In my off time, as a mom and a physician, I spend a decent amount of time lurking in a rather strange environment, even for the internet. A place so filled with anxiety, stories of ill-chosen spouses and little glimpses of unbridled joy, that you’d think you were somehow inside a taping of the Real Housewives of This-crying-baby-makes-me-hope-that-I-end-up-having-a-dissociative-fugue. You know, *that* place.
Online mommy groups on Facebook.
And, there I am, lurking in the background as a physician, who, in all fairness, does need some sleep training advice from time to time. I glance at threads regarding the best finger foods for baby, brands of car seats, and of course, threads about wildly inappropriate comments from extended family members. It’s good fun most of the time.
Nearly every day, though, I run into questions like these (paraphrased):
“Help! My baby has a fever, what do I do? I have a pediatrician, but I clearly trust you guys more than that guy,” or, even better, “My child is ill and also having mental status changes that are rather concerning. Also, of equal importance, I need you to tell me exactly when the Mongolian spot on her back will disappear. Thanks in advance!”
The responses can be even more perplexing (also paraphrased):
“Grape juice is a remedy for any gastroenteritis, given that it changes the pH of stomach acid, and therefore, has some sort of antiviral effect.”
“A fever is never anything bad. Ever. If you call the doctor telling them your child has a fever, all they will EVER tell you is to take some Tylenol.”
Mind you, none of these are followed by a #sarcasm. These are the summaries of actual serious responses to medical questions. In situations like these, I jump in to clear up misinformation, especially when it is as irresponsible as denying the existence of life-threatening febrile illnesses, particularly in a patient population of infants and children vulnerable to meningitis and sepsis.
As I’m composing my responses in clear terms, thinking back to my general pediatrics days, I am left wondering: Why are people so deathly afraid of talking to their primary care providers? Why are they willing to risk receiving downright dangerous medical advice from the internet?
Why is it, that despite our best efforts, we are failing our patients?
It’s a moment of introspection, as I’m explaining that since stomach acid is a buffered system, drinking “3 cups per day of grape juice” (I’m not even joking) does not appreciably change the pH of stomach acid. I think of all the gaps in communication that occur when I’m sitting in doctor’s appointments with my parents. In my mind’s eye, I see that look on my mother’s face when she does not understand a piece of medical jargon, but thinks she should, and nods along. I look back on all the times that I’ve skipped over an explanation of a pharmacologic mechanism to a patient, then received a phone call two days later asking something along the lines of why taking double the dose of a medication isn’t “twice as good.”
Or, even worse, there are the times that they feel so alienated by us that they run to an anonymous internet forum for urgent medical advice.
Seeing the questions of these women, and the rather alarming answers, is a portal into everything that our patients are afraid to ask us. For me, it is a wake-up call to go beyond the standard explanations with my patients. It is a tangible reminder to try to bridge that often-invisible gap of understanding.
And now, I head back for another deep dive into the Real Housewives of Why-did-I-have-children-with-this-man.
Audrey Nath is a neurologist.
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