March 7th, 2005

White Coat

Mommy, tell her to stop looking at me!

I don't want her to look at me, explains the three-year-old sister, because I don't want her to see my hanging nail. She was adamant. How do you explain to a three-year-old that you are not looking at her, you are looking at the baby held in mother's arms who happens to be more or less standing between yourself and said three-year-old. Not to mention that when someone waves her arms and claps, I glance her way. It's a reflex. Movement interests me.
She's just like that, mother reassures me. And I think: A three-year-old doesn't like me.

Two-month physical exam. "I'll send you in and catch up." Dr. T is an excellent pediatrician but always running behind. She opens the chart. "Or..." Lays it on the desk so I can read R=80 in the "Concerns" section. A respiratory rate of 80 is not normal in a two-month-old baby. And so we went in to see the baby. Five minutes later, baby is on her way to get a chest X-ray and an EKG and we are on to the next patient. An hour after that (they had to drive to the other hospital, stupid insurance) Dr. T is on the phone to pediatric cardiology. I have this two-month old baby with a respiratory rate of 80, a mildly enlarged heart on chest X-ray, and a first-degree AV block on EKG. Can you see her? Pause. Admit? Pause. No, she looks fine, just breathing fast. Pause. Okay, I'll get her in. Baby goes to the hospital.
We are now even further behind.

Two children with obvious behavioral issues, going back on Concerta for their ADD. It's only part of the picture. Twelve year old girls should not be attempting to choke nine year old girls who are not their sisters. Refer to child psych.

Why do little G's gums bleed when he eats sometimes, but not when his teeth are brushed, and only sometimes, and we don't really know if it's his gums, his whole mouth is just full of blood? And why won't they bleed now when he is eating crackers? Call when they do, we'll run platelet counts. Maybe it's cyclic.

Babies with ears full of wax. The flu. Croup season. Having a wonderful time, O Best Beloved. Discovering that I need a lot more practice with lungs. And even the best pediatricians have their problems socializing. S starts screaming as soon as we get into the room, a constant stream of "no, no no!" coming from his nearly-three-year-old mouth. He is pacified by mother for a lung exam, held still for the ears. "Oh, my," Dr. T says. "You have goopy stuff in your ears." DON'T LOOK AT MY GOOPY STUFF! It's a new wail, panicked now. We have to backtrack. "No! I won't look at your goopy stuff, I'll just look in your ears."
This time, it works.
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