A two-year-old girl is brought to the Emergency Room. Her father believes there's nothing wrong with her, but the mother says that earlier the child had looked "blank," and is sure there's a problem. The physician tries to work out what might be wrong.

The child seems fine, but he automatically looks for signs of abuse, and the triage nurse suggests the parents, who are African-American and on Medicaid, are there because they want "something for free" (127). There are other patients waiting, the child's vital signs are fine, the father wants to leave.

As the doctor is leaving the examining room, he asks whether she might have taken someone's medication, and the mother mentions that the child's grandmother takes "sugar pills," hypoglycemics. They test the child's blood sugar and it is dangerously low. She is admitted to the hospital.

The physician tells the mother she has saved her child's life, and then considers how lucky they had all been--"I felt sick, cold, and damp, terrified by what I had almost missed" (131). He says that since then, he often thinks of the child, "alive in the world, going out into it, . . . decade after decade ahead."


This brief story neatly captures the tiny decisions that can make a vast difference in the medical encounter. The mother knows her child and has recognized something wrong, although she cannot articulate quite what it is. The physician is--only just--attentive and patient enough to reach the cause of this change and, as a result, the child's life is saved.

The story's happy ending is powerful because of the dreadful "what if?" subtext it carries: it could so easily have turned out differently, not only because the problem was difficult to diagnose but because the patient came from a social group which, implicitly, may not always receive the kind of attention necessary for "lucky" resolutions like this one.


Frank Huyler currently practices Emergency Medicine in Albequerque, New Mexico.

Primary Source

The Blood of Strangers: Stories from Emergency Medicine


Univ. of California Press

Place Published

Berkeley, Cal.



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