Supervising Editor: Brian J. Zink, MD.
Article first published online: 20 NOV 2012
© 2012 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 19, Issue 11, pages 1316–1317, November 2012
How to Cite
Koo, K. (2012), Up, Up. Academic Emergency Medicine, 19: 1316–1317. doi: 10.1111/acem.12001
- Issue published online: 20 NOV 2012
- Article first published online: 20 NOV 2012
“Latonya, you sit down right now!”
The smiling child kneeled gracefully on the seat of the plastic chair, mimicking the Disney princesses that adorned her patent-leather pumps.
“Up, up!” she whispered to her mother.
Curious, I thought. Though I was still the “newbie” medical student here in the pediatric emergency department (ED), my intuition told me I was looking at a playful two-year-old girl, who was babbling happily even in these strange surroundings. If anyone in the room needed attention, it might be Latonya’s mother, who appeared very pregnant and as if she might launch into labor at any minute.
“What brings Latonya to the ED today, Mrs. Jenkins?” I inquired.
Mrs. Jenkins tilted her head back slightly.
“She ain’t eatin’ right.”
A week ago, Latonya had had several episodes of vomiting and diarrhea. She became fussy and irritable, “cryin’ like there’s no tomorrow.” Her appetite all but disappeared, and she refused even her favorite foods.
“This morning she finally ate some cereal and a banana, but I brought her in because I dunno what’s happening,” Mrs. Jenkins said wearily. Beads of sweat dotted her forehead.
Latonya had crawled down to the floor and was hugging her mother’s legs.
“Up, up!” she squealed, raising her arms skyward. Mrs. Jenkins obliged, scooping the child up against her heaving chest.
I listened to the rest of the history, then examined Latonya, who was amused by the crinkling of the exam table paper. Satisfied by normal findings, I returned Latonya to her mother and explained that I suspected a case of gastroenteritis, perhaps food poisoning. As I was about to step out to confer with the attending physician, Mrs. Jenkins’ eyes rolled backward, then her arms went limp. Latonya slid to the floor.
“Can you hear me, Mrs. Jenkins?!”
Her body began shaking, jerking back and forth.
My eyes were fixed on Mrs. Jenkins’ protruding belly, my mind racing. She’s pregnant, and I’m pretty sure this is a seizure, a voice reasoned inside my head. Quietly relieved that we were already in an ED, I yanked the door open and flagged down the first long white coat I could see.
Within seconds, a half-dozen nurses, residents, and physicians were in the room, trying to fit pediatric blood pressure cuffs and nasal prongs to this very adult-sized patient. Monitors beeped, oxygen jets hissed, computers whirred: a symphony of emergency room medicine, the musicians all part of an efficient team.
I watched the scene from a corner of the room, looking supportive but unsure of what my idle hands could contribute.
I haven’t even done my obstetrics rotation yet, I lamented. Everyone seemed to have a role to play—what was mine?
And then I felt a tug on the right leg of my trousers.
There was Latonya, unseen by the doctors but bewildered by the commotion. I tucked my hands—at last!—under her arms and raised her high in the air. She grabbed the bell of my stethoscope, distracted by the smooth metal under her fingers.
“Come on, Latonya,” I said gently, sliding sideways out the door, “let’s go play.”
As a nurse started an IV in Mrs. Jenkins’ arm, Latonya and I gazed at the colorful illustrations in The Very Hungry Caterpillar. While Mrs. Jenkins was lifted onto a stretcher, I offered Latonya a Barbie sticker of courage, which she affixed proudly to her sweater. And as Mrs. Jenkins was rolled down the corridor toward the ED for grown-ups, we followed two steps behind, my patient perched comfortably on my arm.
A few minutes later, when Mrs. Jenkins awoke groggily, there was only one thing on her mind.
Latonya perked up at the voice, and I laid the girl at her mother’s side.
“Where’d you get that from?” I heard Mrs. Jenkins ask, pointing at Latonya’s sticker. I backed out of the room and headed toward the familiar pastel walls of the pediatric ED. Perhaps Forrest Gump had intended to say that, in fact, the ED is like a box of chocolates—you can never quite tell what you are going to get. Life in the ED rarely goes according to the playbook, I thought to myself, but an experienced team is prepared for any patient, or her mother, who comes through the sliding doors. And if the situation falls apart, even a pair of unseasoned hands can pick up—up, up—what might otherwise get left behind.