Wednesday, March 11, 2015


On our SOAPM pediatrics listserve we have had a conversation about treating strep throat. The options are: (1) take oral antibiotics once or twice a day for seven or ten days, or (2) get one shot of penicillin at the time of the visit. Factors include the fact that a shot hurts (briefly); and that it is hard to fulfill the oral medicine instructions for a week or more even if it is yourself, let alone a kid, so that “lack of compliance” becomes an issue with oral medication.
Myself, I've always been a shot guy. Over and out, I figure.
But many of the doctors wrote that they hesitate to give the shot because they themselves remember the pain when they were kids. For instance, my friend Iris Snider from Tennessee writes: “Kim, like you I had my share of Bicillin shots as a child and am loathe to give them. I average about one every 10 years and apologize to the 'victim' every time I do.”
Here's my response:
When I was probably about 6 or so - I was born in 1941 - it was summer and we were at the New Jersey shore, in Beach Haven.  Somehow I got an infection in my foot.  It was bad enough that I had to go back to Philadelphia and was hospitalized, probably at Graduate Hospital.  Penicillin wasn't that old a drug and we were lucky to have it.  At that time there was probably only crystalline penicillin.  I don't know if it was every four or every six hours that the nurse came into the room with a big hypodermic needle and I cried at the prospect and my mother helped to hold me down.
Then after a while my mother reasoned with me.  She said, “Look, it's going to be done, so why don't you stop resisting and just accept it and make the best of it, and after all it is fixing you all up,” or who knows what words she used. 
The next time the nurse came into the room I smiled and turned over and offered my cute little butt to her ministrations.  She said, “Well, what got into him?”
And you guys are complaining about a one time shot, with pain-killer as one of the components, when the kid can walk out of the office and not think about it again?
You should have been in Philadelphia right after the war and seen a little kid with a foot infection in the hospital bed and offered him that choice!
Budd Shenkin

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