Pediatric Faux Pas

Despite my superior clinical skills and exceptional compassion, I have gained a reputation among my colleagues as the student that has an occasional socially awkward moment with a patient. You might remember the time I questioned the possibility of youthfulness in a VA Nurse or the time I exclaimed, "Wow!" to a standardized patient when she said she was 83.

Well, my pediatrics rotation was no exception in making these foot-in-mouth moments. Here are a few:

- In my defense, I was asked by my pediatric resident to test the vision of a patient I had never seen or met before. He had been in a motor vehicle accident and had several broken bones. I entered this young boy's room with my Snellen Chart and instructed him to put the chart in his right arm, hold it a foot away from his face, cover his left eye, and read the bottom line. He seemed to hesitate. I repeated the instructions. Frustrated with his seeming lack of motivation to comply, I started the instructions a third time. Before I had time to finish, he exclaimed furiously, "MY RIGHT ARM IS BROKEN!!!" R-i-g-h-t... After managing to check his (perfect) vision, I slinked out of the room sheepishly.

- During a well-child visit, I examined a 2 week-old male. His parents expressed a concern about his lack of growth in the days since his birth. He looked small but had gained weight on his growth curve. After a brief history about how sleeping, feeding, peeing/pooping, and development were going, I started examining this couple's son. They had no other concerns besides his size. "He does appear small", I thought to myself several times throughout the exam. I managed to keep this thought to myself until the most (in)opportune time. As I examined his "diaper zone", I stated to the parents, "Boy, he does look small, doesn't he?" When I met his dad's eyes, I realized how poor my timing was.

For some funny pediatric faux pas, check out this page.