Thursday, November 5, 2009

Initiation


"Initiation: A rite of passage ceremony marking entrance or acceptance into a group or society. In an extended sense it can also signify a transformation in which the initiate is 'reborn' into a new role."

The H1N1 flu hit our family hard last week. Fevers, coughing, chills, body aches were found all around. During the afternoon of the first day that the fever arrived, I watched my son sleeping and noticed that he was breathing quite rapidly. He wasn't wheezing from asthma. There was no stridor sound from a croup virus. He wasn't blue, so I knew he was receiving adequate oxygen. But he was breathing fast nonetheless. I made the decision to take him to the pediatrician's office - much as he didn't feel like moving.

The clinic was overrun with sick kids and their parents. I got my son a mask to wear, and we waited in the sick child area for what seemed like forever. Finally, a nurse took us into an exam room. When I explained his symptoms and she checked his record, she started moving very quickly. She tested his oxygen level, and it was 98 out of 100. It was good. She seemed relieved. We waited for the doctor.

My son was uncharacteristically crabby. He started banging his foot on the exam table. He started yelling at me because he was irritated that we had to wait so long. Nothing would distract him. I tried to play tic tac toe with him. All he wanted to do was sit and frown.

The doctor finally came in. She was new. And she looked like she should be in middle school. I assessed her every move. It was easy to see that this girl/woman was trying not to be overwhelmed with the situation in the clinic. Her tiny little girl voice was slightly quivering when she spoke. She had pale red hair and freckles on her face. I explained the situation at hand, and she reiterated that my son's oxygen level was fine. I told her that something was very wrong because my son was breathing rapidly. She watched him breathe. She told me that, while she knew that I wasn't lying, she didn't feel that he was breathing rapidly. I told her to watch him again. She did.

I decided that now was the time to put a "full court press" on this girl doctor. I asked her what we could do to prevent my asthmatic son from getting worse. She nervously took her little computer that she had in a bright lime green case. She tapped into it. Her fingers seemed to be shaking. She finally told me in a shaking voice that the test for H1N1 was only 10-70% accurate at any given time, so they didn't administer the test. I must have looked confused because she looked at me and said, "You don't understand what I'm saying." Poor choice of words. I smiled at her, crossed my arms in front of me, and said, "Why don't you explain it to me?" She grabbed the computer and tapped into it with shaking hands. She made only slight eye contact with me when she explained that it would be assumed that he did have H1N1 as that is the only type of flu in this area right now, but before she could prescribe an anti-viral, she would have to rule out strep and pneumonia. I told her to go ahead and do that.

The throat swab was tested and came back negative. They gave my son some Tylenol for his fever which was getting worse as the night wore on. They took chest x-rays. We went back to the exam room for what seemed like eternity. I finally went looking for the doctor. When I walked down the hall, I could hear her tiny voice in the radiology lab talking to the x-ray technician. They were having a disagreement. The tech was adamant that there was nothing on my son's x-rays worth noting. And the doctor was concerned about something on the x-ray. I walked back to the exam room. About a minute later, the doctor came back in and told me that the x-ray didn't show anything, but she was having it sent to the radiology department at Children's Hospital to be sure. She prescribed the anti-viral and we left.

She called me later that night to let me know that my son did have pneumonia in one lung. An antibiotic would be prescribed, and I provided her with the pharmacy information.

That doctor called me once a day for the next three days to ask how my son was doing. He went through nearly two days of throwing up. I had to call the triage nurses twice. At one point, I had to give him gatorade and water through a medication syringe to keep him hydrated.

The last time the doctor called, I was able to tell her that he was well on his way to making a full recovery. I told her that I made an appointment to have him rechecked since he was still coughing at night. There was a moment of silence on the phone, and then she asked me, "How did you know there was something else going on besides the flu?" I said, "He was breathing rapidly." Silence. I spoke her words back at her - "You don't understand what I'm saying." Silence. Then I asked her what made her send the x-rays to Children's Hospital when the clinic's x-ray tech was adamant that there was nothing remarkable about them. I could hear a smile in her voice when she said, "You were so sure there was something wrong. And you are very persuasive."

We saw a different doctor at last night's recheck. The pneumonia has now cleared.

I wonder if I made a lasting impression on this brand new doctor. I think I know the answer to that, and it makes me smile.

All hail the Queen Mother.