A glum eleven year-old sat on the bed. His glum parents
and two glum adolescents sat nearby. The eleven year-old had developed a sore
throat, casting a pall over their vacation. They hoped I would make it go away.
Doctors love making things go away, and this would
happen if the child had strep, the only throat infection (diphtheria aside)
that medical science can cure.
Parents assume that a child with pus-covered tonsils has
strep, but many viruses do this. Researchers have determined that a doctor can
diagnose strep by observing four signs.
(1) pus-covered tonsils, (2) swollen neck glands, (3) fever, and (4)
absence of cough. Since it’s strictly a throat infection, other respiratory
symptoms such as cough or congestion make strep unlikely.
This patient had zero out of four. His throat and neck
glands were normal; he had no fever; he was coughing.
Working hard to turn this into good news, I explained
that the child had an ordinary virus. He would feel under the weather for a few
days before getting better. I handed over some remedies, assuring them that
these would help. Staying in bed wasn’t necessary. They should try to enjoy
themselves.
When the father politely asked if something might speed
things along, I explained why it wouldn’t. Never forgetting their manners, the
parents expressed gratitude. I left them my cell phone number and urged them to
phone if any problem developed.
We parted on good terms, but I could sense their
disappointment. No matter what the doctor said, everyone knows that sick
children must rest. So they would wait.
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