Breanna Keepers – 1st Year New Haven Fellow
Good morning and welcome to a day in the life as a first-year New Haven Fellow on Winchester One and a full-time mom!
I typically start my day at 6:00 am when Charlie, my fifteen-month-old son, wakes us up—he is definitely a morning person. I spend the first hour and a half of my day drinking coffee, playing with him, getting us both ready, and eating breakfast. My husband is a second-year medicine resident and starts early at the hospital, so I am usually in charge of our morning routine as well as daycare drop-off and pick-up. I leave our apartment in Westville around 7:45 am, drop Charlie off at daycare in Hamden at Alphabet Academy (highly recommend!), and arrive at the hospital in time for some quick pre-rounding before morning rounds at 9:00 am. We love Westville for its walkability to the library, Edgewood Park, the farmer’s market, Malby’s Bakery, and local coffee shops, as well as its proximity to the hospital — a ten-minute drive.
On Mondays, we have large team rounds with attendings, fellows, medical students, nurses, social workers, recreational therapists, and our school principal. It’s helpful to have the entire team present to hear how the weekend went (and to chime in if I was on call). I learn something about working with the kids on Wini from every member of the team, and I appreciate starting both the day and the week together. On Wednesdays and Thursdays, we round as a smaller group, and then regroup as a full unit again on Fridays. After rounds, I like to run the list with the medical student I’m working with to create a game plan for the day before checking in on the kids. I try to catch them outside on the playground or during snack time, and if I have time, I’ll sit in on a group. Meetings with families, schools, and DCF are often scheduled throughout the day, and I’m so grateful to coordinate with and learn from our incredible social work colleagues. We are capped at four patients, ranging in age from 5 to 13. Coming from adult residency, I was initially shocked by a caseload of only four — until I quickly realized that caring for one child is the work of at least three adult patients!
Since it’s a Monday, I wrap up on the unit by 12:15 pm, grab lunch to go—either from the hospital cafeteria or one of the food stands outside — and head to outpatient clinic rounds at 1:00 pm at the Child Study Center. The inpatient attending I’m working with covers me for the afternoon. Outpatient rounds are a blast: we hear about cases that first- and second-year fellows are working on and are supervised by the wonderful Dr. Ebaugh. Afterwards, I have individual supervision with Dr. Ebaugh and then head off to see my clinic patients. Right now, the kids I work with range from 4 to 16 years old. For some, I provide both therapy and medication management; for others, I collaborate closely with a Child Study Center therapist who sees them weekly. Sometimes I provide medication management for a child receiving services through IICAPS (Intensive In-Home Child & Adolescent Psychiatric Services), a fantastic model in which clinicians provide in-home therapy multiple times per week over a six-month period. Some afternoons are light, while others I see up to six patients. The clinic support staff are incredibly helpful with scheduling, check-ins, and follow-up for missed appointments — and if I need to take Charlie to a doctor’s visit, they help me block off clinic time. I really enjoy clinic days and getting to know patients and families longitudinally. Plus, I usually sneak over to MOTW across the street for an afternoon coffee and a Mammoul (date-filled) cookie.
On most inpatient days, I leave between 3:45 and 5:00 pm, depending on workload and whether I’m on call. I usually pick up Charlie between 4:30 and 5:30 pm, head home, play with him, have dinner, and start the bedtime routine. Monday nights are the exception: clinic runs until 6:30 pm, and I lean on my village — my parents or my husband — to pick up Charlie from daycare. I get home just in time for bedtime, which is the best part of the day. We read Harry Potter while Charlie nurses to sleep. He’s currently on Harry Potter and the Order of the Phoenix.
After Charlie goes to sleep, free time begins. For the next hour or two, I catch up on chores, emails, or notes. Some days I work out; many days, I go to bed when Charlie does. Good night!
P.S. The best part about Mondays is realizing that tomorrow — Tuesday Didactics — I get to spend the entire day hanging out with my co-fellows. 😊