Medicine can wear down our hearts and souls. My journey as a pediatrician has been filled with many joyful and rewarding moments but some memories are haunting to me. Somehow, writing about these is cathartic. Thank you for reading and sharing your thoughts with me.
A MOTHERS INTUITION
As a third year pediatric resident, I hated my life. I wanted to be a bartender in Jamaica, like in that movie, Cocktail. It looked so warm and inviting compared to my life. It was during my ER rotation that I learned one of the most important lessons of my career. I learned the value of trusting a mother’s intuition.
My patient was a 6 year old girl whose mother was sitting next to her bedside. “Something is not right about my daughter; I would like you to do a blood count.” I was not compassionate. Frankly, I was so tired; I did not really care why she wanted it. “Ok”. I left the room to check the computer for prior visits and a blood count had been done yesterday. Yesterday, the result was normal. I was incredulous. I went to my attending (boss) and relayed the story and the mother’s request. His answer was “do another one like she wants and then release her once the result comes back.”
We were very busy that night. I sighed, went back to the room, completed a history and physical quickly, and let her know I would draw the blood. I was probably short with her, condescending, and dismissive of her concerns. I felt justified in thinking she was overprotective and could not possibly “know” what I knew as a physician. Many years have passed and I do not remember the exact details of that history and physical but I remember that nothing seemed unusual. In all fairness, that could have been my closed minded perspective.
About an hour later, the lab called up to the ER with results. “Leukemia”, the lab technician said. My jaw and my heart hit the floor. “What did you say?”, I asked. “Leukemia”, she repeated. “How is that possible? The result of the smear was normal yesterday.” She said, “we missed it, we went back and reviewed yesterdays smear and that was abnormal too.”
I walked back into that exam room and sat down with tears in my eyes and told this beautiful little girl and her mother that she had leukemia; the oncology team was going to admit her that night and begin the full evaluation and treatment process. I felt terrible; not only for the diagnosis but also for how poorly I had treated this mother and her child. She sighed and said she was relieved to finally know what was wrong with her daughter. “I am so sorry.” I was so sorry for so many more things than I could say.
I have always wished I could have had a do-over. In my ideal replay, I would walk in and take an extensive history and physical, discuss a list of possible diagnoses with mom and draw the child’s blood. I would express compassion for her and tell her it was going to be alright. I learned many amazing and invaluable lessons during residency. I wish I could thank this mother now. She taught me the importance of listening to the person who knows their child best, their parent. It is a lesson I have never forgotten.