“Mommy, I’m Going to Die!”

Autumn, my nurse, called about 7:30 last night. Her five-year-old son, Curtis, had just come running into her kitchen from his bedroom, crying “Mommy, Mommy, I’m going to die!”

“Why, Curtis?” she had asked.

“I swallowed a screw”, he sobbed.

Autumn tried to get him to describe the size of it, but he couldn’t tell her.

Curtis sees a pediatrician in the city for his health care, but Autumn often runs things by me. I am fine with that arrangement, as it can sometimes be hard to be both coworker and care provider.

My advise to Autumn was to take Curtis to the emergency room in case the screw was very large, although that seemed unlikely. An x-ray would settle the issue.

As I was about to fall asleep last night, I got a text message, saying “Doing X-rays now”.

This morning I got the rest of the story from my slightly tired-looking nurse:

Curtis felt well, was his usual social butterfly, and really enjoyed his visit at the hospital. His physical exam was normal, and the angst he had first experienced was long gone. He asked the nurses and the young doctor all kinds of intelligent questions.

While waiting for the x-ray, Curtis asked his mother: “Will an x-ray show everything in your stomach?”

“It certainly will. Why did you ask?”

“Will it show pennies?”

“Yes, Curtis, don’t tell me you swallowed a penny, too?”

“I might have.”

Might have? When did you do that, and how many pennies did you swallow?”

“Only one penny, maybe two or three days ago…”

The doctor came in with the x-ray. It showed a one-inch screw in Curtis’ duodenum. After the doctor had made sure that Curtis was still feeling OK, he went to call Curtis’ pediatrician.

“See, I told you it was a long time ago I swallowed the penny”, Curtis said.

The doctor came back, frowning.

“Well, doctor Patterson’s partner wasn’t very nice. He said ‘Why’d you call me about it, you’re the emergency room doctor!’ Anyway, my feeling is that this thing will probably pass just fine, now that it’s already out of the stomach. Bring him back if he has any symptoms, otherwise just check his stools.”

Turning to Curtis, the doctor said:

“You seem like a really bright young man, Curtis. What do you want to be when you grow up?”

Curtis answered without a moment’s hesitation:

“I want to be a doctor, so I can go to the hospital every day!”

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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