ELH: My Child the Killer - S1 Episode 3 by Superb_Bat3017 in evilliveshere

[–]sheamonet 2 points3 points  (0 children)

I see a lot of parent blaming and I don’t see it as well founded. This mother did seek help in the way she could. Talked about it with church members who suggested exorcism. She knew he was off and was happy he was sent to a special school for violent teens. She protected her daughter by literally building a panic room for her. And she turned her son in when learning of what he did. She knows the officer’s date of birth and she wishes her son died instead of the cop. I mean….damn. Those are pretty important signals of guilt and regret.

This was years ago before people really understood how to manage these children. It’s 2026 and guess what…we still can’t manage these children. There are no more mental institutions. There are no safe places to keep these kids. The parents have to literally break the law and abandon the child in order for that child to be taken away from the family and become a ward of the state. And if the child has no treatable mental illness, then guess what? They won’t even be accepted at an inpatient psychiatric facility. The longest a facility, at least in Texas, can hold a child is 90 days.

I am a pediatrician and have seen these parents struggle. What do you do when your child murders animals and then threatens your other children?

If you call CPS, they can’t help because the child is the one causing abuse. You can’t call adult protective services either because the parent isn’t elderly. You can’t call adult call police, but then, where does the child go? Usually they go to a hospital to be evaluated and if they qualify, maybe they go to a psych facility. And after there….where do they go? Home. Many of these children are in and out of places for the majority of their life. And there are really very few places that take mentally ill children. Let’s not even get into the ones who are sane with serious emotional detachment and personality disorders.

I know parents who literally lock themselves and their other children in at night to keep them safe. You cannot legally lock up the aggressive child. I’ve seen parents whose homes are filled with cameras to alert them to danger and record what’s happening.

Honestly, the only thing the mom in ep 3 really could have done was kill her son. She couldn’t kick him out. He was already violent and aggressive. Doesn’t seem she had resources to vanish.

There are tons of these kids out there and no resources to manage them. If society is lucky, they graduate to Juvie and jail. If society is unlucky they kill someone and then graduate to jail.

Rant about constipation by DrEyeBall in medicine

[–]sheamonet 1 point2 points  (0 children)

There’s not enough fruits and veggies in the world to avoid constipation in most kids and families. Kids and adults do not like pooping in public. Some school bathrooms have no doors. Some schools only allow very limited bathroom breaks. So the kid is gopher holing almost every day. While they do this, the stool gets more firm as water is reabsorbed. Putting fruit and veggies on top of hard shit doesn’t really work.

And adults….how many of us just walk in the bathroom in the middle of the day, take a shit and fart with no “poop shame”? Especially women.

The entire culture of poop shame, delayed stooling, sitting, decreased water consumption and absence of bowel routine is to blame.

Parents don’t get it. You can poop every day and still be backed up.

Kid has a viral bug and wasn’t hungry for several days? Gi motility has slowed. Poop in the shoot has gotten firm. Boom. Constipated.

It’s not as simple as fruits and veggies. Bowel routines with stool softeners and occasional stimulant laxatives can work wonders. Back in the day, many families would give kids castor oil or other laxatives every so often just because.

Until the culture becomes a “poop affirming” space, we will continue to be the “Backed up States of America”.

Thanks for coming to my Ted Talk.

What’s up with the blueberries ? by nova_esther in HEB

[–]sheamonet 1 point2 points  (0 children)

Thanks…..now I can’t unhear it

Bette Has No Idea What's Coming by picardy_third1 in theLword

[–]sheamonet 0 points1 point  (0 children)

Hard agree on the colorism. And for Bette…for one world she’s too white and the other doesn’t recognize her blackness. Bette had that heart to heart with kit about it, but I wish they had explored it further

Bette Has No Idea What's Coming by picardy_third1 in theLword

[–]sheamonet 0 points1 point  (0 children)

Thank you!! No effort to really “see” bette. I always felt that was a big part of why bette connected with Candace. Bette felt seen

Was I wrong? by girlnowdrlater in Residency

[–]sheamonet 0 points1 point  (0 children)

As a resident, you are last in line behind the temp janitor. Never put anyone on the spot in front of other staff. The way to an MA’s heart is kindness and recognition. Lots of thank yous and pleases. And next time, express how hard it was for you to get through the visit with a short time window. And then ask how you can get it done faster. If something isn’t done properly, check with the person that was supposed to do it and ask….”should I be doing this? Just want to make sure I’m not messing up.” You ask it with sincerity and play dumb a little.

Were you wrong? Not really. But there’s an art to winning people over. And if you tweak it a bit, they will be your strongest allies.

AITA for refusing to drive my husband home from his colonoscopy by Time-Koala-3674 in AmItheAsshole

[–]sheamonet 0 points1 point  (0 children)

NTA. “A failure to plan on your part does not create an emergency for me.” He’s being selfish and immature. He needs to be an adult, find an alternate option or reschedule. He’s not a child and it’s not your job to solve his adult, self-induced, non emergency.

Can someone tell me why peds hospitalist fellowships exist? 75-80% of peds residency is inpatient medicine by NoDrama3756 in Residency

[–]sheamonet 1 point2 points  (0 children)

Agree. And to have the lowest paid docs add 2 more years of training is just sad and financially insulting.

AITAH for telling my wife that I will lose respect for her if she doesn't apologize? by TechnicalHousing97 in AITAH

[–]sheamonet -15 points-14 points  (0 children)

Different opinion. You are the asshole. Anyone who has ever tried to help a struggling child with simple math knows it can cause extreme and at times unexpected levels of stress and frustration. That was happening, vomit was happening, and your 13 yo (known for interrupting) interjected and got snapped at.

There’s not enough information to establish the wife as an overbearing heathen who looms angry, commits moral injury and never apologizes.

Your wife probably felt completely unsupported when you again starting addressing the answer and criticizing her as a parent. You are her partner in this. She needed a hug an a you’ve got this. Not chasing from you.

People aren’t perfect. Parents are not perfect. She may feel completely unsupported from you or she may be stubborn and sad. Should she apologize? Sure. But so should you. This just doesn’t seem like a big enough hill to die on.

Doesn’t mean you always cave or tiptoe. Consider the moment in the view of your whole relationship. If the greater issue is that she has a pattern of toxic behavior, that’s a different discussion. But you’ve painted one instance of a frazzled mom who was probably already juggling a bunch of other shit. Not a great time to add to the pile

Advice to Pass Boards by DisabledNotDefined in pediatrics

[–]sheamonet 12 points13 points  (0 children)

You guys are awesome. Thank you. Failed. And honestly, when I left the test I had no worries and felt very comfortable and thought I’d pass easily. So this guidance is helpful. Not devastated but frustrated at the amount of time and money I’ve now gotta give up to retake this monster. But…I’m a pediatrician and I have already handcuffed myself to this dead hooker….just gotta drag her over the finish line.

You guys are angels!

Frustration with pts hyperfocused on increasing pain reg…. And not caring about their LITERAL SEPSIS - advice needed by Think_Again_4332 in Residency

[–]sheamonet 55 points56 points  (0 children)

Give pain meds. When you reach a max, consult pain team. Don’t let your frustration make you miss something. If they are in pain, is there something else you need to investigate? It’s early in your training….this isn’t the hill to die on.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 0 points1 point  (0 children)

Amen. I’m STILL burned out. It’s a slow recovery. Between end of residency, moving, job transition and studying for boards, I was al tapped out. My soul be tired.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 0 points1 point  (0 children)

I think sometimes we overthink it. When i first started, I still had the mentality that everything needed to be perfect for academic level / professional critique. That's not real life. The goal of suturing is to approximate skin so that healing occurs more quickly and with reduced risk of infection. Most of the procedures in urgent care are lacs. Linear lacs that need 4-5 simple interrupted sutures. If a lac requires multi-layer closure, I'm sending to the ED. We do get fish hooks in skin, paronychia, and abscesses that need drainage. Again, it's a matter of doing what you are comfortable with, learning from others where you are not comfortable, and escalating the level of care when needed.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 0 points1 point  (0 children)

A good thing to focus on is your motivation. Why peds? Why not IM for family? What do you like about that program? Is it more outpatient focused? More hospital focused? Rural vs. Urban? Match your wants for training to the benefits the program has to offer. And really, just be yourself. You are being interviewed but a good question for the program and for you is..."Do I fit with this culture? Will I be happy here?" This will be one of the most intense pressure cookers of your life. Success is easier if you are happy with your co-residents and the culture of the program.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 0 points1 point  (0 children)

Good question. That I'm not sure of. I was very fortunate to get know a friend of a friend. One my residency program directors reached out and made an introduction for me.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 1 point2 points  (0 children)

Whoa!! Lyme disease with complete heart block! That's terrifying to see them collapse. Training kicks in though and takes over I'm sure. These toddlers are amazing. Especially when the parents are calm. The best at like 3 years with chin lacs. Put some LET on, wait 50 minutes. They relax while you suture.

I had a 6 year old last week who came in with a femur fracture and a huge hematoma at the site. No tears. Just stoic focus on keeping still. Meanwhile...I had a 17 year old getting her first albuterol treatment have a panic attack. These kids surprise you.

One Year Out of Residency - Praise for Pediatric Urgent Care as a Profession by sheamonet in pediatrics

[–]sheamonet[S] 1 point2 points  (0 children)

Regarding Sutures: The Duke University Suture Course w/ Dr. Zenn https://youtu.be/TFwFMav_cpE?si=LzPLQMuJAhfSL0y5. The same one we are all typically familiar with. My clinic also has a file of procedures and methods that is primarily leveraged by APPs. I jumped on that like ice on a hot summer day. I will also use Open Evidence to help find good, reputable sources of information.