The lady doesn’t look at me, she looks at floor and begins to pray aloud.
Helping out in the paediatric clinic I’ve just taken a history from a child referred by his GP with a possible congenital heart defect and I’m about to examine him.
The lady in front if me is praying because she’s worried about her son, she’s praying because if my examination findings confirm a suspicion then she will have to find the money to fly out to Trinidad to see the only paediatric cardiologist in the Caribbean.
For me this is one patient in a full clinic, for this mother it’s her one and only son, what I say or may or may not find will impact her life. I always keep at the forefront of my mind that I may see the patient for 10 minutes but they will be remembering what I have said or do for far longer.
She’s close to tears and I reassure her I will examine him properly and see. Inside I feel like jelly, shes hanging on my every word as I approach to examine him. Having assessed the way he looks, palpate his pulses and apex beat it comes to the auscultation- all normal this far! Trusty stethoscope in hand I take a deep breath.
Clear heart sounds and I can’t hear a murmur.
The consultant comes in and confirms this. She tells the mother they will monitor him for the next few weeks and that he will need an ECG and a chest xray. I explain to the mother that sometimes heart defects can resolve but he will need to be explored further just incase, we focus on the positives that baby is gaining weight and developing well!
The mother is relieved, she knows she not out of the woods yet but it’s a lot more manageable.
I’m relieved for her and that despite sometimes second guessing what you hear down the stethoscope you just have to be confident in your own deduction! Even if sometimes you don’t feel it, everything is back to basics, put best by catchphrase “say what you see” or in this case “what you hear”.
You have to be confident in yourself for the patients to be confident in you! In a few weeks I’ll be treating and making decisions as the foundation doctor and I can honestly say I’m feeling ready
My sand diagram of the heart- complete with superior be a cava and aorta… Missing pulmonary arteries and veins as a wave washed it away!