Each year, donations to our annual campaign on behalf of Children's Hospital buy care for patients whose families can't afford it. That care takes many forms_bandages, blankets, bedpans, bypasses. But dedicated doctors make it all work. My associate, Beth Schwinn, spent a day this week with one of the most dedicated. Her report:
Welcome to the glamorous world popularized by daytime soap operas -- the life of a doctor. Dr. Barnaby Starr, 29, one of three chief residents at Children's Hospital, is on bed control at the moment. As a result, he knows the condition of every patient. "Basically, by the end of the day, you're going to understand how the hospital runs," he says to a visitor.
The glamor is not apparent at 7:30 a.m., as we sit, bleary-eyed, in the cafeteria over coffee. Dr. Starr is getting a report from Dr. Stacey Hinderliter, the third-year resident who covered the hospital overnight, on each case she admitted.
Dr. Hinderliter is sick herself, and has been up for the previous 36 hours. Her face is pale over the dark red of her shirt. Dr. Bill DeBruin, a second-year resident who assisted overnight, looks almost as tired as Dr. Hinderliter. The visitor isn't feeling too alive herself.
Dr. Starr, by contrast, looks fit and alert. He has thick toffee-colored hair, eyebrows and mustache. His face, tanned from a recent vacation, glows with health. He and Dr. Hinderliter begin going over the overnight admissions. They have paused to discuss one patient when Dr. Starr's beeper goes off. He is wanted upstairs. A critical situation has developed and backup help is needed. Immediately.
Dr. Starr sprints to the patient's room, arriving within seconds of the call. The patient has begun losing blood, and blood pressure is dropping.
Dr. Starr begins trying to stop the flow. "Step up oxygen to 100 percent," he orders. Blood samples and X-rays are taken. He calls for a blood transfusion. A "code" -- an emergency call for medical personnel -- is issued, and a blue light begins flashing over the door to the patient's room. Within seconds, a total of 20 doctors, nurses and specialists is present.
Dr. Hinderliter and Dr. DeBruin have also arrived, and are answering rapid-fire questions from all the doctors about the patient's condition during the night. Dr. Hinderliter is wearing a Garfield button on her lab coat, which reads, "Boring!"
Half an hour later, Dr. Starr emerges from the room. His blue oxford shirt is spotted with blood, but the patient has been stabilized. "Nice way to start a Monday," he says to one of the doctors.
Changed into a hospital scrub shirt, Dr. Starr resumes his review of the patients in the cafeteria. Once he finishes, he is off, picking up a list of the day's "electives," or scheduled admissions. It is his responsibility to find beds and heart and respiration monitors for arriving patients. He begins bed rounds.
Each room sets off a new story. "This kid," he says, as he nods at one toddler, "was invited to a White House dinner by Mrs. Reagan. He was the only one invited, and he probably will get less out of it than any other kid in the hospital." The child has a gastro-intestinal problem, and cannot absorb needed nutrients from food.
Between anecdotes, Dr. Starr strides down hospital corridors, asking and answering questions about himself. "So," he says, "why am I a chief resident? It's a good chance to experience a lot if you don't want to specialize right away."
Three chief residents are chosen each year from among the 22 residents in each class at Children's. "I think the strength of this hospital is that it has been able to recruit the cream of the residents," says Dr. Arnold Einhorn, chairman of pediatric medicine and director of the resident program. More than 300 people have applied for the 22 resident positions that will come open in July, he reports.
Dr. Starr's beeper goes off almost constantly. The latest call reports a patient arriving by helicopter from La Plata. Dr. Starr rushes by elevator to the emergency room. Dr. Richard Mink, another of the chief residents, is already there. Dr. Mink has a four-month stint handling outpatient care for the hospital, while Dr. Starr and Dr. Bonnie Wird, the third chief resident, trade off the academic scheduling and bed-round responsibilities. The three handle each job in turn.
Francis Clark, 14 months old, has had a seizure. He has recovered and will remain here for a few days while doctors determine the seizure's cause. Dr. Mink and Dr. Starr agree that Francis will be admitted to a semi-private room in Intensive Care.
On his way out, Dr. Starr gives a hearty greeting and a quick examination to one of his outpatients. Back in the office the three chief residents share, Dr. Starr relaxes for the first time all day.
He says he has always wanted to be a doctor, and decided on pediatrics after working one summer in a refugee camp on the Thailand/Cambodian border.
"The kids were really inspiring," he said. "They still had a lot of spirit in spite of having nothing. They would make toys out of garbage, things like old soda cans."
He talks about what he calls his "passion" for medicine, and says it is often difficult for him to remain objective about his patients.
"It's really hard," he says. "You go into pediatrics wanting to save children, give them a future, whatever. Then when you start doing it, you see different things -- so many chronically ill kids." He pauses and then shrugs. "I don't know what I'm trying to say, really. It's hard to be profound after the morning we've had."
Grand rounds, a weekly lecture by a different specialist, are next, but Dr. Starr misses most of the lecture. Francis's mother, Carolyn, 23, has arrived. She tells the doctors that her son was exposed to measles last week. As a result, Dr. Starr has to find him a private room.
Over lunch, Dr. Starr, Dr. Wird and Dr. Einhorn discuss the lecture Dr. Starr missed, on ways to reduce cholesterol levels in children.
"We're really tight" with Dr. Einhorn, says Dr. Starr later. "The residents are the nuts and bolts of the hospital, but we don't have a lot of say. Dr. Einhorn acts as our advocate."
Dr. Starr's beeper goes off. Another helicopter transfer will be arriving within two hours. "I feel like we're a M*A*S*H unit," he says. He needs to find a heart and respiration monitor and a room for the incoming patient.
A nurse in Cardiology sees Dr. Starr coming. Before he can speak, she says, "We have no monitor!" They begin reviewing patients to see if one can be taken off a monitor.
His beeper goes off and he is walking at top speed again, leaving one tired reporter with a desire to sit down and rest. "I hope you got enough," he says anxiously. "Usually, I have a lot of fun. I really love what I do."
TO CONTRIBUTE TO THE CAMPAIGN:
Make a check or money order payable to Children's Hospital and mail it to Bob Levey, The Washington Post, Washington, D.C., 20071. The campaign ends on Jan. 24.
Some recent group donations to the campaign:
Staff members of the National Association for Foreign Student Affairs ($18.06).
Employes of The George Hyman Construction Company (a healthy $2,980 -- this group's 11th consecutive donation).
Employes of the Economic Surveys Division, Bureau of the Census ($170).
Thos. Somerville Co. of Northeast ($400 from staff as well as management).
Employes of Building 213, Washington Navy Yard (a delicious $4,222.31, which marks the 17th year this gang has raised funds for the hospital).
Employes of Technology Applications, Inc., of Falls Church (a terrific $5,076).
Many thanks, one and all!