Week 9: Accident Prone

          A panicked mother presented to the emergency room with her sixteen-month-old child. Upon physical examination, both of the child’s feet and ankles were reddened and blistered, exhibiting burn marks that extended about two inches above each ankle, abruptly stopping thereafter. The mother, notably upset, reported what had occurred prior to transporting her child to the emergency room. The mother explained that she had exited the bathroom to answer a ringing phone, leaving her child alone, bathing in the bathtub. About ten seconds after her leaving, the mother was suddenly startled by a scream from her child, who had accidentally turned the hot water faucet, which resulted in expulsion of scalding water into the bathtub, the burn marks being the result. The mother’s story, though seemingly convincing, was a blatant lie (as detected by an emergency room PA, my professor). Her child did not stand up in the bathtub and turn the hot water on; it was the mother who filled the tub with the scalding water. It was the mother who then lifted her uncontrollably crying child and lowered the child’s feet and ankles into the water, submerging them long enough to burn and blister. This was the mother’s attempt, her punishment imposed on her child, to stop the child’s persistent crying. This was a prime example of child abuse.

          It is a mandate in the state of New York that PAs become certified in recognizing cases of child abuse and/or neglect. With this certification, PAs are obligated to report suspected cases of abuse to the appropriate authorities. This week in Behavioral Medicine, we acquired such certification and learned how to recognize and detect child abuse, especially based on the faulty stories documented by a child’s abusive parents. The subject was not an easy one to discuss, and the pictures and cases of the abused children that we studied were all extremely disturbing. All of the stories were based on true events experienced (children treated) by my professor, who stressed the importance of recognizing the common excuses that abusive parents may make, like introducing their child as “clumsy” or “accident prone.” We also learned the relative probabilities of injuries that may occur when a child slides down a flight of stairs, rolls off of a bed, or free-falls from various heights. Surprisingly, very minor injuries are a result of such accidents, so if a parent presents a child with broken ribs from a reported “sliding down a flight of stairs,” the parent is likely lying. Overall, I greatly appreciated this lecture, and I should receive my certification, by mail, in the near future.

          In addition to other classes, which I have focused many of my previous posts on, there is another course I am taking called PA Professional Issues. It focuses on all of the legal issues that concern the PA profession, what we can and cannot legally do as PAs, and medical ethics. We have had a couple of group projects assigned throughout the course of the semester, one of which is due next week. Each group was assigned an ethical case to analyze, specifically the legal and ethical issues that apply to the scenario. My group’s scenario goes a bit like this: a middle-aged female who has been our patient for nine years has been battling recurrent cancer (first in her breasts, now spreading to her bones and spine), and she informs us that she doesn’t want to go through “the last of life’s great experiences drugged out of her mind for pain.” She would therefore like our help in assisting her to end her life by discontinuing her cancer treatment. That’s the case that we have one week to solve, so it should make for some interesting class discussions when we present our topic and findings. 

          All of my other classes are progressing well. This week, we dissected Summer’s reproductive system (uterus, ovaries…etc) and learned the reproductive anatomy of the male cadavers as well. Performing my first pelvic exam on a cadaver was an experience I’ll likely never forget (though I’ve been trying my best to forget about it). I’ll keep the other details of the dissection to myself (unless you want the details…in that case you can ask me personally. I’ll tell you all you want to know!). This week in GI we focused on diagnosing and treating disorders of the esophagus and stomach (ulcers, gastric reflux, infections…etc). Our ID class was cancelled this week, so the information will likely be doubled for next week’s lecture. I think this week was one of the more memorable ones. The topics covered in Behavioral Medicine and PA Professional Issues truly verify the fact that this profession does not only entail the physical treatment of patients; there are important emotional and psychological aspects that must be accounted for in the ultimate treatment of our patients as well. As challenging as the schooling is proving to be, after this week, I have never been more certain that I am pursuing the correct career.

Question of the week: A research study conducted between the years of 2007 and 2008 determined the prevalence of child abuse cases (reported and unreported) on Long Island. The presented findings state that, on Long Island, one child is abused every ______________ on a daily basis (choose one of the possible answers listed below).

  1. 37 seconds
  2. 11 minutes
  3. 4.5 hours
  4. 13 hours 

Last week’s answer: The viral infection, associated with fever, sore throat, and swollen cervical (neck) lymph nodes, also referred to as “the kissing disease,” is mononucleosis.  

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