Friday, 18 March 2016

Doctor in village 4

One of the first things that you learn as you train as a Child Specialist is that the dose of medicines you prescribe is crucially dependent on the weight of the child. Nowadays for many drugs body surface area is used. It is more accurate but difficult to use since you need a ready reckoner. The reckoner will give you surface area from the weight and height of the child. When I started my Paediatric practice therefore the weighing machine was an important instrument that I purchased. By experience you learn to guess the weight from age and appearance especially in busy out-patient departments. But when you have just started to practice you are more scientific .
So when this young woman and ( apparently) her mother walked into my OPD with a toddler hanging on to their hands I understood there was trouble in store. Most parents make their young children stand on the weighing machine ,without realising that they might start crying when left alone. Simple alternative is to weigh both parent and child while the parent carries them,and then subtract the weight of the parent.
When my examination of the child was over , I turned to them and said
" We need to check his weight "
The young woman promptly tried to make the already apprehensive three year old stand on the machine . He promptly started to whimper. Before his whimper turned into a cry ,I told the older woman
" You hold the child. We can take the mothers weight first. Then we can take their weight together and find out his weight"
The young woman hesitated and said
" But doctor ,there is a problem "
" What? " I asked .
" I am not his mother " she said solemnly.
I almost fell off the chair laughing ....

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