The otoscope

Sometimes I laugh at my patients. I can't help myself. And today was no different.

I'm in clinic, seeing a lot of well baby exams, mostly happy, healthy kids, with the occasional runny nose, or cough, just like I expected. And the third or fourth patient of the day is a beautiful little girl, about 15 months old, who looked like she didn't know whether to smile or cry when I walked in. She ended up doing both for a short time, while I talked to mom.

I'm going through the well baby check list, asking mom if her daughter is saying single words, how many, etc. And apparently her daughter, Hope, I'll call her, is saying "mama" and "dada" and "yes" and "no." Fairly typical. Children don't start putting two words together in a phrase until about two years old. I told mom that, and everything's good.

I start on the physical exam. This was already getting difficult, because Hope did not like my stethoscope. I let her play with it a bit, and she got a lot less worried, and stopped crying, but as soon as I put it on, I was glad that the earpieces are sound-proof, because the little girl screamed and started crying again. I felt really bad, but with mom's help, we calmed her down, I listened to heart and lungs, and we're on a roll.

See we're told to start with heart and lungs on little kids, because the stethoscope is pretty non-threatening. But nobody ever likes the otoscope. Hope was no exception. Usually though, kids just cry or jerk away. This one was a little more dramatic. Hope took one look at the otoscope and shrieked "OH MY GOD" at the top of her small lungs, in that range only infants and dog whistles can reach, and threw her arms toward mom for rescue.

I couldn't help it, I started laughing. This little girl, who is only saying "mama" and "dada" according to mom, had figured at least one phrase out. And hearing that from an infant, coupled with the truest look of stark terror I've ever seen, was just too much. Mom started laughing too, which was good. When I was relating the story to my preceptor, her first comment was "well I guess she's using two word phrases now."