Dinosaurs in your ears

A common and frustrating scenario for medical students goes something like this: you go into a room to examine a patient. During the exam you find something, say a heart murmur. You go out to present the patient to staff, saying "Mr. So-and-So has a Grade II systolic heart murmur." Then the two of you go into the room, where the doctor examines the patient while you stand awkwardly in the corner. The patient asks "Doc, do I have a heart murmur?" The doctor listens--and assures him that he doesn't. Now, medicine is often as much art as science, and physical exam findings can vary from observer to observer. But generally speaking, the med student ends up feeling (and looking) kind of, well, dumb.

So yesterday I'm giving a five-year-old boy a preschool physical. He's squirrelly, and I need to get him to sit still so I can get a good look in his ears. (Accidentally administering a deep penetrating brain injury with an otoscope to a five year old during a routine physical is considered extremely poor form; it would probably even affect my grade for the rotation.) So I lean close and whisper "I'm going to see if there are any dinosaurs in your ears. If you sit real still you might be able to hear them!" Sure enough, he sat up straight, stopped squirming, and I got a beautiful view of each tympanic membrane.

After finishing my exam I went out to talk with the doctor about him, and then we came back in together. As soon as the doctor picked up the otoscope the kid smiled, tilted his head to present an ear, and excitedly asked "are there any dinosaurs in my ears?" No, the doctor assured him, there aren't any dinosaurs in your ears.

While the doctor was busy, I stealthily grabbed the clipboard with the physical exam form and scribbled "no" at the beginning of the line where I had written "dinosaurs in ears."