As a doctor, you handle so many cases day in and day out. Some of them remain with you forever. I’m sharing one such story here, along with my learnings and takeaways.
A well-educated mother brought in her healthy-looking four-month old baby boy. She complained that he coughs intermittently through the day, once or twice at a time.
There was no history of fever, cold, or ear infections. The baby’s developmental milestones and anthropometry were all on par for his chronological age. A physical examination did not reveal any abnormalities. The baby was happy, active, and comfortable.
I reassured the mother and asked her to observe the baby for a few days.
When she came back, after two weeks, the baby had gained weight and the physical examination still did not reveal any abnormalities.
On the third visit, the mother had a viral respiratory infection and she was worried that the baby might also have caught it. Examination showed the baby to be stable, but the mother said that the coughing had still not resolved.
I decided to ask for a chest x-ray. Although there was no clinical indication, I outweighed the risk of radiation exposure with the mother’s persistence that her baby still had a cough.
The X-ray shocked us all. It revealed a diaphragmatic eventration on the left side of the chest, into the left lung space, and visible bowel loops in the same. After counselling the parents and speaking to the pediatric surgical team at JSSH, I referred the baby for surgery.
Happy to share that the baby is doing well post surgery.
The co-incidental history is that the maternal uncle of this baby also had a diaphragmatic eventration, which was diagnosed and operated at 9 months of age.
My learnings
• Parents know best: They can see what isn’t shown and hear what isn’t said. If the parents’ gut feeling says that something isn’t right with their child, we must probe the case further. We must do so even if physical examinations do not reveal any abnormality.
• No such thing as a minor problem: A minor problem can sometimes be a symptom for a deeper and underlying issue.
Listen to your patients: When they persist on something being wrong, listen and provide with active solutions, don’t disregard their fears and doubts.
The takeaway for parents
• Pay attention: The mom could tell that something isn’t right with her baby because she had her eyes and ears wide open.
• Trust your judgement: As I said, you know your child best. If you feel that something isn’t right with their health, trust your judgement, your gut instinct, and persist.
