I
had cared for a ten year-old with fever who had vomited twice. It was the usual
stomach virus that might last a day. I reassured his mother 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.
“Of
course.”
“In
that case don’t take his temperature.”
This
is my usual drole response to patients frightened by fevers. It startles them,
but my explanation reassures them. This lady was not startled but offended.
“I
work in the medical profession, doctor, and that is dangerous advice.”
“Actually
not.” I explained that when otherwise healthy people get seriously 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 very bad. 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.
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