"Doctor, I know there's something wrong"

This physician never ignores those words. Her story, which won honorable mention in our Doctors' Writing Contest, tells you why.

By Melodie Blacklidge, MD
Pediatrician/Cincinnati

A breathtaking bouquet of pale pink roses arrived bearing the simple message: "Thank you for saving Jason's life."

Three days earlier, another doctor had diagnosed Jason with croup and admitted him overnight for observation; pronounced fit, he was released. So why was he sitting with his worried mother in our exam room when he'd been "cleared" by other docs?

"Dr. Blacklidge," Jason's mother said, "I've been told that Jason is fine, but I know there's something wrong. When he coughs it sounds like he's going to stop breathing." The chart said an ENT had cleared Jason, he was in no apparent distress, yet his mother's words—"I know there's something wrong"—pierced my heart.

I called the hospital and spoke with the ENT specialist who had examined Jason. "Did you see the cords?"

"No, he was acting well and fighting the exam. It seemed like croup."

"I know this sounds crazy, but I think he has a membrane. Would you look at the cords for me?"

In the emergency department, the ENT resident obliged me by taking a quick look. Within minutes, Jason was in the operating room. It was there that the tracheal membrane became partially dislodged, obstructing Jason's airway and precipitating an arrest.

I wasn't in the OR to help with the resuscitation; the hospital staff did the lifesaving work. But the lovely pink roses sat on my desk the next day. I called Jason's mother to thank her. "All the doctors here at the hospital told me that if you hadn't insisted on sending him in, we would be arranging a funeral today," she said. "Thank you for listening to me. I knew there was something wrong."

Little did Jason's mother realize how profoundly those words stirred my soul. Similar words are part of my earliest memories. Time and again my mother had said, "I showed the doctor that your thigh creases didn't match. Your two older brothers' thigh creases matched; yours never did. I told the doctor that you cried when I held you on your right side. When you started to crawl, you dragged your right leg behind you. When you started to walk, you limped with your right leg. I told the doctor something was wrong, and he didn't listen." That litany is woven through the story of my congenital hip dislocation.

My mother's recitation always ends with, "When you were a year old, I begged the doctor to watch you walk. He said he was too busy, I'd need to reschedule. I changed doctors. The new doctor took one look at you and said, 'Why didn't you bring this baby to me sooner, when I could have done something to help her?'

"I knew there was something wrong. . . ."

I don't remember the body cast. I just know the look on my mother's face when she describes my determination to crawl on my elbows in spite of the cast, trying to keep up with my brothers. I don't remember wearing the splint to keep my knees apart, but that old piece of plastic still sits on a closet shelf in my home. I don't have to remember the limp—every step of my life, I have limped. That painful limp has been my constant companion since childhood. I was quite young when I realized that if I mentioned the pain, my mother hurt worse than I did. "I knew there was something wrong . . . and I couldn't get help for you in time."

So I learned to hide the pain. In first grade, I would wave goodbye to my mother as I started to walk the two blocks to school. Then I'd turn the corner, out of sight, and sit on a neighbor's step until I felt strong enough to walk a little further. That lasted two weeks—until a neighbor called my mother to tell her that I was sitting on a step, crying and talking to my hip.

That scene was reprised during my medical school training. Eager to do my part, I never refused to walk specimens down the long hallways to the lab during nights on call. But there was a blind stairway along the Children's Hospital tunnel where I could sit unseen until I could walk further. And, yes, even then I shed tears of pain and frustration.

My first hip replacement came shortly afterward. It had taken me 15 years to gather the courage to face surgery. Shortly after undergoing a shelf procedure when I was 11, I had been told that I would need a hip replacement "someday." By junior year in medical school, it was clear that unless "someday" arrived, I would be unable to finish my training. We were given time off in senior year to arrange residency interviews. I spent that time recovering from hip replacement surgery.

That hip lasted eight wonderful years. Long enough for me to finish medical school, complete a residency, marry, and start private practice. My second hip lasted six months; my third, six years. My fourth is a little over a year old, and I'm praying that it lasts a good long time. My crutches have been with me for nearly two years and will remain at my side for many years to come.

The limp, the crutches, and my limited work schedule—all are constant reminders that my mother should have been "listened to" in time.

Jason is doing quite well now, thriving, with no repercussions from his brush with death. I still have a photo of one of Jason's roses, and each time I look at it, I'm grateful that I allowed myself to be guided by the words of his mother—and mine. Amid the busy-ness of office practice, thoughts of Jason renew my silent vow to listen to those who know their children best.

 

Melodie Blacklidge. "Doctor, I know there's something wrong". Medical Economics 2001;9:123.