Peace and Pediatrics

My intern on nights with me this past week was a south spoken Syrian.  He spent two years working to get a visa to come and study pediatrics here. He wants to be a pediatric cardiologist. He will be one of the only in the entire nation and even surrounding nations when he goes home.

He left Syria in the mist of a near civil war where every day there are reports of people dying.  The Arab Spring of 2011 has not ended well in his homeland.

But for now, he is here with me taking care of ward of children who have succumbed to the various demons of winter.

Late one night, we admitted a Somali toddlerl for observation after drinking some cleaner.  When the ED called to tell us about her, both of us got excited. Me because I took care of Somali refugees in Kenya and him because many Somali folks speak Arabic.

After we had her settled in, we found ourselves walking for midnight shack in the cafeteria. We talk about the famine in Somalia  that no one is talking about, the children who are dying. How our pediatrician hearts break for the children who are caught in the crossfire of country at war with self and a divided world who cant seem to understand each other.  The West has turned their back on Somalia because they harbor terrorists. But the terrorists who have friends in high places elsewhere are not dying, its the women and children.

Our conversation turns to the ground that divides us.  How hard it was for him to get a visa because he is from the other half. How many of my countrymen suspect something of this quiet soft spoken pediatrician because of his passport and his religion. They haven’t heard his heart for children who are dying of repairable heart defects or watched him play trains with a terrified 3 yo to soothe him. And how his countrymen suspect something of me as an American, as a Christian, as a Navy brat, as a global health doctor surely, surely she is an imperialist. Surely she wants the whole world to be like America. Surely she must be like that man in FL who burned the Koran (which apparently is a popular viral you tube like video in the Middle East).  They don’t know that I took an Islam class, read the Koran and that my best friend from medical school is a Muslim. They don’t know that in the end I love the diversity of the world and dress like a Kenyan, cover my head in Eastern Europe and am mildly horrified at how viral McDonalds is much less the rest of my culture.

And our conversation stops for a quiet reflective moment.

In the end, we conclude. It all comes down to pediatrics.

No really it does.

We want a better world for our children.  A safer world. A more peaceful world.  A world where our children are not hungry, are not sick, go to school and grow up free.

We smile.  We eat our snacks and rush back to the havoc of the wards in the winter.

If only we could put aside our fear, our pride, put down our guns and realize for a moment just how simple it really is.

It renewed my desire to be a global pediatrician, to be part of the solution.

Gratitude

One of the things about growing up with a progressive although manageable illness is it teaches you gratitude for the little things that make life truly beautiful.

Baking something yummy.

North Carolina Wine

Old Friends.

New Friends.

Summer Nights.

Clean clothes.

Good Books

Clean hair.

Pedicures

Grace

Children and their wisdom.

A Good Night’s Sleep

I can’t save his heart but I can save his soul

Former 25 wk premies

bad lungs.

bad gut.

bad heart.

on a ventilator.

cant eat.

…can’t fix the heart. (inoperable)

The heart will be the end of him.

I got a page asking for restraints.

I go and see him

He is waving his little arms and legs.

Looking at the world.

They tell me they are afraid of toys.

Because it might overstimulate him.

Overstimulate his fragile broken heart.

I find a rattle half buried under blankets.

His eyes light up and his hands reach out.

His heart rate is steady,

his breathing is smooth and unlaboured.

He smiles.

I say to heck with his heart.

which I can’t save.

No I won’t restrain him.

Play with him. I tell them.

I cannot save his heart.

But I can save his baby soul.

A soul that just wants to learn

and play

and love

and be.

Organic Free Lunch….or why I can’t be a pediatrician in the American suburbs

As I ponder the mysteries of being an American pediatrician again. I find myself struggling to relate to American Moms who come from my socioeconomic level….

1. Moms shell out for organic, soy, sensitive, Free range, IQ boosting formula but won’t breast feed their babies.  They shell out for organic, homemade, free range, rice based baby food…. But they won’t breast feed their babies And they are really snobby about their organic free range formula….  There is nothing more organic or natural than breastfeeding.

2. They shall out for your Baby Can Read products/Baby Enistein….turn off the TV and talk to your baby, read to your baby…..FOR THE LOVE….TURN OFF THE TV.

3. They yell at me for not prescribing antibiotics for their 24 hours of nasal congestion…..ITS A VIRUS. I can’t fix viruses and it will be gone next week Yet they wont let me vaccinate their child against h. flu which killed a un-vaccinated child in this CITY last year.  Nasal drops and Tylenol vs. watching your child seize in the PICU on a ventilator…..  ?!??!?!!?! NOT TO MENTION THAT WHOLE VACCINES CAUSE GREEN HAIR/AUTISM/GENERAL BADNESS is bad, bad science and there is a very expensive law suit in England as a result of it.

4. Moms who yell at our team (including the attending) when we cannot get their child butter pecan ice cream to their child in the hospital and threaten to leave AMA…NO JOKE.  We have Graters for crying out loud on the menu…. and Ice Cream vs. your child has cancer..??!?!?!

5. One of my colleagues spent an hour with her Private Practice preceptor last week consulting an irate family about the lack of success of acne treatment…being  a teen is rough don’t get me wrong, my baby sister struggled with acne but yelling does not make it better and I counter yet again…acne vs. nearly every other medical problem known to man…what would you pick?

6. I recently had a allied health professional make fun of an Amish patient and another make fun of a patient from the inner city….cultural sensitivity is not our strong suit…and still a colleague make fun of a visually impaired fellow We say we want diversity, we say we want tolerance but we like it better when THOSE people stay on their side of town (I dont know if the visually impaired fellow has a side of town…I guess its my side of town….).

7. We say we want women to be able to be mothers and work and do it all but its not acceptable for a women to pump at most places of work (although it is where i work ) and its often not culturally comfortable for a woman to breast feed outside of a cramped bathroom stall in public.  (yes I know two of the top 10 are about breastfeeding)

8. Then they is the other extreme….(and I am about to be called a heretic)…the stay home at mom who is snobby about being an organic, free range, non-vaccinating homeschooling stay at home, Sunday School teaching, Women’s Bible Study leading Mom who will condemn my single Moms/married but working two jobs in poverty sending their kids to day care and public school in the inner city for not staying home.  Where is your compassion that you preach about?  I love you and I grew and went to church camp with you but I can’t be your pediatrician.

9. The Moms who see one of us come into the room and say “No way, I don’t want a  resident, medical student, fellow, attending under the age of 35 touching my child.” Or my favorite: “They can practice on SOMEONE’s ELSE child.”  I understand Moms, believe me I do, I have had many clumsy orthopedic residents do a lot more than examine me over the years but in the end I also helped train a generation of pediatric/skeletal dysplasia doctors so that the next generation of my tribe gets better care.  This is why so many training hospitals/Resident clinic are in the inner city or the worst part of towns because we care for the indignant SOMEONE ELSE’s child so we can finally get enough gray hair to graduate and move out to where we can take care of your grandkids. No Medical Education = No well trained doctors.

10. Another colleague was recently at a church gathering where one of the other girls is pregnant and said: “I don’t think I can go to a pediatrician because they are so militant about things like vaccinations and breastfeeding….”  

yes I am militant but its only because its all about the babies and they are wroth fighting for…no matter where they live, what language they speak, where they go to school or how much free range, organic gruel they are fed.

…..off soapbox….

SOAPBOX

President Obama’s budget as it stands will substantially slash pediatric graduate medical education (PEDIATRIC RESIDENCIES) and funding for all of our nation’s childrens hospitals on Sept 30. The current plan would force many smaller pediatric training programs particularly the primary care based programs to have to close their doors to new residents. Larger programs would have cut their numbers and cut out benefits and educational funding for research and care for the underserved. It also cuts crucial funding to all childrens hospitals many of whom (like mine) give care to children who otherwise would have limited access to care. Ironically we desperately need more pediatricians in the US, particularly primary care doctors yet this plan would make it nearly impossible for us to expand our numbers and would in fact CUT THE numbers of pediatricians that graduate every year!

My patients don’t have a buck and they don’t have a vote, they can’t buy their own health insurance/health savings account/or even barter a chicken in exchange for their care. So no matter your opinion or political affiliation, stand up for your children and grandchildren (Not to mention all my people who always get the shaft any way (all the gimptastic, disabled kids who need health care so they can grow up and become politically incorrect pediatricians if they want)).They are the future voters, physicians, teachers, politicians and citizens of this country. They are also the patients whom if we don’t provide care for now will be the future citizens on disability, medicaid and welfare.

Please help me support children! Please help me by clicking on the link through the National Association of Childrens Hospitals and sending a letter through their program to your representative. (it will link you to the right people in your area through the link and it took me exactly 125 seconds) (or if you have more free time than me and feel inclined write your own letter). Make sure to note your local Children’s Hospital or a Hospital that has made a difference in your life or the life of your child or grandchildren!!!!!!!

HELP KIDS!

Love,

Amy

(just another American voter who just works 90 hours a week to takes care of other people’s babies who apparently are just not that important)