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Always Trust A Mother’s Hunch: My Experience With a Sick Baby and an Untrusting Doctor

A recent post on KevinMD.com caught my eye. The piece was written by Niran S. Al-Agba, MD, a pediatrician, who was reflecting on a distressing moment during her third year of residency. On a busy night in the hospital, a mother requested a re-do of her 6-year-old daughter’s blood work, which had come back normal the previous day. Al-Agba ordered the new test at the advice of her attending but remembers feeling like the mother was being overprotective. Exhausted, she wasn’t feeling very compassionate that night.

However, the mother’s hunch that something wasn’t right proved correct. The lab had missed something in the first test and the girl actually had leukemia. Al-Agba, understandably shaken, returned to her patient to break the bad news.mother child-1298137_1280

“It was during this trying time I learned one of the most important lessons of my career: the value of trusting a mother’s intuition,” she writes.

That really struck a chord in me, and triggered a memory of an experience I had years ago after the birth of my youngest son. I was living in San Francisco at the time and my son was barely a month old. When he started vomiting after eating, I recognized the signs immediately: pyloric stenosis. My oldest son, then 5, had experienced the same symptoms and underwent surgery to fix the problem when he was 6 weeks old. The condition was in my husband’s family; his brother had the same thing 30-plus years earlier.

Pyloric stenosis is a narrowing of the opening leading from the stomach to the small intestine. The enlarged muscle surrounding that opening prevents normal digestion and often leads to projectile vomiting. It is sometimes hereditary and usually develops in boys in the first couple months of life. Surgery involves making a small incision in the enlarged muscle so food can empty into the intestine. While it’s traumatic to witness your newborn undergoing surgery, the procedure is almost always successful nowadays and resolves the problem permanently. But it has to be diagnosed and treated right away.

The whole experience was fresh in my mind when I went to the doctor with my youngest to get a diagnosis. My husband was away at the time and I had my other son in tow. Like any new mother, I was sleep deprived–perhaps more so due to dealing with the vomiting. I explained the issue to the doctor on duty, including the genetic link, but her response was noncommittal. “Babies spit up,” she said. “This could be just normal spitting up. Why don’t you try ipecac and come back in a few days if it gets worse.”

Her attitude infuriated me. I felt patronized and dismissed. I knew the difference between spitting up and projectile vomiting–babies with intact digestive systems don’t project the contents of their stomach halfway across the room, landing with a loud splat against the wall. Plus, I had been through this before.  The doctor wouldn’t budge, though, seeming to regard me as another overanxious new mother. So I asked to see another doctor. I was, she reluctantly admitted, entitled to a second opinion.

The upshot is that my son received the diagnosis and was admitted to the hospital the same day. (Remembering the sight of his tiny body hooked up to IVs and the sound of his desperate cries still makes me feel physically ill, but it all worked out in the end). I know now that this doctor was probably just young, and perhaps in a similar state of exhaustion as Al-Agba during her residency. But I’ve never forgotten the experience and it has colored my interactions with doctors to this day.

What I learned that day was to trust my instincts, ask questions, and demand answers. While I’ve encountered some thoughtful, intelligent physicians over the years, I believe that taking care of my health is ultimately up to me. I do my research and seek out facts. The doctor’s opinion is one voice of authority to be weighed along with others.

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My sons: all grown up.

So, when something “just doesn’t seem right” about my children or me, I pay attention to that gut feeling and tell my physician in a spirit of shared decision making. That shouldn’t undercut the knowledge and expertise of my doctor but actually help him or her make a correct diagnosis. Isn’t that what patient-centered care and shared decision making–those frequent buzz words in medicine–are all about? Reflecting on her experience that day, Al-Agba says she learned the “importance of listening to the person who knows their child best, their parent.” I couldn’t agree more.

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