Published on in Children's View
Mary Fabio, MD , is a pediatrician at the Nicholas and Athena Karabots Pediatric Care Center who sees patients in CHOP’s Refugee Health Clinic one morning each month. This is a day in her life.
Reads Pediatrics in Review on the train.
Two residents will be working with Fabio in the Refugee Health Clinic today. She gives them background on the clinic — it was founded in 2011 and cares for about 75 new patients each year — and goes over what to cover with the families they’ll see: medical history, dental care, how to call 911. “The other thing to think about is mental health,” Fabio says. “These families have been exposed to so much.”
The Haddad family — four children and both parents — is squeezed onto four chairs in an exam room. They arrived from Syria a month ago; this is their second visit with Fabio.
A medical interpreter arrives. Fabio and a medical student examine each child and ask about friends, school and sleep. The children’s mom pulls out a bag from the pharmacy. “Vitamin D — perfect,” Fabio says. Also in the bag: eye drops for 9-year-old Ahmed, who has been blinking almost constantly. “It may be what we call a tic,” Fabio says. “I’ll see if there is anything we can do for him today.”
The children’s dad explains that one of the boys recently had a sore throat. “We were going to come here,” says his mom, “but we didn’t know how to get here.” Fabio reminds them that they can always ask their caseworker at the resettlement agency for help. “There are also support groups for Syrians in your neighborhood,” she says. “I’ll see if we can connect you with one.”
The residents tell Fabio about their visit with the Sonams, a Bhutanese family that had been living in a refugee camp on the border of Nepal: All the children have severe tooth decay, but they’re otherwise healthy.
“We have lots and lots of papers,” Fabio says when she returns to the Haddads’ exam room. She goes over each one: vaccine records; a prescription for antibiotics for Rima, who has an ear infection; a neurology referral for Ahmed. “Everyone should be brushing their teeth twice a day — and not too many sweets,” she adds.
Checks on the Sonams and reviews the eldest girl’s chest X-ray: “There’s no concern at all for tuberculosis.”
Fabio’s last appointment is with three children from a different Syrian family who need an “adjustment of status” exam — a step on their path to U.S. citizenship. “I’m good, I brush my teeth three times a day,” one of the boys tells Fabio with a grin.
Eats lunch and calls Early Head Start; she wants to refer one of her patients, a teenager from Burundi who recently had her second child.
Calls the resettlement agency about scheduling adjustment of status exams for three patients, one of whom received a bone marrow transplant at CHOP.
Reviews lab results (“We have a lot of kids with high lead levels”), answers emails and sends book recommendations to a colleague (A Yellow Raft in Blue Water; The Elegance of the Hedgehog).
Arrives at her home in Meadowbrook, PA. Her husband and son have dinner waiting for her.
Updates patient charts.
Checks email one last time before bed.
Categories: Children's View Spring 2017