Did you know that one third of your brain is dedicated to vision? Of course this is something that I would think about on a pediatrics rotation! Let me explain:

First of all, pediatrics or “peds”, rocks! For most of my life I have always wanted to be an ophthalmologist, and now I think, maybe I want to be a, wait for it — a pediatric ophthalmologist. I am currently rotating at Good Samaritan Regional Medical Center in Corvallis in the Pediatric Inpatient Hospital Unit, and it is incredible.

Pediatricians in the hospital attend baby deliveries to help resuscitate, if needed, the baby in the first few minutes of life. They screen newborns (like a physical exam for babies) within the first few hours of life, and they also deal with acutely ill children that are in the hospital. Pediatricians are some of the nicest people that I have ever worked with.

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Being born into this world is a rather stressful experience. Could you imagine having an elephant sit on your head? The force of going through the birth canal could be comparable to that. Babies are often tired right when they're born.

They could have amniotic fluid in their lungs, and a whole host of other issues. Therefore, a baby’s heart rate is monitored while in mom’s uterus during labor, and if indicated, the hospital pediatrician is in the delivery room or operating room when the baby is born.

In the first few minutes of life, the baby’s doctor suctions fluid out of the lungs, or provides a CPAP machine to help with breathing. Despite the stress on the baby that labor produces, this process actually helps the baby, as the stress from squeezing the head releases steroids which helps the lungs mature. In fact, babies that are born prematurely or with C-sections are sometimes given steroids so that their lungs can develop properly, enabling them to breathe well during the critical first few hours of life.

Another main part of the pediatrician’s job is to screen the newborn shortly after birth. One thing that is very important to assess is the red light reflex of the eye. When a doctor shines a light in the back of the eye, it reflects back off of the red retina. This phenomenon is observed commonly in family pictures when the people have red eyes. There are a few congenital conditions in which there will not be an appropriate red reflex in a baby, such as tumors, (specifically one called retinoblastoma) or also congenital cataracts.

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If the baby has a congenital cataract, it is very important that this be repaired within the first four weeks of life. A cataract is a cloudy lens. Therefore, no light will enter the back of the eye, and the baby will not be able to process light or begin to develop this part of their brain. The first four weeks of life are very important as the baby is looking around and the brain is starting to grow. If the visual axis is not cleared within the first four weeks (via corrective surgery to replace the cloudy lens with a new clear one) the baby will never see better than 20/40, not with glasses, not with surgery, not with anything.

It is amazing to think that a third of human brain function is dedicated to vision. Just like the screen on a laptop uses up most of its battery, the vision system requires an incredible amount of energy, because so many receptors, pumps, and signal pathways are used to transmit and process light photons that enter the retina to the back of the brain.

I have always found this area of science and medicine to be the most incredible and fascinating. If the baby has a congenital cataract that is not cleared by four weeks, the best vision that this baby will ever be able to achieve will be a little fuzzy. This is one of the reasons why it is so important to have your baby see a doctor shortly after they are born.

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Pediatricians also manage the care of sick kids in the hospital. This includes viral infections, medically managed appendicitis, asthma exacerbations, and a whole host of other things. Pediatric emergencies don’t always happen during the hours of 9 to 5, therefore, there is a pediatric doctor working in the hospital all night to make sure that sick children get the care that they need.

Advocating for those that cannot always advocate for themselves, pediatricians have a love for their patients that is very unique to their field. Thank you Dr. Paz, Dr. Bunce, Dr. McKee, and Dr. Styles for the chance to rotate with you this month in the pediatric unit.

Jonathan Shader a third-year medical student at COMP-Northwest. Shader plans on becoming a (now pediatric) ophthalmologist. Shader grew up in the Lebanon area.

Jonathan Shader

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