Hey everyone, it’s Medicine Mondays today. Today I just wanted to talk about me doing “Career Day” at my daughter’s elementary school.

Career Day

When I initially signed up to do the Career Day for my daughter, I wanted to try to explain the differences between different types of doctors. I wanted to help the children to understand that while we do different things, we’re all still doctors. So I’ll just try to explain how it went.

So I was scheduled to give two separate presentations.

There are 4 kindergarten classes, so each presentation had 2 classes in it, probably around 36 kids per presentation.

The first thing I wanted to convey to the children was that anyone could be a doctor. To do this, I stood up in the front and introduced myself. I was wearing plain street clothes, which for Hawaii, is a shirt, shorts, and slippahs. I asked the kids what they thought I did just from how I looked. The answers I received were varied, which would include, crossing guard, librarian, and teacher. I was actually surprised one kid said “doctor”… perhaps he had some inside information from my daughter or something.

Then I said, well let me try to help you guys. I took out a white coat and put it on and asked them what they thought now. The answers came faster and more confident, and included scientist, pastor, and teacher.

However, once I pulled out my stethoscope, all the kids immediately jumped up and said “You’re a doctor!”. I asked them why they said that, and they said “because you have a stethoscope!”. I guess the stethoscope is the universal symbol (to children) that someone is a doctor.

So then I decided to push them a little bit.

I told them “What if I told you — I’m a doctor, but I don’t use this anymore?” The children were all puzzled and so I went on to explain more. “There are many different kinds of doctors.” The answers came out again, 5? 10? 100? Millions!??!?! I responded, well, a lot, but maybe not millions.

At this point I told them that I am a radiologist. I’m a certain kind of doctor that takes care of imaging. “Does anyone know what an x-ray is?” Of course, all the hands shoot up in the air. The best example that they all seemed to understand was getting an x-ray of their teeth at the dentist.

I had them hold their left arm up and asked them. “What’s this?” followed up by “What’s in there?” Answers of bones and blood came up. “How many bones?” Various numbers came out. Then I said “There are two here — but how do we know that?” One child said “Well, if I push on it, I can feel them kind of.” I said, that’s absolutely right. “What about here?” pointing at my wrist — “How many bones are here?” Various numbers came out again, with the majority saying “1”.

What if I told you there are a lot of little bones there?

Then I took out an x-ray of the left wrist and held it against my own left wrist. I showed them the bones they could feel (radius and ulna) and pointed at all the bones they couldn’t feel (the carpal bones). Then, I showed them oblique and lateral images as well as I held them against my own wrist.

I told them this is a normal wrist x-ray — in fact, it was my wife’s wrist x-ray, which she had sprained last month.

After that, I took out another x-ray, of a broken wrist this time. This one had a fracture of the distal radius, in this particular case, it was a Colle’s fracture. I held the normal wrist x-ray next to the broken one and had the kids explain to me what is wrong. Of course, it’s kind of hard to articulate as a child, but they could tell me “it’s broken”.

To help them along, I traced the cortex of the bones with them and showed them how the lines were “intact” on the normal wrist x-ray, but lost on the broken one. They seemed to understand.

Moving on…

I then said, now, this is what an adult’s bones look like… what about you guys? Do your bones look the same?

The general consensus was yes, their bones were the same.

At this point I brought up a picture of a 7 year old wrist which showed the growth plates. The children said “Oh, the bones are broken!”. I explained to them that this was a normal 7 year old. The growth plate here (the gap) is what allows the bones to keep getting bigger. I’m an adult, so can’t grow anymore, but you guys are still kids — don’t you want to get bigger? This was met with a resounding “yes!”.

Then I wanted to explain the differences between adult bones and kid bones. For this, I used the props of a Pocky stick and a Starbucks straw.

Pocky Stick? Starbucks straw?

Yea.

I said, my bones, as an adult, are like this Pocky Stick. It’s hard, and it doesn’t bend, it just breaks. I demonstrated this by snapping the Pocky stick in two. I explained, my bones are hard and aren’t growing anymore, so that is what happens to me.

However, for them, their bones don’t really “break”, they “bend”. I demonstrated this my holding up the Starbucks straw and asking what it was made of. Everyone understood it was made of plastic. I said, your bones are more like this — and I folded the straw in half. It snapped back into its original shape, but you could still see a little indent where it was folded before.

So then I asked them “How do we find a broken bone on you guys then?”

I put up another wrist x-ray – this time of a younger child’s wrist, which was younger than them, probably 2 or 3 years old. I showed them that there are “missing bones” in the wrist compared to the 7 year old wrist and the adult wrist. Then I asked them, remember the straw with the bump (indent) on it? Do you see anything wrong with this x-ray?

In one presentation, no one could see anything. However, in the other presentation a little boy in the back pointed out the small “bump” along the radius — which is a buckle fracture. After he pointed it out, all the other kids saw it too.

For the last piece of the presentation, I wanted to show them a CT.

However, it’s kind of hard to understand things and visualize things as a child in the axial plane. For this reason, I choose to show them a coronal CT. In this picture they can see liver, spleen, stomach, small bowel, large bowel, gallbladder, bladder, and pelvic bones.

I called a volunteer up and asked them “what is this” pointing at their belly. The kids said a lot of things, like stomach, food, water, vegetables — things kindergarteners would think. Interestingly, one child said “small bowel and large bowel” — which was great.

I then placed the coronal CT image over the volunteer’s belly to show them “what’s inside there”. I pointed out the different organs and bowel.

Then I explained how it can help with diagnosis.

I gave the example of having a bad belly pain and going to the emergency room. Then they might end up getting a CT and finding out they have appendicitis. I described the appendix as an “extra piece of large bowel” that doesn’t really do anything, but can sometimes cause problems. It may require surgery in order to be removed so you can feel better.

I then explained that in that situation, you have multiple doctors involved in helping you — the Emergency Room Doctor, the Radiologist, and the Surgeon.

I wrapped up my presentation by explaining that this is a just small portion of all the doctors. However,there are a lot of different kinds, and we all help each other out to take care of everyone.

I also reiterated to everyone that education is very important. You can be whatever you want in the future, but no matter what you want to do in the future, it all starts with kindergarten.

Listen to your teacher, work hard, and learn a lot.

All in all the presentation took 20 minutes or so and I think I managed to hold their attention. Overall, I think it went pretty well. I’ll probably end up doing it again in 3 years for Lucas’s kindergarten class.

TL;DR

Career Day was a success!

Don’t forget that we’re all doctors on the same team.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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