Peds

My first couple weeks in peds were spent doing next to nothing. In the morning I would follow the doctors around while they did there rounds, feel some hepatosplenomegaly, hold children down while the doctor tried to insert an IV or do an LP, and a lot of observing (which was only helpful when they decided to speak English instead of Twi. Once rounds were finished, I’d spend the rest of my day at the Peds OPD (the pediatric clinic) for more observing, and perhaps looking in a couple of ears (as it is my otoscope to begin with lol). However, since last Thursday, Dr. Boakye has decided to give me more responsibility, probably more than I should be given at my stage of training. I am now given my own patients (but only the ones whose parents can speak English), order my own tests, and write my own prescriptions (well sort of, he still has to sign the sheets, although he never questions anything that I order or prescribe).
Although it is exciting on my part that I actually get to do things now, I know if I was the patient, I wouldn’t want me as my doctor. Sure, cardio, resp and ENT does help when treating patients, but it would be helpful to know about a few other things as well (like say the brain, muscle, bones, kidney and skin). As well, little things like not being familiar with what drugs are available here, or many of the significant diseases here (like malaria, typhoid fever, and meningitis) makes things a little challenging. However, I guess I can always fall back on the fact that any child here presenting with a fever is 98% likely to be diagnosed with malaria (snake bite is to PR, as malaria is to Ghana).

With that being said, it is interesting to see how differences between Dr. Boakye and I in how we were taught have lead to different approaches to the pediatric patient population. From block II, I still remember that when dealing with kids, the key to a pleasant visit is stickers and bubbles. I have found this technique very useful since getting my own patients (although I have yet had the need to bring out the bubbles) as my fair share of screamers do come through the clinic. This is completely understandable, as not only are many young children scared of the doctor, but some of the kids I have treated have never even seen a white person before, and will start to cry with one look at me. However, once I give them a sticker, it seems as though all of their reservations disappear. I try to not give my stickers out right at the beginning though (except for those that are terrified at the very sight of me) preferring to leave it until they’re not too pleased with a particular part of the examination (some it’s listen to their chest, others looking in the ears). I always leave looking at the back of the throat ‘til last though, as that is rather unpleasant for many, however, if the kid’s a real screamer, sometimes to can forgo this part, as I can sneak a peak whilst they are wailing away. I don’t know how well stickers will work back in Canada, as back home stickers are very common, while here, many of the children have never even seen a sticker before. Dr. Boakye, while he works well with the kids, does not stoop to bribery like I do, and thus has to deal with many more screaming children.