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Chapter 14: Pediatric Reality

  The afternoon dragged. More ward work, more documentation, more feeling useless while trying to look busy. By four-thirty I was done with my assigned tasks and Pierce had disappeared somewhere, probably back to clinic or theatre. Nobody told us students when we were officially dismissed so I just... left.

  Walked through the corridors toward the main exit, taking the long route because the shortcut was blocked by some maintenance crew fixing a broken water pipe. The detour took me past the Pediatrics ward on the third floor.

  The noise hit first. Crying. Not just one kid but multiple kids at different pitches and volumes. A baby wailing that high-pitched newborn scream. A toddler screaming words I couldn't make out. An older kid sobbing in that hitching, gasping way that meant they'd been crying for a while.

  The ward was painted in bright colors, walls covered with cartoon characters and animals, probably meant to be cheerful but coming across more manic when combined with the noise level. Parents clustered around beds looking exhausted and stressed. And there, near bed 4, was Akki.

  He was holding a screaming toddler, maybe two years old, red-faced and furious, while trying to listen to the kid's chest with a stethoscope. The kid was having none of it. Arched his back, twisted away, swatted at the stethoscope. Akki's face was a mask of concentration and barely suppressed frustration.

  A woman stood next to him, the mother probably, watching with this apologetic expression. Behind Akki stood a doctor, mid-forties maybe, arms crossed, watching with obvious impatience.

  I stopped in the doorway. Shouldn't have, should've kept walking. But watching Akki struggle was somehow compelling in a schadenfreude kind of way.

  Akki tried repositioning the stethoscope. The kid screamed louder and kicked him in the stomach. Not hard enough to really hurt but enough to make Akki wince.

  "You need to get control of the patient," the doctor said. His voice cut through the noise easily. "I can't assess your examination skills if you can't even keep the child still."

  "He won't—" Akki tried to adjust his grip. The kid twisted harder. "I'm trying to—"

  "Trying isn't doing. Do you know how to properly restrain a pediatric patient for examination?"

  Akki's face went red. "I don't want to hurt him."

  "Restrain doesn't mean hurt. It means secure. Hold his arms against his sides, support his back, keep him still long enough to auscultate. Basic technique."

  Akki tried. Got one arm secured but the kid got the other one free and grabbed a fistful of Akki's hair. Yanked hard. Akki yelped.

  The mother finally intervened, gently extracting her son's hand from Akki's hair. "I'm so sorry, he's not usually like this."

  "It's fine," Akki managed, though his scalp was probably screaming. He tried once more to position the stethoscope. The kid was crying so hard now that even if Akki got the stethoscope placed correctly, there's no way he'd hear anything over the screaming.

  The doctor uncrossed his arms and stepped forward. "Enough. You've had five minutes. Step back."

  Akki stepped back, defeated. His hair was sticking up where the kid had grabbed it. His shirt was rumpled. He looked miserable.

  The doctor took the stethoscope, then turned to the mother. "May I?"

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  She nodded. The doctor picked up the toddler with this smooth confidence, held him against his chest with one arm securing both of the kid's arms, supporting his back. The position was firm but not rough. The kid still cried but couldn't thrash as effectively.

  The doctor placed the stethoscope and listened for maybe ten seconds. "Breath sounds clear bilaterally. No wheezing, no crackles. Respiratory rate elevated but that's from crying." He set the kid down back on the bed. The mother immediately scooped him up, comforting him.

  The doctor turned to Akki. "See? That's how you do it. Confident and firm but gentle. The child can sense when you're uncertain and it makes them more agitated." He pulled off the stethoscope and handed it back to Akki. "Practice that technique before tomorrow. You'll be examining another pediatric patient and I expect better."

  "Yes, sir."

  The doctor walked away to the next bed where another student was waiting, looking terrified after witnessing Akki's failure.

  Akki stood there for a second, then noticed me in the doorway. His expression cycled through surprise, embarrassment, then irritation. He walked over.

  "How long were you standing there?"

  "Long enough to see you get your hair pulled."

  "Fantastic." He walked past me into the corridor, moving fast. I followed.

  "That looked—"

  "Don't. Just don't." He kept walking, heading toward the stairs that would take us down and out of this building. His jaw was tight, hands shoved deep in his pockets.

  We made it outside before he finally stopped, leaning against the wall near the entrance. Took a deep breath. Let it out slow.

  "Kids are impossible," he said finally. "They don't cooperate. They can't tell you what's wrong. They just scream and you're supposed to somehow examine them through the screaming and figure out what's wrong and not look like a complete idiot in front of your attending."

  "The doctor seemed... Well, how to put it... Like... "

  "Like an asshole? Yeah. Dr. Morrison. He's known for it." Akki rubbed his face with both hands. "He picks one student per day to publicly humiliate. Today was my turn apparently."

  A woman walked out of the building pushing a pram, baby crying inside it. Akki flinched at the sound.

  "I don't know how people specialize in Peds," he continued. "You'd have to actually like children. I don't dislike them exactly but I don't... I can't..." He gestured vaguely. "I can't do the thing where you're confident and calm and they magically stop crying. That's not a skill I have."

  "Maybe it's learned."

  "Or maybe some people are just naturally better with kids and I'm not one of them." He pushed off the wall. "Anyway. How was Ortho?"

  "Changed bedsheets. Watched surgery from a gallery. Got called furniture by fourth years."

  "So about the same level of usefulness as my day." He started walking toward the main gate. "We're both useless. Excellent."

  We walked in silence for a bit. The rain had finally stopped but everything was still wet, puddles everywhere reflecting gray sky.

  "You coming to the emergency meeting tonight?" Akki asked. "Wait, we already had the emergency meeting. Never mind."

  We reached the gate. Both of us wet, tired, thoroughly demoralized by a single day of clinical rotations.

  Inside our room Murin was already back, sitting at his desk with textbooks spread out. Looked up when I came in. Akki went to washroom.

  "How was day one?"

  "Survived." Dropped my bag on the floor, collapsed on my bed. "Saw Akki get destroyed by a toddler in Peds."

  Murin's eyebrows went up. "Destroyed how?"

  "Kid wouldn't let him examine. Pulled his hair. Attending made him look incompetent in front of the mother."

  "Morrison?"

  "Yeah."

  "He's notorious. Does that to everyone." Murin went back to his notes. "Akki will be fine. We all get humiliated eventually."

  "Comforting."

  My phone buzzed. Pulled it out. My mother again.

  Don't forget to call your father tonight. He wants to hear about your new rotation.

  Great. Another conversation where I'd have to pretend everything was fine and I was learning so much and definitely not spending my days changing sheets and feeling useless.

  Typed back: Will call him after dinner.

  "Yeah, thanks for that."

  Murin looked over. "You talking to yourself now?"

  "Just tired."

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