December in the hospital

Pediatrics is over and I'm pretty neutral on it any way you look at it. The kids are cute, the parents aren't always as annoying as I had anticipated, and it's not hard work (especially not compared to surgery, ha!). But it's just not for me, I fear -- unless I could magically become a Peds ID or surgery attending without doing general pediatrics or (even worse) general surgery first.

Some highlights:

• -Crazy little Ruby R., 2 years old and with probably no well-child-checkup in her life. She got her shots at the health department and went to her Passport-assigned family practice clinic for sick visits (Passport is KY 's Medicaid, essentially). But when she rolled into Kosair with bronchiolitis, she had a palpable liver and a crazy-ass heart murmur, and it was obvious no one had ever listened to her heart before. And she had the CRAZIEST parents -- they were definitely what we call a "social nightmare." We suspected Marfan's, so I was sent to take all her measurements (a wingspan-to-torso ratio of > 1.2 is usually what you find), but it turned out she instead had Williams syndrome (supra-valvular aortic stenosis -- take THAT, shelf test!). She was a cutie pie, jumping up and down in her hospital crib/cage like a little monkey (a cocktail party monkey!), and even though it was sad that she wasn't talking or walking yet -- instead, scooting herself around on her butt, again like a monkey -- it was adorably sad. I meant to call the cardiologist to see if she ever made it to her follow-up appointment, because I'd be willing to bet she didn't.
• -Room 513's mom, who had been in the hospital with her 2-month-old son for 3 weeks straight. He had had pneumonia (actual, bacterial pneumonia, not viral or atypical, yay for me!) and had been intubated in the PICU for over a week. Now he was back on the floor, and being weaned off his morphine. One night, we figured out the wean was going to quickly, because his withdrawal symptoms were pretty bad, so we stepped back and started the wean over, with much begging from mom. The next morning I checked in and asked mom how he was doing. "Oh, much better, he does much better with that morphine. And so do I." And that's how addicts are born, I thought to myself. Just kidding. The kiddo did fine, and so did mom, although she actually was planning to have a hysterectomy the day after we discharged them, and refused to believe that should would have any problems getting out of bed to take care of her son the same day!
• -L.J., who was 3 years old and weighed 120 pounds. And did not have Prader-Willi or any other type of genetic problem. And what did "L.J." stand for? Little James. I shit you not.
• -A little girl at my outpatient clinic who declared that her "pooket" was itching. I didn't actually see her myself, but that story was spread far and wide immediately after the resident got out of the room. Her "pooket"? Where do parents come up with these names for genitalia? And of course, I was picturing that she was saying "Phuket" and thinking of the "What happens in Thailand stays in Thailand" SNL skit with Ben Affleck. Sure, maybe "vagina" is a little much for a 3-year-old, but where does "pooket" come from?

It's nice to be home, although the stress of splitting holidays among two families and trying to see as many friends as possible means it's going to be a tiring week and a half. Happy December!