First of all, good news from the homefront. My sister was just accepted to an excellent New York City medical school! She was already set to attend another med school, but had been holding out for her first choice, where she was waitlisted. I'm glad she held out. She's psyched to start this fall, and despite the fact that I would never, ever want to go back in time to the first two years of medical school, we are psyched for her. (I don't really want to give the name of the school, obviously, but let's just say she may be bumping into our friends from "Push Fluids" in ye olde hospital cafeteria.)
Today was my first clinic day as a second-year. Interns only have half-day clinic once a week, but once you hit the big-time, your clinic is upgraded to a full day. Depending on how you feel about clinic, you could view this as either a perk or a pain in the ass, but at least it's something different than being in the hospital.
I had a little visit in the afternoon with one of my overweight patients. Let me clarify first that almost all of my clinic patients are technically overweight, to the point where I kind of stop noticing, and start thinking that normal kids are malnourished. After working in inner city Pediatrics, my whole perception is skewed. But anyway, even by my inflated standards, this kid was overweight. Like, six years old, 85 pounds kind of overweight. So during the visit we were talking about the usual things--cutting out all juices and sodas, portion size, snacking habits, what have you, and I asked the kid about fast food.
MICHELLE
How often do you eat fast food? Like McDonald's or Wendy's?
KID
I don't eat Wendy's!
MICHELLE
OK, McDonald's, then.
KID
I don't eat Wendy's!
MOM
(Dominican accent)
Fass food? He dun et fass food. Neber.
KID
One time a week!
MOM
OK, so maybe one time a week. Perro no too much.
[Note: As soon as they're old enough to talk, ask the kids what they eat. Parents will try to make a good impression at the doctor's office, but kids will always give you the real dirt.]
MICHELLE
OK. Well, still, that's better than last time. Last time you were eating at McDonald's four times a week.
KID
Yeah! McDonald's!
MICHELLE
(Noticing little plastic thing on the kid's belt)
What's that thing?
MOM
Oh, thass wha dey give ah McDonald's when you order the ensalada. Ess por exercise.
MICHELLE
Oh, the pedometer! Great! And I'm glad to hear that you're ordering the salads. Show me how it works.
KID
It's a toy! Look! (Shakes the pedometer) When you shake it, the numbers go up!
MICHELLE
Right. Actually, that's supposed to be counting how many steps you're taking. Like when you're walking on the street, or jogging, or running. It counts how much exercise you're doing.
KID
(Maniacally shaking the pedometer up and down to increase the step count)
MICHELLE
Right...
MOM
Es por walking, perro he can' walk now.
MICHELLE
Why can't he walk?
MOM
He have rash on his legs here (gesturing to inner thighs). So when he walk, it hurt him.
MICHELLE
Wait, let's take a look at that.
Turns out the kid has a contact dermatitis from where his thighs are rubbing together. Which makes him exercise less. Which makes his thighs bigger and rub together more. Sometimes working with kids is like building a sand castle. You get one wall built up real good and a tower on the other side crumbles.
I gave him a script for a topical steroid and told him to try swimming for now.
Currently reading: The New York Times review for "Before Sunset." I feel cheesy saying this, but I really want to see this movie.
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