Reflecting.

The internship, I miss it. As I started my Child Health (Peds) class this semester, I realized just how much I'd learned over the summer. Even when, at the time, I complained that it was unfortunate that we as interns were limited in what we were allowed to do. Now, I saw just how much knowledge I've gained by doing what were seemingly trivial tasks over this summer.

Those urines I dip and how to get them out of diapers, keeping track of I&O's and the importance behind it, checking on IV's every hour and keeping track of those numbers, monitoring those vitals during conscious sedation, the little tricks you use with children to get them to cooperate with you, getting blood from those central lines. They all came rushing back to me, and when my instructors lecture or showing us things in the lab, they make an absolutely perfect sense. And once again, I am humbled to be where I was this summer.

The floor I interned at receives Hematology/Oncology patients, so a lot of the children that I've taken care of are frequent fliers or regular costumers, which means they stay on the unit for a long period of time and/or frequently return for treatment. As a result, the staff get to know them and their family pretty well and vice versa. There is not a day that has gone by since I ended my internship that I don't think about those "regular costumers".

How are they responding to their treatment? Have N & M lost their hair? Is P still scared when it's time to change his port-a-cath needle? Is G still refusing his meds? Has R finished her round of chemo? How are they and their family coping? Is Y home by now? I hope her count stays up. I hope C's bone marrow transplant goes well. I hope none of them relapses....

My heart breaks for them, for what they have to go through. I used to read their charts in the lounge, then I'd watch from the window in the corner, out to the green of Central Park across the street. A playground was there, swings, slides, monkey bars, you name it, and everyday I watched as kids filter through that playground throughout all hours of the morning and afternoon, wishing the kids I had on the unit could do the same. I'd take a long sigh and get back to work, saying a little prayer as I pass each room for them to get better a little sooner.

Yet in all of this, I've found great courage. Cliche to say that, but it couldn't be more true. For two days I watched as one family broke down as their 3 year old was diagnosed with Leukemia, but in the days afterward I watched them gathered every strength they had to pull through. They took in every ounce of information the doctors tell them--treatments, procedures, side effects, risks, prognosis, asked questions, and clang to every hope. They braved procedures that they have never heard before--lumbar puncture, bone marrow aspirate, port-a-cath insertion--and one they've heard but never thought would exist in their family--chemotherapy--being done on their tiny child. They held their child's hands and soothed their child through every vitals, labs, and meds with "It's okay, it's okay. It's gonna be okay." Sometimes, I even think they said those words to assure themselves too.

Those children, they're bravery and courage personified. As angry as they might have been, as scared as they might been, as rebellious as they might have been against all of these diseases, they manage. They just do. Somehow, along the way, they find a way to cope, to accept, to fight, and a reason to live. Every so often I'd come across charts so thick with health history, full of conditions so foreign to me, I had to google as I read those charts, and every so often afterward, I've found myself dumbfounded as to how they find the strength to go through all of that for years and years. My hat is off to them.

I really do miss those kids. Baby D, unaware of the how sick he really is, moving his head happily when you play his music toys as you take his vitals. Little N, the little tod, screaming bloody murder at everything and anything done to him, but once in a while when you're just checking on him throughout the day, he'd show you what game he's playing, he'd smile and you'd forget an hour ago he was kicking all four limbs as you and your nurse restrain him down for an oral med. R, in her early teen, as sweet as she can be, letting me draw my first central line blood from her even though she's very particular about her line. S, who came in for a sickle cell crisis, was quiet as a rock, but once she talked 50 mph with her 5 year old imagination, you knew she was no longer in pain and she was going home soon.

With this experience, I look forward to my Peds clinical this semester. I love working with children, they are a source of inspiration.