Sunday, October 26, 2008

"But aren't you a doctor?"

It's funny how in medicine, you fall into your own little niche. In medical school, you start out "learning it all." Eventually, you find yourself gravitating toward a certain area of medicine. Once you decide what it is that you want to do "for the rest of your life," the rest of the schooling tends to fade into the background in favor of learning the intricacies of your chosen field over the broad generalities of medicine. Of course you still have to know enough to pass the tests, and often you can cram that information into your brain for the whole of 24 hours, only to happily empty it out once the exam has concluded. You become a doctor, and you forget more than you have ever learned, but you still hold the title of doctor of medicine.

In residency, you become even more specialized. No more prostate exams or interpretation of peak spirometry tests for me! Of course, that doesn't keep people from asking you medical questions to which they think you should know the answer. Why do I hear rushing in my ears when I lay down? (I'm no ENT, but, um, probably just your blood circulating?) Could you tell me what this rash is? (I'm no dermatologist, but I'll bet if you put hydrocortisone cream on it, it will go away!) I'll never forget the day that Mr. Whoo and I were witnesses to a pretty bad car accident my intern year, and as we pulled over, I panicked "What am I going to do, check their *cervix*?" (Everyone was ok, thankfully, and neither my meager first aid/BLS skills nor my advanced cervical checking skills were needed.)

In the same vein, I still find myself overwhelmed with uncertainty when it comes to medical knowledge about my children. In fact, I am certain that my kids have been to the pediatrician more in their young lives than most kids are in all of childhood. I can't help it. It is the best example of a little knowledge being extremely detrimental. A high fever? What if it isn't just a virus? What if they have MRSA that I brought home from the hospital? Bean isn't wanting to bear weight on his leg after a fall? What if it is a bone sarcoma?? This week I had Bean to the pediatrician for a freaking cold. Even though my pediatrician is too kind to say it, I'm sure she is thinking, "Um, hello? Aren't you a doctor, too?" Are my diagnostic skills so shoddy that I cannot distinguish between a common cold and pneumonia? I guess, when it comes to my children, they are. Ever since I became a mother, I am better able to understand why physicians should not even attempt to treat their own family members. Not only are we too emotionally involved with the outcome of their care, those very same emotions cloud what little medical prowess we may have. Do you find your medical education a help or a hindrance when caring for your family?


  1. When it comes to colds and fevers, I probably worry less than most parents. I hardly ever call the pediatrician and she's only been there once in her life aside from her scheduled check-ups.

    However, since I work in rehab, I worry much more about random catastrophic things happening, like getting in a major car accident.

  2. Yes - that's me - totally and when our kids get sick, my husband expects me as the "medical doctor" to reassure him.

  3. I've written about this phenomenon before ("Perspective" and "Regular Mom") on this blog.

    As a former medical provider to children in my FP clinic, I always felt a bit weird when my colleagues would bring their kids to see me.

    One day, one of my patients, a practicing general pediatrician for TEN YEARS, brought her kid to me with conjunctivitis. I asked her why she didn't just treat it herself.

    "What if I'm wrong? What if it isn't conjunctivitis and he goes blind? I'd have to kill myself," she explained.

    That's why I don't treat my own kid. The stakes are too high and we can't be objective.

  4. For coughs and colds I am less worried, definitely. Once my eldest son had nappy (diaper) rash that just would not go away and the thought of taking him to the doc was alien, and I jut plastered on more and more exciting ointments. In the end I succumbed only to find that the wounds were colonised with MRSA. Eek.

    My background was a hindrance, though, when he developed massive lymph nodes with a viral infection, and I could barely sleep for worring about lymphomas and othe nasties.

    I tend to let my husband take them if they have to go; much less embarrassing.

  5. i am a pediatrician and im the same way exactly.

    the first sign of fever, im at the doctor.
    a really high fever, im calling in the middle of the night.

    my son's pediatrician must think im a really bad doctor- umm, hello? dont you do this for a living??? what would you tell a patient calling for the same reason???-

    BUT, i just cant separate myself. im a mom first and when something is wrong with my son i get nervous...the only symptoms im relaxed about in my own son are rashes- i can tell which rashes need to be seen, and which ones dont need any worrying.

  6. My husband and I are both (non-pediatric) physicians, and our pediatrician as well as our son's specialists tell us that we "underreact" to our kids' illnesses and that our "bar is set too high" for what constitutes sick. I am an oncologist, he is an HIV doc. I guess it's true--our patients are pretty sick.

    While it is true that we now know the mg/kg dosing of Amoxicillin from having 3 kids, in general, I think it's unwise to treat your own family unless it's an emergency or at least highly inconvenient to get them to another doctor. I remember when my fellow med school classmate asked a very well-known and well-liked pediatrician (who was also our Dean of Students) at a noon conference what he should be looking for if he checked his son's ears. The pediatrician answered: Nothing, you shouldn't be looking in them in the first place.


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