Today was the day for rashes. I think there must have been five adolescent girls with rashes, and two younger kids. And the explanation was never the same. One of them was recently put on the cheerleading team, and explained that she “needed to get a tan,” and that’s how she showed up with a rash two days later. The doctor and I both raised our eyebrows, and he said, “You needed to get a tan?” I don’t know whether it was good or bad that he didn’t then talk about skin cancer. I mean, this was a fair, blonde girl. I don’t think she can tan no matter how hard she tries; all she’ll get is red – and cancer. (Anyone who knows how you get a rash on the extremities – not a burn – from tanning salons, let me know.)

Then this afternoon there was a younger teenaged girl with a sore throat for one night, and a rash that seemed to have spread as she was being taken home from school. As I was looking at her, I thought, “Wow, a centripetal rash, that sounds like Rocky Mountain Spotted Fever.” But I’d already had a few weird diagnostic suggestions shot down for the day, so I didn’t suggest it. Of course, he started her on antibiotics for . . . Rocky Mountain Spotted Fever, although he also sent for a ton of lab work, since she didn’t have a fever or much else by way of symptoms. I could have looked brilliant if I would just have spoken up. . .

For the rest, I saw my first case of real acute otitis media – and couldn’t recognize it. Idiot! I should know better. It did look bad, I should have known. At least I recognized some tonsillar petechiae on the same kid, which the doctor couldn’t believe would either exist, or be recognized by me, until he saw them himself. 🙂 And there was one very cute three-year old, who sat up and demanded to “play doctor.” So I let her do everything except look in my ears. When she listened through the stethoscope, she declared after one second that she heard something, pulled the ear-pieces off, and said, “thump, thump, thump.” She must be a genius – it took me several weeks to recognize the heart! (Very different from the nine-year-old, who listened with a scowl for five seconds, and said he couldn’t hear a thing.)

Advertisements