By virtue of being one of the only pediatric attendings in the hospital, Lillian found herself in charge of ten different pediatric services. Only PICU, NICU, and heme-onc had attendings, so it was up to her to divide and conquer what was left.
Which left her to cover one hundred patients spread through the fifth, seventh, and eighth floors. Their full hospital capacity was easily double the current numbers, but the chief residents had made an effort last night to discharge every possible patient before the storm.
Of course, none of the chief residents were here today.
“This baby’s Apgars are 9 at 1 minute and 9 at 5 minutes,” Clarissa declared in her ‘what a great delivery voice,’ allowing reality to intrude.
They were on the fifth floor in Labor and Delivery at every delivery because most of the respiratory therapists who attended routine deliveries were out. The current delivery team was Lillian, Clarissa, and yesterday’s post-call medical student, Doug.
Clarissa and her two roommates had fought their way together through ice and snow the ten blocks from the resident and fellow housing in Doctor Row. The post-call resident was doing newborn checks in the main nursery since she was too shaky to stay upright from lack of sleep after the NICU had called her for help overnight. Unstable preterm babies apparently were unaware a city-stopping blizzard was raging.
“Apgars 9 and 9,” Doug repeated, writing down the numbers on the delivery note. As per usual, the medical students got more sleep than the residents since his delivery pager never called him to the NICU.
“Good.” Lilian got off her BAT phone from her call with one of the neurology residents. According to their resident, their patients were currently stable. All the pediatric and general pediatric clinics were closed.
Not letting the med student touch the baby, Clarissa gave the infant to the single remaining nursery nurse. The baby boy was placed on his mom’s chest for post-delivery skin-to-skin, and their team bowed out to the hallway.
“You don’t have to be here, Dr. Hernandez,” Clarissa said. “Sleepyhead and I can handle it. Can’t we?”
Doug looked one hundred percent terrified. “No. Please stay.”
“What specialty are you thinking about?” Lillian asked. So many male medical students acted like babies were space aliens.
“Internal medicine.”
“You just don’t love bundles of joy yet,” Clarissa said cheerfully. “It’s okay. We might convert you.”
The medical student’s face clearly stated that was quite unlikely.
The second pager on his belt went off—not the delivery pager. He glanced at it and quickly erased the message.
Something similar had happened during the start of the delivery. Lillian asked, “What did it say?”
“911. Mass casualty incident. It does an automatic group call to the medical student pagers. Delivery call supersedes those.”
No wonder they rarely heard those on peds. Most mass casualty events were adult only, and pediatrics had fewer medical students than any other service. Outside of the mandatory third year ICU rotation, which was split between NICU, PICU, and MICU, the med students only did a month of outpatient peds clinic. Inpatient pediatric rotations were voluntary and primarily taken by fourth years who were planning on careers in pediatrics.
As the words left his mouth, Lillian’s phone rang again. “Hello, Dr. Hernandez.”
“This is Dr. Angela Perkins, downstairs in the ER. I’m the cardiology fellow… actually, I’m running the internal medicine service this morning.”
“I see. I’m the current pediatric attending. How can I help you? Do you have a consult?”
“No, I don’t have a consult, but I do have a whole nursing home. It’s asking a lot, but do you have any medical students we could borrow?”
“You want my medical students?”
“Yes,” Dr. Perkins said emphatically. “If it has a pulse and a short white coat, I’ll take it off your hands.”
“Peds doesn’t have a ton of medical students on a good day. Today, I have four medical students total, and they’re all post-call zombies.”
“Me too. The medical student dorm is frozen closed. Unless the med school issued pickaxes and snowmobiles, more aren’t coming, so we’ll take whatever you’ve got.” Perkins’s voice got muffled as she fired off a long list of orders to someone in the background. “Can you spare any?”
“I’ll gather the couple I have.”
“I don’t suppose you have any rotating family medicine residents? I could use any body that can admit above the age of eighteen.”
“Thanks to the affordable health care act, the hospital lets me admit up to twenty-six,” Lillian clarified for her. “Provided they aren’t pregnant, there isn’t much of a difference between a seventeen-year-old and a twenty-two-year old.”
