Two places internists never want to be - Pediatric floors and Ob/Gyn.

BABY IN PERIL

Amy paged me at work on Saturday. It was about baby Ooseung-ee.

“She just projectile vomited on the floor, four times in a row,” she told me as I was driving home.

“How is she now?” I asked.

“She’s fine.”

“Just watch her. See how she does.”

"He who is his own lawyer has a fool for a client.” This saying is just as true for doctors. Whether it’s because of our schedules, or “doctor not patient” mentality, or perceived control of the Villains of Illness, we frequently minimize our own health (although I’ve met some docs who take meds like they were Viagara at the Playboy mansion too). For instance, if I had a patient with the same cholesterol and family cardiac history that I have, I’d probably put them on a cholesterol medication STAT. But no, not me. Deep down I honestly think I can “run it off” if I can just. run. enough. Plus, it’s not like I’m going to sue myself if I actually do have a heart attack (like you have to assume anyone else in this country would), so no worries! But enough about me.

My point is that, as a physician, you know what the limits of any given hospital or ER … are. A lot of medicine (especially ER and office medicine) is just hand-holding while things get better on their own.

As a medicine doc, I never want to be in the position where I go into the hospital for anything less than absolute necessity. So I elected to do at home what they would do at the hospital anyways. Watch and wait.

Baby Ooseung ate a little bit. Then an hour later she threw up a little bit. Maybe she’s queasy.

Then she went to sleep and threw up a little. Maybe she was rolling around too much.

Amy’s mom was visiting that day and said to Amy in Corean,

“[You don’t have to worry because you have a doctor in the house.]”

To which an irritated Amy replied back in Corean,

“[He’s not a BABY doctor.]”

To which an irritated me replied,

“I CAN UNDERSTAND WHAT YOU ARE SAYING!”

But she was right. I had guessed our baby just had a little viral illness, but it obviously wasn’t going away.

I called Dr. “Big Momma” Brown – the very maternal medico legally-savvy head of my hospitalist group – for some baby tips.

“Amy, when’s the last time you changed her diaper?” I shouted upstairs.

“Four hours ago, and it’s still dry now,” she said.

Dehydration. She’s just a baby. Shit.

I still look like a doctor, right?

As we called relatives, and dropped Sun Su off at her brother’s house (saw Kevin there too), it became more and more obvious to me how “dry” Ooseung-ee was.

There is an old Corean saying that says a slobbering baby is a healthy baby. This is because a slobbering baby is well-hydrated and has water to spare. Little Ooseung on the other hand was conserving all her water at this point.

She didn’t cry when Amy awoke her. She had no tears or energy to spare. In the car, with her winter hat on, her hair wasn’t sweaty like it usually was either. In the pediatric waiting room at St. Azrael (the hospital I work at now), she wasn’t slobbering like usual and her gums weren’t as shiny. And of course, she hadn’t urinated yet. Thankfully, she didn’t have a fever though – which would have burned off water like gasoline.

“Cluck! Cluck!” I tried to communicate with my baby girl by speaking in Clucking Tongues, our new secret language.

She eeked out a tiny “cluck” and put her head back on Amy’s worried shoulder and we waited for those giant holiest of ER doors to open and heal my baby girl perhaps where I had failed her.

Hate the sinner. Just help my baby.

“Ooseung-eeee … Cluck?”

“…”

Typical ER room. They should leave nudie magazines in here so you don't mind waiting.

In the ER room, the nurse completed our registration details.

NURSE (filling out forms): “Mommy, what do you do?”

AMY: “Nothing.”

NURSE: “…”

AMY: “I mean I’m a homemaker.”

NURSE: “That’s better. Hardest job in the world.”

AMY (exhausted): “Yeah.”

NURSE (turns toward me): “What do you do?”

ME: “I’m a physician – medicine. I work here.”

NURSE: “Ahh, so you are one of us.”

ME: “But I don’t know anything about pediatrics.”

NURSE: “What kind of insurance do you have?

ME: “Um… we don’t.”

Maybe she thought I was lying about being a doctor at that point. It’s kind of a long story but basically we had just cancelled our medical insurance with the Empire (the hospital I left) and were about to pick up a new one. Then we ended up here.

[Side note: Being uninsured doesn’t really affect medical treatment, at least in my experience with medical colleagues. On the other hand, if you spend ten hours taking care of people who don’t have medical insurance, chances are that will be ten hours you will never get paid for, since people who can’t afford insurance are frequently people who can’t afford medical bills.]

The pediatrician was a nice young smiley-faced woman. Light hair, light eyes. I suspected she was a peds (pronounced “peeds” as in “pediatrics”) resident. Emergency room attendings tend to look more glazed and burnt out. She also hung around longer (standing the whole time) than I think most attendings do – just sitting down practically adds four minutes to “perceived face time” in my experience.

Baby Ooseung cried horribly when the nurse taped a little urine bag on her. And even more so when she took a rectal temperature. Two last little pearls of tear drops fell from her otherwise dry eyes.

“That’s a good sign that she still has tears,” the peds doc said.

Baby Ooseung stared with wide dark eyes at the smiling doctor from across the room, ready to leap like a leopard at the slightest hint of danger. But then Ooseung must have remembered she just knew how to crawl and she began to whimper.

TO BE CONTINUED….
(Sorry. It’s been a long weekend and I have to work tomorrow. Baby sucking boobie pics in next entry I promise.)