… is the closest medicine will ever get to an assembly line.
Sure, I have a certain appreciation for how evidence-based newborn medicine is: The NRP algorithm (the process we go through with neonatal resuscitation) is rock-solid. The science is satisfyingly pure physiology. There is no Past Medical History. If the baby so much as blinks at you funny, you simply send it to the NICU for a rule-out sepsis work-up.
And the answer to 99% of new parent questions is “Ah, that’s perfectly normal newborn behavior. Your baby’s body is just trying to figure out how to adapt from being in a dark swimming pool to being in the outside world.”
… literally, that’s pretty much the stock answer I use for almost any parent question.
Sure, I like to change it up a bit sometimes – for newborn congestion I’ll say that it’s the baby’s mucous membranes that are getting used to air instead of water… for erythema toxicarum I’ll say it’s the skin cells… occasionally I’ll have to talk about in utero positioning or birth trauma, sure, but… largely, everyone’s simple.
In fact, I’m getting this weird phenomenon where I really enjoy nurses stopping me in the hall to ask me questions. There’s no dread! No sinking stomach feeling! No problem I cannot solve with stock answers!
No matter what the RN asks, the answers are always so clear! It’s so different from general peds! It’s either
- “Oh, really? Let me take a look and then we’ll notify NICU.”
- or “That much weight loss? I’ll go talk to Lactation.”
- or “OK, I’ll put in the order for bili lights.”
And newborn exams are beautiful. Sure, sometimes, when the census is full, I wish I could just line up all the babies in the hallway and do a slow-mo run down the hallway high-fiving all their anterior fontanelles (“Soft and flat! Soft and flat! EVERYBODY’S SOFT AND FLAT! And I’m done with pre-rounds.”) to improve my efficiency, but usually I’m okay with going to their rooms individually.
I guess the biggest problem is that newborns are essentially just fat irritable potatoes.
I really miss being able to make faces at babies old enough to laugh or mimic my dumb expressions.
I think I even miss the babies who are old enough to shoot me skeptical looks.
Mostly I just miss babies who are real, live, people.
ONE TICKET BACK TO GENERAL PEDIATRICS PLEASE.
(One more week…)
Action Potential 