never a dull moment

So yesterday I finished inpatient Peds---on to the clinics! I did well-child exams today; and usually you're supposed to see one and do one, but the way the patients fell my preceptor said "Eeeehh, you're ready. The next check is on a 13 year old boy. You can't really mess it up. Go in there and then tell me how it goes; any questions?" And I said, "Well for genital exams, are we supposed to bring in a chaperon?" And he deferred to his female colleague who said "Well, sometimes I feel like bringing in a nurse = two women ganging up on a young boy. I find it better just to do it alone if they already decided they don't want mom in there with them."

So I go in and ask mom her major concerns, then kick her out and ask the boy his major concerns. And then I do my exam and get to the last part, the genital exam, and say, "Now, this next part can be kind of embarrassing for patients, but it's important for your health that we check everything." And so I get him up off the exam table and we get his pants down. And he promptly gets an erection.

So I'm down there like "ohmygoodnessnowwhat?" and feeling like laughing but of course NOT laughing because come on, how embarrassing is this whole ordeal for this poor kid?! So I basically mentally recover from the initial shock, do a sloppier version of what I'd normally do, brush it all off somehow, finish up, and report back to my preceptor. He says "Everything go OK?" And I just HAD to tell him. His response was: "Oh no! I'm sorry....well...uh...take it as a compliment!" But then when we BOTH went in, it happened again. "Well I guess it's just his reaction to being examined. And quite honestly, it doesn't happen that often."

To HIM maybe! First well child exam...check! My second was on a 4 month old. Not quite as shocking.

Then I was in at the tail-end of another visit, this time with 3 little kids in the room. And I'm herding these kids as they're trying to steal away through the door while my preceptor educates mom on a script when this angelic 3-year-old blondie says to me: "Why aren't you wearing SHOES?!" And I say "These ARE shoes." To which she retorts, "No they're not, they're slippers!" I say they're flats, and then we focus on brother's shoes a while. Then she asks me "Why is your hair fuzzy?" And I say "What???" So then I explain to this child with pin-straight hair and sibs just the same that it's CURLY. Not FUZZY. Thanks a lot kiddo.

The end of the day was the newborn exam in the newborn nursery. Which was just amazingly interesting of course. And of course the first thing I find when taking off her diaper is a big 'ol dark poop. And I learn that the rule is you find it, you change it.

So let's recap: I examined an excited 13 year old, was insulted by a 3 year old, and rounded out the day with a newborn diaper surprise.

Gotta love Peds =)