Two patients came in on one January night with the same complaint: shortness of breath, fever, and cough. One had a routine problem, easily treated. The other was close to death.
The first was an 11-month-old boy, who was "coughing and short of breath," according to his chart. His father met me in the hallway. "You've got to come right now, doctor. Didn't the nurses tell you about my son? He's got this terrible cough. He can't breathe."
I felt a flash of terror. Usually I can be sure that if a patient is really sick, the triage nurse will come and find me, but that night I was subbing for someone at a small ambulatory clinic, not a real emergency room. The nurses weren't used to very sick people, especially sick kids.
We hurried down the hallway together. "It's been going on all night," he said.