Week 3: Fai

In the first two weeks I followed Dr. Schumann and Dr. Frayer to round in NICU (Neonatal Intensive Care Unit). In this week I got an opportunity to observe a new unit -PICU (Pediatric Intensive Care Unit). I shadowed Dr. Howell’s and Dr. Pon’s team which included one doctor, two residents, and one or two fellows (no nurses and no nutritionist who are usually included in NICU team). The overall process of rounding is the same as that in NICU-the team visits each patient, the residents and fellows report patient’s previous record and then the team discuss and decide about future plan for the patient. It seems that in both units mechanical ventilators and patient monitoring systems are imperative for every patient. However there are several aspects that PICU is different from NICU. PICU deals with the medical care of infants, children, and teenagers so patients’ record is very long and full of diversity. In one case, a three year old boy fell from the third floor of an apartment. Besides knowing the cause of illness and symptoms in order to provide appropriated health care, doctors have to concern other information, for example, is there any witness or not?, who is the owner of the building?, where are the parents?- to make sure that it is not because of neglecting from the parents, etc. If the doctors feel something wrong, they have to immediately report to the relevant authorities.

In this unit I also witnessed one very heart wrenching situation. On Friday morning I shadowed Dr. Pon to round and visit a 15 year old boy who suffered from respiratory arrest for months. His health has regressed everyday and most of his brain has already been damaged. It made Dr. Pon decide to talk with his mom who usually came to visit him every other day. As expected, she came that day. Dr. Pon spent a lot time explained all the reasons to should not resuscitate the patient. Despite knowing the situation very well, it was still hard for her to admit. The whole room had any other sound except her incessant cry. It took her for a while to decide to sign “Do not resuscitate (DNR)” consent form and to become calmed. Then Dr. Pon, one resident and I left the room but one psychologist was still there to talk and to soothe her more. After leaving the room, I sat by myself. I had several feeling at the same time. It is hard to explain if one is not in the real situation. I made me realize that “it is the way of life”.