On a recent morning, Natalia Barbieri came out of Ali's room to take part in rounds. Ali had been in isolation since her arrival - doctors discovered she had a contagious infection when she arrived. Whoever wanted to go into her room had to wear a gown over their clothes, as well as a surgical mask and gloves.
The doctors discussed whether it was time to lift the restrictions on visitors - which would involve yet another test, one that involved suctioning the little girl's nose. Her mother asked them to wait till the afternoon so she could be there. "It's not very fun," Barbieri said of the suctioning.
The doctors were happy to accommodate her. Ali was taken off isolation the next day.
Bringing in parents wasn't as simple as opening the traditional circle a bit. Some doctors were skeptical: Could they be as frank and open in their discussions? Would it take too long to include someone with less understanding of medical concepts? Would they be able to explain themselves in plain English, and not doctorspeak? Would there still be time for senior doctors to do the teaching central to medical rounds?
Dr. Jason Custer, pediatric chief resident at Hopkins, said his colleagues are working kinks out of the system every day. But he said everyone seems to be benefiting from the effort to provide full disclosure.
Parents of patients used to watch through the windows as doctors did rounds. They wondered, "Why aren't they telling me this stuff?" Custer said. "They always thought there was something they were missing. The more transparent you are, the more parents feel like they're getting the whole story."
The scariest situation for a resident is examining a sick child and struggling with a diagnosis, he said. "Sometimes parents want to hear that - we don't know, we're trying our best to figure out what's wrong."
That's just what Adrian Osborne of Aberdeen and her husband, Roger, have faced in recent days. Born April 28, their third son, Christopher, was admitted to Hopkins a week later after he stopped feeding.
Doctors discovered a heart murmur, and in rounds each morning, they discuss the tests they're conducting to rule out various causes. So far, Christopher has had an EKG, a spinal tap and lots of blood drawn. For now, he's on antibiotics, as doctors think he may have an infection.
His mother says she prefers being in on the doctors' conversations, even though she usually ends up crying through the whole thing.
