Pediatrics I

Oddly enough, on my cardiology rotation I had a few patients that were really close to pediatrics. I had a young patient in his early 20s with pulmonary hypertension from a congenital heart defect. He was extremely dependent on his mother who was at bedside 24-7. The patient dynamic was interesting. Even though he was technically an adult, he deferred all his decision-making to his mother. I sometimes felt that I was treating her as much as I was treating him. She made lists of questions and concerns while the patient didn't want an active part in his care. Perhaps growing up with a chronic disease keeps one in an earlier developmental stage; perhaps infantilization is a defense mechanism. But on the other hand, I met a girl who was also in her early twenties who grew up with a double inlet single ventricle. While our hearts have separate chambers for oxygenated and deoxygenated blood, she only had one chamber and the mixing of blood causes her to be cyanotic (blue). Her body has compensated for the lack of oxygen; her red blood cells are much higher than yours or mine. She's undergone at least a dozen surgeries to create shunts to alleviate the consequences of this congenital heart defect. And yet, she is incredibly self-sufficient. She understands her disease better than anyone else, can draw out diagrams of her heart, manages her many medications. I was impressed by how independent this patient was.