They just come bouncing back

I don't usually go to postgraduate medical meetings, but to my surprise I actually enjoyed it.

It was good to see that the drug reps are still flogging their stuff, and I took enough free pens to last 100 years.

It was also good to meet my colleagues and find that cynicism and world-weariness remain our chief virtues. Among other things we discussed the NICE guidelines on childhood fever: 'Just dump them all into hospital then everybody'll be happy' was the general consensus.

Apparently there were GPs involved in the development of these guidelines, which gave me extra confidence when Mrs Magee came in for the weekly course of antibiotics.

Mrs Magee has for years waged an unrelenting and deeply personal war against childhood fevers. She knows every trick in the book, every strategy and, as usual, began with an hour-by-hour account of the night's encounter. 'Wee Johnny's temperature was up at 8pm. I got it down by giving him Calpol, then it came up again so at ten hundred hours I dripped him in a bath full of crushed ice and dead otters, then it came up again so I force-fed him some pureed squid ...'

Little Johnny looked full of beans and had managed to get his head stuck in the sharps box. He was screaming but this was, I thought, an appropriate response.

'I have here,' I interrupted, with as much gravity as I could muster, ignoring the muffled screams from the now bloody sharps box, 'the very latest research from the National Institute of Clinical Excellence. It clearly states that a fever is not a bad thing; it may even help children fight infection.'

This, I knew, was tantamount to heresy, and Mrs Magee's brow began to darken.

'It further states,' I continued, flourishing the guidelines like the Sword of Truth, 'that antipyretic medications such as paracetamol and ibuprofen are not recommended.' Mrs Magee gave a little gasp.

'Also,' I said, aware that I was challenging a whole belief system and implying that Mrs Magee had been living a lie for the past 20 years, 'physical measures, such as ice baths and tepid sponging are not recommended.'

I expected a panic attack, but people are resilient.

'I'll just have an antibiotic then,' she said.

Dr Farrell is a GP from County Armagh Email him at GPcolumnists@haymarket.com.

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