One evening during my first year of medical school, I was waiting by the entrance to The Salvation Army to let another student back into the free clinic. The weekly clinic was organized by MEDiC, an organization of student-run free clinics in the Madison area. A family with four small children was returning to spend the night at the shelter, and one of the kids saw the stethoscope around my neck.
“What’s that?” a boy who was about five years old asked.
“It’s so I can listen to hearts,” I explained.
Then they all wanted to know if I would listen to their hearts and if they could listen to mine. Spending that time with them, showing them how to listen to my heart, and making sure they all had a turn was the highlight of my day. I knew that I wanted to have interactions like that every day.
That wasn’t the first time I had considered pediatrics as a career. Even as a college undergraduate I knew I was interested in pediatrics. I worked as a research assistant at the University of Wisconsin Hospital in Madison within the department of pediatrics, observing and coding data from over 400 pediatric acute care visits. Even though most of the visits were children with upper respiratory infections, every child was different and presented a unique puzzle. Also a puzzle was how the doctors found the right way to communicate with each family. These challenges spurred my already-discovered interest in pediatrics that dates back to assisting in the infirmary at a summer camp when I was a teenager.
My experiences so far as a medical student have continued to reinforce my desire to become a pediatrician. They have also shown me definitively that I want to care for the whole child and build the long-term relationships that are possible in primary care.
While on rotations, such as neurology, psychiatry, and surgery, I found myself frustrated at focusing on only a particular organ system or problem and not on the child as a whole. I enjoyed my time with these children so much, however, that I found it hard to say goodbye. I still wonder how each of the patients is doing; it was hard leaving and not knowing what eventually happened with each child. Primary care will allow me to follow children over time and watch them grow and develop.
Throughout all of my rotations, and even after each rotation ends, I try to follow the children as much as I can. I especially enjoyed following a baby boy whom I met on my PICU rotation. He and his family were a delight to work with. His parents even instituted a policy that everyone who entered the room had to say something positive to their son before leaving. Two weeks after my PICU rotation ended, I stopped by to visit him. I was thrilled to see the progress he was making. His parents proudly showed me that he was no longer intubated, he no longer had IVs, and the only “wire” was his pulse oximeter – the finger clip that monitors the heart rate.
I also loved following the progress of a six-year-old girl with Guillain-Barre Syndrome – a disorder in which the immune system attacks the nervous system. It was inspiring to watch her begin breathing on her own and regaining her strength as she completed physical and occupational therapy. Even more fulfilling was how much I could tell she was improving over the week while we painted and played games together. A couple weeks after that rotation ended, I asked the physician who was taking care of her how she was doing, and he told me that she was ready to be discharged, so I stopped by to visit her. She excitedly showed off her increased strength and how she could propel a manual wheelchair. Before I returned to my clinical duties, we spent some time roaming the halls and reading one of her favorite books in the schoolroom.
I have learned so much from all of these children and their families. As a primary care physician, I look forward to really knowing my patients and coordinating their care with other providers or specialists when necessary. Each patient will have unique needs, and even for patients with the same medical problem, the care and management will not be the same. Following families over time and developing relationships with them will allow me to provide the best care and to help them improve and maintain their health.
Katie Gesbeck is a medical student who blogs at Primary Care Progress.