Consanguinity

This morning I took a D train deep into Brooklyn for my first Pediatric clinical. As I walked down the street toward the hospital in my purple polyester scrubs, holding my coffee mug and drug book, I noticed an abundance of overdressed Hasidic children and broken appliances on the sidewalks. It was about as dreary a neighborhood as I could imagine. Fences broken, strollers tipped over in small uncut patches of grass, garbage collecting itself in drains.

When I arrived to the unit, my instructor informed us that Brooklyn is a great place to work because of the challenge: "One in ten immigrants to the U.S. comes through Brooklyn." Great. Pop on by, bring your tuberculosis to our hospitals for a visit, and don't forget to leave your broken stollers in your lawn before you make your way to Iowa. Of course that's not how I really feel about immigration. I'm actually baffled that everyone thinks the Senate is Mr. Nice Guy for the policy it approved yesterday. The Senate may be providing more ways for illegal immigrants who have already hopped the border to become legal, but they are making it much harder to get into the U.S. than the House ever dreamed of. For example, the House's Bill called for a new 2-layer fence at land borders; the Senate Bill makes it 3-layered...is anyone else reminded of taco bell? We took a tour of the pediatric floor. Half of it was under construction, complete with plastic draped over some doorways and drilling in the background, and so all the patients and treatment facilities were condensed into a claustrophobic mess.

Then I met my poor patient. She couldn't walk, talk, eat, or even sit up on her own- now or ever before in her life- and she was three years old. I picked her up out of her crib and she felt like she weighed less than my purse. I tried to assess her VP shunt (a tube running inside from her brain to her abdomen to treat hydrocephaly) but she cried and batted my hand away until my will power was completely obliterated. I got her chart and found the reason for her severe disabilities in a horrifyingly simple family tree drawn by her doctor: her parents were first cousins. Consanguinity, he wrote underneath. I returned to her room and tried to take her vital signs. Her attentive and affectionate mother hovered over me as I did my best to assess the daughter she had marred so badly. In her limited English, she explained the little girl's floppy wrists and sluggish pupils with the word she had learned: "handicapped."

And that's how I felt. Handicapped. This is not the kind of challenge that sets a person free.