Friday, February 24, 2006

Great Ormond Street Hospital

I visited Great Ormond St Hospital this afternoon as part of the Paediatrics course. The doctors there received us warmly (they don't normally have students) and taught us at the bedside. The experience made me think of a piece by Edvard Munch (famous for 'The Scream') called 'The Sick Child':

I was surprised that 8 students were taken on bedside teaching in one go, we made for an intimidating bunch for sick children. We visited a dozing child with a vastly distended abdomen. He was alone and one of us examined his tummy. I was saddened to see him awaken (yet remain confused and drowsy) and yelp plaintively during the exercise. The doctor informed us that he was 'a practised patient' and we weren't really hurting him - although his recoil and discomfort made me think otherwise.

We were encouraged to distract him with play - to no effect - but all the while I felt that I was somehow intruding where I shouldn't be. His parents were not there to consent to our presence, and the despondency of his medical condition was heart-wrenching. However, there was a definite air amongst the students - one of quiet respect, compassion, and sadness.

Having spent a reasonably peaceful week on the postnatal wards, I felt I had been exposed to the darker side of Paediatrics. Spending the morning performing baby-checks on newborns was a stark contrast to both the neonatal intensive care unit I later visited, seeing tiny premature babies in respiratory distress, gasping and grunting for breath.

Paediatrics seems an ideal opportunity for students to examine their own ideas about empathy and compassion. I'd be very interested to hear others experiences...


Taz said...

Thanks for this post AJ. It was interesting to see at the recent Careers Fair that so many medical students had chosen Paediatrics as their probable career path, myself included. While most of us have not had the wonderful opportunity to visit such a specialist childrens' hospital such as Great Ormond Street, those of us who have completed our Paeds placements know that it is a specialty that does really challenge your emotions and professionalism. One particular example was of a young boy with a rare disease called hypermelanosis of ito who was constantly having seizures, sometimes with only a second in between each episode. He was 2 years old but had never been out of hospital for more than a week. Looking at him, it seemed as though he was totally absorbed in his own stormy cloud and was unaware of anything except his lightning fits. One could not help but feel as though it was inappropriate for a group of medical students to be examining him and learning from him. Yet the consultant teaching us dealt with the child and his parents so beautifully that I walked away feeling far more comfortable, however saddened I was.

I agree with you AJ - Paediatrics is most definitely a time to learn about yourself, how you deal with what are often emotionally charged situations and the real meaning of empathy and compassion.

aj said...

Funnily enough Taz your example is very similar to the book 'The Spirit Catches You and You Fall Down', which we read during the Medical Humanities course last year. It deals largely with communication barriers, and the handling of different perceptions of health and disease. Unfortunately the healthcare professional involved didnt manage such a smooth handling of their patient, not least from the point of view of the parents.