Friday, February 17, 2006

Diagnosing the Sick Toddler

OK people, settle down, settle down. We have a lot to cover in a short amount of time, so let's get right to it. Today's material is on diagnosing the sick toddler. Now, as doctors you'll often have to diagnose people who have a hard time communicating what is wrong with them. This is hard enough as it is, however when you're dealing with a person who is completely removed from the actual happenings of the physical world, the toddler for example, this becomes even more difficult. Also, due to the rambling, stream of consciousness nature of these creatures, often times the maladies will change from moment to moment, making treatment a difficult situation. Let's just jump into some examples so that we can see what works and what doesn't.

Situation 1: Normally cheerful toddler is picked up at daycare, having been crying for no reason for the past hour. Upon calming down said toddler, you are able to ask him what is wrong. His response is "A spider bit me on my finger." OK....Johnson, go.

Johnson: Well, I'd try and find out what spider bit him so that we could call the hospital and prepare an anti-venom, then I'd---

Wrong, wrong, wrong. Stevens, go.

Stevens: I'd inspect the afflicted finger and kiss it to make it better.

Correct. Moving on. Once you get the child calmed down you get him and his sister out to the car. After getting his sister in the car, you try to get to the bottom of what's bothering him. For this exercise, I'll be the toddler and I'd like, let's see, I'd like Davidson to try and diagnose the problem. Davidson, you ready? All right, and...go.

Davidson: So a spider bit you?
Toddler: No. A spider scared me.
Davidson: A spider scared you? Where?
Toddler: On my finger.
Davidson: A spider scared you on your finger?
Toddler: Yes. Miss Frances threw it.
Davidson: Miss Frances threw what?
Toddler: A black spider. Threw it on the ground.
Davidson: Wait. Miss Frances threw a spider on the ground and that scared you?
Toddler: Yes. Ryan drew it.
Davidson: Drew what?
Toddler: A spider
Davidson: Ryan drew a spider? Where? In class?
Toddler: On my eye.
Davidson: I got nothing.

As you can see, the "spider" that bit the child, either didn't exist at all, or not only bit him, but also scared him, got thrown on the ground, and was drawn on his eye. This then expands the diagnosis from a simple spider bite to possible retinal scratching and/or detachment, pyschological trauma manifesting in arachnaphobic tendencies and possible blunt trauma to the spider. In this case, it was determined, upon getting home, that the child had a fever. He was given a bath and put to bed. Upon waking the next morning he was fine.

All right, next case, same child, next day. Child, who normally sleeps very soundly wakes up crying. Child request dinosaur from downstairs. Possible diagnoses people? Anyone? Come on folks, this isn't hard. OK, it's Friday, so I'll let you slide. Possible diagnoses include, but are not limited to: nightmares, full bladder/bowels, empty bladder/bowels, hunger, a stiff wind, it being Tuesday, ear ache, stomach ache, foot ache, male pattern baldness, pain, suffering, lost wages. Treatment? Harris?

Harris: Go downstairs and get the dinosaur?

Jesus, Harris, don't ever have kids. No, remember, it's late and you're tired. Franklin?

Franklin: Tell him he's not going downstairs to get his goddamned dinosaur, that it's late and that he needs to go to sleep.

Bingo. Franklin, you just won Father of the Year. One hour later, child again cries for dinosaur. This time he complains of ear pain. Diagnoses? Mr. Chung?

Chung: Um, tennis elbow?

Normally I'd say yes. Had you asked him if his ear hurt, in an attempt to figure out the source of irritation, and he answered yes, tennis elbow would be a viable possibility. However given that this statement was unsolicited, we can assume that his ear pain is genunine. A subsequent trip to the doctor would prove an ear infection was to blame.

OK, next morning, child is again crying. Again, let's roleplay. Andrews you're up.

Toddler: Waaah.
Andrews: Does your ear hurt?
Toddler: Yes.
Andrews: Does anything else hurt?
Toddler: My face.
Andrews: Your face hurts?
Toddler: Yes.
Andrews: What happened to your face?
Toddler: Wall hit it.
Andrews: The wall hit it?
Toddler: Yes.
Andrews: You've been in bed all night? How could the wall have hit your face?
Toddler: Waaah.

OK, Andrews, what's the diagnoses? What? Misplaced facial pain as a result of the ear infection? Close, but not quite right. The correct answer is "spider bite".


MQ said...

What can I say SJ? You are an incredible father. You should write the book before those OTHER quacks do: TODDLERS - The owner's manual.

My husband thought it would be funny to market a glass encased binki with the words "Break in case of emergency" on it. Of course in our house that's Every Single Day.

suburbanjoe said...

Don't forget the glass encased bottle of scotch. I've found that more useful in emergencies than the binki.

Bones said...

I'll second the bottle of Scotch, but only if we're talking about using it in a toddler sleeping aid capacity. None for me though, thanks.

Anonymous said...

holy crap - classic. thanks for lightening my online search for "toddler" and "chronic stomach ache" - reading some pretty heavy stuff and came upon your blog. very enlightening. her "tummy ache" probably residule spider bite trauma. THX!!