it was a dark and stormy....week

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I have written before about being "on service" for a week on the pediatric inpatient unit.

I love it. I hate it. It's fun. It's exhausting. It's happy. It's sad. But mostly its never dull.


This week just past was no exception. Monday though Friday felt like it happened too fast. I was sooo tired by the end of the week, but I felt fulfilled. It was a difficult week. There were many unknowns, and much sadness, but it was totally worthwhile.

I can't discuss any specific patient cases with my readers. I can't tell you their names, ages or genders. But I can give you an idea of what was going on, what the week was like. Kind of like watching "Grey's Anatomy," "House," and "ER" all at the same time.This was April fool's week, and at some points we felt that mother nature was playing the ultimate joke, by having it snow in April. And there were times when I wished some of what I witnessed was not real. But alas, we have no scripts, no contrived endings, no magic wands or crystal balls. I cannot kiss it and make it better, no matter how much I might want to so so. There is no "happily ever after" for anyone--patient, staff or physician. We are all just human, after all.


I had medical students who had never been on pediatrics before. I did not know until the end of the week just how scared they were of the kids. I had experienced interns, residents and nurse practitioners. That was very important, because the patients had complex problems that were difficult to deal with sometimes.


Here is an incomplete list of the problems we saw in our patients this past week. It was quite busy--we even had to take care of some patients in other units of the hospital. That is no fun at all, since we are so used to staying in our own little corner of the world.


abnormal weight loss

belly pain

breathing trouble


chronic lung disease





genetic disorders

heart disease

neonatal fever

possible child maltreatment

renal failure


skin infections

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The children ranged in age from a couple of weeks to seventeen years of age, and in size from smaller than a bread box to as big as a linebacker.

We saw family dramas play out on our unit, some not so happily. But for the most part, the children got better, and most that I was taking care of at the beginning of the week were home by the end of it.

That's really not bad.

photo credits: castle, wand

About Dr. Ackerman

Alice Ackerman, MD, MBA, FAAP, FCCM is the Chair of the Department of Pediatrics at Carilion Clinic and Professor and Founding Chair of Pediatrics at the Virginia Tech Carilion School of Medicine. Dr. Ackerman is recognized nationally as an expert in pediatric critical care.

She has been at Carilion Clinic since June of 2007. Her primary goals are to enhance the health care of children in the Roanoke Valley and Southwest Virginia, and is actively working to do this both as physician in chief of the children's hospital, as well as through involvement with many state-wide initiatives.

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