Monsters

Person: "What do you do for a living?"
Me: "I'm a pediatrician."
Person: "Wow, I couldn't do it dealing with all that sad stuff."

They are right...in medicine there is alot of sad stuff and in pediatrics it's the sad stuff that can really jump up and grab you.  You will see countless adults in medicine that have made poor choices and now they are at the end of the line, honestly it's easy to get over that - they had thier choice now they are living with the consequences, you do your best to help them and the sadness of their situation (cold as it may seem saying this) washes over you...because you don't know them and you can tell yourself that.  In pediatrics, that statement is never made or even thought about.  No kid deserves to be sick.  I think that's why I'm in pediatrics,  every day my patients actually DESERVE help...it drives me nuts working with a 40 year old diabetic who doesn't listen to my advice or take my prescribed medication.  Ussually if there is any frustration in caring for my patients it is derived from the parents.  The parents are often the source of the child not taking the medication or the child being sick...and none of these undeserved problems is more frustrating and sickening than child abuse. 

The typical case you'll see on TV is where suddenly they see a child with abdominal pain and the doctor walks in while the parent is hitting the child.  Suddenly the doctor slams the parent against the wall and screams for the police, its all very draumatic and leaves you with this rewarding feeling that "good" has been done.  That's not typically how these cases go.  In real life the child comes in with some injury...something just slightly conspicuous (ie the child rolled off the table and got a skull fracture).  At first it doesn't seem all that concerning...you want to believe in this beautiful and perfect world...the mother is going to tell the truth about her little girl...you will believe her...and that's that.  However, when you speak to the father...his story doesn't quite match up.  As you begin thinking about it, how many children fall 3-4 feet onto the floor and get a serious skull fracture (very few - there have been studies).  As you involve child forensics and the cross examination begins of the parents and the family, this perfectly optimistic world you live in develops "cracks".  After multiple tellings of the story from the parents, the mother finally collapses in tears, snapping under the stress of trying to hide that her mother is the cause.  Suddenly it's as if this magic bubble of a world you believe in shatters...suddenly  you wake up in the real world...a world where monsters really do exist.

There isn't always this black and white answer to the abuse or accident.  Sometimes it's nobodies fault, sometimes it's everybodies.  One thing is for certain, at the end of the day you don't feel like somebody's hero and you don't feel like your TV episode is rolling with credits, playing a happy song.  You feel like the world is "darker" than it once was and as you walk out the door of your hospital...maybe even before you go to sleep that night, you'll be thinking about how your patients don't deserve this...and that's why, no matter how tough it gets, you'll walk back through the doors in the morning.

Newbie Doc