institution.  I would love to see how the HR contracts actually read, wondering if they’re anything to the effect of: “Thou shalt not be a pain in the ass, even if you’re on your 30th hour of call, have had children vomit and defecate over you, have had parents scream at you for keeping them waiting two minutes while you were saving someone’s life down the hall…all the while the pesky med student is perpetually asking ‘What can I do?  What can I do’  like an annoying chihuahua yapping at your heels.”

This is premature: I think I might want to be a pediatrician.