It has been rough in the office lately. January is always rough for pediatricians…February is worse. Everyone and their sister is sick, the doctors all get sick too, those of us left standing work extra….Oh well. At least the great thing about pediatrics is that the kids are still cute and make us smile.
Part of what makes the days hard is also that many of the parents who come into our offices are exhausted from lack of sleep and worry. They need our help also. But when so much of the time all we have to offer is the dreaded diagnosis of yet another viral infection they feel frustrated. Sure, parents come in for reassurance – they want the piece of mind found in knowing their doctor did not hear a pneumonia or see an ear infection. However, much of the time there is often the hope that they will be handed a medicine that will help their child and get the parent some much-needed rest. I know. I’ve been there; I too have kind of secretly hoped there really was an ear infection to be found because I knew that could be “fixed”.
Too often we can’t offer a fix; we can only offer the diagnosis of “viral infection”. Let’s face it – that is read by the parents in our office as having the subtitles: “I’m back on my own with my sick child” “no sleep tonight” “I wasted my money/time”. And for us as physicians honestly, handing over the diagnosis that clearly deserves an antibiotic is much easier, much more satisfying than saying yet again… it is “just” a virus (of course this concept of a viral infection being a “just” could take up a whole other blog post).
Then there are the even harder visits when we find an ear infection but need to embark on the discussion of “to treat or not”. Claire McCarthy, M.D. recently posted a wonderful article about this very discussion: Shades of gray: Why medicine isn’t always as clear-cut as we’d like. Her words and perspective have stuck with me through the past rough days at work. They have helped to reassure me and to guide me.
The practice of pediatrics is not unlike the practice of parenthood: full of uncertainty, impossible to understand completely and done best when the child is more important than anything else. We’re coming at it from different places, but we’re in this together.