1) Home to DSS: This morning we discharged 2 of our newborns "home." For them, home meant into the custody of the Department of Social Service. On many levels, this situation is less than ideal. Less than ideal because it means that these kids came into the world, and their biological creators were deemed unfit to take care of them. Deemed unfit by the pediatricians (us), who notified the state about our concerns for the welfare of these children. The state then investigated and went to court to take custody of these precious 2 and 3 day-old children. The children then end up in a foster care for the night, or for their life, or get adopted, or maybe get re-united with their parents. We gamble that going into the world of foster care means that these children will be loved, sheltered, and fed to the extent that they wouldn't have received from their bio parents. I think it is a shitty way to start life. The protective pediatrician in me almost would have preferred taking these kids home myself!
2) PPI. Or proton pump inhibitor (ie, omeprazole-Prilosec, esomeprazole-Nexium). I was chatting with a fellow resident about my upcoming month in the CCU. I start in October, and it's a bit anxiety provoking. She was kind enough to point out that she had to start taking meds for ulcers during that rotation. Comforting. Thanks.
3) Pregnancy Testing. If you walk into a clinic, and you ask for a pregnancy test, and while waiting for the results you GIVE BIRTH TO A BABY-is the test positive? I kid you not. And, this woman has had a baby before. I know there is some serious comedic potential here... What bothers me most is that there has been no prenatal care. I've thought about this for a few hours now.. no prenatal care. We've done such a good job medicalizing a normal process like pregnancy and birth that I had to stop and think this afternoon about what to do for this kid. The kid looks great. But what if mom has hepatitis B, or HIV, or untreated group B strep, or or or... Or the fact that this woman, who admitted that she "knew but didn't know" she was pregnant made no attempt to ensure that the child she was carrying was healthy. Is this woman fit to be a parent? Am I passing judgment or am I really just focusing my concerns on the welfare of this child? hmmm