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.

God's plan

We’ve all heard the story of the man stuck in the flood who prays for deliverance. He lets two rescue boats and a rescue helicopter pass by because “God will save me.” He succumbs to the flood and asks God at the gates why he wasn’t rescued. “I sent you a rescue three times!”

It’s tempting, to pray for something and try to intuit how God will answer, and it’s tempting to try to do as much for ourselves as we can. Another familiar saying: “Pray as though everything depends on God. Work as though everything depends on you.” But sometimes I feel like I’m working myself into a hole, at the expense of the first part of that saying. 

For me, when faced with the anxiety of a dilemma requiring both prayer and work, I tend to do everything in my power to affect the outcome, and then kind of throw it up into God’s hands and say, “Okay, your turn.” Not only do I think that’s probably the wrong order in which to do things, but it separates God’s work from our work. 

Instead, what if we pray without ceasing and also continue to labor without complaining, letting God work His will through us, in spite of us. What if every day we walk with confidence knowing the Good Shepherd will not let us go astray, and we ask only to be able to share His love and do His will, not get all the answers or see the whole path clearly. That’s what I want—to see the map. I want to know where I’m going and every step along the way, plus how long it’s going to take. God doesn’t work that way, because, as a great man just told me, “God is smart. We are not.” 

If I saw the path, I’m sure I would argue about the best route, the timing, the journey, even the destination. But if I just start walking, I get to experience God’s love every day. That is more than enough.