Short White Coat: Working weekends

For a cousin recently diagnosed with diabetes, I could offer encouragement before his now-daily exercise routine and a gentle slap on the wrist when he reached for that fourth cookie. But the real fun -- and the boon of second year -- is the physical exam. Another cousin brought up a family history of thyroid problems, so I showed her how to palpate hers, gently poking the tips of my middle and index fingers into her throat and asking her to swallow.

In a playful integration of our child psychiatry and physical exam courses, I gave my 6-year-old second cousin an abdominal exam to convince him (at my mother’s urging) that he needed to eat more fruit. When I taught him how to percuss (essentially, tap) a tummy or a chest to listen for air, fluid, or organs, he quickly turned on me -- finding it endlessly amusing to percuss my head and claim he heard nothing but air. That afternoon, he also ate some apple slices. (The psych technique worked, at least.)

Later in the weekend, my father worried about his stomach pain, and I was gratified that I could use the same abdominal exam to ease his mind. A few questions and basic stretch maneuvers suggested that he’d stretched a muscle, and my board-certified internist sister-in-law agreed.

Of course, none of this replaces a proper doctor’s visit, but a little practice and carefully delivered patient education never hurts. Now to perfect my techniques for winter break. ...