5 Ways to Think Like a Doctor

Those who know me know my big doctor secret: Kid medicine isn’t rocket science, it’s a big download of information learned over several years and organized by topic and body system. You may not want to invest all that time in the details, but you can master the basics, get a good idea of what’s going on with your own kiddo, and know when it’s time to get help. There’s no magic, it’s just a matter of learning to think like a doctor.

Think history. Have you noticed when you go in for an office visit that kiddo’s doctor asks  a bunch of questions about general health, onset of symptoms, when, where, what, and how before she even begins the exam? That’s because doctors know that 80% of diagnoses are made entirely by history; meaning the story you tell about your observations of what happened when. The physical exam then serves to confirm what she already suspects.

So when you’re trying to figure out what’s causing the symptoms, think back over the past several days and focus on when you first noticed something was up, what the first sign was, and what was going on around the same time.

Did Junior have a snotty cold for a few days before he started waking up in the middle night with a cry that screamed “I HURT!”? Think ear infection, because mucous hanging around the middle ear can be a great growth medium for microbes.

Is your 7-year-old suddenly complaining of leg pain that’s keeping him up at night around bedtime or after? Think growing pains. Yes, they are a real thing, and the regular timing and typical age is the tip-off. The internet may be a help here, just be careful to stick to the symptoms you’re sure of and seek out reputable sites like WebMD, KidsHealth or MamasOnCall, of course.

Think organ system. Various health problems gravitate to their organs of choice. Cold and flu viruses are attracted to the respiratory system, which is make up of the upper airways (the nasal passages and big tubes) and the lower airways (bronchioles and lungs). They present with cough, snot, and sometimes wheezing. Strep bacteria love to land in the throat, and can often spread the misery to include vomiting, headache and high fever.

These symptom constellations are seen routinely, and once you’re aware of it you’ll start to notice them yourself. Some childhood viruses express themselves on the skin, causing rashes with a typical appearance (chicken pox is a classic example). For more detail, take a look at a Mamas favorite, Name That Rash. Other virus varieties, like rotavirus and norovirus, cause GI distress, nausea and vomiting that are unmistakable.

There are several great youtube videos that can help introduce you to what happens where. Check out The Organ Song, and do some searching to find others you like.

Think tiny baby. Pediatricians know that infants younger than 12 weeks are at greater risk. Their immune systems haven’t revved up yet, and they’re basically dependent on the immune factors that travelled across the placenta from Mom. When these little ones get sick with a temp greater than 100.4 or other signs of illness they need to be seen quickly to rule out something serious.

It may seem like overkill, but sometimes they will be admitted to the hospital until test results come back clean. That’s because they’re sitting ducks for nasty germs and can go downhill fast if critical signs are missed.

A 1-year-old with a fever of 102 who’s eating, drinking and peeing will make your doctor yawn, but call about your 6-week-old with the same symptoms and she’ll tell you to come in right away.

Think I’s & O’s (intake & output). Speaking of peeing, kiddos who are taking adequate fluids by mouth and excreting them accordingly  have surpassed a certain bar that could have made your doctor worry. If you reach the triage nurse at 2 in the morning because Junior is burning up and you don’t have a clue what’s wrong, chances are she’ll ask if he’s able to drink and when he last had a wet diaper. Kiddos who aren’t drinking and peeing regularly should set off your mommy radar.

Peeing too often can be a sign of illness as well, but everything’s relative. In the big scheme of things, what goes in should come out.

Trust your gut. Experienced docs know to trust that uneasy feeling they sometimes get about a sick kiddo. A quick glance at how a child looks can speak volumes.

One great thing about pediatrics is that many kids’ illnesses are self-limited: they get better whether you treat them or not. Except when they don’t. Part of the art of medicine is knowing the difference. Is this routine childhood crud, or something serious that needs attention now?

Moms get that feeling in the gut too, but we don’t always know why. That’s okay; always trust your mommy gut. When those alarms go off and you know something’s wrong, demand answers until you’re satisfied that all is well. No one knows your kiddo like you do, no matter how many years of school they’ve been to.

Don’t hesitate to call for help. Keep asking questions until it makes sense, and never leave an appointment without knowing exactly what the diagnosis is and what treatment is required.

Like I said: It’s not rocket science. Just think like a doctor.


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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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