I sat in my pediatrician’s office for a follow-up after my second son, Daniel, had been hospitalized overnight.  Dr. Klebanow, the named doctor for the practice, asked me to recount what happened.

A few days before, Daniel had wakened up acting wrong.  He just didn’t seem right, and I didn’t know why, in part because he was too young to tell me.  After I took his younger brother to the babysitter, I headed over to my pediatrician’s office, feeling a little apologetic for going in without an appointment for I didn’t know what.  Daniel, always the obliging child, started to crash in the waiting room.  That began the best service I have ever gotten from health care.  The nurse looked at him, got up, escorted us to an examination room, checked his blood oxygen, then called my regular doctor, Dr. Wollney, who arrived in minutes.  He looked at him, at the chart, and told her to give him some albuterol, which she had already set up.  He stood over her and watched as she administered the drug.  It had no effect.  They gave him three more doses, still to no effect.  He said it might be asthma.  I told him it did not look like asthma, to me, because he was not wheezing.  He told me to take Daniel to the hospital, now.

When I got to the nearby hospital, the people in admitting expected us.  They took us in immediately, and a nurse put him on oxygen.  They said the paperwork could wait.  Daniel was passive by this time, and tolerated the mask.  This unnerved me, but I punched the cold feeling in my belly down.  I had work to do.  They gave him more albuterol, and the doctors said it could be asthma.  I told them he’d already had a bunch of albuterol, it was not asthma, and was more likely an infection.  They took an X-ray and said they could see no pneumonia.  I told them that I’d had pneumonia before, and it had not appeared on the X-rays until later.  We spent the whole working day arguing about this.  They explained that, without a diagnosis, they could not treat it as an infection (that is, use antibiotics).  In retrospect, they were probably constrained by hospital policy to minimize use of antibiotics.  Toward the end of the day I said, “Albuterol is not working.  This isn’t asthma.  Why not give him an antibiotic, and in six hours, we’ll know if it works.”  They agreed, but it had to be intravenous, because they feared he would throw it up.  

By morning, I had my sparky little boy back.

Dr. Klebanow sat with that a minute, then asked me, “What does a wheeze sound like?”

That question stopped me cold, because nobody had ever asked me, and I could not quite describe something I knew all too well.  Hesitantly, I said, “At the end of the breath going out, there’s a whistle.”  He said, “Who in your family had asthma?”  I said, “me.”

It is unquestionable that the doctors around me all had more medical knowledge than I did.  Once they decided to use an antibiotic, they selected one that worked well.  I have no idea what it was, but they cured him overnight.  What I had to offer were my observations, first about myself, then of Daniel, which suggested that, if he was reacting somewhat like me, he did not have asthma and did have an infection, possibly pneumonia.  Regardless of whether I was right or not, this led them to try something that worked.

This is the proper role of a parent in this setting:  to bring up observations of the child and possibly siblings or parents, which provide context for diagnosis.  There have been other occasions when I’ve given a description of myself or my kids to doctors, who have told me that it was probably something else, and they turned out to be right.  You, as a parent, might not get the diagnosis right, but if you get the observations right, you can provide insight that leads to good treatment.