Of all the symptoms when the boys get sick, I think fever must be the one I hate the most. When they throw up or have a rash or a cough, I can focus on getting them feeling better. But when their temperature climbs, it's as though a little red warning light has gone on. Involuntarily, my mind starts listing all the horrible things that can cause a fever: leukemia! Kawasaki's disease! Rheumatoid arthritis! My mind becomes split in two: the rational physician portion looks at my son, sees him wilted but otherwise okay, and does a pretty good job of not worrying. But the mommy portion, combined with a little more education than most, quietly but insistently keeps worrying and fretting until everything goes back to normal.
Alex, seven weeks old, has one week of daycare under his belt. All the kids in his room had colds last week. Jonathan started running a fever and running at the nose a day or two later. So when Alex started to feel warm to us on Sunday, my rational mind knew he most likely had the same cold, especially when he started snuffling. On the other hand, my rational mind also knew that a high fever in an infant less than eight weeks old was supposed to get a more formal evaluation. We went about our usual activities on Sunday, taking his temperature throughout the day. The pediatrician's office had given us a number - anything higher than 100.4 and Alex had to come in. He hovered around there until Sunday night, when the temperature registered 100.6. I put a few things in a bag, kissed Chris goodbye, and drove Alex to the ER.
It was crowded, but I managed to work my job and title into conversation with the front desk staff and we got in within half an hour. Alex's fever was even higher - up to 101.6, definitely a fever. The ER attending recommended a full fever workup and admission. Everyone agreed that Alex had been exposed to kids with colds, and that except for his temperature, he looked pretty good. Still, here he was in the ER, and with a fever, and so young. Who could say no? My education and experience were enough to be a torment and not enough to be much help. I knew that most of these fever workups would be negative - would not find anything seriously wrong. But what kind of odds were they? I didn't know. I knew that the ER had done lots of tests on my own patients that I found unnecessary - but which tests could I decline safely? I wanted to use every skill I had to protect Alex and make him better. But I had to worry that applying my skills might also endanger him, however slightly. I was going to be allowed more leeway in decided Alex's course of treatment than non-medical parents, and I wasn't sure what to do with that leeway. There are so many different ways to approach a medical problem. I didn't know whom to trust, and Alex had to trust in me.
He got the full workup. I asked about the experience of the ER intern in doing spinal taps on babies, and the attending quickly offered to do it herself. Alex did amazingly well through the whole ordeal. He sucked on my pinky finger during the IV and the spinal tap and barely cried at all. He did hate the nasal washing but quieted down thereafter. I had cried when we decided to put him through all that, but smiled and wiped my tears when it was time to comfort him.
We're home from the hospital now. We were there two days while Alex got antibiotics and waited for all the tests to come back negative, which they have. In talking with Dr. Ranney, there were other options that night that a more experienced pediatrician might have offered. But in all, she thought doing the full workup was one reasonable option of several.
Alex, I'm sorry you went through all that poking and prodding at such a young age. It was so hard to drive you to the ER knowing that was likely to happen, but too scared to keep you at home and watch you with your fever. You and Jonathan are probably going to have several episodes like this as you grow up, just because you're mom is a doctor. I won't be looking in your ears or palpating your abdomen - I'm going to have to defer to your own doctors and sometimes I'll have to quiet my doubts and let them do their job. You may get more tests and treatments sometimes than I might feel are absolutely necessary. I can just promise you that I'll be there as your mom the whole time, and do my best to speed us through the waiting room.