I sat in the freshly sanitized classroom in the miniscule chairs waiting for students to come through the door in all different conditions. One student came through with an IV pole and a huge smile. “Hi, how are you today?” I asked as I knelt down to their level.
“I’m good, do you have any cars?”
“Yeah we do, but you are going to have to built it, but I’ll help you out.”
“Okay, I can do that, lets do it!”
Excited to build their first car the student was mesmerized by the circuit board that we had to make to power the car. After explaining the importance of the circuit, the student went to work, not picking up their head till they encountered a confusing section. We both tried to figure out how to complete the circuit, and ran into some obstacles when trying to fire it up. The student’s energy never ceased as we began to change out the batteries and recheck the whole circuit board, and then off we went. The car began to move across the classroom, as the student tried to control the car with the remote. As the student tried to drive the car, I pushed the IV pole behind them to keep up the student’s enthusiasm. Letting the students be kids, and not make the circumstances of being in the hospital a hindrance to the kid’s ability to have fun and engage in the classroom is important. To avoid disturbing the other students, who were actually working on schoolwork, we went out into the hall of the ward. The student drove the car up and down a portion of the hall, and then I asked, “Hey, do you want to make a maze and then drive the car through that?” Without hesitation he nodded with a teeth-bearing smile. I pulled out some cups and then went to work. The maze started at the classroom and then ended at the door to his room, which wasn’t too far away. Doctors, residents, nurses, parents and other kids kept walking by and through the maze admiring the student’s driving skills. Shortly after mastering the course we began to time the cars run through the maze trying to beat the previous time.
Once the car phase deteriorated, we made a volcano. The anniversary of the eruption at Mt. St. Helens was on Wednesday; so later in the week we built extremely powerful volcanoes out of cups, clay, baking soda, soap and vinegar. The volcano was an erupting machine, having lava spew out eight times in about ten minutes. First with blue lava, then red sparkling lava, and concluding with pink lava, the first and most unique volcano ever made that may go down in history.
This week I had many experiences with children, as the classroom was the place to be on Thursday and Friday, although some of the optimistic students make a greater impression. The student I worked with on Thursday described above, was unable to come to the classroom on Friday, although one would have never known that the student was suffering and about the endure an invasive procedure.
On Thursday I attended pediatric grand rounds again, the lecture this week was on “Deciding Without Data” making decisions based on gut feelings in medicine. The lecture focused on comparing a doctor’s conscious decision to have the patient endure a particular test, and finally determine a diagnosis, in comparison to the methods of the doctor’s mind that occur subconsciously. Many conditions in medicine have little research involved, and most of the time it seems physicians make hypothesizes of the potential diagnosis as the main source of the decision. Research has been conducted constantly on adult cases, although for pediatrics it is difficult to take all the adult results and apply them to children directly. At times doctors have to make a decision without evidence, or only case reports, ask someone, and then if all sources fail rely on a gut feeling and then “guess.” When making a decision neuroscience doesn’t have the exact answer to how the brains pathways elicit a conscious decision, although it is a complex process. Then when considering how we make a guess, is that justifiable? How else would we make a decision if the data weren’t there without making an arbitrary estimation? It seems that when setting out clear algorithms to follow when diagnosing a patient with heart pain or disease for example do we need to get an EKG, stress test, cardiac echo etc… No. In the end of a study conducted on the accuracy and validity of algorithms, the algorithm won. Is too much information better or worse? That is the big question when considering how many tests to do on a patient. Also the algorithms save money, which is highly praised especially when trying to keep up healthcare plans associated with Medicaid and Medicare. In addition, we have to consider the emotion behind reasoning, and it is concluded that up until our conscious decision everything else that occurs in our brains is based on what we are trained to do, personal experience and emotion.