Vol. 1 - Issue 5 [Gerard Beirne]
LECTURE NOTES ON PAEDIATRICS
I
On the journey to the hospital
you held your stomach
and told me all I needed to know -
how the first twenty-four hours
presented greater opportunities to save life
than any other time between birth and death.
Yes, oh yes, I repeated clenching my fist
while you stressed how essential it is
to recognise at the earliest possible moment
ill-health and congenital defect,
of treating immediately whatever I could detect
Yes, I repeated. Yes, oh yes.
My foot to the floor you held your breath
then gave me a run-down of the routine checks:
the back, the limbs, the ears, the eyes,
head circumference, weight and length,
the mouth, the jaws, the hips, the chest,
the responses and reflex tests,
sutures, fontanels, and femoral pulses
and the heart, of course, oh yes oh yes
amidst the revelry of my laughter
you gave me a list of the conditions sought after
how to observe the abdomen and perineum
and to watch for urine and meconium
(or in their absence to search for lesions)
how congenital heart disease
might not be detectable for days or weeks
and how hard it may be
to suspect renal tract anomalies
unless urinary infection supervenes.
I nodded at all you impressed upon me
and down on one knee
I promised my best
Yes, oh yes, oh yes, oh yes.
II
When the time came you squeezed my hand
and encouraged me in techniques of breathing.
Push, you shouted, in between my gasps
push, push, push, until at last
I held our newborn baby firmly between my thighs.
I screamed and felt for her ears, her eyes,
deliriously assessing her earliest condition:
hydrocephalus, intrauterine malnutrition,
cleft palate, congenital teeth,
dislocation of the hips,
abnormalities of the feet,
lungs, limbs, mandible,
dermal sinus, post-anal dimple
mediastinal displacement, palmar creases,
talipes, microcephaly, cystic kidneys,
glaucoma, cataract, corneal opacities,
coarctation of aorta, facial palsy
Yes, oh yes, I have to confess
Yes, oh yes, oh yes, oh yes
III
When all else had failed
when our child had passed each and every test
I turned to you for something more
implored you for your advise.
Deoxygenated I heard you suggest
I revise perinatal asphyxia
to use the Apgar score on a scale of 0 to 2
for the 5 signs of hypoxia:
whether the body colour is pink or blue,
the heart rate low or high,
the muscle tone active or limp,
the respiratory effort regular or slow,
the reflex irritability with a grimace or a cry.
Once again, she passed with flying colours,
a faultless 10 out of 10,
a veritable body of straight As.
The perfect child in every way.
Dismayed I called the midwife
to finish off the rest
handing her our child
while you congratulated me
on my great success
a life begun in blood and mess
oh yes, oh yes, oh yes, oh yes
yes, oh yes, oh yes, oh yes
I
On the journey to the hospital
you held your stomach
and told me all I needed to know -
how the first twenty-four hours
presented greater opportunities to save life
than any other time between birth and death.
Yes, oh yes, I repeated clenching my fist
while you stressed how essential it is
to recognise at the earliest possible moment
ill-health and congenital defect,
of treating immediately whatever I could detect
Yes, I repeated. Yes, oh yes.
My foot to the floor you held your breath
then gave me a run-down of the routine checks:
the back, the limbs, the ears, the eyes,
head circumference, weight and length,
the mouth, the jaws, the hips, the chest,
the responses and reflex tests,
sutures, fontanels, and femoral pulses
and the heart, of course, oh yes oh yes
amidst the revelry of my laughter
you gave me a list of the conditions sought after
how to observe the abdomen and perineum
and to watch for urine and meconium
(or in their absence to search for lesions)
how congenital heart disease
might not be detectable for days or weeks
and how hard it may be
to suspect renal tract anomalies
unless urinary infection supervenes.
I nodded at all you impressed upon me
and down on one knee
I promised my best
Yes, oh yes, oh yes, oh yes.
II
When the time came you squeezed my hand
and encouraged me in techniques of breathing.
Push, you shouted, in between my gasps
push, push, push, until at last
I held our newborn baby firmly between my thighs.
I screamed and felt for her ears, her eyes,
deliriously assessing her earliest condition:
hydrocephalus, intrauterine malnutrition,
cleft palate, congenital teeth,
dislocation of the hips,
abnormalities of the feet,
lungs, limbs, mandible,
dermal sinus, post-anal dimple
mediastinal displacement, palmar creases,
talipes, microcephaly, cystic kidneys,
glaucoma, cataract, corneal opacities,
coarctation of aorta, facial palsy
Yes, oh yes, I have to confess
Yes, oh yes, oh yes, oh yes
III
When all else had failed
when our child had passed each and every test
I turned to you for something more
implored you for your advise.
Deoxygenated I heard you suggest
I revise perinatal asphyxia
to use the Apgar score on a scale of 0 to 2
for the 5 signs of hypoxia:
whether the body colour is pink or blue,
the heart rate low or high,
the muscle tone active or limp,
the respiratory effort regular or slow,
the reflex irritability with a grimace or a cry.
Once again, she passed with flying colours,
a faultless 10 out of 10,
a veritable body of straight As.
The perfect child in every way.
Dismayed I called the midwife
to finish off the rest
handing her our child
while you congratulated me
on my great success
a life begun in blood and mess
oh yes, oh yes, oh yes, oh yes
yes, oh yes, oh yes, oh yes
