Saturday, January 17, 2009
I torture small children
My life became a lot easier the day I realized my job is to torture small children. I was the supervising resident one evening when I was called down to the Emergency Department for a consult on a 5 year old with alteration of consciousness and fever. The patient had been at school when it was observed that he was lethargic ( see previous post) and febrile (fancy for has a fever). The patient had been seen by the resident in ED and had had blood work, urine and spinal tap and a CT scan (CAT scan), all of which were normal. I went to look at the patient and really had to fight him, he was no longer lethargic, to get a good look at his ears and throat. Mom was not happy with me because she didn't want me to hurt him and did not assist at all with holding him still for the exam. His throat was nasty looking. I swabbed him and went to talk to the resident who had already seen him. I asked her what she thought of his throat and she said " Well I didn't get a good look at it because the mom was upset." The patient's strep came back positive. Here's what happened: The patient had a febrile seizure that was not witnessed and then was post-ictal. After seizures people are usually quite out of it. The poor kid had been put through a whole battery of tests for something really quite simple. I concluded that my job was to make sure I got a good look at kids ears and throats regardless of how mad I make a parent. Especially in pediatrics a lot of infections are in the upper respiratory tract. I don't try to hurt kids and I try to make the exam as fast and fun as possible, but my job is essentially to torture small children.
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3 comments:
It's the parents who don't help hold down their child that I don't understand. Doctors are always surprised when I willingly hold my (two year old) son so he doesn't kick the daylights out of them. I'll never forget one anesthesiologist who complimented me on the way I handled having my son put under. He said many parents try to reason with their small child to try to get them to lay there and cooperate... yeah, that's not going to happen. Maybe it's just that we're so familiar with having to do it, that it's the only option that makes sense to me.
Thank you for torturing! Madison had a febrile seizure when she was one and after two hours at the ER, several "exams" and an attempt at a spinal tap, a new pediatric resident came down and saw her, then cussed out the other drs for not cleaning out all the ear wax to see a huge ear infection. It took all of about 2 minutes for her to see what was wrong.
We need more doctors like you and more crazy parents reading your blog. I don't understand parents who bring their kids at their sickest and won't do what it takes to get a good exam. Boggles the mind.
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