Dr. Andy

Reflections on medicine and biology among other things

Wednesday, January 25, 2006

A good article, by one of the best medical writers around, Peri Klass (no blog, but I guess when you have gigs with the New England Journal and New York Times you don't need one).

She talks about how hard it can be to separate the truly sick kid with meningitis or leukemia out from the sea of viral infections and worried moms.

I posted a similar experience here. I think one of the most important things for a pediatrician is being able to differentiate sick from non-sick kids. And by "sick" I mean really sick, not the flu. I have one more case I'll describe in the future, but when caring for the kid with a viral illness that was really leukemia, I wasn't smart enough to know right away that it was leukemia. I was, however, smart enough to know that something bad might be going on. In the midst of a busy night seeing "non-urgent" kids in the emergency room that was enough.

2 Comments:

At 6:31 PM, Blogger girl MD said...

This is what keeps me up at night after my continuity clinics.

 
At 10:51 AM, Anonymous dr ibear said...

I've learned somewhere along the way working the ED that it isn't necessarily important to make the diagnosis. It is more important to distinguish who needs more attention and who can be discharged to follow-up. Also I've discovered it is sometimes better to be lucky than good. That scares the heck out of me.

 

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