Medical dictionary

This exchange happened in the urgent care recently:


Mom: He threw up bile yesterday.

Me: (doubting face) Was it fluorescent green or grass green?

Mom: (like I was crazy) No, clear.

So, now, my hand is forced. I must do the world a service in the form of an easy-to-read medical dictionary for the masses.

I give you the most commonly misused words by parents, which often lead to either unreasonable medical workup if we take you seriously, or—more likely—us not taking anything you say seriously.

Pay attention.

Bile—the fluid made in your liver, stored in your gallbladder, and released into the small intestine to digest fats. This means if you are truly throwing up bile, things are flowing backwards. That is bad. Fortunately, it’s also rare. Also, bile is DARK GREEN. The two weeks spent dissecting the abdomen in medical school turns all your gloves and tools green. Everything is green. It looks like the Naked Green Machine drink.

This is what bile looks like

              -therefore, clear? NOT bile. Yellow? NOT bile. Ecto-cooler? NOT bile. Snot colored? NOT bile.

NOT bile.

Fever—in an infant, 100.4 rectally or higher. Generally we use this number throughout childhood and adolescence (thankfully the rectal part goes away), although I was recently made aware that our own occupational health (based on AAFP literature) considers 100 a fever in adults. Good thing I don’t treat adults.

                -therefore, 99.1? NOT a fever. Felt really hot? NOT a fever. She normally runs low but was 98.6? NOT a fever (unless you have true hypothalamic dysfunction). I gave her motrin but she was still 100? NOT a fever.

High pain tolerance—this one is a trick question. Just don’t ever say this. Unless you once broke your tibia and walked three miles to get to medical care, or gnawed off your own arm to break free of a rock slide, no one cares. Trust me.

Lethargic—this one is tough, because Merriam-Webster and I might get into a fight about the real definition. Traditionally, it can be a synonym for lazy, sluggish, listless. In medicine, and in pediatrics specifically, “lethargic” means “I think this kid has meningitis”. It means nothing moves you, not even discomfort, not even your favorite cartoon, not even me trying to look in your ears. It’s not good. Please try to be more specific in what you are describing.

                -therefore, your child is less active than normal, but is still happily watching a movie? NOT lethargic. Your child is wanting to be held, but still throws a fit when you don’t let him have his toy? NOT lethargic. Your kid “just isn’t himself”? NOT lethargic.

That’s it. Easy, right? Now you can save yourself the humiliation of all the health care providers rolling their eyes at you, save your kid unnecessary testing, and practice saying what you actually mean. You’re welcome.