Thriving

My maternity and pediatrics rotations have come to a close. I wish I'd had more time to write about each clinical experience, but posting got away from me.

I would like to talk about my most memorable patient from these past weeks. His name is Bryan and he is 13 months old, but is about half that in age when it comes to mental and physical development.

Bryan was born at 25 weeks gestation (40 weeks is what we hope for). His lungs were underdeveloped and he was, and continues to be, hypotonic; he lacks muscle tone and cannot hold his head up. He feels, in your arms, like a very large, newborn. His arms and legs get stronger by the day, but he still cannot sit upright without your constant assistance or pull himself to stand; these developmental milestones are usually reached by six months, and a year, respectively. In short, this is what they call "Failure to Thrive."

Despite the fact that Bryan is fed entirely through a tube in his tummy and is on oxygen chronically, which might make anyone unhappy, wow, could that kid laugh! When I first met him, he was kicking like a squirmy worm on his back, just kicking, kicking, kicking. I saw his little feet flailing as I passed by in the hall and thought I'd pop in and make sure he was all right. He was content! He slid down from usual propped up position (he is at constant risk for aspirating/choking) and was just having a ball kicking his legs all around. I played with him, cleaned him up, kissed him and when I kissed his feet and gave him zurburts he would let out this amazing laugh! Oh, my yet-to-be-utilized eggs cried out! Have one! Have one! My cramps were the worst I'd had in my life, as if my body was literally aching for this little baby. I wish that were a joke, because I was not ever a believer in the biological urge/surge to have a baby, but OK, I believe it now; at least it's true for me.

I had Bryan as a patient for three days over the course of three weeks. First, he was the patient I took on in addition to my assigned newborn, whose jaundice had improved and was able to go home. On the second week, I did the same; I attended to my initial patient and when they were stable and with their family I went to hang out with Bryan. On the third week, my instructor looked at me and said, "Well, we know who you're working with today."

Finally he was all mine, all day. I was over-the-moon. I learned that Bryan's prognosis was not bad; he was expected to continue to grow and learn and gain strength, but just slower than the rest of children his age. I worked with the resident doctor assigned to him to have his feedings adjusted, changed his diapers (even when he contracted C. Dif. which is highly contagious and makes you have tons of foul-smelling diarrhea). I mean, I really didn't care if this kid pooped all over me, and then made me poop like crazy, and yes, that is a first. To have this connection with such a small human, who could only communicate with the word "ow," or by laughing hysterically, was intense. He really moved me, and my instant love for him was powerful. I feel like putting in a cheesy reference to the Twilight series' concept of "imprinting," but that's a little creepy. I digress...

For someone who spends a lot of time advocating for women and their partners during the birth process, this was my first experience, truly being an advocate for someone who could not speak for themselves. It was profound. What more can I say?? I'm rambling, I know, but this was hugely important. It means...I am in the right field! It means I have a giant heart and that's good! It means that I can love a complete stranger in an instant and want them to be well and to keep them safe, any and every way I can. In a nutshell: it blew my mind and I am forever thankful for this little boy.