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Wednesday, May 31, 2006

Fear of the Package Insert

Summertime and the living is easy. . . for skin problems, apparently. Felix got something that looks angry and seemed to be spreading fast so I did what every parent apparently does after a holiday weekend and trotted over to the pediatrician.

The office was flooded with the usual assortment of extremely new babies, kids with stubborn splinters, limbs wrapped in ice from recess falls, and ailments that held off on making themselves manifest until the offices were closed for the long weekend.

So the rash, while rashy and large wasn't wildly impressive. Ointment was prescribed and the pediatrician told me not to worry about the fact that the warning label would probably say that the medication is not for children under 18. Fair enough. I was prepared.

Until I read the package insert that came with the remedy, and then I turned anxious. There were oodles of warnings about how this topical medication could trigger syndromes that crop up in the differential diagnoses for the fascinating mystery cases on certain medical television programs. I braced myself and left a message for the doctor. I'm sure that doctors city-wide dread the little scraps of paper covered with anxious messages from parents who read the package insert.

As I was calling, I was thinking that of course the doctor would be annoyed. The rash had to be gotten rid of and it is unlikely that the cure would be hideously dangerous. This wasn't something acquired in the bush or anything. (I worked once for an anthropologist whose husband, also an anthropologist, acquired an amoeba while doing research somewhere that was so persistent that it made much of the poor man's hair fall out. The cure not only encouraged the hair loss but was so toxic that he occasionally felt he was better off with the parasite than the medicine.) This is something that is prescribed all the time.

But there I was, leaving the message. There I was, getting the impatient reply about how only extremely prolonged use causes the terrible syndromes. There I was, certain that a big green "C" for CRAZY MOTHER had been etched onto my kid's chart somewhere.

Now, as charming as it is to acquire new titles, I don't really want that one. "Who would?" you say. Plenty of folks. I had a conversation not a week ago with a woman for whom "crazy" was clearly an adjective she used to brag about herself. "Crazy" was code for "knows best" or "takes better care of my kid than you do of yours because you don't stay on top of people." For me, though, "crazy" is not a compliment and I don't like that my gentle behavior could be interpreted as falling into that category.

Of course I'll still ask my questions that may test the patience of professionals around me, but I do wish there were a little more sympathy for nervous queries. Kids are worry-generators and even if everything is going well, those package inserts make one frightened that all that hard work one has done not to screw things up so far could all get blasted away with some poorly applied ointment. And I really have to say that people who happily call themselves crazy are giving the rest of us a bad name.

posted by Elise at 3:08 PM

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210 Comments:

Anonymous said...

As a medical student, I hope that I'm never impatient when my patients are asking me questions about things that I prescribe. Unless the information that only prolonged use caused those scary syndromes was on the package info somewhere, you had every right to worry and wonder and to call your doctor to get your question answered. After all, if his answer had been otherwise, you may have decided to request a different medicine or gone to another doctor for another opinion.

5/31/2006 6:18 PM

Elise said...

Thank you. The information about prolonged use was, in fact, not on the insert or packaging, only the discussion of the side effects. I actually wonder now why the insert would not have mentioned prolonged use. I think the doctor was probably a little short primarily due to the unfortunate timing of my visit and queries - the day after a holiday weekend is truly a drag. But I do hate feeling that I am somehow even a little unreasonable for wanting to be reassured. (There is no question that the rash needed assistance, by the way, it was not going to clear easily.)

5/31/2006 7:16 PM

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