Today, I got to see two specialists in addition to shadowing Dr. Villareal. The first was Janice, the developmental screening specialist. She typically has fewer appointments but each one is longer than a traditional checkup due to all the skills she has to test. I had the opportunity to watch a screening of a three-year-old boy whose mother was worried about his speech and fine motor skills. The boy turned out to be on the higher end of Janice’s spectrum of patients – they are carefully tested for specific skills and scored on a scale of 100, with 45 being the passing mark. (This patient received a score well into the 80s.) The meeting consisted of Janice asking the boy’s mother about how he behaved at home, then using toys and pictures to stimulate responses from him. He was a very bright kid; the only thing he had some trouble with was pronouncing certain consonants such as c’s, g’s, and r’s, as well as gripping a crayon. As he answered questions, Janice would take notes on a sheet of paper and at the end she scored his responses to report.
The second specialist I had the opportunity to briefly shadow was Zana, the nutritionist. The particular appointment I observed was a bit different in that only the mother of the patient was present, with the nine-year-old boy himself absent. The boy was on the spectrum as well as a supertaster, and was very picky about foods but seemed to be gaining weight. His mother had brought in a sheet of paper with a list of all the foods he could eat, as well as a slightly shorter list of foods he used to eat but now refused. In the end, Zana helped her create an eating schedule for the patient to make sure he wasn’t just eating out of boredom (the next step would be to try to change his food combinations).
There were also a few interesting cases during my time with Dr. Villareal, notably an ADHD consultation and a medication modification checkup. I can’t disclose any information that might identify the patient, but I will say that the latter meeting became quite tense and lasted over half an hour, much longer than the typical appointment. It didn’t seem to be within the scope of Dr. Villareal’s job (and he told me afterward that it was a rare occurrence), but he dealt with it with surprising calmness and poise. It just went to show how flexible and prepared a doctor has to be. I’m looking forward to the rest of my work experience!
