Session 72 Dr. Leslie Pineda is a private practice Neonatologist in Orlando. We talk about her inspiration to go to the NICU and what she likes, dislikes, and more. I am constantly looking for physicians who would make great guests here on the show. If you know someone who might make great guests here, send them my way at ryan@medicalschoolhq.net. [01:33] An Interest in Neonatology Leslie's mom is a NICU nurse who have been doing it for over 30 years. So she was basically exposed to the field at an early age. She would go visit her at work and back when the babies were still in a nursery, she'd get to see her mom and get the babies through the windows. Through the years, she always knew she wanted to do pediatrics. "I would branch off and think of different things but I always kept falling back to neonatology." As to why not a NICU nurse like her mom, Leslie explains she wanted to make the "big decisions." The bedside was fun but she wanted to pursue further and get to lead the team and make the decisions as the team leader. Other specialties that crossed her mind included emergency as she enjoyed doing procedures. As a resident, she also looked into Pediatric Emergency medicine which she also found exciting because of the procedures and the acuity. Ultimately, she realized she enjoyed working with babies the most. What she likes about the environment is that you're able to get that long-term relationship with the patients within the hospital stay. Understand that some babies could stay there for months and so you really get to know the family. You see them everyday and take care of them all the time. So you're able to make that relationship with them and get that long-term care while also that short-term acute management you'd have to do at the beginning or when they get sick in the parts in between. [05:25] Traits that Lead to Becoming a Good Neonatologist Leslie says you have to want some excitement and that adrenalin rush of taking care of a potentially really sick baby. One must also like the interaction with the families since you're not talking with the baby. At the end of the day, it's about being able to tolerate all your interactions with family members and parents concerning the baby's care. [06:23] Types of Diseases Neonatologists often deal with premature babies. Especially up to less than 35 weeks, they will automatically come to the NICU although full-term babies may come to them as well if they're having some trouble transitioning from intrauterine life and maybe having some respiratory issues like retained fetal lung fluid. You may also encounter some hypoglycemic full-term babies as well if their infants of a diabetic mother. You may also have meconium aspiration or if it's a very stressful delivery, sometimes a baby could get stuck because they're so big They could be into so much stress so they would have to be watched in the NICU and taken cared of in the NICU. "A lot of different pathologies, not just the premature babies that everybody thinks of." [07:56] Community Hospital vs. Academic Hospital As to why Leslie chose community over academic, she admits it had a lot to do with location. Growing up in Orlando, she always knew she wanted to come back there. Why she chose private practice is there's a lot of emphasis on the educational side and research studies, which she still gets to have in her current position. [08:30] Typical Day of a Neonatologist Aside from mostly inpatient, Leslie says there's also outpatient follow-up in certain groups. But for her, she does 100% inpatient. Typical day for her, as she describes, is that each day is a little bit different. They cover multiple hospitals with differing levels. In the main hospital, they come in the morning and take sign out from the outgoing person from overnight about what happened to the babies you'll be following. They huddle with the respiratory therapists and the deliver team, as well as all the neonatologists on for the day. They'd deal with the