Watchful Waiting and a Prescription for Love


Winter.  That time of year when my office is full of children with viral infections that I can do nothing to improve.  I routinely recommend treatments as technical as rest, humidifiers, steamy showers, and water.  Yes, water.  And if I’m feeling more exotic, I suggest honey.  And almost universally, parents look back at me and say, “is that it?”  This is a season of disappointed and frustrated stares.

In her book, On Immunity, Eula Biss says, “the wise practice of waiting and watching is hard to sell, in part because it looks a lot like doing nothing.”  When doctors are pressured into doing something, when the right answer is to do nothing, harm can ensue.  Biss continues that “the purpose of heroic medicine was not so much to heal the patient as it was to produce some measurable, and ideally dramatic, effect for which the patient could be billed.”  Writing an antibiotic prescription would be much easier than a lengthy discussion about viruses versus bacteria, but doing something is not always the right decision and sometimes watchful waiting is what is best for the patient.  As a steward of antibiotics, it is also part of my job to use them wisely and appropriately for the clinical situation.

I have been the patient though with the miserable viral illness.  Wrapped in blankets, surrounded by tissues, and sipping chicken soup, I have also pleaded for “something” to make me feel better.  We all want some magic pill to take away our suffering in those moments.  When your child is sick though, this desire to find a cure is even more pronounced.  I know the heartbreak of watching your ill child, the burden of missed days of school and work, and the misery of sleepless nights.

While I may not be able to prescribe a cure for the viral illnesses that walk into my office, there is some guidance that I can offer based on my experiences with them.  When one patient inquired on my way out the door, “hey wait, where’s my medicine,” it felt good to inform him that his mommy was taking good care of him and that was all he needed.  In the end, I know he will get better and empowering his mom to trust that the warm tea, vaporizer, and back rubs she is giving him are all the medicine he needs is the best prescription I can give.

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