For example, I missed my 2-year-old daughter’s post-varicella cerebellar ataxia. Our babysitter told me that she was “walking like she’s drunk,” but I dismissed this as I watched her run right by me that day at the beach. The next morning, unable to walk, she crawled into our bedroom. Fortunately, she recovered in a few weeks and eventually became an athlete.

Then there was the time that my 9-year-old son lacerated his chin when he fell off his bicycle. Judging that I could do a better job closing the laceration than an intern, I had my wife bring him to the community ED where I was working. I have seen a lot of gore, but this was the only time in my entire medical career when I very nearly passed out at the sight of blood–just as I was gloved and had him prepped and draped and ready to begin the procedure. I recovered without fainting and after about 10 sutures, so did he. However, I could have fallen, been injured, and needed laceration repair myself.

On the other hand, being a do-it-yourself physician can come in handy. So far, I have managed all my episodes of renal colic with ibuprofen, a urine dipstick, and a coffee filter.

When I fracture-dislocated my ankle on Mount Rainier, there was no one to do the emergency reduction; so, aided by a rush of endorphins and the lack of swelling, I did it myself. It should go without saying that unless you have no alternative, you have no business handling high-risk situations yourself.

Pay Attention to Everything

Today’s physicians suffer with an overload of information and responsibility. Even the best will occasionally overlook things. No one cares about your health as much as you do. I was recently hospitalized for a fever of unknown origin at a well-respected teaching hospital. My doctors were wonderful. Eventually they made a diagnosis, and I was cured. I continue to go to this hospital for my medical care. Yet there were logistical issues and interservice communication breakdowns that delayed aspects of my care.

With access to my patient portal, I was able to read every physician note, diagnostic report, and laboratory result while I was in the hospital. At times, it was distressing to find out what diagnoses my physicians were considering, but there were a few instances where I uncovered clinically significant incidental findings that were overlooked by my medical team. They had so many other things to focus on and I was only one of their many patients.