mentors, students, friends

“I’m still a student,” I told our friend’s 15 year old daughter yesterday, “Thirty years into school and I’m still studying, still learning.”

I take my pediatric emergency medicine boards in 6 weeks, so studying has filled every crack in the day –  to teach me just one more thing that might help with the next in a string of formal exams that have marked the last 15 years.  Each chapter I study brings more flashcards, but also memories of people who have poured their knowledge and kindness into me.

Last week on our ward service, we finished rounds early and my residents asked for a lecture to learn something more with the extra time that we had.  I decided to talk about shock in kids, and we sat  huddled on a bench outside the ward with a 5×8 notebook and talked about the initial management of the sickest of the sick kids – the complications brought about by management, and the FEAST trial, done in their own backyard. I was assured by the insightful specificity of their questions, and we left for lunch still discussing the nuances 30 minutes later. . .

Vital signs, oxygen, examine, IV, fluids – but not too much – antibiotics, constant vigilance, reexamine, ask, listen. . .

The next morning, as I was walking into morning report, Morgan, my intern, called.  “I have a child in clinic that just came in. . .I think he’s in shock. . .I have him on oxygen. I’m getting an IV to give fluid. Can you come help?” I practically skipped into the hospital, still a bit out of breath. He stood at the bedside with appropriate urgency and I smiled as he ordered the antibiotic, comforted the mom, and walked through the steps with thoughtful deliberation.

The child was in shock. . .and  my intern brought him from sickness to health. I reveled in the pride on his face as he realized the child was getting better, as he suggested the right next step again and again, as my assessment matched his and I saw what he had learned in his first month caring for pediatric patients. Two more children came in that day with almost the same picture and story – and I watched the story play out again and again.

Vital signs, oxygen, examine, IV, fluids – but not too much . . . The next morning we wrote orders to move the children out of our monitored unit and Morgan smiled at me as we left the room . . .”We have learned shock, Dr. Arianna. Thank you.”

My mind flashed to the faces of the people I still want to be when I grow up. . .and how we moved from learning about shock and asthma to the nuances of  excellence mingled with compassion and expectation combined with grace.

to Dr. Kitzman telling me in high school that medicine is hard, but we can love what we do,

to Dr. Tofil drawing up 60 cc syringes and teaching away as she resuscitated a child on the floor,

to the place in the ER where I was standing when Dr. Liebelt and Dr. Baldwin first told me they thought I could find a home in Emergency Medicine and made me believe a bit more that I had a definite place in the care of children,

to Dr. Stagno’s phone call at 8am post call to make sure I was doing okay and encourage me to think about the future,

to Dr. Nichols teaching me the value of trust as I sat in tears in her office after my toughest months of fellowship,

to Dr. Klasner popping her head into the room of a sick child and asking if she could help as she trusted me to assess the child correctly,

to Annalise’s beautifully supportive sarcasm when I wondered about my next place in medicine,

to Shruti, Nicole, Laura, JB, Salli, Courtney, Tricia, Gina, Laura, Grace, John, Susan, Abby, Heather, Elizabeth, Stephanie, Kasey, and all my other friends in residency and fellowship who walked through triumphs and heartache with me as we began our journey. . .

to Imma and Sarah and Jennifer and Mardi and their patience and reassurance as I have learned the new challenges of medicine in Africa  in the last 6 months. The memories came in waves. Amazing mentors who had become friends. 

Last night, I sat with 2 of my clinical officers, 3 of our medical officers, and my nutritionist intern at our house for dinner around the table David had made talking about medicine and life. As I introduced them to Madeline and Belle, I said, “These are my teachers.” They all laughed, but it is true. They taught me more these months than I had taught them – of malnutrition and tuberculosis and resource management –  of compassion and grace, of diligence and commitment. I hope that I will in some way become part of the stories of  this next generation of Kenyan doctors. What I know, though, is that they have become part of mine.

It is my privilege to teach them and to continue to learn. I am still a student, always will be. . .

*my team from Nursery and Wards this month after dinner