Drinking the Kool Aide or atleast sampling it.

A group of churches including mine have come together here in Winston and started a free clinic. Its held at my church once a month. Today was the first day I have able been to go in a while.  This was the week in NC where all kindergartners who had not previously filled out their physical forms got a letter saying they would be kicked out of school if they did not get a physical and vaccinations. The clinic was a mess.  I was hurried to a room given a file and told to just do whatever needed to be done, the doctor would check behind me.  Honestly if we had a first year medical student I think they would told them the same, we were desperate. So I threw myself into exam after exam of  5 yr olds who ranged from terrified to crawling up the walls.

About half way through the morning, a family with two kids, 4 and 6 came in. The Mom hands me a giant pack of papers, her daughter has just started kindergarten and has already been suspended for hitting the teacher. I take a good development history and undercover she had a global speech delay at 3 (as in not talking at all) and has only seen a doctor once or twice in her life. The parents can’t afford insurance because they both work they don’t qualify for Medicaid. The little girl is running around the room in circles one second or in her Dad’s lap messing with his face the next.  She doesn’t seem to understand my questions or instructions, she fails her development exam across the board, its obvious she has a global delay. Her Mom thinks its ADHD, I know that its far more than that. This is a free clinic. We give vaccinations, we do acute care, we even monitor BP and Diabetes a little bit but we can’t help this little girl. She needs a developmental pediatrician referral and is going to have a long medical journey one that we are already at least 3 years behind on. The window for early intervention is gone.

Its maddening. These people aren’t unemployed, they love their kids, they most likely are not criminals or dealing drugs, they are part of the PTA, they go to church and they don’t live in some god forsaken corner of the world, they live in America.  Yet they can’t afford health insurance and they don’t qualify for assistence.  So who suffers because of this? This little girl does, so does her family but don’t think it stops there.  Her teachers suffer having to deal with her behaviors and society suffers because we get to pay for it if she ends up in trouble legally or ends up on assistance later because she drops out of school or can’t stay employed.

For all the resources we have in this country, are not our children among our most valuable? Are  they not the ones who will run this country in 25 years?

In the mist of  Sarah Palin action figures and all this talk about hope and change…I sit in muggy NC  with tears of fustration in my eyes because from my point of view my country cares more about the value of a barrerl of oil than the life of a child.

life yeah.

I keep writing blog drafts and then not publishing them because well they stink. Life is sweet right now though. I am on pediatrics and loving it. I could have stayed in newborn nursery forever. It is impossible to be unhappy when you are surrounded by tiny brand new perfect little creatures.  It is amazing to watch them grow and change and develop into little people. So  yeah I have found my calling for sure and for some reason I have no profond things to write about.  Give me a week or two perhaps I will have less writer’s block.

Beyond that, its nearly Fall which is my favorite time of year. I am i the mist of being in charge of a church mission trip to Romania which is cool to be sharing my passion for empowering street children and orphans with my faith community but scary because I am sort in charge of 20 Americans in the developing world. I am sure there will be some good stories.

as always I have lots of studying I should be doing, so I cam going to get on that.

when my worlds collide questions emerge

How important is it to be 5′3???  I of all people should have an answer. I am sort of walking medical mystery. A dwarf in terms of genetics who never fell off the growth curve. My family with its hybrid of medicine and religion has its theories, as do the physicians.  I grew up being told I would be some where around 4 and half feet. Being little was not a scary concept for me, I had friends who were little. I realize as always my bias.

Today I met someone who has another genetic variation far more common than mine, she has one X chromosome (Turner’s Syndrome for the medically inclined). She is of short stature and is now on growth hormone shots once a day. She hates them. (she is quite young) and they might not even work. In the back of my mind, the part that has existed before the medical school brainwashing, I said why are we doing this???  What is so terrible about being little? I mean it has its social challenges but medically there is not much we are fixing.  Dont get me wrong the social challenges are REAL, I consul teens with the SED/KNIEST group about it. But the same voice in my mind shouted some of the social challenges are societal…classic medical model thinking.  It wasn’t so much that I disagreed with the decision as it was I disagreed with the absoluteness of it. Growth Hormone is what you do for THIS.  THIS is obviously a disease, a medical problem.   A medical problem according to whom?  Turner’s itself has some other complications that I would classify as PROBLEMS but short stature I think of as variation. Injections of growth hormone every day is not entirely a benign procedure physically, risk wise and psychologically. Is it worth it?

Would I have taken it if I had the choice? The answer is probaly not but it was because I was brainwashed to believe that height was not important.  Its all about perspective.

What if the biggest enemy in the exam room is not the so called disease but our perception of it?

yeah we all see why medical school is problematic for me at times.

not dead…

I wish I had profond and exciting tales to tell but I dont really. I finished OB and did well on my final and then did two short of longish weeks of Radiology and then Anesthesia. Lots of sitting in the dark and lots of watching people sleep and freaking out with the slightest twitch of the vitals. I then wen to vacation for two glorious weeks. I went to the Bahamas with my family in which I read, swam, read, slept, swam, read, watched the Olympics and snorkeled. The second week I went to DC to hang out with my Dad, to Richmond to see my adorable niece-son (niece plus cousin, its complicated) and then to Roanoke to do laundry and eat food.

NOW I AM BACK AND TODAY WAS MY FIRST DAY ON PEDIATRICS AND IT WAS AMAZING. And today was orientation, I oddly became one of those annoying kids who like knew the answers to the questions and stuff. It was a new experience. More importantly I sat through 3 hours of lecture and wasn’t bored, shocking. Best of all my community pediatric health rotation (first month) is simply spectacular: a week of genetics, a week of newborn nursery, a week of general peds and a whole week of nothing but special needs kids: NICU follow up, two mornings in a special ed classroom and a day of homecare and then some other related clinics!!!!!

if only all of med school could be so fun.

Wal-Bride…

I went to David’s Bridal today for the first time. I was to be fitted for my first real bridemaid’s dress. I walked in and found myself in a huge room filled with rows and rows and rows of dresses. I shivered in the air conditioning. One side was for bridemaids and the other side for brides. It was an overwhelming swarm of purples, blues, greens, blues, oranges and pinks in contrast to egg shells, cream and white. I was absolutely overwhelmed by the selection and by the sheer majesty of a sacrament/rite of passage/etc supersized and Americanized! stood there for a minute and waited to be directed to the blue light special on aisle 8. It took me 10 minutes to wade through the forest of dresses to find someone who worked there. I told her I needed to be fitted for a dress. She found the bride’s name in the computer and pulled a dress from the forest of a different shade but the same model as my dress. I tried not to think about the 1700 other size 6-8 girls who had worn this generic 100+ dollars worth of satin to be fitted. It reminded me distinctly of buying a car, I was test driving and then sending away for the right color. I was led to a changing room. It fit although it will need to be hemmed. I looked at myself in the giant mirrors up on a stool they use for altering and felt overdone, on display and well ridiculous . Is this beauty? Is this what I am supposed to want? Is this what every little girl dreams of? Walking into a store like this, pulling the magical white dress from the plastic hanger and then standing up here for everyone to see how beautiful she is?  This is one of the ultimate displays of love between two people?

10 minutes later and 150 dollars later I have a brown satin dress on order.

Where is the sacred in this strange form of marriage? In all the money we spend? In the party we throw? In the gifts we receive? There is celebration and love of course but where is mystery, the divine in all the fluff. What am I really doing…Am I assisting my friend by standing with her, affirming her commitment, her love? That I think I can do, the rest of it well I dont quite understand. I know very little of these things of love, of romance, of glamor, of marriage . But the glimpses of what I see I find disappointing.

I love my friend and I will do my best for her.

and so I enter into to this strange cultural ritual.