Baby Doctor

I was on call a few weeks ago when we admitted a young boy with fever. He had a short history of severe muscular aches and pains and difficulty walking. As part of the preliminary workup we decided to get viral cultures to try an isolate a pathogen. One of the ways this is done is by collecting a sample from nose. You take a sterile swab, a thin plastic instrument that resembles a long Q-tip, introduce it into a nostril and gently rub it along the walls. Once you think you have a good sample, the swab is removed and snipped off, inoculated in a tube of transport media and sent off to the lab for analysis.

I went into Bryan's room with the test kit. He was laying in bed, tired from all the bloodwork that had already been done. I showed him what I was going to do, told him it wasn't going to hurt and asked for his permission. He looked at me and then at the paraphernalia I carried in my hands.

"What's it for, sir?" he asked.

"We want to make sure there are no bugs, or viruses, at the back of your nose." I simplify it for him.

He looked again at the swab I was holding. It was about the length of a tongue depressor and probably as ominous as a spear to the child.

"Don't worry, not all of it is going to go in your nose. Only a small portion, just enough to get get some bugs," I reassure him.

He looked at me hopefully. "Is it OK if I just sneeze on it?"