For as long as I can remember, August is the time of year for my yearly physical. My height and weight are measured, my heart and lungs are listened to, and I answer all sorts of questions. However, this summer, I have gained an inside peek into the world of pediatrics through shadowing Dr. Chung at the Pediatric Associates of Brockton. At his three locations in Brockton, Canton, and Bridgewater, we saw well visits for people from ages 4 days to 23 years old as well as sick visits for anything from strep throat to swimmers’ ears.
During my first couple of days, it was great to observe the rhythms of a well visit. From “What have you been up to this summer?” to “How many cups of milk do you drink a day?” I witnessed how Dr. Chung forms long-term relationships with his patients while asking rather mundane questions in interesting ways. As the weeks progressed, I grew more comfortable interacting with patients and having conversations about Percy Jackson and Pokémon. Through lots of repetition, I grew more confident using otoscopes to look into patients’ ears and stethoscopes to hear what a normal heart and lung will sound like. I even got to remove a suture! I also learned how much thought and observation go into each patient interaction. For example, I l started to figure out how to get a two- year old vs. a six- year old to trust you. I also learned the importance of going beyond just giving medical information and explaining the “why” behind the advice. Lastly, and perhaps inevitably, after hearing the importance of eating your green veggies and turning off your phone 1.5 hours before bed multiple times a day, I also picked up some healthy habits.
During the sick visits, it was fascinating to see what goes into making a diagnosis. Before seeing the patient, Dr. Chung would go over information such as the patient's history, family, and current symptoms and narrow down what is most likely/what would be the worst-case scenario. By first seeing the "behind the scenes," it gave me context for understanding how the actual visit went and how Dr. Chung narrowed down the almost infinite possibilities of ailments into a diagnosis by asking questions, doing a physical exam or running tests.
Through seeing thousands of patients, one interesting observation that Dr. Chung has made is that some kids never get strep throat, and some kids get strep all the time. Additionally, this "strep trait" seems to run in families. Caroline Lefebvre, a past intern, tested this theory by conducting a Rivers survey. The results seemed to confirm this hypothesis. Knowing this, during one sick visit, Dr. Chung asked the young girl's mom if she was a "strep kid." When she responded that she got strep all the time, it made sense to run a strep test on the patient, and sure enough, she tested positive for strep throat. While strep was not the initial guess, I saw the importance of adapting and using all the information available to make the best decision possible.
Dr. Chung demonstrated how to make a splint.
Pediatric Associates of Brockton is part of the Reach and and Read program where books are given out at each well child visit between six months and five years of age. Dr. Chung emphasizes the importance of reading, advising parents to read 8-10 books daily to their young children. For my project, we had the idea of making a children’s book series where the reading level of books would “grow up” with the reader.
I began by reading children's books for various ages (and rereading some of my childhood favorites) to see the differences between reading levels. For example, many board books are nonlinear, meaning that every page can stand on its own, which is perfect for babies who are exploring how to turn their own pages. Also, many books can serve different purposes for different ages. What was once a bedtime story can turn into an interactive game and later become a tool for practicing reading to a younger sibling. I began writing my own stories about animals, numbers, and medical mysteries. I worked with Dr. Chung to understand how children develop as they grow older. While my time shadowing has ended, I will definitely continue to work on this project and maybe one day will have real books to give to kids at their pediatrician's office.
I have had an absolutely amazing experience this summer and every day seemed to just fly by. Through this invaluable, hands-on opportunity, I learned so much from Dr. Chung about pediatrics and medicine as a whole. I want to give a huge thank you to Dr. Chung, Mr. Schlenker, and all the medical staff and patients who let me learn from their visits.