Doctor in the House?
and I went to the Sacramento Zoo
this morning. We were waiting at the gate to have our membership card checked while the gentleman at the window made a phone call. I overheard him saying "yes, she woke up... she seems fine now."
Nearby was a family obviously in some distress. I took Matthew over and said "Hi, I'm a physician; is there anything I can do?" I saw relief flood over the faces of a man holding a small girl and the tearful woman standing next to him. It was their two-year-old's birthday, I learned. The extended family was there for her party at the Zoo and she had fallen from a picnic bench and momentarily lost consciousness. "Please examine her," the mother asked.
That's when it struck me. The closest thing I had to a medical instrument was a ball-point pen. What could I do for this little girl and her family?
Not much. Her fall was a slip, not syncope or a seizure. Her loss of consciousness was momentary and clearly happened after
the fall. She was now as alert and as oriented as a traumatized two-year-old can be. A quick exam showed that she was breathing and well-perfused, her pupils were equal and reactive, and she had full motion of her eyes and all four extremities. She was not vomiting. Though she was growing a goose egg on the back of her head, she didn't have any palpable skull fracture. From just this simple information, I was pretty confident the she was in no immediate danger. She probably needed a CT scan and extended observation to rule out internal bleeding, but paramedics were on their way and an ER doc would have the resources to do a proper exam and any necessary imaging. Matthew and I headed toward the flamingos.
Then it occurred to me that there really was
something I could do. I recognized the relief on the parents' faces when I introduced myself, and again when I said I thought their baby would be fine until the EMTs arrived. I knew if Matthew were injured I would be freaked out, and reassurance would only go so far. The EMTs probably wouldn't consider it a high priority, and might take a few minutes to arrive. Though I didn't really believe there would be anything to do, I thought that the least I could do was wait with them. After all, I suppose I could provide CPR if the unthinkable happened.
We found the family and sat with them for a few minutes until the EMTs arrived. No emergency intervention was necessary while we waited. We couldn't save the girl from having to spend part of her birthday in the ER, but we at least saved the family from too much distress while waiting for emergency services to arrive. Sometimes just being there is the best prescription of all.
- 24 Jul 2005