NfAS: The Day I Learn About Worms

April 7^th 2016

Only 5 patients today. Why? What happened to my high numbers? I sit in my little office, reading a novel on my iPhone, occasionally standing forlornly by the door hoping for someone to walk in. It doesn’t help to see the pediatrics resident inundated in patients. 

A woman walks in, smiling at me. She looks awfully familiar. Hey, didn’t I see you a few weeks back, I ask her. Yes doctor, she says. I came back to talk to you again. 

I am thrilled. Someone actually likes me enough to return! Then I tell myself to get a grip and not to be so needy. She thinks her one year old has worms because his tummy looks big. She says she has been trying to get him to have a flatter tummy for months now, but always, it looks like he has a “thondi” (pot belly). Oh yeah… worms… I’d totally forgotten about them, coming from my decade-long American background. I’d been dewormed multiple times as a child and that thought triggers multiple memories. “Does his bum itch?” I ask. “Does he keep wanting to eat weird things, such as paint or erasers?” Have his bowel movements changed? Does he keep wanting to eat continuously?” 

No, no and no, she says. He’s totally normal that way.
Okay, does he play in the mud?
Yes.
Do you wash his hands afterward?
Yes.

I tell her to talk to the pediatrician for albendazole, though it doesn’t seem like the kid has worms. I reassure her on the pot-belliness of infant bellies and explain about stomach muscles and how they tighten over time. I end by asking her detailed questions about the baby’s diet and praise her for a good job done.

Soon after, we get up to leave and I catch hold of the pediatrics resident and ask her to tell me all about worms. 

All these weeks, all these kids in their dirt-stained clothes and mud-stained hands and their low weights, and I never thought about worms before. A bulb just switched on in my head.