Ruminations and Transitions on Life as a PEM Fellow

Life happens.

In a matter of seconds, life can change from one extreme to another.
Some recent examples that come mind are:
A 4-year old boy wearing Superman pajamas, just diagnosed with a brain tumor.
A 9-year old girl who is scared of doctors, diagnosed with acute appendicitis and in need of surgery.
A 12-day old boy with persistent fussiness with HSV meningitis.
A 13-year old girl playing Candy Crush on her iPad with new-onset diabetes.
A 17-year old boy taking a Calculus final exam in school found unconscious. He was in ventricular tachycardia.

How do you break the news to the Parents in Room 11 that their only child has leukemia? What can you say? What do you do to comfort them?

Immediately after such an emotional conversation, how do you remain calm when you are yelled at by a Mother in Room 5 that is worried about her daughter’s fever, which started one hour ago?

In the Pediatric Emergency Department, seeing a wide-spectrum of medical and surgical conditions – urgent and routine – is the norm. However, no child is the same. Every child is unique and a world unto him or herself: a child first and an illness second.

Have you ever used Ketamine sedation for a complex ulna/radius reduction, only to have the child tell you “Knock-Knock” jokes in the middle?
Have you ever felt a great sense of accomplishment when you successfully removed three small lego pieces from an 18 month old’s nose thinking it was only one?
Have you ever mouthed the words to the song “Let It Go” from the movie Frozen while trying to complete your charts because it has played on continuous rewind in every room?

Sure, I will continue to have hectic days in which I do not have a minute to answer my wife’s phone call or eat my leftovers for lunch.   But, I am doing something I love!

I would never trade my job for anything else. In serving as the first-line of defense, I welcome the privilege to act quickly and decisively to perform  life-saving procedures and be able to make decisions which  impact  the life of each child I see.
So, bring on the rest of my Pediatric Emergency Medicine Fellowship – I am ready!

Thanks to Dr. Jared Friedman.  Dr. Friedman is a  PEM fellow at the Michael Altieri Pediatric Emergency Medicine Fellowship at Inova Fairfax Hospital. His address is below.

The Altieri Pediatric Emergency Medicine Fellowship 
Inova Children’s Hospital 
Inova Fairfax Hospital Emergency Department
3300 Gallows Road, Falls Church, VA 22042

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