Or, “The Four Most Dangerous Words a Doctor Can Say.”
Here are a couple of cases where the doctor expressed some version of the above. We are never that blunt, of course. We hide it behind medicalese and euphamisms. But we do try to get the message across to our daily population of hypochondriacs.
First case: Another provider in my office saw a patient for cough and allergies. The patient was prescribed allergy medicine and a cough syrup with codeine (yes, this is the infamous “sizzurp,” but it remains one of the best cough suppressants available if used correctly). A couple weeks later, she came back when I was on because she still had a cough, and felt “hot inside.” Has she actually used the cough syrup? Well, no. Any fever, coughing up anything, fever, literally anything? Well, no. But she was convinced she was near death.
Her vital signs were all normal, including temperature. As far as the “hot inside” — I pointed out to her that we were in the midst of a heat wave so bad that the office’s modern HVAC system couldn’t keep up. She looked at me like I was speaking gibberish.
She insisted on a chest X-ray. The results were wholly unremarkable. At that point, with a hard, objective test behind us, the patient finally realized that she was Being A Baby without my having to even say it, and left with a muttered apology.
The second patient was one who had red, painful eyes. (Not itchy. Painful.) Another clinic saw this patient, and gave him Polytrim antibiotic drops for what they considered routine pinkeye. He went back to them a few days later after the drops weren’t doing anything, and they essentially told him “Stop Being A Baby” and literally told him to use Visine. After which, he came to my attention.
Now painful eyes are often a completely different issue than itchy eyes. The latter is usually either allergies or else routine pinkeye. The former, though, can be something far more dangerous. And this patient’s eyes were not only red and painful, but swollen. Not the eyelids. The eyes themselves.
The success of an urgent care doctor is often directly proportional to the responsiveness of area specialists, and I am fortunate to have a couple area ophthalmologists who actually take same-day appointments. (Bless their hearts!) One of them was able to get this patient in, and diagnosed him with acute, closed-angle glaucoma. Not to go into the weeds about this diagnosis, but it is serious bad mojo. The patient was lucky that he wasn’t blind by the time he reached me.
So, many times when you want to mentally just shake the patient and yell “Stop Being A Baby,” you really shouldn’t. Mostly because you can overlook something truly serious. But partly because, even if the patient is being a hypochondriac like in the first case above, simply telling them that doesn’t solve anything. They’ll just nod, state they understand, and then show up at another clinic or, worse, the ER. No, sometimes you have to show them that nothing is wrong with bloodwork or an X-ray. (WebMD has something to do with this — that site can turn anyone into a hypochondriac.)
Either way, the most dangerous and least productive words a doctor can say remain “Stop Being A Baby.” Even if the patient is being a baby. And, besides. Hypochondriacs get sick, too.