Wednesday, 3 October 2007

A well child

Things have been getting a bit gloomy on this blog lately, and I wouldn't want you to think that all is doom and gloom. As I've said before I am fine at home, it's the job that's the problem. And even on the worst days there are little moments of satisfaction. So for this, my hundredth post, I wanted to mention one such moment that happened today.

A woman in her thirties brought her toddler in to see me. The story was fairly humdrum: a cold, some diarrhoea, a little off colour, some cough, all for four or five days. In particular mother had noticed lumps of undigested food in the diarrhoea. Apart from a runny nose the child looked perfectly well (and hadn't a pain - what is the matter with Mary Jane?)

As mother talked I had a quick flip through her child's thin records, and saw a referral letter which mentioned that mother was a GP Registrar (a junior doctor training to be a GP). I hadn't realised this at first, and of course it put the whole consultation in a new light. And I modified the way I discussed the problem with her. As a rule I try to talk to all my patients as though they were intelligent lay people (modifying things slightly if they don't appear particularly intelligent). That way, if they turn out to be solicitors, eminent scientists, or even doctors, there is no need to be embarrassed about what you have said. But it helps if you know in advance. However, once you have found out that your patient is a doctor you mustn't assume that they are automatically “on your wavelength” so that minimal discussion is required. Even if they know a lot about the area of medicine concerned their judgement may not be dispassionate, and they are just as entitled to open discussion and reassurance as everybody else.

So we talked, and it turned out that mother really just wanted reassurance that her child was not seriously ill and that she was doing all the right things. I was happy to give it.

6 comments:

The Shrink said...

100 posts and still going strong, huzzah! :-)

And you continue to evidence to one and all that you are being a good enough mother ;-)

Hope it gets less fraught and frazzled when your partners return. Even though you do pique whistful memories of GP land, I know I couldn't (and didn't) hack the struggle and strife you're grappling with!

Ms-Ellisa said...

Isn't it frightening to have sick kids when you are a doctor? Do you think of every possible and impossible desease they migh/could/"definitely" have and become tremendously over-anxious?!

Dr Andrew Brown said...

Ms-Ellisa. I tend not to get anxious about symptoms in myself or my family. But of course I worry a bit.

My first child was born at the hospital where I was working as a Casualty officer. She had a meconium plug, and so she underwent a sweat test to exclude cystic fibrosis. A friend of mine, who was a paediatric SHO at the time, knew about this. He went and found out the result as soon as it was analysed, and let me know straight away that it was negative. I have never forgotten that act of kindness.

Dr Andrew Brown said...

The Shrink: Many thanks for all your supportive comments and subtle flattery. You're a decent chap too! :-)

Xavier Emmanuelle said...

Merci beaucoup for assuming your patients are intelligent. I do get quite tired of being spoken to as if I haven't a single neuron!

Dr Andrew Brown said...

Xavier Emmanuelle: Je t'en pris. :-)