Life at Kid Central : Sore throats, ear infections, piercing cries-- and lots of newborns. A day in the life of pediatrician Dr. Nick Roulakis has it all.

What a way to wake up. A burly shape in a Hawaiian shirt pulling on your arms, rotating your joints, pinching your soft belly.

But Joseph Brandon Hubbard, age 7 hours, 28 minutes, seems not to mind. His eyes flutter open and his mouth falls into a crooked baby smile at the sight of Dr. Nick Roulakis, his first pediatrician.

Joseph’s face, wrinkled as a walnut, wrinkles harder as Roulakis touches the stethoscope to his tiny chest. The startled baby sneezes, hiccups, and sneezes again.

“Happy Birthday, Master Hubbard,” the doctor whispers and slips the baby back into his mother’s arms.

“Hey! You’ve got a double chin!” the mother announces.

Roulakis looks up and smiles. “I do?”

“No, no. I mean, my baby. I guess newborns make me a little bit nervous sometimes. . . .”

“Sometimes, me, too,” says Roulakis sweetly.

*

At 8:22 a.m. on a recent Thursday at Huntington Memorial Hospital, there are newborns everywhere. Seventeen at last count, says a nurse, and more on the way.

Only four of them are crying, but it sounds like 40. A nurse rushes around, looking for a lost chart.

“It’s cool to be around at the beginning of somebody’s life. Really cool,” says the understated (except for his shirts) Roulakis.

During his pediatric training, Roulakis worked nights and weekends resuscitating high-risk newborns. Now, most of his young patients are glowing and healthy.

“That’s a great thing about pediatrics. Most of the time, children who are ill do get better. The other great thing is that pediatricians are like family physicians. The child is usually not your only patient.”

Roulakis will treat 27 patients this Thursday.

He also will see 60 parents, siblings and caretakers. He will counsel a working couple about what to do with a neglectful nanny. (“Replace her!”)

He will give the mother of a depressed teen-ager an emergency psychiatric referral. (“This is not just another identity crisis.”)

And he will console the family of a precocious toddler who somersaulted down 100 cement steps. (“Hey, he’s fine. Let’s all relax.”)

He will play peekaboo with babies, exchange karate chops with preschoolers, and advise a dozen grateful mothers on how they can get more sleep.

Parenting is tough work, says the 40-year-old father of three. “One of my goals is to make it easier. Who does that ultimately benefit? The child, my patient.”

*

On the other side of Huntington Hospital, in a sky-blue room with a mountain view, 13-month-old Matthew Beal lies in a bed littered with Cheerios, waiting for Dr. Nick. The chubby-cheeked boy was admitted four days ago with a respiratory infection and a frightening purplish rash. Now the rash is gone and his mother, a nurse, wants Roulakis to send her son home with a supply of oxygen.

“You’ve had a tough week, haven’t you?” Roulakis asks the boy.

“Oh my, yes,” sighs Matthew’s grandmother, Bea Call, who is trying to change an especially offensive diaper.

“I can help you,” volunteers Roulakis, rolling up his sleeves.

“You won’t see a physician do that every day!” confides an aide watching from the hall.

Before writing the order for Matthew’s release, Roulakis washes his hands again. “After a while you get used to just about everything, I guess. . . . I’ve found I can even tolerate crying when I have to.”

*

Crying is too meek a word for what greets Roulakis when he arrives at his sunny Arcadia office shortly after 9 a.m.

It is a brain-splitting, screeching, squalling, multipitched assault on the ear that can come only from the combined efforts of several angry infants getting shots.

As in most pediatric practices, doctors--anxious to preserve their young patients’ trust--rarely give shots. In Roulakis’ office, shots are given by nurses, including serene veteran Nancy Romero and bubbly newcomer Isabel Farrar.

Seven-month-old Trevor Van Riper is not getting a shot today because he has the sniffles. He seems to be celebrating by bouncing nonstop on his father’s lap.

“As you can see, doctor, Trevor is good on his feet,” says his mother, Michele. “But, doctor, what about all this drooling?”

“Oh, I think he’s hungry,” interrupts Trevor’s dad, Mark. “Even after a meal, he smacks his lips, like he wants more food, more food. What can we give him? What’s safe at this age?”

“Squishy stuff is good,” says Roulakis, whose years of study at Ohio State prepared him for such questions. “How about mashed potatoes, nice and lumpy? Softer is safer right now.”

*

In Examining Room 4, a curly blond 2-year-old waits for the doctor by “reading” a book first upside-down, then right-side up.

When Roulakis walks in, she frowns and looks away.

“Hi, Katie. Let’s listen to your heart!” Katie shakes her head and glares at her mother. “No!”

“OK,” Roulakis says. “Then, uh, . . . let’s sing ‘Happy Birthday’!”

Katie, whose favorite song just happens to be--and how did the doctor know this?--”Happy Birthday,” smiles and begins to sing.

“Happy Birf-day, Hap-py Birf-day, Hap-py Birf-day to meee !”

Katie, who has a history of what her mother calls “somewhat volatile” behavior, keeps singing even as Roulakis opens her diaper and peeks inside.

“We’re going to check this private area now. It’s a very private area. Only the doctor checks and only with Mommy or Daddy here.”

*

In the cozy pink room at the end of the hall, a mother already an hour late for work rocks a dark-eyed 3-year-old on her lap.

The moment Roulakis opens the door, the anxious mother pushes the long-haired child toward him. “Does she have an ear infection, doctor? Does she?”

Roulakis takes one look at the mess of clotted blood caked around the child’s right ear and exhales, “Oh, yeah. A pretty nasty one too. Blood. Pus. Ouch!” The girl falls against her mother’s chest.

“She never complains of pain, never,” protests the mother. “Oh, my poor little thing.”

Roulakis writes a prescription for antibiotics and promises the foul-smelling drainage will clear up in about four days.

“That long?” the mother asks. “Well, thanks for squeezing me in today. I had no idea she was so sick.”

*

A loud sucking sound is coming from behind the door of Room 6.

It is Robert, age 18 months, trying to extract the last drop of water from his sports bottle.

The sound continues after Roulakis walks in and sits down. Both Robert’s mother and his baby-sitter try to pull the bottle out of Robert’s chubby grasp, but this only makes the noise louder.

The mother, an elegantly dressed woman from Brazil, throws up her hands. “I’m sorry, doctor.”

“It’s OK,” Roulakis shouts over the noise. “I used to have a date who made that sound.” At that, Robert drops the bottle and claps his hands. “He likes jokes--even mine,” Roulakis says.

But it is Robert’s twin sister who is the patient. “Miss Pretty here, she doesn’t sleep and she hardly eats,” says the mother. “If I give her a bit of ice cream or yogurt, her whole face gets red and itchy. It upsets me so much. So, doctor, I wonder, can you test her?”

“You already have. She definitely is allergic to cow’s milk. You have proved that. She knows it too, that’s why she avoids so many foods. So no more cow’s milk for her. She is truly allergic.”

“No mas leche. No mas. OK?”

“Si, doctor, si. Milles gracias.”

*

Roulakis, a second-generation Greek, speaks four languages. In addition to English and Greek, which he speaks with his children at home, he also speaks Spanish and French.

“Communicating is very important in the practice of medicine. But with children--especially those who don’t speak too much yet in any language--I’ll try just about anything to communicate.

“That’s where Larry comes in.”

Larry is a gray, long-nosed, stuffed creature who hangs on Dr. Nick’s stethoscope by tiny fur paws. When children decline to be weighed, sit down or refrain from assaulting other family members, Larry often steps in to help.

Even though he has no voice of his own, Larry can exert considerable influence.

“Larry,” Dr. Nick will say, “can you help me out here? Jason is a little nervous about me looking in his ear.”

Or, “Will you please hold Larry while I listen to your new baby brother’s heart? Larry is feeling a little bit left out today.”

Or, to an older child, “Say, did I ever tell you I have a cousin who looks like Larry? Scary, huh?”

It’s a technique that works, says Roulakis, who has dropped to his knees more than once in search of a lost Larry. “I certainly don’t want to lose him. We’re a team.”

*

By 12:55 p.m., Roulakis has said adios to his last patient of the morning. And by 1, Tina Roulakis, who designed her husband’s new columned office building, has arrived for their weekly lunch date.

“If we didn’t mark this on the calendar--Thursday, Take Your Wife to Lunch--I doubt we’d ever have a quiet moment together,” she says.

They walk to the little sushi place across the street and less than an hour later, walk back holding hands. He kisses her goodby in the parking lot.

“Any idea about what time you’ll be home tonight?”

“Not late, not late.”

Tina laughs indulgently. “Sure, hon, sure.”

Back in Examining Room 8, an unsmiling boy in Simba underpants settles into a chair across from Dr. Nick’s desk.

Armando, 3, is here for a well-child visit. “His height and weight are very good,” reports Dr. Nick. “We did a vision test and a urine test, we’ll also check his hearing.”

The mother, holding Armando’s 2-month-old brother, Andres, against her shoulder, nods.

Roulakis closes Armando’s chart and looks at his mother. “How do you feel about going back to work?”

The floodgates open. “Oh, I don’t want to. Really, I don’t. Maybe I’ll win the lottery. I’m so worried about how things will work out. I worry about doing everything, getting home at 6:30. . . . How will I do it all? When will I be with my children?”

“Do you have someone to stay with the boys?”

“My aunt. She’s just wonderful with them, but still. . . .”

“I know, I know, it’s hard to be apart, isn’t it?”

*

In the hallway, to the sweet recorded strains of Pachelbel’s Canon, Dr. Nick greets his sickest patient of the day--a frail-looking boy with congestive heart failure.

“The trouble, as you know, is that this hole in the ventricle makes his heart work very hard to pump the blood,” Roulakis says. “The concern at this very moment, though, is that children like this get pneumonia so easily and. . . .”

Suddenly, the baby suffers a violent fit of coughing, shaking his thin body down to his bluish toes.

The 7-month-old boy was born 13 weeks early and his health will be fragile until he is strong enough to undergo corrective heart surgery.

“When he was born, he only weighed 1 pound, 14 ounces, and today he weighs 11 pounds,” the mother tells a visitor. “I know 11 pounds doesn’t seem like much, but for us, it’s great.”

She wraps her arms around the baby and coos in his tiny elfin ear, “Oooo I love ya. Mama loves ya, loves ya, loves ya.”

“I talked to the cardiologist this morning and he said wait and see. I know that’s hard,” Roulakis says.

*

“This is a new patient, doctor,” says nurse Romero.

Roulakis reaches out to shake the little girl’s hand. “Nice to meet you. And, nice to meet you, Dad.

“What brings you here?”

“Me and my daddy, we’re both sick and my ear it hurts and I’m having a big birthday party and I don’t want to be sick, OK?”

“OK.”

“When is my birthday, Daddy?”

“Saturday, sweetheart.”

“Saturday, OK? So, hurry up, OK, doctor?” she says.

“OK.”

After fifteen minutes, Dr. Nick knows a lot about this new family.

The father is recovering from a drug addiction; both of them are recovering from the recent death of the girl’s mother. They don’t have insurance and they both need an expensive course of antibiotics.

Roulakis loads them up with free antibiotics, office samples left by a drug salesman, and asks the girl to “bring your daddy back when the medicine is all gone.”

Later, Roulakis says, “I hope they make it. I hope they come back.”

*

The sun is setting and Roulakis’ partner, Dr. Lauren Ashforth Dimen, returns to the hospital for a final bed check as the last patient of the day arrives at the office. He is 10 and is accompanied by his mother.

He seems very sad; she, highly agitated. “What’s going on?” asks Roulakis.

The boy looks down and shakes his head. “I have a cold.”

After a quick exam, Roulakis confirms it. “You’re right. You have a cold. Now, what’s wrong?”

“He misses his father,” says the mother. “He misses his father too much, I think. It makes him sick. What can I do?”

“Where is your husband?”

“He has gone to work for two years in another country. It is very hard for us.”

“Why didn’t you go with him?”

“Because my mother-in-law, she is dying of cancer and she lives with us. You see, in our culture, we are from Taiwan, it is my job, my responsibility, to stay here to take care of her. But it is not easy for my son. It is not fair to him. And so he is very, very sad and I think that is making him sick too.”

The mother pulls a handkerchief out of her leather handbag and dabs her eyes. “I am so sorry that you must be apart,” says Roulakis gently, “but I wonder if there is anything we can do to make it easier. Does your husband have a fax where he is?”

“Oh, could we, Mom? Let’s fax him my math test. He’s going to be so happy!”

*

At 8:10 p.m., there is a full moon over the Roulakis home as Dr. Nick rushes through the back door.

“Hey, I’m home! Dad’s home!”

Eleni, 3, rushes to the kitchen to hug her father’s knees. Ereeni, 7, glides in to plant a quick kiss on his cheek. And son Steven, 10, yells out from his room, “Hi Dad!”

“Let’s eat,” says Tina.

“Let’s pray,” says Nick.

Steven begins. “Thank you God for the food we eat. Thank you, God, for the world so sweet. Thank you, God, for everything. Amen.”

Roulakis spears a forkful of pasta and raises it to his mouth. The phone rings and he swallows fast.

“You think that might be for me?”