parentnoia

Can anyone explain to me why I’ve been sitting here for 90 minutes waiting to see a doctor? My son is feeling fine now and wants to just go home and rest!
— 

Mother who didn’t know why she had come in to the urgent care. SERIOUSLY – she didn’t want a school note, medication, lab tests, or even a physical exam of her child – who had vomited last night but was now feeling fine. I was equally befuddled.

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My mom won’t let me take any over-the-counter medicine for my sore throat, because she thinks I’ll get addicted to Tylenol.
—  17-year-old female patient with 6 days of sore throat (yeah, it was strep), in reply to my question “Have you tried doing anything for your symptoms yet?” She was dead serious. I’ve met her mother in clinic before, and I wasn’t really surprised. (Helloooo, anxiety disorders!)
TSK: Bruise Clues
  • Cranquis: So, Bobby, your foot was hurting after you jumped on the trampoline yesterday, and today it looked a little bruised?
  • Bobby: Yeah, but...
  • Mother: IT WASN'T BRUISED YESTERDAY BUT NOW IT IS SO I DIDN'T LET HIM GO TO SCHOOL.
  • Cranquis: Ok. Is the foot still hurting when he walks on it?
  • Bobby: No, it's...
  • Mother: WELL IT SURE LOOKS PAINFUL I MEAN IT HAS A BRUISE ON IT!
  • Cranquis: So did you do anything for the pain then?
  • Mother: WELL NO HE DIDN'T COMPLAIN ABOUT IT SO I DIDN'T GIVE HIM ANYTHING.
  • Cranquis: *examines Bobby's foot, finds nothing wrong except a tiny fading bruise that doesn't hurt* Bobby, I want you to stand on your tip-toes.
  • Bobby: Ok! *jumps up from chair*
  • Mother: OH NO DON'T DO THAT, IT'S GOING TO HURT!
  • Bobby: *walks across room on tiptoes happily*
  • Cranquis: I think his foot is fine.
  • Mother: WOW I DIDN'T EXPECT HIM TO BE ALL BETTER ALREADY.
TSK: Parental License Revocation #38

Child: calm happy non-distressed 3 year old, occasionally scratching at what are obviously mildly-irritated mosquito bites on her arms and legs and face.
Parent: red faced dad, screaming at Cranquis to hurry up and give the kid “an appy-pen injection” because she was “stung by, like, 15 bees, or ants, or whatever!”

Cranquis:

Behind the Medic: It's a Jungle (Gym) Out There

Hey hey, readers! PRO TIP: If you’re seeing a school-aged child in clinic for “spontaneous” development of “mysterious” musculoskeletal complaints, ask them what they’ve been doing in gym class!

Example #1:

12-year-old overweight boy, complaining of “achy legs” since this morning. No trauma, no rash, no fever, no nothing. What have you been doing in gym class, buddy? “Oh we just started playing Dance Dance Revolution yesterday!”… CASE CLOSED. 

Example #2:

11-year-old slim girl, complaining of “central chest pain and left arm pain” since last night during dinner. No other symptoms, no trauma. Her dad can’t stop blurting out “It couldn’t be a HEART ATTACK, could it?” (repeatedly, despite the obvious anxiety that this is causing to his daughter). What have you been doing in gym class, young lady? “Oh we just learned how to do push-ups yesterday, I did 30 of them!”… Yeah, and it turns out her right arm is hurting too, along with her upper back and her legs. CASE CLOSED. 

Example #3:

16-year-old boy, complaint of “stiff neck”. Mother totally freaked out – “Doesn’t that mean MENINGITIS?” No fever, no nausea, no trauma, no nothing. What have you been doing in gym class, young fellow? “Oh I just started weight-lifting class this week.”… CASE CLOSED (and maybe you need to work on your lifting form, mister.)

Behind the Medic: Why I didn't sleep well last night

The dream began in my Urgent Care (as so many of my dreams do).

6 year old boy whom I had never met before, pain in wrist after falling down. I ordered an xray, and the report came back in about 2 seconds of Dream-Time, flagged with a Highest Priority exclamation point which made my innards clench.

…RAT-BITTEN APPEARANCE, PATCHY OPACIFICATIONS THROUGHOUT VISUALIZED RADIUS/ULNA, PATHOLOGIC FRACTURE THROUGH DISTAL RADIUS, STRONGLY SUGGESTIVE OF UNDERLYING MALIGNANCY, RECOMMEND PET SCAN…

My dream-self began to cry silently, reading this awful truth, imagining the unexpected shock and grief that I was about to unveil upon this boy and his parents.

I took a deep breath, squared my shoulders, re-entered the exam room prepared to Deliver the Bad News.

The boy on the exam table looks up at me. It’s my own real-life son.

*****

I awoke in a cold sweat. But the dream wasn’t done with me yet. For endless minutes, my half-asleep brain served up memories of my son, tiny insignificant memories, mutated by the dream’s adrenalin and the confusion of night into “subtle diagnostic clues” of House-ian proportions.

“That time his finger hurt for no reason.” “The times that he complains his stomach hurts after eating a big meal.” “The way he repeatedly twists his left ankle (or his left ‘nickel’ as he prefers to call it).” “The solitary lymph node that stayed present on his scalp for over 6 months I mean sure his complete blood count was normal but what if there was a lab error I should go into his bedroom right now and feel for lymph nodes and I wonder if he’s gained any weight since his last doctor’s visit when was that anyways and…”

It took time and prayer and time before my mind relaxed back into sleep again.

TSK: This mom would not make a good mad scientist.
  • Cranquis: Have you tried taking anything for your sore throat?
  • 11-year-old patient: Well my dad gave me a couple pills of something, and it really helped. But my mom hasn't given me anything since I came back to her house 3 days ago.
  • Mom: Yeah, her dad didn't tell me what he gave her, so I didn't want to risk it.
  • Cranquis: You mean, you didn't want to risk giving her any of the standard over-the-counter pain relievers which are safe for kids with sore throats?
  • Mom *totally not catching my sarcasm*: Exactly!
Cranqsgiving, Day 3

(Thanksgiving reminds us to be thankful. Cranqsgiving reminds you that I’m cranqful.)

This Cranqsgiving, I’m cranqful for – parents who invent signs of illness.

Mother: Well, I just know my toddler has a double ear infection.

Cranquis: Hmm, but you said she hasn’t been congested or coughing or feverish. What makes you think so?

Mother: When I pulled her ears during her nap, she woke up and started crying.

NO OF COURSE THE CHILD WAS FINE AND HAPPY – BUT HEY AT LEAST SHE COULD BE EXPOSED TO ALL THE SICK KIDS IN MY WAITING ROOM.