Dr. Simonné Dr. Katalin Szigeti

Getting to the bottom of things

Sometimes I wanted to be an archaeologist, and sometimes I wanted to be a lawyer, but I wasn't sure I could identify with the latter at all times, so to my parents' great joy, I became a doctor instead. After I made my decision, they let me in on their little secret that I had always intended to be this career, but they didn't want to influence me. I was more of a humanist, so I had trouble with physics, chemistry and biology during the entrance exam, so I was very happy to be accepted. Dissection never caused any difficulties, but the first few years were a series of challenges while I was cramming through the preparatory subjects. I really enjoyed the clinical subjects. I loved having to unravel logical processes and find connections. I learned more and more from communicating with the patient, especially how to find out and then filter out the essence. These exercises were very useful, but less so when fifteen of us jumped on an uncle, listened to his heartbeat and palpated his liver, but everyone wanted to learn, right?

Educational nurse's past

The best school had mandatory practice, nursing. We had to perform nursing tasks, catheterization, blood sampling. One of the doctors took me under the arm, treated me half as a nurse, half as a medical student, and gave me a lot of tasks. I enjoyed it so much that I extended it for another month. In my fifth year of university, I decided that I wanted to work not only in the summer, but also during the academic year. That's when I got a job as a night nurse in the premature infant ward of the Szeged Children's Clinic, and it was then that I first began to understand what it meant to be a doctor. Going to university without sleep after twelve-hour shifts, then going back to work with twelve crying children at the same time. It took time for me to get used to it. In addition to the many experiences I gained there, I also learned the humility necessary for the profession, and to discover the beauties of the career in a complex way. I decided then and there that I would become a pediatrician.

Pediatrician-pediatric gastroenterologist

As a graduate doctor, I spent a few months in Baja, then when there was a vacancy, I returned to the Szeged Children's Clinic and, due to my previous local knowledge, to the premature baby ward, which was a great advantage, as I knew the nurses and the operation of the institution, and they knew what I knew and what I didn't know. I hadn't even been here for two years when I was asked to transfer to another ward, and gastroenterology came into my life. A very smart, highly qualified, gold-certified - and beautiful - woman became my boss, who dictated a strong pace. According to her expectations, I had to perform not only the duties of the ward as a resident, but also, due to the high outpatient turnover, I had to help her in the outpatient clinic. At first, I really hated the back-and-forth work, but later I started to pay attention to how she did her job, how she asked questions and what she did and why. Then I realized that even though he didn't start teaching me specifically, I learned an incredible amount by observing his everyday life. I learned from him how to structure an analysis recording, what to look for, and also that the only way to examine a patient is to undress them from head to toe.

Naked method: I see everything, I know everything

Patients are often surprised that I examine them naked, but it is a useful method because this is how I get the most information. The basic rule is to look at their bottoms, because diseases can sneak up on them. I examine a lot of things on them, because anything can be significant. There can be countless reasons for a stomachache besides those listed in textbooks, which I can only find out with well-targeted questions and a detailed examination. It may happen that the little one's tummy hurts because he is anxious in kindergarten, the teacher said something to him, or his peers hurt him. I learned how to really find out the cause of the problems and determine their severity, and then give a proper explanation. I think it is very important to spend enough time informing the parent, because only with the right information can he understand the essence of the problem and the correct treatment. It is a waste of time and money if he comes back because he did not understand something. I try to dispel misunderstandings and urban legends as soon as possible, so he will not need to constantly seek out new and new specialists.

Misconceptions, dead ends, urban legends galore

A common problem is that people cannot differentiate between lactose and milk protein allergies. Another common misconception is that eczema can only be caused by a food allergy, or that gluten sensitivity can definitely be outgrown. These are recurring misconceptions that I have to explain regularly. The internet provides a huge amount of information on lifestyle and nutrition, but it is quite common to come across absolutely false content. Not to mention the millions of new trends, tips, methods, and pseudoscience that, far from being effective, can even be harmful. In my appointments, I often encounter such unfounded information and “alternative” experiences that they want me to verify, but I cannot support these results with the testing methods accepted by academic medicine. The worst case is when they start putting the child on a gluten-free diet, even though it is not supported by medical advice and due to the changed nutritional conditions, it is not easy for me to get a realistic starting point. When I often come across a “fashionable method” in my practice, I sometimes try it out of curiosity, but they never shed light on my real problem, but on the contrary, they can recommend a lot of other terrible values, for which they can of course recommend an expensive pill… Even though this would cost a thorough medical examination.

Stress also affects children’s lives and bodies

We already live a different life than decades ago, and this is also true for children. Nowadays, they also have to enroll in primary school and from then on, they are exposed to more and more stress. Nothing proves this better than the fact that in August and September, the majority of patients come to see me with some kind of somatization complaint, which is caused by school from top to bottom. Children are anxious, have stomachaches, or struggle with diarrhea because they forgot to write their summer reading diary or because they are stressed about school. Our diet has also changed, and as a result, there are many children struggling with fructose intolerance. Fruit sugar is not only found in fruits and vegetables, but it is also added to many soft drinks and foods under the name fructose-glucose syrup. It is also an ingredient in products that we would not even think about, such as muesli, which is considered healthy. Excessive consumption puts a strain on the body and this causes symptoms.

A lot of information is needed to investigate complex problems

As a gastroenterologist, I examine everything from the oral cavity to the stomach, which is within this, but when someone visits me, I do not approach the examination exclusively from a gastroenterological perspective, but try to draw general pediatric conclusions. My first appointment takes three quarters of an hour, because that's how long it takes to thoroughly examine and assess the background of the problem. But sometimes it takes more time, because after a lot of conversations and resolving frustrations, it can only be found out that the little child is hitting and hurting his head with his kindergarten classmate and that he is feeling pain somewhere from this stressful experience. 30-40% of cases are psychological in origin. It may happen that someone is not found out in kindergarten that he has dysgraphia or dyslexia, and since the smart child compensates for a long time with his IQ by recognizing word pictures. However, when he can no longer read longer words and sentences in the third grade of school, he is overwhelmed with frustrations. Of course, these sooner or later manifest themselves in physical symptoms, and the parent runs to me in despair, wondering what's wrong with my child, what is he doing wrong, everything was fine until now, what has changed?!

It is not difficult to communicate with children

It is not true that it is difficult to communicate with children and that they cannot express minor complaints and symptoms in the same way as an adult. You can see a lot of things on them, and the parent can provide a lot of useful information. A lot of unnecessary tests can be saved by thorough questioning. I also liked gastroenterology because it overlaps with many border areas, for example with allergology, dermatology, endocrinology. I especially enjoy sorting out possible problem areas and finding the right path, one symptom can belong to several diseases. Due to the complexity, I try to follow the allied professions because I am interested in how they think about certain topics. For example, I will soon visit a dermatology congress because I will meet many children with eczema who are smeared with steroid cream from head to toe instead of examining their diet.

Teenage body image disorder

Adolescent eating disorders, anorexia and bulimia, can be caught with great attention. The whys are always important with these diseases. I had a 17-year-old, 36 kg, bird-bone patient who, during her hobby – going to some acrobatic dance – was taught that she had to be thin, so she starved herself. Anorexia and bulimia must be recognized as soon as possible, because they can be fatal. The psychiatric disease, body image disorder, can only be reversed with hard and difficult work.

Family balance: 2 doctors, 2 children

My husband, who is a pediatric cardiologist, and I are raising two children. We make sure not to take work home, only if there is a special case, we usually discuss it. Unfortunately, the kids don't see their dad much anyway, so when he's home, I don't want to talk about illnesses for the world. Between Bethesda Hospital and my two private practices and my family, I don't have much time for hobbies. My two little kids absolutely use up all the energy I have. I also chose sports based on what I can do quickly, which is how I found speed fitness. For me, it's perfect; fast, effective and it still fits into my time after the appointment before I go pick up my child.