Pediatrics and Community Medicine: 19 Days to Go
April 1, 1999
Sunday
Dear On-Line Journal of Internship Subscribers,
Hi everybody! Long time no write. Because there’s nothing much to write about 😀 and the server was down for a week sometime in the beginning of April. My last issue was 30 days ago and about the Pediatrics Emergency Room. Since then, I’ve gone through the last 2 weeks of Pediatrics in the outpatient department and the first 1 1/2 weeks of Community Medicine.
During the final days of Pedia (including my Pedia oral exams, which I passed, thank you) we were exposed to out-patient specialty care (e.g., Pediatric Neurology, Endocrinology, Cardiology, etc.). Duty nights were spent at either the Nursery, Wards or Pediatric Intensive Care Unit (PICU). From previous journal issues, you know what the wards and the nursery rotations are like. As for the PICU, it really lives up to its “Intensive Care Unit” moniker. Most patients here are intubated and on mechanical ventilators.
I guess the most interesting patients are (1) 1-month old Siamese twins and (2) a baby with tetanus neonatorum (neonatal tetanus). The Siamese twins were joined at the chest area, and have separate hearts (but joined pericardial sacs, which is the fluid-filled bag around the heart), one liver, and 3 kidneys. They’re for surgery after all the evaluation is done like the CT scans, etc. One twin is intubated and the other can breathe normally. The other interesting patient is a baby with neonatal tetanus, which she got because non-sterile scissors were used for cutting the umbilical cord. Infection spread from the cord to the whole body, which is why she goes into muscle spasms (adult form of tetanus also makes muscles go into spasms, particularly the jaw muscles, hence the term “lockjaw”). The baby has eye shields, ear plugs and is placed in a dark room to minimize any stimulation which can make her go into more spasms. Everyone has to be gentle with that infant.
Pediatrics ended April 1, 1999 – otherwise known as April Fool’s Day or Maundy Thursday. It could have also been called the first day of summer, as all the other undergrad medical students started their summer vacations on this date (their last day was March 31). Would have been insignificant to us interns save tor the fact that manpower was glaringly low…. There were 2 of us interns manning a whole ward (50 kids). Previously a ward would have 2 interns, 1 clerk and about 3-4 3rd year students called integrated clinical clerks or ICCs); since everyone but the interns were on vacation already, we were running around most of the day and night. I say day and night because duty started at 12 noon instead of the usual 5 PM, for April 1 was a holiday; therefore, everyone was off at 12 noon instead of 5 PM. Since it was also Maundy Thursday, I guess this is what you would also call my penitensya [penitence, sacrifice] for Lent 😀
Freedom began at on Good Friday. Community Medicine would not start until Tuesday, which is when we leave for Batangas province. The good thing about ComMed is chat you eat regularly, you sleep regularly and holidays are holidays. The bad thing about it is you’re not at home, and interns are required to submit a research project. As ComMed is my last rotation, I am practically done with internship (at least the hospital work) and just awaiting the April 30 end-of-internship bonfire. That would be a double celebration for me. I am also proud to say that I’ve never been on duty on my birthday for the whole duration of med school 😀
Special note: Although our community rotation requires us to leave on Tuesdays and pome back to Manila on Saturdays, my weekly stays in Batangas are cut short because of school functions. For instance, on the third week of April we leave on a Wednesday instead of a Tuesday, because we are supposed to go to the U.P. Manila Graduation Tuesday, April 20. This is different from the May 16 College of Medicine Graduation, which happens after internship is done.
This may be the penultimate issue of the Journal, as the last one will be published around the first week of May, once my final exams are done. Thank you for your subscription.
JOINT is the Journal of INTernship, a series of email messages to family and friends (“journal subscribers”) written during my yearlong medical internship from May 1, 1998 to April 30, 1999. Internship is one of the requirements before taking the Philippine Physician Licensure Examination (also known as the Medical Boards). Journal entries were edited for clarity in January, 2020. Read more about it in the first blog post, Introducing JOINT.
