Intern Year

Where did the year go? Intern year is done in a couple weeks. Yay! Yikes! Two more years left of Pediatric Residency! The other day someone asked me if I like kids more or less since starting residency. The answer is a resounding MORE! Kids are awesome. Babies are the best. Adolescents...(nevermind, I don't want to get into that). It has definitely been a blessing taking care of sick and healthy babies and kids throughout the year. Med school taught me a lot about the reality of life. Intern year puts you in the front lines of that reality. You learn to not take things for granted. That stuff happens. That bad stuff can happen. That you can't control that. That sometimes nothing you do as a parent or a doctor will change much. That there are lots of things we can prevent, but sometimes I personally will not change a situation. Some of my favorite moments:

- Talking to an 8 year old girl and her mom in acute care after this girl was sexually molested by a good family friend. I talked to her about strong women in the Bible that had gone through terrible things, talked to her about her journaling to God and listened to her mom's concerns.

- Taking a 1.5 year old boy waiting for a liver and small intestine transplant to the helicopter pad to be transferred to another hospital where he would be put on the transplant list. The housekeepers said their good-byes to him. The security guard said, "You know you're kinda cute!" even with his bright yellow jaundiced skin and yellow eyes.

- Getting my first champagne tap (nice, clean lumbar puncture) on a 2 week old who came to the ED with a fever. Phew. Proud moment.

- Holding one of my NICU babies with classic congenital CMV (blueberry muffin rash, hepatosplenomegaly, thrombocytopenia, neonatal teeth) and soothing her to sleep. I was always so upset when her parents came because then I couldn't hold her. :-P

- Treating a patient for typhoid fever. Another for malaria. In Baltimore. And every type of rare genetic disorder I never knew existed. And 5 STDs in one patient including Syphilis, which I thought just didn't exist anymore....

Basically, being a pediatrician is awesome. Yes, sometimes I don't get to sleep as often as others or go to every single social event but when I put it all in perspective, I still have an awesome job. I often wonder what kind of baby and child Christ was. When I hold a "normal" baby, it is such a great feeling. What then did Simeon feel as he held the Savior of the world, his Creator?!

2012: Year in Review

Looking back on 2012 is bittersweet. We experienced a couple range of emotions over the last year. Here are some memories, times, that we will never forget:

- Match Day brought our answer to the question everyone was asking us: where will you live?? It has been wonderful to live in a completely new city, make new friends and really establish ourselves as a married couple.

- Our wedding in April. The best day, surrounded with our families and friends. The love we felt that day was overwhelming and we continue to flourish from it, growing more and more in love every day.

- Intern year started in July. It's been a learning curve. It's been a challenge, sometimes rewarding, and usually fun because of my co-interns and senior residents.

- October came with a heartbreak. We lost our father, suddenly. The numbness that comes with the finality one is faced with evolved into transient moments of realization of loss and grief over the next months. We still love him, care for him deeply, remember him daily and try to support his beloved wife.

- November was exciting as a Coptic person when we witnessed the selection of the 118th Coptic Orthodox Patriarch (and the reelection of Barack Obama---had to put that for my husband).

In 2013, we look forward to what God has in store for us. By God's grace, we'll celebrate a big graduation --the kind with the doctoral robes-- this May, a new career, and whatever else God is planning for us; his plans are greater than ours.

FOB unaware

I recently went to a delivery where the mother was HIV positive. We were told by 4 nurses on the way that the father of the baby (the FOB, as we say), was unaware of the mom's HIV status so to make sure we're discreet about it when we go in. Man. I stood there at the warmer, waiting for the baby to be delivered and saw the FOB holding the mom's knees, encouraging her to "push" and overall, looking quite excited for the upcoming event. I felt bad for him. And I felt bad for her. Living a daily lie. Hiding the truth. Probably scared about the consequences of telling him about her HIV diagnosis. Nervous about coming up with an explanation of this daily medication that the baby will have to take for at least 6 weeks. And him being clueless. And of course, I think of the risk he is in (they are not using condoms obviously) for contracting HIV. For spreading it to others (unfortunate reality in a population that hasn't stressed sex for monogamous married people only). Man. That sucks. (That is the depth of my eloquence at 3:30 am during a night shift speaking).

What's Residency Like?

I've gotten this question often and I usually find it appropriate to only say, "it's good." How else can I answer this question without giving "too much information"? I've only been an intern for two months and yet I've already seen and dealt with stuff that....I wasn't expecting. Here are what my real answers would be if I were honest and open...

"What's Residency Like?"

Sad. I almost cried watching a mom weep during a rapid response when her son who has Down's syndrome was vomiting blood after getting his tonsils removed. I was overwhelmed watching the love of his mother, mourning what her son was going through and probably what he'd already been through...in a way, I felt she was like St. Mary looking on to her son, Christ, on the cross, and feeling helpless. Further, I felt sad that I didn't have it in me to comfort her and tell her he would be okay and that this happens sometimes as a complication of surgery. Why not? I was afraid I'd cry in front of her if I stayed around. Instead, I was annoyed that the chaplain didn't come to the rapid response...it's their job to be at these codes to deal with the parents...

"What's Residency Like?"

Gratifying. I take care of lots of kids each day, most of them very sick, some of them not that sick. The majority are essentially back to their normal, happy, playful selves by the time I discharge them. I've even hugged a couple before them leaving. It's also gratifying to have a parents' trust and confidence in you, after all their child is the most precious thing to them.

"What's Residency Like?"

Exciting. I've taken care of kids with lots of different things and babies & kids respond to illnesses in interesting ways. Typhoid fever. Asthma. Diabetes ketoacidosis. Rare immunodeficiency syndromes. Bladder Extrophy. Meningitis. Herpes. Abnormal labs. And sometimes just a baby that doesn't want to eat.

"What's residency like?"

Frustrating. I can't stand some of the parents I meet. It's hard to not judge them with their facial tattoos or not wanting us to examine their meningitic kid because its 8 am. Or what about the parents that essentially are the reason their kid has an asthma exacerbation but aren't there in the hospital with them when they can't breathe? Or the parent who brings in a baby that is found to have fractures all over --child abuse? Or seeing the 16 year old neurologically devastated, ventilator-dependent kid who is that way because of abuse when he was a baby? And then on the flip side...I see saintly parents. Those who adopt kids that have no future. The mom that drives 2 hours each day to see her child in the hospital. The first time mom that is actually breastfeeding, even though its a hard job, because she knows its the best she can do for her child. The parents that will fly from overseas because they want to give their kids the best chance of a successful outcome.

"What's residency like?"

Humbling. I walk into the room of the child that is neurologically devestated...they can't talk, they don't feel much (we think), they can't interact with anyone to a meaningful degree, and I just have a hard time...are they even really alive alive? What does being alive mean? Alive? Living? I don't know the meaning of life with these kids. I am heart-broken for them. I wish they weren't here. Here where? The hospital? The world? I wish they would just die. But I can't say that. All life is valuable. Right? What do they think? Do they think? Do they want to die? What do they want? And then I think about how does God see them. I really wonder about that. "You are fearfully and wonderfully made." Even them, Lord? I don't know the answers to any of these questions but each time, I try to touch them as Christ would touch them. Respect them. Love them. Care for them. As humans and not just as bodies.

That's kind of what residency is like.

Little Victories

This past weekend, hubby and I were fortunate enough to have our priest and his family come to our house. We had been waiting for this day so that our house could be blessed. I was anxious about the visit. Not because Abouna was coming over...but that he had two kids...and kids are picky eaters. And we are in the middle of a fast so the grown-ups are eating fish and fish is a sensitive subject for many kids. (One of our relatives tells her kids they are having sea bass-chicken or salmon-chicken..."just add chicken at the end and they forget they're eating fish!"...such a smart mom). Anyways, I decided to make chicken tenders for them and they could eat pasta with pesto and salad like the adults if they wished. Well, Abouna's son made my day. "Best pasta ever!!" said the quiet kid with a huge smile on his face. Later when his mom and I were cleaning up after the late lunch, he asked her if she had gotten the recipe from me!! Small but big victory for me. I am starting to realize the pride that Egyptian women have when kids like their food. Even if it required to culinary skill on my part--you can't get easier than pasta with pesto!! :) :)

Must Read

When I was first given this book, I had no idea how amazing it would be. Father Arseny truly is a modern-day saint and to read a couple chapters each day was like entering a paradise. It only because of God's glory, that he was able to not just touch, but transform people's lives: atheists, criminals, lonely people, the hungry, the ill-stricken. His relationship with the saints, especially the Theotokos was striking. He reminded me of a nun I had spent some time with before in Upper Egypt who ran an orphanage. She always emphasized that St. Mary was the mother of the girls and Christ was their father. And the Two of them provided for the girls and the orphanage. The book told many stories of people who were in the hardest situations interceding to St. Mary: a girl who was about to be raped, a girl who was being followed by the Secret Police, a husband who was praying before St. Mary's icon for his unfaithful wife. Unreal stories. Humanity that is rare but as this book teaches us, not as rare as we think. St. George protecting the girls from soldiers who wanted to rape them on the top of a train to Moscow. Everyone should read this book. Whether you are Orthodox or not, and I daresay Christian or not. Read this book and allow Christ to show you his love for everyone and for you.

Understanding Confusion

"My people are destroyed for lack of knowledge." Hosea 4:6

Last night, we attended bible study. It was our first time at this particular Coptic Church but we learned so much in the short 2 hour period. Fortunately for us, the priest held a PhD in Theology so it literally felt like we were in an upper level course studying Genesis 9-11. I wanted to just reflect on one topic: confusion. Genesis 11 has the passage about the Tower of Babel. Babel means confusion and symbolizes the world's evil. I won't get into the biblical theology and history of this passage but what stuck to me was that confusion is a characteristic of those living in the world. If I am confused, I am definitely tainted by the world, instead of being

"unspotted from the world." (James 1:27)

I am afraid that many of us in this generation, me foremost, are like those in Babel: confused. We are confused about who God is, the importance of the Church, what is actually important in life, and what living as a Christian really looks like. Why? Because we're listening to the world through all its insidious ways including who we spend time with (and oh-so-softly adopting their beliefs and philosophies), stuff we read online carelessly without examining it and the lies we are fed hourly through the tv, radio, internet. If we do find that we are confused, let us run back to God:

"For God is not the author of confusion but of peace." (1 Corinth 14:33)