Today was a tough one. Little baby girl comes in for “recurrent UTIs”. Parent is frustrated because she’s been to ER multiple times this year when these symptoms started where she’s given antibiotics & sent home. But symptoms always come back - belly pain, pain in urination,…

discharge, foul odor. She goes back to ER - antibiotics & sent home. & the cycle continues.

But, wayment - vaginal discharge? Foul odor?
UTI?

Nope. Nope. That ain’t right. Okay, let’s consciously avoid anchoring bias and THINK.

When is a “UTI” not a UTI?

When it’s an STI.

Stands for “Sexually Transmitted Infection.”

An itty bitty chocolate muffin under the age of 6. (Intentionally not specifying age/identifiers)

My heart is thundering in my chest as I gently prod the child’s parent.

This is my nightmare as I’m a mom of itty bitty chocolate muffins too.

And this one looks just like them.

What could have changed in 1 year that all of a sudden an otherwise healthy child is sprouting “UTIs” (Urinary Tract Infection) all over the place???

Not responding to all the antibiotics in the local ER?
Constipation? No.
Bubble baths? No.
Known genitourinary anatomic anomalies? No.

Foreign…body?

“Parent, is it possible that someone touched little baby child in their genital area?”

“Yes.”

Last year.
Soon after when these symptoms started.

Tears.
Heartbreak.
I’m weak as my head hangs low on my chest.

This never gets easier.

Sending STI tests on a child is supposed to be a never event.

I’m grateful to my teachers who taught me to always be vigilant against heuristic errors & cognitive biases that compromise one’s ability to make correct diagnoses.

To take time and pay attention.

To ask questions gently, lovingly, & explain why it’s important.

To always be developing a differential diagnosis.

To know when the math is not mathing & to bring my own calculator & do my own math - because it can mean the difference between someone’s life & death; relief & suffering; oppression & freedom.

& often that someone looks like me.
Like my mama, my papa, my partner, cousins, aunty, uncle, grand people.

Like my kids.

Thankfully, justice prevailed & the perpetrator is doing time.

But this baby.
Their parent.
Will have to carry the wounds forever.

and I…

Today is a tough one.

~End~