Stephanie P.

January 7th – January 14th (13.83 hours) –  One meaningful experience I had in the past two weeks was when Joy came back. A long time ago (back in September/November times), I mentioned that Dr. Price and one of our M.A.’s, Joy, were leaving the office. Well, Joy’s back. So (stepping out of my crazy shyness that literally only happens when I walk into the office and ends when I leave), I ask her what happened. And I was very happy that she was open with me and told me about the other office (it wasn’t a good fit for her). She told me about her experiences and then even went as far to tell me that since she left and then came back, she has to earn Dr. Dyson’s trust back. I felt included and overall, good, because she told me that last part just because she wanted to. It wasn’t part of the question and it seems to be pretty personal, but she still told me.

One major soft skill in the medical field, especially in pediatrics, is the ability to communicate and do it very well. You have to communicate with patients, staff and parents and each of those are very different from each other. Plus with the patients, there’s a huge range of ages and even that can’t always prepare you for the type of personality of the child. Through my last semester, I’ve worked very hard to build up this skill. Dr. Dyson continuously tells me some background from each patient before we enter the room, giving me advice on the type of child, and parent(s), that I will encounter. He also provides insight on his patients with autism and other disorders that I should be aware of before I enter the room. However well I have progressed with communicating with parents and patients, I have equally regressed with communicating with the staff. I feel awkward and so that’s a huge part of the skill that I need to improve on this semester. I have to be more vocal with the staff.

Communication is HUGE in college. Parents aren’t there to email your professors or talk to supervisors or counselors. You have to do it all on your own. So my increasing communication skills through this program is really going to benefit me in college. I will be able to approach people about study groups and classes in general, for advice and help. In my career, this is also very important. I mean, it’s the main component of the medical field. Doctors, nurses, technicians, everyone has to be aware of their words and pick up on social cues and, just overall be able to communicate everything very well to succeed (and not offend anyone or get themselves into trouble). Communication and just overall interpersonal skills will be extremely beneficial to my future.

Dr. Dyson and I were in with a patient for a sick visit and Dr. Dyson mentioned that the symptoms added up to something called “ecthyma”. Ecthyma is crusted sores beneath the skin. It begins as a bilster and soon the hard crust covers the blister, causing “discomfort or pain”. To treat this, he suggested that the patient go to a dermatologist for a firm diagnosis and a prescription.

January 15th – January 28th (6 hours) –  I am a part of the Human Anatomy and Physiology class at school and during these two weeks, we are going over a unit on the special senses. So far we have covered sight (eye anatomy and function) and hearing (ear anatomy and function) and are moving on to taste (tongue/mouth anatomy). What was so cool about this was also during this unit, I went in to Dyson’s and there was a truly incredible family we were seeing. The mother was almost completely deaf (a few noises were all she could hear) and the dad was also deaf (able to make out most sounds to help form words, but still deaf). And their two year old daughter has dancing eye syndrome. It’s so remarkable that when they came in, I had just moved on from eyes to ears and both subjects were completely applicable in this case. I was stunned that this family came in right when I was learning about it all! It was so crazy and I ended up doing even more research on deafness and on the little girl’s syndrome.

As I said in the first question, I met a remarkable family and the two year old had something called, dancing eye syndrome (DES), also known as Opsoclonus myoclonus syndrome (OMS). This is a very rare condition in which the eyes are “dancing” or moving very irregularly and the person cannot control the movement. It causes vision to be blurred and distorted from the constant movement.

January 29th – February 11th (9.17 hours) – If you remember in reflection logs past, I mentioned that we had lost and gained an MA, we lost a doctor, and we have been adding new members to our team only to see them be re-stationed again. I want to point out that it’s not normally like this. Dr. Dyson has been my pediatrician since I was about 2 or 3 and I remember only one switch in staff and that was when he moved locations. Since he moved locations a few years ago, he had the same MAs and receptionists. It’s just my luck that I arrived and then he lost so many of his staff. So far we have had both receptionists be moved to another office (and one of the replacements just disappeared one day so I’m assuming she moved too so that’s three receptionists now); one MA leave and then come back; another MA leave and is now replaced by a 19 year old MA named Paula; and the second doctor (the one who takes Dr. Dyson’s overflow patients like walkins) also was re-stationed. On that note, I got to finally meet the new doctor who will be joining the team. Her name is Dr. Altomare and she actually had met Dr. Dyson because she had children seeing him (at least for an ear piercing but I’m not sure if he was their full time pediatrician). I was there on her first day of observations and of her getting her office together as well as her first day seeing patients. I hope to be able to shadow her sometime too since I’ve now seen how two male doctors work and it would be nice to see how she does.

My first goal of the semester was to complete a considerable amount more research outside of the clinic than last semester. Before I would do the occasional “look up” here and there, maybe once or twice a month at max and I really wanted to change that. If I wanted to succeed in this internship I needed to be able to converse more with the doctor(s) and nurses on a more professional level. The first thing I noticed while beginning this goal was that I needed to pay attention to specific vocabulary that was not given to me already by Dr. Dyson. Normally, Dr. Dyson will give me a vocabulary word or two a day to look up and I would jot down some notes on said word and be done for the day. That wasn’t enough. I began to listen more carefully to the pronunciation of the medical terminology that he was saying in the rooms so that later, I could easily find it when I would Google it. After the first few days of this, I began to realize how accomplished it felt to know what was going on in the rooms and that, if I wanted to be successful in completing my goal, I would need to be as specific as possible in describing my day at Dyson’s. So I got a larger white binder, transferred all my paperwork into the new one and added a whole ream of lined paper to the notes section. Every day now, I describe each patient visit in detail while Dr. Dyson is charting in his logs (I used to sit awkwardly, listening to the MAs talk, so this is a good change).

As I mentioned before, I would get one or two words while at Dyson’s, but I wanted to expand on that and I succeeded. I used to look up only a few words outside of the office, but now, I have upped that one-to-two-word-a-month trend to upwards of six or seven a week. What really surprised me in this process was while I was trying to complete this goal, I was starting to begin succeeding on my other goal without intending to. I began to ask more questions; some based off of what I had found on my own, some during the visit itself, and others taking what I have been learning in my Human Anatomy and Physiology class and applying it to what I was observing at Dyson’s. Without planning on it, I am only a month into the second semester of my internship and into setting these goals, and I’ve already completed one (though it’s not like I can stop so it will continue until the end) and started the other. This was definitely a good surprise and I’m glad that the daunting idea of my second goal is no longer as daunting.
Hopefully completing this goal will do more for me than just help me be more vocal in the office. There is definitely no harm in expanding my knowledge and I know that having this knowledge and continuing to pursue answers outside of the clinic and my classes will brighten my chances in my medical classes in college. I feel like my getting accustomed to learning more now, will help me in college by also continuing a “thirst for knowledge” while there. I know that goal setting has been extremely helpful because it has allowed me to come out of the strange shell or shyness that overcomes me when I step into the office and I know that my second goal will do an even better job at that.

I learned during these past two weeks that there are currently 3 strands of the flu: two type As and one type B. We had six kids in one afternoon (3 hours mind you) with at least one of the type As (two had one of the type As as well as the type B). Type B can only be found in humans and tends to be less severe than either of the As and strain A spreads faster than B. All strains are just as harmful if left untreated and the symptoms mirror each other.

February 12th – February 25th (5.42 hours) – One really amazingly meaningful experience I had was on Monday the 18th. Dyson was out of town for the week, but I still went in and I got to follow around Dr. Altomare, our new doctor. She is really lively and conversational with everyone and she was more than willing to show me some new tricks. We had three newborns in the afternoon alone (she had more earlier in the morning which I thought was really interesting) and so I got to read the newborn paperwork and see a different way of dealing with newborn patients (and parents). She seemed to go more by the book than Dr. Dyson and I assume that’s because she’s newer to pediatrics than he is (and maybe because she’s new to the practice and doesn’t want to slip up). I really enjoyed working with her and I hope to do again soon because it’s always good to experience new people and their way of doing things.

This phrase seems pretty self explanatory, but I had never heard it as the diagnosis before, even though we have seen cases of it in the time that I’ve been at Dyson’s. It’s called “delayed developmental milestones”, which is the diagnosis that is put into the computer system, but has never been spoken aloud to me. It’s when a child is showing severe signs of delayed development (key word: severe) and needs extra help with whatever the case may be (usually speech, but in this case, it’s eating).

February 26th – March 11th (0 hours) – Because I didn’t go in these past two weeks due to a busy schedule on my part, I think my most memorable experience was when I got an email from Mrs. Wahl. Mrs. Wahl emailed me and my parents to tell us her feedback on my last SMART goal narrative. I was very pleased to hear that the narrative was “stellar” and “insightful”. She was glad to hear that my goal expanded into more than just doing more research and instead it was wanting to learn more. I was thankful for the fact that she sent it to my parents as well. It was a nice surprise to not only get the email but also for her to send it to my parents.

My second and, I would say, my hardest goal seems pretty simple: talk. And I’m pretty good at talking. However, something happens when I walk in the door at Dyson’s and I become very shy and I don’t speak. I don’t ask questions, I mumble answers, and I’m very quiet whenever I do talk. It was especially bad and embarrassing when I spent almost a full two weeks, eight hours a day, at the office last semester during fall break. Even after logging close to 60 hours, I was still the same–quiet, not talking, shy. Dr. Dyson took the office out to play pool one day at lunch and I still was awkward and quiet and another day, he took me to TMC during lunch to talk with other doctors and eat lunch there, and I felt like there was a lot of awkward silence. This and just the overall fact that it is the complete opposite of my normal behaviors, led me to make this goal for the second semester.

My first goal was all about doing more research and giving myself some homework which, lucky for me, really helped my second goal. Because I was doing more research and getting more information outside of the office and school, I was able to draw some conclusions and ask about them the next time I was scheduled. I think just knowing more led me to ask more questions. I think that because my Human Anatomy class began to move into larger parts of the human body (moving on from atoms and enzymes, etc), I was also getting a little more education on that part, leading me to ask more questions (in both my class and at my internship site, in fact). Despite all of these improvements in the second semester, I still felt like I am way too shy and I not very engaging with both the staff and the patients/parents. So I had a new plan and approach to reflecting on this goal, which turned out to help me in the long run.

Since I hadn’t gone in for this reflection log, I waited to write this and finish my reflection assessment of this goal until I went in again, but not because I wanted to get another day in to complete the goal. No, it was because I wanted to ask Dr. Dyson, face to face, if he noticed a change. Before I say what he said, I want to note that I felt different.

Normally, I got this feeling–I’m not sure how to describe it–in my stomach area, when I wanted to speak up or ask a question. I always felt better after I spoke (if I decided to overcome that and speak, which was infrequent to say the least), but I still felt it every single time. Every. Single. TIme. It was one of the reasons I wanted to set the goal. I wanted to get rid of that feeling. When I went to ask Dr. Dyson about my progress, I almost had my answer before I even opened my mouth. I didn’t feel nearly as funny as I used to. I did feel a little something, but it was so little and so insignificant that I was able to ignore it as if it wasn’t even there and ask my question.
As for what Dr. Dyson said, he definitely has seen improvement and that he understood why I was like that before. He mentioned it could’ve been a bit harder for me since I was, and still am, a patient at his office so unlike other interns, I had to transition from that role to the role “behind the counter”, as Dyson put it. It also didn’t help that I went in as a patient during the first semester after I had already started. He said that all was good and that I have improved and if it was a problem (on either side of the spectrum, being too quiet or too assertive) he would let me know.

Overall, I think I can improve more, but I am pleased, now that I’ve talked with Dr. Dyson, with how far I’ve come. I think that this was a good experience because I have never had to worry about this before. In fact, I always prided myself on being more outgoing and having the ability to judge that assertiveness in situations. So I think that it was great that I had a situation in which that wasn’t true before I left for college so that I was still in my regular environment and I had the support of friends and family, even if they were unaware of their help. Hopefully this means I’ll be more prepared for if this situation happens again.

There was a little boy, maybe 6 years old, who came in for another treatment for asthma (he had come in a few times before) and when Dr. Dyson was listening to his breathing, I noticed he had a divot in his chest so I asked about what that meant as well as if it would impact chances of asthma. He had pectus excavatum which is a deformity of the chest wall that causes several ribs and the breastbone to concave (also known as funnel chest or sunken chest). Dyson said that it probably didn’t have any effect on the boy’s asthma. And just today, there was another case I saw (he was about nine months old) so I was proud that I knew what it was.

March 12th – March 25th (20.58 hours) – During these past two weeks, I was able to meet another student following Dr. Dyson around every Wednesday, named Daniel. If you remember, earlier in the year I met another student who was studying to be a Nurse Practitioner. I didn’t catch what Daniel was studying for, but I was able to talk about my future plans. As I’ve stated in my narratives and past reflection logs, I have a seriously hard time talking with Dr. Dyson (maybe it’s because I’m intimidated or maybe I’m just unsure, but either way, I don’t tend to talk with him). I was able to talk with Daniel about my plans for college and get his opinion on my future based off of his experiences. I really enjoyed being able to talk to a current medical student to get some insight on what’s awaiting me in the near future.

One of the full days that I was able to go in for we had a two year old who had acetabular dysplasia (hip dysplasia where the hips are irregular in some form, normally shaped) and who had to have surgery. She was in a cast from the mid-chest (ish) area all the way down to the feet for a few months and was coming in for a check up since her cast came off. I got to see a picture of her cast and I was very impressed that she was walking almost normally and it had only been a few weeks since getting her cast off.

March 26th – April 8th (0 hours) – I didn’t go in these past two weeks, however, I was on the interview board for next year’s interns. It was definitely not what I was expecting and it made me think about my score from last year when I did it and if I did things like fidget or stutter. I was lucky that I knew one of the interviewees and had previously talked with her about the program (in fact, I’ve been talking about it for practically the whole year). I was able to ask a question of my own that I thought would be helpful and I was just generally curious. I really liked being able to be on the other side of the table and do something that I might get the opportunity to do again for a few more years.

I have always been a very outgoing, lively person and I prided myself in being able to speak with adults in a mature way. Afterall, many of the leadership positions I’ve held and continue to hold today require me to have those traits. So I was very much caught off guard by the fact that I was having a very difficult time speaking up at my site and conversing with the other workers and physicians. I definitely think that that has made me grow exceptionally because I was not expecting having to work on that as a character trait during this program. I guess I could say that I learned to be prepared in new situations because some things that I previously thought about myself my not apply there.

I think I also learned that I need to slow down. I had a bit too much on my plate and although I pride myself in being a planner/organizer, I learned that even I need a break here and there. That’s why this semester I’m taking it a lot slower and not going in as much. I’m already nearing the required hours and I’m not even at the first hours check. I learned to slow down, take a few deep breaths and not feel like I need to take so much control. I don’t have to everything. I learned to take care of my mental health and that it’s just as important as my physical health.

One recommendation I suggest is to participate in any out of site experiences that your site offers. For example, my site had at least once a month a day where the doctors and staff would all go to the zoo a Saturday morning and walk the zoo to talk with patients and non patients alike and just get exercise and sunshine. If your site offers something like that, it’s a good way to bond without the stress and expectations of the workplace. Even if it doesn’t count toward your hours, anything that can help you adjust would be extremely beneficial.

Another one that I suggest is to push yourself to ask questions, even if it’s uncomfortable. You are an intern. And a high school one at that. You are not expected to know everything. This may be the first time you are put into a situation in which you are unsure of things like vocabulary or mannerisms, especially if you have always been at the top of your class. It will be daunting at first, but the sooner you push yourself to speak up and begin to ask questions and interact with everyone around you, the sooner you will feel comfortable and accepted.

This last tip I have goes for more than just being a part of the program. It is a lot to ask of someone, especially a teenager to take on so much. For me, I have two AP, two Honors, a regular class and the internship program. Plus the extra time it takes to be a part of the instrumental music program (like practicing on my own and out-of-school group practices and events), taking private lessons, be a high-ranking officer in a club, participate in National Honors Society, volunteer for two hours every Sunday, complete homework, classwork, etc. for those classes, completing all the senior requirements/deadlines and a bit more . . . it’s a lot. You may not have this much of a rigorous or busy schedule, but either way, being a senior will be a lot to say the least. Take a mental health day or two. Plan ahead. DON’T GIVE IN TO SENIORITIS!! It’s a real thing, but you can get through it if you are accountable to yourself or to others. It took me a whole semester to recognize my mental health so make sure you do it early on and not stress yourself out. Trust me. I’m still recovering. Mental health. It’s a real thing and it’s serious. Take care of yourself and you should be okay.

So a few weeks ago when I was alone in a room with a family and I had to answer a few questions on the chickenpox vaccine, varicella (eek). Luckily, I was able to answer all their questions, but I decided to do some research on my own. I learned that it was first introduced in other countries in Asia like Japan and Korea and finally came to the US in 1995. I researched on all the effects of the vaccine (pros and cons) as well as the effects of the disease itself and weighed them against each other.

April 9th – April 22nd (7 hours) –  One thing that was very meaningful to me during these past few weeks was when I asked Dyson to sign my narratives. Previously, I had the opportunity to talk to Dyson about if I had succeeded in my goals. I was very insecure about that and he assured me that I did well in both goals. Then, I had to have him sign my narratives and he read them over the weekend and gave me feedback. He said that I did a very good job with explaining myself and since him knowing about the struggle I was having, I feel like I’ve been able to open up even more when asking questions.

I learned about progestin this week. We were going in to see a patient who was discussing the birth control implant and her symptoms from it so I was curious and looked up how effective the implant is and what makes it that way. Progestin is a hormone that keeps ovaries from releasing eggs, therefore keeping the woman from getting pregnant.

July 20th – August 13th (9.47 hours) – So far the internship program has been exhilarating. The most meaningful part has been learning how to be in the workforce. Throughout the first few months of being a participant of the internship program I learned more about the real world than I did in the past fifteen years of school. Most importantly I learned about interviews. I learned what to say, what not to say, how to sit, how to act, how to create a résume and much more. I especially liked the pointers on the résume and how it was supposed to be set up and how much to actually add since I have a tendency to add more than what is needed. That has been extremely helpful in my journey to adulthood.

Through this program I hope to learn a lot. Already I mentioned that I have learned about interviews, but hopefully throughout the rest of the program I will learn about the workforce specifically. Mrs. Wahl’s PD meetings and individual meetings will hopefully lead me in the right direction. I want to learn how to act in a more professional environment than a doctor’s office. From Dr. Dyson, I would like to come out knowing if a private practice is right for me or if I should go into a group practice. I would like to learn more about the paperwork and environment of the office. Mainly I hope to learn what it takes to be a Pediatrician and if this is the right path for me to take.

Through this program, I have learned that I am not prepared for communication with other professionals in settings like meetings and interviews. I either tend to over-explain every situation or not give the right information. However, I do believe that I am ready for the other aspects of the professional world because of my strengths as a student. I have learned that my organizational skills are not a burden and they can be helpful. Through being organized I tend not to procrastinate and never miss dates (both deadlines and events). Before, I knew organization mattered, but now, I know how much it can cost you to not be organized and prepared.

August 14th – August 27th (8.73 hours) – Through the internship, I have had many meaningful experiences, but I think my favorite one has to be when I met Dr. Dyson’s wife. Dr. Dyson’s wife runs Dyson Dermatology in a conjoined office to Dyson Pediatrics and she stopped by on Wednesday, the 15th, to give Dr. Dyson something. I was having a conversation with Dr. Dyson about technology and the appropriate age to allow screens for a child (which is no earlier than 3 for a child to watch TV/videos/etc. and he doesn’t believe in phones before 13-15 years of age) when she came in. The three of us ended up discussing their children’s anticipation to have a phone and my regrets to getting one as early as I did (13 years old). We discussed what technology does to a person, both factual and what we have observed, and how their son turned 13 recently and wants a phone because their daughter got one at 13. We discussed my experiences with my phone versus their experiences and their daughter’s experience. I mentioned how when my phone broke last year, I wouldn’t have gotten a new one if I hadn’t been placed in this program, which requires the use of a phone. They were surprised by my distaste for phones and technology in general, given that everyone else my age is attached to theirs. It was a lively discussion that put both doctors behind schedule about 15 minutes or so, but it was a great experience and it really made me think about the effects of technology on our society.

August 28th – September 10th (12.3 hours) – One meaningful experience I’ve had at my internship site has been when I interviewed Dr. Dyson. I have been asking a lot of questions lately and I have learned a lot about the profession and his view on vaccines. My favorite part of the interview was when I discussed with him his school choices and his major and minor choices. It was very insightful and helped me when I was applying for some colleges these past two weeks. He went to UC Berkeley, then relocated to Atlanta for medical school and he told me his experiences at both. It was a very interesting discussion and it ended up being very helpful.

My coworkers are always busy–either with paperwork or with patients. When I am with patients, I should be happy and smile. If I have had any previous problems during the day, those are left at the door. Especially since I’m working with kids, I have to be very observant, which means I am expected to be quiet most of the time, but still have questions after we leave the room. This is so the parents are more comfortable with me in the room. If it sounds or looks like I don’t know what I’m doing, parents don’t like that I’m in the room. However, every once and awhile, Dyson asks me a question in the room which means I should be ready to answer. In other cases, I have to be ready to ask a question of the parents concerning the child and his/her condition, so no matter the situation, I have to be observant and attentive.

I believe that this is a natural fit for who I am, both my personality and my conduct. I am a very lively and happy person, even if I have some burdens or problems. Over the years, I have become very skilled at hiding any of my problems to make other people feel more comfortable. The quiet part might be a problem, though. I have been known to be extremely talkative, but right now, since I’m still getting used to the office and the procedures, I have been pretty good at staying quiet. When I continue to come and get more used to what I’m supposed to do, I might be more likely to talk. I will have to work on that and making sure that I am not too talkative and if I do talk, it’s not going to be irrelevant.

Over the past few weeks, I have come to know a few new words, one of which is “fontanal”. Fontanels are the spaces between the bones in the skull. When I arrived one day, Dr. Dyson and he co-doctor, Dr. Price, were discussing a patient that they had earlier that day. We had some down time, so Dr. Dyson gave me a mini-lesson and then had me research it and draw a diagram of it.

September 11th – September 24th (5.42 hours) – I found out during this time period that some of the employees at Dyson’s were leaving. Jess, one of the front desk receptionists, had her last day Friday, the 14th and Heather, the office manager, had her last day on Friday, the 21st. What was really heartwarming about this was that when it was each of their respective last days, they congratulated me on how well I had been doing and wished me well. I was surprised by Jess because I rarely talked to her. I say “hi” and “bye” but not much else since I immediately go into the back to begin with Dr. Dyson. It made me realize that I am being watched and maybe even talked about and thankful that I hadn’t made a fool of myself. Heather was the one who interviewed me and talked with Mrs. Wahl and did all the correspondence between me and Dr. Dyson, so I felt more connected with her and I was sad to see her go. Heather also wished me well. Now I have to get to know the new office manager and receptionist, but I’m just glad that both got to move on to another position.

One of the days I was at the office, Dr. Dyson and Dr. Price were discussing “floating knee” and how and when it happens. They began to talk about if the patient had it or not and what it would look like if a person did. Floating knee is a flail knee joint that happens because of fractures of the bones around the knee like the femur and the ipsilateral tibia.

September 25th – October 8th (51.12 hours) – One thing that happened these past two weeks was my site visit. Because of the topics that were discussed with and without Dr. Dyson, I was able to step it up. I’ve been uncharacteristically shy these past few months interning at Dyson’s but after openly discussing it, I was able to step it up and ask more questions. I realized that everyone there was just trying to show me how the healthcare profession works. I have been able to ask more questions with both Dyson and some of the MAs, mostly Joy since she seems to know more (and I sit right in front of her on the bar-like counter around the MA desks). Unfortunately I learned just last week on Wednesday that she will be moving practices so I have to step it up and ask more of the other MAs. The site visit overall pushed me to do more and say more.

We talk way more than anything else. The front office staff with sometimes page the phones in the back to ask a quick question or tell one of the MAs that a parent is on a line and they need to answer their questions. Other than that, there aren’t any phones in any of the exam rooms and that means that Dr. Dyson or I have to open the door and ask the questions. Normally, Dr. Dyson will have me leave the room to ask questions of the MAs or to get things that he needs. It wouldn’t be appropriate to email or text since this is an active workplace, so in-person conversation and the occasional phone use is used. I normally don’t use the phone just because I can run around and I’m not tied down to working or using the systems or to a patient.

Well, since this workplace is solely based on verbal communication, I haven’t had such a hard time with it. I have had some issues with asking questions but that was just at the beginning because I wasn’t familiar with being a part of the practice. In the past two weeks however, I’ve gotten a lot better with asking questions since I’ve spent more time there. During the down time in between patients, I take notes and when I have a question, I can ask either Dr. Dyson or Joy since both of them are usually logging their interactions with the patients. Being there for full days has really strengthened my relationship with the staff there. Hopefully, as the year progresses, I can gain more knowledge so that communication will come easier because I think that the main reason I was so hesitant to talk was because I have almost no knowledge of the field.

These past two weeks have allowed me to ask more questions and experience a wider variety of patients and conditions so I learned about more medical terminology than I had before. During one of the days I was at the office, I learned about “ventriculoperitoneal shunt”. This is a medical device that relieves pressure on the brain caused by fluid accumulation and primarily treats a condition (hydrocephalus) in which excess cerebrospinal fluid collects in the brain’s ventricles. This was mentioned as a treatment that one of Dr. Dyson’s patients was undergoing at TMC and I got to read the report.

October 9th – October 22nd (5.67 hours) – On Friday, October 12, I had a sad day. It was Joy’s last day at Dyson Pediatrics. Joy was the MA that sat in front of me, answered all my extra questions, showed me the ropes of her side of the Pediatric profession, and basically put up with me since I got there. She was the one who I liked the most and who was a lot more welcoming on the first few days (next was Priscilla–let’s hope she doesn’t leave too!). I was sad to see her go but I still wish her well in her new office (she followed Dr. Price to his office when he left a few weeks before). That makes four people who have left since I’ve been there so I have definitely got to memorize new names and get to know more people. What was nice about her last day was that I got to sign a goodbye card and I wished her well. It was interesting to see how the medical field is fluctuating so much. I learned about Poland Syndrome during a wellcheck on a new patient (not really new they had just been seeing Dr. Price and now that he’s gone, Dyson has been working with all Price’s former patients).

Poland Syndrome is when a child (usually male) is born with missing or underdeveloped chest muscles (usually the right side). This is a rare condition and doesn’t normally cause alarm and this case is so slight that there is no true worry.

October 23rd – November 5th (13.47 hours) – Halloween was in these past two weeks and that was amazing. Since I intern at a Pediatrics office, I was very interested to see what they did for the children on Halloween. It was really fun. Elva dressed up in a hippo onesie, Kassandra dressed up in a unicorn onesie with a headband instead of wearing the hood, Priscilla dressed up in a Yogi onesie (from Mario), Alma dressed up as a black cat, and our office manager, Vianey, did some AMAZING makeup as a deer (or doe since she’s a she). It was so cute! I just wore a candy-corn scrubs shirt and my black pants since all my costumes are too elaborate for the office setting, but it was fun nonetheless. The best was Dr. Dyson. He’s very professional and I have to mention that he said that he tries to be very professional even though it’s children and his patient families are pretty familiar because he is a African American man who is running his own business (he says he doesn’t see much anymore, but he is still on the edge). With that being said, he is always in professional-casual (button down and slacks and nice shoes but no tie and fun socks for the kids). But on Halloween he was dressed in a teddy bear onesie! It was awesome to see him dressed up, but in a onesie? Wow. Halloween was a great let-loose day (but more rushed than usual so everyone could get home for their kids).

Priscilla, Alma, and Elva are our MAs and they handle things like shots, records, referrals, basically anything you can think of. So every once and a while, I’m asked to do something for Dr. Dyson that I don’t know how to do or need just a little guidance. The most frequent of these situations is asking for shot records (ever since Dr. Price left, most of his patients are now Dyson’s so Dyson doesn’t have the same records as Price did so it can get a little complicated). In fact, this week, I asked Elva to print a shot record for me. I had to tell her the name and date of birth of the child (since she wasn’t the one who roomed him) and explain to her the situation. It was challenging because I didn’t have his birth date (only his age) and I didn’t have much information (since I’m not the one who is on the computer during the time that we are talking with the parents and patients). This has happened pretty regularly lately so I’ve gotten the hang of how the conversation should work.

Priscilla and I have discussed the gender of her baby (girl) and the due date (February 14). We have talked in the past about this so it’s been an ongoing conversation. Before she found out the gender she mentioned that she wanted a girl since she had three boys already and this was for sure going to be her last. So she got her wish. I’ve also talked to Elva about her wedding. She actually was talking to the other women about her dress then asked me to choose between two of her possible dresses (and it was cool because she actually took my opinion into consideration). I also followed up with her on that conversation just a couple weeks ago and it turns out she isn’t going for either.. She’s choosing to have her dress styled the way she wants it (almost designing it herself but not really because it’s just piecing parts of the dress together). I would have to say that starting up the conversations is difficult (I’m still trying to get out of the strange shyness I feel there) but continuing with it in one sitting I’m pretty comfortable with.

This time, the vocabulary I learned was not from something that was mentioned in a room or from someone, it was from a pediatric doctor magazine. It’s called Kawaski disease and it causes inflammation in the walls of blood vessels. It’s most common in infants and young children (which is why it was main focus this week) and some of the early stages can be hard to determine from a viral infection (mainly fever). However, some of the later stages the skin can begin to peel which is a bug tell-tale sign.

November 6th – November 19th () – I met one of Dr. Dyson’s son. One of his sons, his youngest (6 years old), has really bad asthma so he had to stay home from school. Since he went out for Halloween the night before, it had gotten really bad. So since he was at the office I got to talk and interact with him. He is soo cute! Anyway, I got to see Dr. Dyson interact with a child in a different light: his own son. He was a little more stern one time since he had to explain what not to do and how he should know better. Overall though, I was in a state of shock at how the little differences in the way he interacts with his patients/parents of the patients versus his child really makes a difference. I guess even though I knew he had a family, it seemed so strange to see him interact that way that I must’ve never fully realized that he had a whole other side.

Well, at first I think I did pretty good. I went in every Monday, Wednesday, and Friday. Then fall break happened and I went in every day, all day which was amazing, by the way. After that, I think it got a little shaky. I continued with the Monday, Wednesday, Friday thing, but with breaks and half days and schedule changes and overall the craziness of my life I have had to cancel on my days so many times, I honestly feel really bad. And a lot of the time I had to cancel last minute through a text to my office manager instead of telling Dr. Dyson myself the last day I saw him. I definitely always told them all i couldn’t make it and normally at least the morning of at the absolute latest (normally though it was the day before). Even though it seems normal, I just feel really bad about doing it so I’ve definitely tried extra hard to stick with the schedule. Overall, I did an okay job but I can definitely do way better.

At first I was great. It all fit very well and it was smooth sailing. Then after break, I began to get overwhelmed with everything I took on this year. I am the event planner for a club at school and this quarter I took on a huge project and balancing that with the internship, two instruments, homework, and family took a toll on my time management. Then I went on a trip and it got even more off. I had to cancel twice on my internship days because I had meetings with people and then I just got so overwhelmed with homework, that I had to cancel another time to spend 4 hours on homework instead of the internship (and I still didn’t get all I needed done by the way. It was a lot). Overall, I can do a lot better in the future but I have to say that I was impressed with my first quarter.

I learned more about ringworm these two weeks. We had a patient with new cats who came in claiming they had issues with ringworm (it was true). Cats can carry ringworm from person to person. Ringworm in a “highly contagious” fungal infection of skin (normally the scalp).