Finding Home

   Yesterday I came home and was on call (Mombasa epic post is coming...).  It was an odd day, it was a holiday but the outpatient clinics where open so it was crazy busy with only two interns and a few consultants (attending like folks). I was playing a role in the later. The consultant on the day before me (who actually kindly switched calls so I go to Mombasa had a terrible, terrible night the night before). She paged me at 6:20 AM to ask if I could come in early so she could sign out. We had multiple premies, two codes and a kid with severe, severe dehydration and bilious aspirates to inherit. I rounded on the most of nursery and Gen Peds. It took me till 2 PM to get it all squared away. My severe dehydration kid had to have his labs drawn three time to get adequate sample. I felt inadequate because I am inexperienced with access because I get such few chances to try. Glad for my Anesthesia rotation next year. Finally when the labs came back his sodium was 199 and his Crt was 10.  So dialysis is not an option, we aggressively hydrated him and I prayed that it would help. I honestly felt ok about the gen peds patients but some of the sick critically ill newborns are above my pay grade as a peads intern on my own.
   I loved my first two weeks on nursery. But I am no neonatologist.  My attention span is severely lacking  when it comes to advancing feeds (about 5 mins in I am daydreaming about something else). I like the delivery room, the procedures and the codes best. I like talking to the parents (because we all know I like to talk and that there is really no one I won't talk to...including myself or the walls ;)). Details are not my strong suit and my big picture thinking makes NICU torture if I had to do it forever or ALL the time. But in small doses I like it which is good becuase I am going to do it in the future if I live here.
    I have been on general paeds the last week or so and its not nearly as organized as nursery. Honestly, its barely organized chaos. But I sort of like it that way which most likely indicates some sort of odd personality flaw. (Although my highly OCD, complete opposite of me partner last month on Cards says that I am amusing and refreshing in this way). The attending treats me like a senior resident on steroids and I ran rounds by myself this AM.  And surprisely despite the fact I am still very, very dumb. Somehow it worked and it was like I had been doing it for a long time. I admitted that I have no idea what to do with my GCS of 5 TB meningitis teenager minus praying (not really a candidate for a vent when we only have limited number and he is going to be in a coma indefinitely). But there were also things that I did know. I went back over the patients with the attending later and much to my amazement we changed very little of what I chose to do...awesome and scary.
   I gave a presentation today on Diagnosing and Initially Managing Congenial Heart Disease (on a Shoestring aka NO ECHO and basically NO ECG).  I really enjoyed it. Teaching makes me happy. In general, being here makes me happy. I love this work so much.
    Everyone keeps speaking of HOME and how I am going there in three days but I find that a confusing idea. Where is Home?  Is Home OHIO?   Honestly...not really. Ohio is sort of like boarding school or boot camp or something of the like. I enjoy my work, my friends and my church but it still feels like I am camping there for a time.  Is Home NC/VA?  In some ways YES. I pine for old friends, BBQ, humid afternoons, Southern Draws and mountains.  But there is no work for me there.  Is Home Kenya/Mission Field? Yes, in some ways it is. It certainly is my professional home. In the same way my classmates seem to be finding homes in hematology and PICU and neonatology. This is what makes me excited about pediatrics. And even deeper, this is where some my most profound and most cherished relationships are. 

I am both leaving and going home simultaneously in the strange paradox that is my life.