Anita Sri (LEH 2006-2013)

Anita Sri who is a Fifth Year Medical Student at Imperial College London says: “I have my sights set on becoming a paediatric cardiologist in the future, and so I want to ensure that I do not shy aware from golden opportunities that will allow me to become the best doctor I can be, in order to provide the best care for the future children I will be responsible for.”

Here’s her report: "You can go anywhere in the world for your medical elective and yet I knew I wanted to work at a hospital that would contribute to my interested specialty- Paediatric Cardiology. However, for a challenging specialised field, I would need to apply to hospitals renowned for their care and access to complex cases. Therefore, I visited two hospitals: The Royal Children’s Hospital in Melbourne and The Great Ormond Street Hospital in London.
 
I started my four-week elective at The Royal Children’s Hospital in Melbourne in May, where I was greeted by kind and friendly healthcare colleagues, who welcomed me into their team at the Cardiac Paediatric Intensive Care Unit (PICU). The hospital itself is only a few years old and one of the biggest hospitals I’ve seen. It contained a small aquarium, a meerkat enclosure and numerous restaurants, including a McDonalds!

In PICU, you are welcomed by a bright spacious area with patients allocated a private room for themselves and their family. What initially seemed like a relaxing area, in fact contained a bustling team of specialised cardiac intensive care (ICU) consultants, registrars and nurses working alongside the cardiac thoracic surgeons.

A typical day consisted of an 8am handover, followed by a detailed ward round which focused on each unstable patient- this can take up to five hours. The age range of patients seen was from a few days old to the eldest being a 16-years old. Many of these patients were born with abnormally structured hearts, most commonly associated with other organ failures and ECMO complications (a device that takes over the function of the heart), for example strokes due to clots in the machine.

I witnessed numerous children undergo palliative care, with some newborns not surviving more than a few days. I also observed a cardiac crash call where sadly the patient later passed away. Observing the team and being able to examine these patients, accelerated my learning in not only the complexity of the cardiac conditions, but also the emotional weight carried by the team and the families. After finishing my placement, I explored the Great Barrier Reef and Sydney, before flying back to the UK for the second half of my elective.
 
What I didn’t expect, when I started working at Great Ormond Street Hospital (GOSH) in London, was how similar the hospital was to The Royal Children’s Hospital. They may not have had an aquarium but they had a new Disney Lagoon, providing children a world to escape and enjoy their childhood. For families who have travelled far, a hotel is provided and there was always something to do for the patients and their siblings with the Play Team.

At GOSH, I conducted a research project looking at the anaesthetic use in Brugada patients and the potential adverse effects that could occur, for example a cardiac arrest due to drugs interfering with the conduction of the heart. I am still working on the project as these types of projects can take roughly two years to be published. As well as the research project, I took part in the cardiac ward round and observed the Cardiomyopathy and General Cardiology clinic. Here I examined the children, with some coming in with a healing hole in the heart and others with dysfunctional valves. I learnt how to carry out an echocardiogram on children and the challenges that comes with it.
 
I am incredibly grateful for the support the LEH Alumnae board had provided for my elective, as I wouldn’t have had the opportunity to witness and learn as much as I did without their help. I hope that those reading this report enjoyed this brief insight into what goes on in large children hospitals."