Medical Student Chronicles: Surviving Paeds

Paediatrics 1 was a ghetto of postings. And it wasn’t even about the people; they were mostly nice. I remember us discussing that they were just very principled, and as long as you did at least the minimum expected of you, you should be fine. But that minimum—Lord help you if the consultant ward round was on Monday and you “locked out” during the weekend. By the time you came back to your senses, it would be 9 a.m. on Monday, and the consultant would be asking, “Whose patient is this?”

Usually, the probability of being asked to present your patient was highest if your patient happened to be the first reviewed. That often depended on how much of a hurry the consultant was in. You could even risk answering “yes” to having clerked the patient and get away without being asked to present. But Lord help you if the consultant had enough time in the world. “Tell me about your patient.”

My story was a crazy one. Three of us were assigned a patient. Two of them decided to split the clerking presentation between themselves—one took the history and the other the examination—so I didn’t have to bother. I had already even prepared a solid backup plan though, gathered all the information, and written my own clerking just in case.

On our way from OTCHew (The Children's Emergency), the consultant sent one of us on an errand. Unfortunately, that was the person who did the clerking. We soon realized that the person who was supposed to handle the examination hadn’t even seen the patient. Damn.

On getting to the ward, the consultant asked the most terrifying question for any medical student: “Whose patient is this? Present!” The group representative couldn’t identify the patient, so we ruled out the others and assumed it must be ours. The main guy had been sent on the errand. The patient was supposed to be a girl, but her hair wasn’t plaited. She was also supposed to be born to Muslim parents, yet her mother wasn’t covering her hair. The one who was supposed to do the examination refused to take responsibility. The main was still not around yet either.

Then the consultant’s eyes fell on me.

I began reading out the biodata. I mumbled through the part where I was to state the gender. The other consultant, a very cool man by the way, egged me on with his eyes encouraging me to continue. By the time I got to the part where I had to mention the religion, I lost all remaining courage. What if the mother was asked if she was a Muslim and she said she wasn’t? (Which was true, as I later found out on returning to clerk. She was the second wife to the Muslim husband and wasn't a Muslim.)

I stopped my presentation. The consultant who had asked me to present looked at me.

“Yes, go on.”

In my mind, I screamed, I don’t have it in me anymore, ma!

She asked, “Did you clerk this patient?”

I said, “No, ma.”

She asked, “Why?”

And then I fell for it. I said one of the worst things a medical student could ever say: “I’m not the primary owner of the patient.”

At that moment, I knew I had messed up. The main guy had just returned from the errand. The consultant replied sarcastically, “Oh, I see.” Then she asked rhetorically along the lines of, “As a doctor, do you choose to take primary or secondary care of your patients?”

Game over, bro.

“Get out of my round!”

She still taught us that day though—a wonderful woman. Another person could have even refused to see me till the end of that unit.

So, it’s not really about the people. They’re wonderful and often go out of their way just to make us excellent doctors. There was just the responsibility of clerking one’s patient and have enough stuff to answer questions during rounds. (The situation of the country must have contributed to having fewer patients, making it unlikely to be assigned more than one patient) . Although clerking your patient also meant you had the opportunity to complete the required three in the booklet or push later to be able to present it.

Other requirements in the booklet included observing and carrying out procedures, from Random Blood Glucose checks to Lumbar Taps. I found Exchange Blood Transfusion the coolest of them all. There were also the eight ward calls required, which spanned from evening till midnight. Ideally, one call should be done each week, and at least one should be in each unit of the department. There were also two case write-ups, each submitted at the end of the four-week posting as well as other ward activities, lectures and tutorials.

To think that students now have it easier than before—fewer patients in the hospital and fewer registrars in the department—means they have more responsibility to carry out without the extra burden of medical students to supervise often preferring to release us earlier during calls.

Who do I know that didn’t fall ill during Paediatrics 1? Just try to stay hydrated during the posting, fam.

by Stranger Lee