A last-day-of-pediatrics-clerkship thread.

#BuckleUp #MedTwitter #MedStudenTtwitter #Pediatrics

When my sister was 3 years old, my mom brought her to her general pediatrician for a regular well check.
She was a healthy appearing, curious and impassioned 3 year old. I wasn’t there but I imagine her pediatrician had to use the kind of magic only pediatricians have to get her to sit still for the visit.
I imagine that maybe he and my mom chatted casually about life’s happenings as he proceeded with the physical exam. I imagine that the exam was made challenging by my sister who was probably squirreling around, excited about the lollipop or sticker that awaited.
Until, very quickly, things turned from casual to concerning.

Until, in the midst of his usual routine, he palpated a softball-sized mass in my sister’s tiny 3yr old sized abdomen.

In that moment, the routine was no longer.
There were no other signs. No pain, systemic symptoms, eye exam abnormalities, hypertension. Nothing. But the mass in the abdomen of this otherwise healthy appearing young girl was undeniable.

My family would later find out that it was Neuroblastoma.
After getting a CT that day, she was immediately transferred and scheduled for resection @mghfc.

I’ll skip ahead to say that luckily, her story’s ending is a happy one. She has since run 5 Boston Marathons in support of MGH’s Fighting Kids Cancer team.
Not all patients are as lucky as she was.

Or maybe, it wasn’t luck, per se. Maybe it was because her pediatrician & all her other providers weren’t stuck in heuristic thought patterns. That they were present & tuned-in enough to recognize the gravity of the situation.
Maybe it was b/c instead of becoming complacent with the details of his physical exam, her pediatrician approached every patient with the curiosity & thoroughness they deserve. No matter how healthy they looked on the outside.

Details matter. And so does our attention to them.
I’m grateful to have worked with preceptors during my #pediatrics clerkship who agree. Who encouraged active participation & weren’t bothered by clinic being slowed down a bit.

Instead, they celebrated thoroughness and voiced appreciation for taking time with patients.
My hope is that as students, we never stop being thorough and careful. That we never lose the curiosity and intrigue we currently have.

That even when this work becomes routine, we never just go through the motions.
My hope is that all providers recognize that what may seem commonplace to us could quite literally be the difference between a patient seeing their next birthday or not.

I know it was for my sister.

Thanks for coming to my #tedtalk.

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