A physician approach to a missing child

There was a brief scare in our neighborhood this past weekend. Our phone rang. Our friend, who lives nearby, asked if her 12-year-old son was at our house. He wasn’t.

The child had been gone for about 15 minutes. Their family had just returned from a shopping trip with a family friend, and that family friend had forgotten one of his items at our neighbors’ house. The child said, “I’ll run it out to him, Mom.” His mother said, “I think he’s already pulled away,” and the kid replied, “I can still catch him.”

As the mother was putting away groceries, she realized it had been about 10 minutes, and she hadn’t heard her son come back inside. She called through her house, went outside and looked around, called her family friend (who had not seen the child since he left her house), and then called us. Her husband jumped in his car to look for their son.

All five of us headed outside while the mom called the police. My husband took one car and left to drive an east-west pattern, and our eldest son took another car to drive a north-south pattern. Our two younger sons went on foot to check local parks. Each of us had a cell phone. I walked to our neighbors’ house, and asked my friend for details of everything that had transpired in the past 15 minutes. Their family friend had returned to their house, and he and I went inside to search the house carefully as our friend spoke to the police officers who had just arrived (small city, quick response time).

I did not think that the boy was in the house. But I looked anyway. It’s a doctor thing. Listen carefully to the story. Figure out the most likely cause. Think of the potential life-or-limb-threatening causes. Respond in a systematic way so as not to miss anything important. Being methodical and systematic also helps keep panic from taking over.

From listening to my friend and knowing the child, my assumption was that the kid had just gone to the family friend’s house. My friend did not think so — it was a mile-and-a-half away, and she said he wouldn’t have any idea how to get there. I still thought it was the most likely explanation. The police thought it was most likely that or perhaps he saw a friend and went to hang out with the friend and forgot to call home. My friend was terrified that her son had slipped on ice and was lying unconscious somewhere or that he had been abducted. I’m a mom — I get it. Same thoughts went through my own head.

The first of her fears was not overly likely, since it was the first warm day in a while, lots of people were outside, and someone would have seen him lying unconscious and called the police. The second fear was statistically very improbable. But those were the possibilities that were most threatening, so people started searching immediately. Why search inside the house? I certainly didn’t think he was hiding, but what if our friend hadn’t heard him come back inside and he had fallen on the basement stairs or been reaching for something on a shelf and had something fall on his head? Not super likely, but you wouldn’t want to have a dozen people searching outside while he’s lying unconscious inside.

So you’re systematic. You look. Even when you think someone’s chest pain is likely to be benign and coming from his esophagus, you still check an EKG because you don’t want to miss a heart attack. The kid was not inside the house.

I stayed with our friend, reassuring her that she would probably be scolding her child for his disappearance within the next few minutes. The family friend drove back to his house to look — and saw in his mailbox the item the child had run to return to him. He called. And at the same time, one of the police officers swung by to say that another officer had just picked up the kid and that they were on their way back. We called the driving and on-foot searchers, and everyone came home.

The child was missing for less than a half-hour, but it of course felt like hours to us. Our friends’ son learned the importance of telling someone when he’s going somewhere, and of bringing his cell phone with him. Our friends learned that their child could navigate his way around our town a lot better than they had thought. And we all had reinforced the importance of responding quickly, systematically, and appropriately (news crew hadn’t been called, no Amber alerts issued, just as a doctor wouldn’t go straight to a cardiac catheterization for that patient with chest pain without first checking an EKG and some other basic things).

Breathe. Call for help when you need it. Be systematic. Communicate. Ask questions. And remember that the most likely outcome is indeed the most likely outcome, but take necessary steps to address other possibilities.

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

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