The art of medicine lies in knowing when a little time is needed

Our 13-year-old woke up feeling lousy two days ago. He had a sore throat and sinus pressure, and felt really tired and generally icky. He didn’t look toxic — just a little tired. I gave him a zinc lozenge and told him to get ready for school — a method that generally can tease out exactly how bad one of my kids feels. He just sat at the table.

We generally adhere to the “unless you have a fever, are actively vomiting, or have blood squirting out of your ears, you can go to school” policy, but there’s been a particularly hard-hitting virus going around the neighborhood, so I figured I’d keep him home — no need to infect others if he was in a particularly germ-effusing state.

He had awakened at 6:30, and by 7 he was back in bed. He slept until 11, and then got up, gargled with salt water, ate a little rice, and worked on a math assignment his teacher had emailed to him when we told her he would be out sick that day. Back to sleep by 12:30.

He woke up again around 3:30, had some chicken noodle soup, was back in bed within an hour, and woke up again around 7, when he was feeling well enough to join the family at the dinner table (where his 16-year-old and 17-and-three-quarter-year-old brothers joked that we never would have let them stay home without a fever, to which my husband and I smilingly responded that that was obviously because we love the 13-year-old more). He went to bed for the night at 9:30, and woke up yesterday morning feeling completely fine.

He doesn’t normally sleep for 18 hours total in a 24-hour period, so my powerful doctor-sense tells me his body really needed some rest to fight this thing off. Or maybe it was the zinc lozenge. Or the salt water gargle. Or the chicken soup. Or maybe he would have been perfectly fine by yesterday morning even if I had made him go to school the day before.

There’s really no way to “know” for sure — I can’t do a prospective, placebo-controlled trial of each of the possibilities on my child, so my medical decision making was not “evidence-based,” nor is my conclusion that I did the correct thing based on rigorous academic study. It is based on common sense. A generally healthy 13-year-old who felt yucky and exhausted stayed home and slept and felt better the next day. No need for antibiotics or any other “big guns.”

Much of the art of medicine lies in knowing when a little time is needed, and when more is needed.

Sometimes, as Voltaire said, “the job of the doctor is to amuse the patient whilst nature takes its course.”

Abigail Schildcrout is founder, Practical Medical Insights, and blogs at DocThoughts.

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  • Judgeforyourself37

    For some illnesses sometimes Tincture of Time or ToT is the best course of action. This comes from my late PCP who cared for our family for over 35 years.

  • drjoekosterich

    Brilliant!! The tragedy is that the “evidence based buffoons” wield the power and influence. Time to fight back!