JR

Last week the ER resident called me to admit a patient. "I have an eight-year-old boy with pyelonephritis. And he has rash." Interesting, I remember thinking, you don't really get a rash with pyelonephritis.

I made my way down to see JR. As I knew I was already going to get out of work late, I decided to take my time and make some small talk with JR and his mom before I asked them all the medical questions.

So, I asked him about what he liked to do. And he told me he liked to knit. I was taken aback. What 8 year-old boy likes to knit?? He told me how he has knitted scarves and also a hat. This was no normal 8 year-old boy. We talked a bit more, and the more we talked, the more inferior I felt.

"So, JR, can you drive a car?"

"No, I can't reach the pedals." Well, I was glad to know that there was one thing I could do that JR couldn't!

Even before asking him or his mom any questions, it was very obvious that he did not have pyelonephritis. As we talked, I was looking at the rash on his hands, looking at the injection of his conjunctiva, and looking at his red cracked lips. It was time to stop the chitchat and get down to figuring out what was going on...

After taking a history, examining JR, and looking over the labs, I suspected that he had something more serious than just pyelonephritis.

I talked to JR's mom and told her that I was concerned about what was going on. She asked me to call her partner, who worked in health care, and discuss what I thought was going on. And I told them I suspected that this was Kawasaki's. But it was too early to make a diagnosis.

I explained to mom #1 that they would have a new residents taking care of them in the morning.

"But, we like you. Will you please be our resident?"

Our team size was alread a little unruly, but how could I turn down taking care of this cool kid, with two moms, and an interesting/complex medical condition.

JR had a rough course. There was disagreement about whether he had Kawasaki's or some infectious cause. He failed initial treatments. And on day three, he was looking worse. We had multiple family meetings daily discussing his care, and what more we could/should do. We called the Kawasaki specialists in Boston, and were on the verge of transferring him. Thankfully though, he responded to the second course of treatment, and went home a week after coming into the hospital.

When I went back to work on Monday, they have left me a card with their number, and an invitation to come over for knitting lessons...

They were the coolest family that I have taking care of, and if I ever have a family, they would be one of my role models.