This concerns the same hotel guest I wrote about three days ago. I had cared for her son who was feverish and had vomited twice. It was the usual stomach virus that might last a day. I reassured her and gave anti-nausea pills.
“I’m concerned about his fever. How often should I measure it?”
“Whenever you want.”
“I’m not comfortable with that. How often?”
“Are you worried about his fever?” I asked.
“In that case don’t take his temperature.”
This is my usual witty response to patients frightened by fevers. It startles them, but my explanation reassures them. This lady was not startled. She was offended.
“I work in the medical profession, doctor, and that is dangerous advice.”
“Actually not.” I explained that when otherwise healthy people get sick, they look sick. If they don’t look sick, they’re probably not sick, and having a fever doesn’t change matters. Infants and the elderly are exceptions; otherwise this is a good rule. People worry too much about fevers.
“I’ve heard different. Fever can kill.”
“You see life-threatening fevers in diseases like meningitis and rabies, but these patients look sick. I haven’t seen a life-threatening fever in thirty years. Sick people look sick. Make your decision on calling a doctor on that basis. Never mind the fever.”
“We’re done here.” She held out her credit card.