Articles and Case Studies

What I Love About Paediatrics

22 Mar 2016

by Dr Conor Hagan

Some people start and/or finish medical school knowing exactly what they want to do. Some people even seem to have been born with an innate knowledge of their chosen specialty, and woe betide anyone who stands in their way.

Others tend to accidently stumble into the right field and are left with a lingering suspicion that someday, people will find out how much they enjoy their job and start charging them for it.

It was often said during my student years that I would make a good paediatrician (this is by far the nicest way I know of being told I’m behaving like a child). I signed up for twelve months to start with, ensuring I tested it out thoroughly before making any career defining decisions. Halfway through that year, I found that I was indeed a square peg in a square hole! And while I’m not so much climbing the career ladder as meandering in a vaguely ascendant manner, I’ve no regrets about what I do. Here are some reasons why:

It’s very rarely their fault

They didn’t get type II diabetes because they’ve been mainlining sugar through their eyeballs. They didn’t get their third myocardial infarct because they can’t say no to a burger. And their asthma is not exacerbated by their smoking habit. This is a huge deal for me. A patient who bursts into tears when you tell them they need a needle is acceptable when they’re not twenty five. Sure, occasionally a kid comes in with injuries following a stunt that any adult would preface by saying “hold my beer”, but those cases are more amusing than annoying – which brings me to my next point.

They make you laugh

Kids are unintentionally hilarious – from the girl who, after her first puff of salbutamol, gravely informed me, “I’ve had  enough medicine, thank you” – to the young boy who paused in the middle of oral dexamethasone administration to point out: “it smells of blackberries and tastes disgusting”. I’ve lost count of the number of times my professional demeanour gets thrown out the window and I burst out laughing. Not only is it acceptable, but parents will often be laughing right along with you.

They get better quickly

Average length of inpatient stay is in the order of two to three days. In that timeframe, they can go from struggling with each breath to giggling while they hit you with a teddy. That is satisfying. There is a tangible sense of achievement in making someone better so quickly, although in all honesty it’s the child’s body doing most of the hard work while we take the credit. Part of this is due to the fact that they’re incredibly resilient. Kids will bounce back from things that will floor an adult, without any of the bragging. Some of them aren’t even that sick to begin with and all that’s required is some parental reassurance. Allaying a parent’s fears with simple knowledge is surprisingly satisfying.

People are nicer

Because they have to be. Once you’ve upset a child, it’s hard to get the examination findings you need. So we fall into the habit of being friendly and approachable to make our patient interactions more successful, and this spills over into all our interactions. The lack of cross examination for every single referral you make lends itself to a laidback work environment.

You can still specialise

It’s a specialty that allows you access to all the other specialties – Cardiology, Nephrology, Rheumatology and even Palliative Care, all have their own paediatric version. You name it and it’s probably available. All you really miss out on is Geriatrics – but Neonatology is not so different, just with smaller sized nappies. When you sign up for Paediatrics you’re not limiting your career options, you’re just focusing them.

Dr Conor Hagan (MDA National Member)
Advanced Trainee General Paediatrics
Princess Margaret Hospital, WA

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