5. Systemic Lupus Erythematosus, Pediatrics
JI 13/F: A patient in her early teens diagnosed with lupus came in with her adoptive mother for follow-up. Clinically the case was not so remarkable, except for the fact that she came in with the classic presentation of SLE (fulfilling 8 of the 11 criteria.) What was more of note though was the fact that they came in with their complete records organized in an envelope - doctors notes, copies of ward charts, even the prescriptions and receipts for every laboratory request and medication throughout the course of the child’s illness. They also came in conversant about the disease - they knew its basic pathology and principles of management (like things to do to avoid complications.) Most importantly, they were curious and inquiring, asking questions to clarify points, etc.
In short, she was the poster girl for the ideal patient. Every clinician appreciates patients who make work easier for them and are in-charge of their own health. The strongest allies of a doctor in optimal patient care are in fact the patient and his/her family themselves. In a setting full of ‘difficult patients’ such as that in the PGH, this patient was a refreshing reminder to everyone that they should be in-charge of their own health.