The Bird in Flight

Sorry, no picture today.  I haven't really had the inspiration to take any photos lately, hence my lack of posts...  Anyways, life is speeding along as always.  I finished up my month at CHOC, and I'm still pretty happy with the idea of becoming a pediatric cardiologist.  I'm working at UCI now, doing a sub-internship in pediatric ward medicine.  UCI's pediatric program is mostly based at Miller's Children Hospital, and interns really only spend one or two months at UCI Medical Center (where I am).  As such, it's a very low-key rotation, and I don't follow a lot of patients.  Things were very frustrating at first: it took some 30 phone calls to get access to the computer system, they refused to give me a pager so I had to buy my own, and lots of small things like the way they do their discharge summaries infuriated me.  But I settled in and now I'm enjoying myself quite a bit.  Phew!

Which brings me to the title of this post.  To cap off the first week and my first night on call, I got woken up by a page in the early morning because one of my kids had broken yet another fever.  The kid needed a lumbar puncture (aka spinal tap), and I had to do it.  I got a little scared, imagining the horror of sticking a needle into the spine of a 4-month-old baby and somehow wrecking the spinal cord or something, paralyzing him for life.  Which of course couldn't happen if I even barely knew what I was doing, since really the most serious complication would be an infection or maybe an allergic reaction to lidocaine.  I wouldn't be poking around where the spinal cord lies, just where the fluid collects.

So I went over the procedure with my senior resident, and we got the baby ready.  With the parents just outside the treatment room all teary-eyed and the baby crying inconsolably, I put on my sterile gloves and got to work.  Finding the right spot was tricky at first, but I figured it out.  I broke sterility.  Oops.  I changed gloves, and finally put in the needle.  I pushed forward in a gentle motion, staying straight as I could, and I felt the pop I was told to expect.  I pulled back the stylus, and badabang!  CLEAR AS WATER!  No blood at all, just pure, pure sweet cerebrospinal fluid (brain urine).  A champagne tap!  On my first try!

Now I know I was lucky (there are so many variables), but hey, that was still awesome.  Bwa!  And no, I didn't paralyze the baby.  I checked in on him about 30 minutes later, and he was just as happy as he could be.  (He was being fed.)