Age Differences

The strangest thing about pediatrics is the developmental difference between our patients. In adult medicine, even if two patients have ages 15 years apart, their care remains pretty much the same. A 65 and and 80 year old heart attack patient are treated with the same drugs, in the same approximate amounts, with predictable effects.

In pediatrics, on the other hand, it is possible to have EXTREMELY different patients. Today, mine were 2 years old, and 18 years old. One pulled at my earrings, and tried to RUN AWAY from the blood pressure cuff, the other was worried about missing his chemistry class.

It's actually kind of amusing, once you get past the shock of going room to room and adjusting speech patterns and priorities by age. For the teenagers, you need to emphasize (against the express dictates of Very Catholic University) sex education, good decision making, and independence. For the toddlers you focus on SIMPLE choices: "do you want the BP cuff on your ARM or LEG?" or "temperature BEFORE or AFTER I count your pulse?"

All in all, I like pediatrics, except for the teens in Status Dramaticus. They drive me NUTS! After all, if your pain level doesn't CHANGE after you've received a MASSIVE dose of painkillers that makes you REAAAAAALLY high, and you STILL rate your pain level as "the same! 10!", what would the point be of me giving you any MORE pain meds? If you're breathing at 6 when you sleep, due to the sheer amount of narcs, we CANNOT give you more! Plus, don't think I didn't notice that when I was not within view, you were giggling, laughing, eating a FULL lunch, and chatting with your friends about how you were SO getting "the whole week" off from school. Yeah. I told your doctor. :-p