Shaken Not Stirred

Tuesday, November 07, 2006

A Missed Observation

One of my really good friends in medical school invited me over to his parent's house this weekend. His girlfriend was going to be in and his brother (with newborn baby)was also visiting. I thought it would be a good opportunity to get away from the books, the lonliness of living in solitude and also a perfect opportunity to eat a home cooked meal. I haven't seen his brother in about a year and I had only seen pictures of the baby.

When I got to their house, my buddy wasn't home yet. His brother let me and brought his daughter out to see me. He said that she wasn't feeling well and was a little cranky. He asked me if I thought it was because they took her to the mall the previous afternoon, thinking she may have caught something from one of the many strangers around. I asked him what the temperature was and what he had done for her so far. He said the temp was about 100 and that his mother (a physician) had given the baby some baby tylenol. I told him to wait a few hours and then take the temperature again (I've really gotta brush up on my pediatrics--but ask me anything about hypertension).

A few hours later, the baby still had a temperature. However, she was still drinking milk and also pretty active. My buddy told his brother, "if they can still eat/drink, they should be alright". He looked to me for confirmation. Their mother and father still weren't home from some social activity they were attending. I told him that I thought so, that I had heard that as long as the baby remained active and not lethargic, there wasn't anything. I looked at my buddy and asked where his pediatric Blueprints were.

When Grandma came home she asked about the fever--and asked how many times the baby tylenol was given. She then pulled a grandma, pushed a speed-dial button on her cell phone and informed someone on the other line that she would be arriving with her grandchild.

My first thought? I can't believe that I advised my friend that I had thought it was okay--that the fevers weren't too bad.

We got to the E.R. and my friend was interviewed by a somewhat "rude" nurse. She informed my friend that a temp of 99 didn't constitute a fever and then proceeded to say, "next problem--what did you do and any other signs and symtoms that brought you in". My friend and his wife were speechless and stuttering. I was wondering why would you be so rude to people who were obviously nervous because they were new parents.

Anyway to make a long story short, it turns out the baby had a urinary tract infection. The parents were told some further work-up would be done to find the problem.

My buddy and I were talking in the car afterwards and wondering how we could have missed it. We wondered why it wasn't even a differential on our list of possiblities. And instead of a relaxing weekend, we pulled out our books and started reading again. When do I switch over from becoming a student to a physician?

20 Comments:

  • Wow interesting story, glad the baby is okeh! I have learned from all my hospital stays which nurses are the ones you want, and since I was a kid I always got the good ones, you don't wanna cross the bad ones.

    Best of luck on that transition!

    By Blogger Phats, at 1:19 PM  

  • If you're going to be a good doctor, never.

    I have every confidence you will be a good doctor.

    By Blogger blackcrag, at 1:51 PM  

  • Pulling a grandma is a good line. When I was young you had to have a severe loss of blood to go to a doctor. Now my mother insists on taking my kids to a doctor every time they cough.

    By Blogger :P fuzzbox, at 3:26 PM  

  • Don't feel bad... a fever could indicate a number of different things and not all of them terribly bad. Depending on the baby's age, it could have just been her teeth...

    You're going to be a great doctor... #1 reason is that you care.

    By Blogger JJ, at 4:40 PM  

  • You'll be fine!

    Question for ya - How would a baby get a urinary tract infection?

    By Blogger sassyglass, at 5:14 PM  

  • You'll be great! The learning process is ongoing.

    By Anonymous Babette, at 5:45 PM  

  • My mom was the same way with my son when we first moved back. I had been through cetain medical problems with my son before and pretty much knew when to take him and when to not. But Grandmas will be grandmas and new parents will be new parents so I am sympathetic to them b/c something that new to someone ought to be nerve wracking. Like parenting.

    By Blogger Drywall Mom, at 6:21 PM  

  • Hey, Angel, it has been a long time **I know, I'm sorry**, but I thought I would stop by and see how you were doing. Sorry to hear about your relaxing weekend ending up being a studing session. I am sure that you will be a great doctor - just remember this weekend and know that even when you are a doctor you will still need to go back to the books every once in a while!! Well, I hope that I hear from you soon. I am hoping to be writing on my blog again soon. Stop by some time. :)

    By Blogger SquirmsteR, at 1:21 AM  

  • From what I know of GOOD doctor's it never really ends.

    Too bad that it made your weekend stressful though.

    Scott

    By Blogger Scott, at 9:37 AM  

  • Glad the kid is okay.

    I wouldn't worry about your abilities as a doctor based on this one tiny thing though.

    Steve~

    By Anonymous Anonymous, at 10:48 AM  

  • A fever is such a general condition, and urinary tract infection is just not the first thing to come to mind.

    Eventually, it would've been found through a urine sample or something, right?

    Some nurses aren't happy with their jobs and are rude like that. It's actually quite rare, but that lady should be stocking crap in the back instead of working with patients.

    By Blogger The Phoenix, at 12:05 PM  

  • so let me ask you this...if a fever is indicative of a problem, then why would you deliberately bring the fever down, or attempt to eliminate it, to me if you do that, whatever infection is going on is going to be pro-longed, or become worse...because if you dont technically have a fever, because you've rid yourself of it with tylenol how would you catch the urinary tract infection. i agree with seeking medical help at the sign of a fever, but i don't agree with stopping the fever the minute it presents itself, or you'll miss the bodies natural cue to tell you something is wrong.

    By Blogger Badoozie, at 12:26 PM  

  • Angel, you're going to be doing that for the rest of your life. Better get used to it.

    I would start giving bad advise, then people will stop asking. This was a godo start.

    By Blogger slopmaster, at 2:21 PM  

  • "pulling a grandma" haha. love it.

    I think a fever can indicate any number of things. Sounds to me like you did an excellent job! You'll be a great physician because you obviously care a lot.

    By Blogger Belle, at 5:32 PM  

  • You will always be a physician if you have a medical situation you are thinking about.
    I think you are going to be great at what you do!

    By Blogger Lee Ann, at 9:32 PM  

  • I would think that being a physician is a lifelong learning thing so you will always be the proverbial student.

    By Anonymous Anonymous, at 10:24 PM  

  • i didnt even know you had a medical degree!! But how would one suspect UTI with a fever of 100 and no other symptoms? Am impressed!

    By Blogger How do we know, at 1:07 AM  

  • I'm sure you are a physician already...but there's always more to know...if you care to keep learning...& it certainly seems like you care...so...I'd have every confidence calling you my doc.

    By Blogger Chick, at 8:42 AM  

  • Just wait until you are a doctor and are attending parties, trying to relax and friends are seeking advice and showing you their lovely wounds and other such things....ick.

    I harassed my friend who is a family doc to tell me what men refer to their nether regions as...he told me grown men call it their Pee Pee sometimes haha.

    By Blogger Miss Ash, at 10:14 AM  

  • Don't feel bad about that situation. At all. The baby is fine and you are good at what you do. You might want to check out this new blogger:

    http://www.laylasramblings.blogspot.com/

    I don't know who she is, but sounds like she needs some advice from another doctor-type...

    Keep up the good blog dude. Good luck with that exam!

    By Anonymous Anonymous, at 6:33 PM  

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