getting closer...

It's been quite some time since I've shared my experiences, and I have a lot to tell, especially from OB/GYN. But I felt the need for a quick update because I had a moment where I felt really good about what I'm doing here.

For pediatrics, we have 2 days on call in the pediatric ER, though I wish we had a week of that, and 1 less week of something else. I love the ER of course, and I didn't care if I was taking care of adults or kids- it's the environment, the variety, and the pace that makes me happiest.

The second kid I saw in the ED was 12 with abdominal pain and vomiting. After hearing his story and examining him, I thought... oh my God, this kid has cholecystitis... at 12. I walked out of the room and said to the attending, "How likely is it that a 12 year-old has acute cholecystitis?" He said not likely. After his exam, he was not impressed by the possibility, but he agreed that I could order an ultrasound.

Ultrasound findings: gallstones, gallbladder sludge, thickened gallbladder wall- consistent with acute cholecystitis.

The attending was surprised and impressed. He said, "You created a differential, had a high suspicion, ordered the appropriate testing, and confirmed your diagnosis. Good job." In med school, praise does not come higher than that :)

Little things like that make me breathe a little easier.