February can be rough, and so I tossed a jacket in the car before we left the house. It was another brutal mid-winter day in Northern California when my wife and I left to meet my sister and her husband in Lodi. Yes – it was 68 degrees, cool, clear and dry. Brutal. The day went as planned; two wineries, lunch and a lot of conversation. As we prepared to leave for home a call from our son hastened our departure. I knew even without answering something was amiss. Questions about dinner, friends and trivia go to my wife. Calls to me are invariably because something is broken or someone is sick. In strained tones my son reported a fever, sore throat and body aches, and so I figured the flu had finally found our family. Conferring with my wife we recommended ibuprofen and fluids and let him know we would be home in an hour. It was a drive tinged with guilt for not being home at the moment he first became sick. Feeling guilty for things beyond your control is just part of the landscape of parenting.
We arrived to find our 14-year old son sick in bed with chills and feeling miserable. He was flushed and feverish and a throat that was red and impressively swollen, and more worrisome I detected a fullness on the left side of his neck. In short, he looked sick enough to concern me, and as a critical care physician I am generally not easy to impress. The decision was made to take him to the Emergency Department.
On arrival to the ED we were checked-in and very quickly taken back to the see the doctor. I described my son’s symptoms and the findings on my examination. The doctor finished obtaining the history and did a brief physical. He concurred with my findings and concerns. Demonstrating that “I’ve still got it” is always a relief when you are doctor and your wife is watching. The four of us discussed a list of possible diagnoses, and the doctor suggested a set of tests and studies to be done. I simply nodded my assent.
As we finished that discussion the doctor once again asked me my name as he thought he recognized me. I assumed he must have been a student or resident who had rotated through the PICU during my years as pediatric critical care physician at the UC Davis Children’s Hospital. Pediatric and Emergency Medicine residents frequently spend a month or more in the PICU during their training. After telling him again my name and where I practiced he surprised me by telling that “no” that wasn’t our connection – rather I had cared for him when he was a child.
A couple of thoughts immediately flashed through my head as he told me this. The first was that I had cared for a child who was now a doctor. My heart sank as I realized that I must be a lot older than I believed possible. Second, was the humbling experience that occurs when you realize that something you have done, someone you have touched, someone you have cared for remembers you many years later. As an ICU doctor you see many patients through the years. The encounters are most often brief – days not years – and always at a time of crisis for the patient and their parents. My own memory of these patients is clouded by the number of patients seen and the years that have passed. At a very basic level the day to day experience of being a doctor is a job and each day, and each patient, is not necessarily committed to memory. So, when you are reminded years later by a patient, or their family, of a time when you cared for them it is profoundly humbling.