"Seven "o" makes a D.O"

In medical school we had a saying "seven "oh" makes a D.O." Colleagues will probably shudder that I've gone public with our secret. Some of our classes were pass or fail, and a 70 was passing. We would joke that years from now when we were taking care of patients no one would ever know if we were the top of our class or one of the students who just got by with barely passing grades all the time. In all fairness sometime the exam schedule was so grueling that if you had two or three exams in a twenty-four hour time period you truly would have to pick and choose which class to study for and which one you thought you could just "get through".

I remember clearly... an exam we had in March of 2000. One of my closest friends in school was single and lived in an apartment, alone, near campus, and on the beach. I commuted an hour one way and lived with my husband and baby. We had just gotten our exams back and laughed that we had the same score "72". My friend shrugged and said, "I really should have studied more, I spent way too much time lying in the sun this weekend." I looked at her without ANY empathy and said "yeah I wish I had studied more too but Jakob had the croup and I spent hours in the emergency room this weekend."

That memory is probably clear for other reasons as well. No parent ever forgets the sound of "seal barking" croup. Jakob had just turned one, it was the night of his birthday party and he got a low grade fever. At that point I had gotten better about panicking, a small fever was okay, nothing for alarm. I tucked him in as usual and started to study. Around 11pm I heard the bark. He was in his crib and starting coughing and crying all at once. When I scooped him up I was horrified- it really sounded like he wasn't able to breathe at all. I immediately called the pediatrician who sent us out into the cool March air; to no avail. After almost an hour of hot shower and cold air I put the phone to Jakob's face so the pediatrician could hear him struggling. Every breath he took in was "stridor" and every breath out a barking cough. If you've never heard stridor your lucky. Its a scary sound because you can feel the tightness of the air trying to get in and the look in someones eyes who is having stridor is pure panic. He was afraid and I was terrified. I was convinced he was going to keep getting worse and stop breathing. A fast ride into the emergency room brought relief. They treated him first with nebulizers (those don't help croup) then finally an injectable steroid. As we waited for the steroid to work on his breathing, he became more and more alert and as he was bouncing off the tiny walls in the ER cubicle the nurse began to explain the side effects of steroids including hyperactivity, irritability, increased appetite, and difficulty sleeping. Well doesn't this sound like a great thing for a one year old, and an even worse thing for a mom who had a big test on Monday.

We got through our first battle with croup and we've made it through at least a dozen more since then. My kids seem to be prone to that stinking viral infection. If there was a specialty in croup I would have considered it. It's amazing how that one experience, the 72 on my test has continued to impact my life. One of the first few times I was on call as an attending physician I got paged from a dad who was calling about his daughter that had a "funny cough". He was very worried and you could hear his wife in the background holding their baby and telling him she couldn't breathe. The second I heard the seal bark I not only knew it was croup but knew what it felt like to hold your baby and see the fear in their eyes. They were more fortunate than I had been. After a few minutes outside, the cough settled down and the baby fell back asleep. It felt great to be able to reassure these new parents and help them take care of their sick baby. It sure helped to have "been there".


"believe in your dreams for all dreams can come true"
-dr. mom of 4