Thou Shalt Not Oompa-Loompantasize Children

In Commentary, Opinion by Nadim Lalani2 Comments

Got a letter of praise forwarded to the ER manager by the Patient Advocate Office the other day … ZZZZZT! Wha? Did he just say “praise” or did he say “complaint” … [re-read … no it says “praise”]. Staggering! Furthermore it came from a patient encounter that I had in paeds ER. Hmm …

I thought about posting a screen-capture of the letter, but it’s honestly embarrassing to receive such praise [and I’ve been looking over my shoulder for weeks waiting for something bad to happen … because letters of “praise” are exceptionally rare occurrences]. To put it all out there would be a bit conceited, but I will share this excerpt:

” … I went in feeling scared and came out feeling validated, assured, relaxed and well taken care of. He took the time to listen to ME and accept my input … and did an extremely thorough physical exam …”

Ok … doesn’t sound like much does it? [I can hear you saying ” pfft! really? all you did was talk to the parent and do a physical exam … no “House” style diagnosis?” … nope … “okay you must have performed a life-saving maneuver right?” … nope x 2.  Actually … no diagnosis … only more tests and a referral …]


I remember having a love-hate relationship with paeds EM [just ask my wife]. It wasn’t until late in my residency that I began to learn the “art” of pediatric EM. I had a mentor teach me how to gain the trust of an infant and I learned the hard way how to approach the tired, sleep-deprived and anxious parent.  I also learned the value of performing a thorough assessment even [and especially when] there may be only a ‘minor’ complaint [parenthesized because it’s really not ‘minor’ to the child or parent]

I don’t really remember this recent encounter in detail. It’s humbling that there was no diagnosis, but it just goes to show that even when you do not have the answers, these two things … recognition that a bit of old-fashioned understanding is needed and then performing a  thorough physical exam can sometimes be all it takes to treat child and parent.

I didn’t realize then that I was also actually following two of the “Ten Commandments of Paeds EM“.The original Ten Commandments of EM were written by Wrenn and Slovis et. al in 1991. You can find them here at LITFL. But make sure to read Dr Robert Cooney’s update on The Ten.

Nadim is an emergency physician at the South Health Campus in Calgary, Alberta. He is passionate about online learning and recently made a transition into human performance coaching. He is currently working on introducing the coaching model into medical education.