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 Why I won’t shouldn’t answer “What would you do if it was your child?"

 

Your 11 year old son was playing “Cherry Bomb” on the school playground today (a wonderful game of tag where the person who is “it” tags people, but can only do so with eyes firmly closed) and while “it” sustained a blow to the face by another classmate. He is not clear as to the details of what happened, and while the children who saw him get hit say that it “looked bad” the bleeding from his nose has stopped. You have yet to see your son, but the teachers reassure you that someone is cleaning up the blood from his favorite sweatshirt and aside from feeling embarrassed, he is fine; he only has a swollen nose and face.

You call my office, looking for advice as to whether or not he should be seen.  Then you ask me, “If it was your child, what would you do?”

First off, a little about me. I am a board certified pediatrician practicing general pediatrics in Southeastern Wisconsin. In addition to my residency in pediatrics, where I spent many months in the pediatric and neonatal intensive care units (PICU, NICU), I did additional training, first as chief resident then as fellow in the NICU. As part of the year I spent as a fellow, I went on “transports” to pick up kids from other hospitals, sometimes getting back and forth in a helicopter. I consider that time in the ICU and on those transports to have invaluable experience for what I do now. I have lots of practice in heat-of-the-moment situations. I do not like when those moments happen but I am glad to know how to keep my head and help when I am needed.

I tell you that I would like to see your son and we talk about ways to keep him comfortable until I could see him.

Except, this scenario was not your son. It was mine. And when you asked what I would do. I cringed. All bets are off when it comes to my sons and I am sure I am not alone in my reaction. Ask anyone in healthcare.  

My son? What? Which one? Oh no he’s sick. I knew this would happen if I sent him to school. I should have homeschooled. All of them. I should be working part-time. He was knocked to the ground and hit his face. If his head hit the ground I will have to go, right now. Concussion, stroke, seizures. Traumatic brain injury. At the least he has a concussion. He will need to stay away from screens and rest his brain. I should bring my concussion forms. What if his nose is broken? Oh, he is going to have black eyes tomorrow.  I hope they have ice on it.  If he hit laterally, he could have injured his middle cerebral artery. Those injuries do not show up at first. They need to watch for vomiting. Did I tell them that? Was he making sense?  He will need an MRI. Maybe 24 hour in-house observation. I wish they could take his blood pressure. How bad was the bleeding? Why would he be bleeding if the injury was minor? Enough to clean off his sweatshirt? His platelets are fine. Probably, since he hasn’t been sick recently. He’s never had a problem with bleeding before. What if this is really the first signs of leukemia?

And so on. What would you do if it was your child? No, I shouldn't answer that.

Jenny Thomas, MD, MPH, IBCLC, FAAP, FABM