Tuesday, February 13, 2007

Pediatric Check-Up:Passing Disease

One big issues with having a centralized institution for the care of the sick is that there are naturally a lot of sick people there. Furthermore, they're sick with different things. In pediatrics, this translates to clinics and floors full of infectious diseases that can be passed from patient to patient, from patient to staff, and vice versa.

On a systems level, that means that everyone is generally treated with "standard precautions", which include hand-washing before and after every patient contact, and not eating in areas where we care for patients. That second part is generally why I am usually dehydrated. For unlucky hospitalized patients, there are also "contact" and "droplet" precautions. The first is for those patients who have an infectious but not respiratory illness, in general. The second is for everyone who has a cold. There's even further levels of precautions for people who might have tuberculosis or pertussis, but fortunately we don't see more than a few cases of possible pertussis patients in a month. Precautions are for everyone's safety, however they do have an emotional impact on our "chronic" patients: those children with chronic diseases who are hospitalized often, and for long periods of time. These patients are often left in the hospital by their families. The staff of the inpatient unit is often like a second family to them, but when they are placed on any protocol above standard precautions, they are usually isolated in their rooms alone other than the two to five hours that their nurse or the Child Life workers can spend with them. Spend some time listening to a three-year-old sobbing "mommy daddy gone" when you haven't the time to spend comforting her, and you'll know why hospital staff hate taking certain precautions even though we know why we have to.

On a personal level, this being my first winter in pediatrics also means that on top of my resolving lack of sleep, I've also been flat on my back with rather violent viruses, one of which has recently migrated to my eyes, giving me the all-to-gruesome "pink-eye". It's really hard to drive when your eyes are full of gunk, I've noticed. However, I am making a come-back, and next week is the three-day Intern Retreat in Taos, New Mexico. It's a rural town famous for artists (and some art), an aggressively organic lifestyle, a world-class ski resort, and yes, there really is art there. I'm looking forward to it, and my second vacation of the year starts after it!