My, oh my, what an incredible month with some truly remarkable pediatric cardiologists! I got to spend 4 amazing weeks working with various pediatric cardiologists at Riley Children’s Hospital in Indianapolis, IN. Because of my interest in pediatric outpatient care, I spent most of my time in the outpatient clinics trying to train my ears to appreciate the intricacies of normal and abnormal pediatric heart sounds. However, between the outpatient clinic and the various other settings, I was able to see and do so much, things that the average student doesn’t get to experience. As with my other rotations, I walked away thankful for having gained a vast amount knowledge, both about medicine and people.
Experiences that were had:
- Spent the day in the pediatric ICU where kiddos were waiting for heart surgery or had just recently had heart surgery
- Saw an infant’s heart held in the hand of a surgeon above an open chest in the OR (a moment of pure awe and wonder)
- Saw an infant who had complications after surgery and was on ECMO (extracorporeal membrane oxygenation: a dialysis-like machine that functions like lungs to oxygenate blood)
- Watched the collection and interpretation of fetal echocardiograms to identify and monitor congenital heart disease (including discussing birth plans with a mom that involved rushing the baby off to surgery immediately after delivery)
- Listened to a lot of unique heart murmurs
- Watched catheterization procedures, one for a PDA closure and one to get a biopsy to test for heart transplant rejection (had to wear a full lead ensemble throughout the whole procedure to protect against Xray radiation)
- Visited parents, whose precious children were in the NICU, to draw pictures and explain their baby’s abnormal heart physiology
- Made a lot of kids smile
Lessons that were learned:
- A healthy baby is truly a miracle.
- Kids are incredibly resilient…like, it’s amazing how resilient they are.
- In the face of restrictive health conditions, kids push themselves and are self-limiting. Adults…not so much.
- Parents of these “heart kids” are strong and should be admired, encouraged, and prayed for.
- Children can survive with only one functioning ventricle…incredible!
- The beauty of a healthy heart is not to be taken for granted.
- Lots of “holes” in baby’s heart close up all on their own. Sometimes doctors just have to prescribe time.
- Cardiologists are liked skilled musicians who have trained themselves to appreciate the subtle nuances of the heart’s music; it’s beautiful.
- There are a wide variety of pediatric cardiac conditions with a genetic link.
- For some patients, it takes a lot of work to convince them that they (or their child) is healthy and physiologically normal.
- Kids say the funniest, most honest things.
- Each heart transplant usually only last between 10-15 years. So babies who need heart transplants, often need several in their lifetime.
It seems like an injustice to just have bulleted lists, but it would have been a bigger injustice to try to write in more detail all that this month-long rotation entailed. If you are interested in knowing more about my experience, feel free to ask. Also, while I didn’t have much exposure to the surgery aspect of pediatric cardiology, if that is of particular interest to you, I would recommend the book Walk on Water: The Miracle of Saving Children’s Lives by Michael Ruhlman. It’s very good.
Next rotation: outpatient medicine at a local county health department clinic. Let the learning continue.