Because it’s a holiday…

but I have to work, I’m going to post something frivolous about a professional pet peeve.

Parents of the world, take note!  If your reason for bringing your child in for an appointment is a skin lesion, and the lesion is so minute and nondescript that I am not sure what you’re pointing to when you try to show me where it is, I am willing to guarantee in advance that it is:

1) Benign

2) Probably not really a lesion

3) Quite possibly not even there

Furthermore, if what I am staring at is a patch of normal skin, I am then forced to come up with an explanation for what you’re seeing that is both:

1) Honest

2) Medical-sounding enough to give the appearance that I have taken your concern seriously

This involves a time-honored medical heuristic known as “pulling something out of my ass.”  Since neither staring at you blankly nor inventing a completely bogus diagnosis are workable options, I must pick some totally normal skin structure and cobble together a dog and pony show about how it might possibly have been a little inflamed but we can probably just monitor for now.  Nobody’s time is well-spent in these situations.

Believe it or not, this kind of appointment occurs with surprising frequency.  The parent will indicate some tiny (or invisible) spot on their kid’s skin, which isn’t bothering the kid and that they noticed incidentally, but for some reason is concerning enough to warrant a visit.  Because “I don’t know what you’re talking about” is an even less appealing statement coming from me than “I’m sorry, but I’m not giving you an antibiotic for your cold,” I have to say something.  The ability to concoct something plausible-sounding is a skill I didn’t learn in medical school, but one no physician can live without.

Thank you.  I feel better.

Russell Saunders

Russell Saunders is the ridiculously flimsy pseudonym of a pediatrician in New England. He has a husband, three sons, daughter, cat and dog, though not in that order. He enjoys reading, running and cooking. He can be contacted at blindeddoc using his Gmail account. Twitter types can follow him @russellsaunder1.


  1. Gently, but firmly, grasp arm.

    Ask mother “Have you and little Johnny been around waterfowl recently? Feeding ducks at the park or something?”

    • /Reminds self not to take daughter to Jaybird’s Pediatric Clinic.

      • There are entire universes of things to worry about… at my clinic, we will ask questions that will help you understand exactly how much you haven’t been terrified of.


  2. It occurs to me that a guide along the lines of those given to pregnant women might be in order. That is, “If your child experiences symptoms A, B, and C call day or night, for symptoms D, E, and F call the next day, for symptoms G, H, and I, monitor it.” Probably wouldn’t cut down on the really nutty parents, but it might cut down on some who are just unsure of themselves.

    • As a parent who’s boys used to be infants, I can tell you that there is something about the “if X occurs then you need to get them to an emergency room, otherwise you’re ok.”

      You and your spouse end up debating for hours, “Is *this* x? No? Maybe… Should we call?”

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