Punchbag

It will be one of those patients who has had an unusual presentation of a rare disease, with symptoms mimicking something more common and invariably more benign. And now they've developed diarrhoea, or bleeding from some orifice, and we need to take some blood for further tests. "No, you are NOT taking any more blood from my baby," the mother fairly shouts at me. She stands up - her arms planted on her hips, her face stony, eyes burning. It is Sunday, and she vents her frustration at the events of the past week. She feels the doctors are hiding something from her, and keep changing their minds. She demands that I somehow produce the results of all the tests done on Friday afternoon (most of them are microbiology specimens, which will take at least 5 days to return final results). Having seen her child for the first time 5 minutes ago, I am at a loss as to what to say. My task is to take the blood. I have 10 other patients to get through before lunchtime. I decide to do the 'see things from the other person's point of view' thing. I let her go on for a bit. "I can see why you're frustrated," I say, at last. "K* is clearly very ill, and we don't have a certain diagnosis." I am just about to artfully explain the delays and justify the need for further tests (clotting, electrolytes as she is on IV fluid, and stool culture), when she interrupts and lets forth another torrent. Why, if we think K* has an infection, is she not on antibiotics? Why do the doctors tell her one thing and then contradict it? I begin to explain that the commonest cause of infective diarrhoea in children is a viral infection, and that antibiotics do not help a viral infection. "Why didn't they grow the poo for viruses then?" At this point I am exasperated, and return, rather too bluntly, that we have treated her child to the best of our knowledge and that the results of today's tests will help take things forward. In order to escape from the room, I say I will give her some time to think over things and come back later. She shouts after me that no-one is going to take any samples from her child and that's final. In retrospect, I guess she wasn't really interested in the logic behind the decisions, she just wanted someone to shout at, and it happened to be me. I hate my job.