NFR

Another interesting day at work.

Started with an ED nurse saying "If I wasn't married I'd marry you... actually if you'll pay for my divorce I'll marry you.. you're my type!" She's from the Shire, and makes jokes about white supremists... not my type! (although she is threatening to wear a white pointy hat to the hospital's 'multi-cultural-dress-up-day' and I don't think its do do with Harry Potter)

Then my registrar handed over the patients on the ward and ended with; "Oh by the way there's a baby due to be born overnight I should tell you about. It's got Trisomy 18 which means its not really compatible with life. We don't expect it to survive very long so when you get called to go to the birth you're not to give any active intervention" (ie you get to sit and watch the baby die if it's not coping) We had spoken to the parents. They were in agreement. The 1 year survival of babies with this disease is 5% and those that do survive have very very poor quality of life with huge disabilities. But that said, it was kinda discomforting to be told to go to the birth, but not to do anything beyond a bit of passive oxygen. No intubation, no IV fluids. Just let nature take it's course. The only reason I would be going to attend the delivery as a paediatric doctor would be to watch. I honestly dunno how I feel about that. It goes against everything I entered medicine for. To be out of control and have no options left at the start of life is awful.

Thankfully the baby didn't come during my shift, but it was a busy night anyway. A nearby hospital was overcrowded and so started shipping kids to my ward. Only problem being that we had no spare beds ourselves and so I was left with 6 kids on 4 beds (don't ask me how that works, I still don't get it) in ED plus another one on an ambulance trolley and a cranky paeds nurse refusing to allow me to send my patients to MY ward.* I was juggling them all at once and trying to work them up and work out what was wrong with them. Had an Asian boy rock up with a fever, red hands and feet, red cracked lips, injected pharynx, cervical lymphadenopathy and purpuric lesions on his feet. Just on initial examination, my heart sank, looked like a case of Kawasaki Disease.

Kawasaki Disease is a 19 in 100,000 incidence vasculitic disease. My boss had grilled me on it yesterday and so when I saw it sitting in front of me I remembered what it looked like from the one case I had seen as a student and admitted this kid pronto. Although the fever hasn't been there for 5 days, I'm putting my money on the diagnosis of Kawasaki's and hope I can write him up for my case presentation (how nerdy!) Would have been nice if the patient didn't show up on such a busy day though.

Anyways, here endeth my long day and in 24 hours I will have finished my 13 day fortnight and can rest. Sigh...

* I'm sure she must have been a midwife in a former life cos all the other nurses on my paeds ward are gems... absolute angels in disguise