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Every day, and all day if he had his way, my son plays with his good buddies and neighbors, Max and Milo. They are thick as thieves, a veritable neighborhood mosh pit of sporting equipment, dirt and laughter. We joke with our friends how they “babysit” each other; something I can only wish for more parents. The words, “can Noah come out and play,” are so innocent and pure, reflective of the simple pleasures in life. They remind me of my own youth with best friends, riding bikes and just “playing.”

So the other day when Milo wasn’t outside playing with the boys, it caught my attention. “Where’s Milo?” I asked his brother. “He’s not feeling well,” Max replied, much as any ten-year-old might. When I saw their mom later, I mentioned it. "I heard Milo isn't feeling well." “I think he has the flu,” she responded.

Here in the middle of summer, probably not.

So many people lump these non-specific symptoms of fever, malaise, or vomiting, into “the flu” and call it a day. How many sick people go unattended to because of it?

"He’ll be fine, right?” she asked. “I can take him to urgent care if I need to.” He’ll probably be fine. Human resilience is impressive. But as an emergency physician, I'm not satisfied with probably. I have to be convinced he’ll be fine. In fact, he’s not fine until we prove it, or at least until I feel more assured. “Why don’t you bring him over and I can take a look?” Milo's mother seemed startled but she brought Milo over. On the way to our house, he stopped and vomited into our planters, a lot. Diaphoretic, warm and a bit listless, he had my attention—more so when I noticed he seemed uncomfortable walking.

"Where do you hurt, Milo?" I asked. He pointed to his lower abdomen. I laid him down in our backyard, keeping my tone light, and asked a few simple questions. Abdominal pain, decreased appetite, low-grade fever, vomiting and yes—he had been complaining for the past four days that his belly hurt when he walked.

After trying to put him at ease, I lay my hands on his belly. It was tender…in the right lower quadrant. Not a difficult diagnosis, it was appendicitis until proven otherwise. I shared my concern with mom. No, he couldn’t just rest. No, he shouldn’t just go to urgent care.

Like a lot of us these days, they were worried about insurance and child care. Max could stay with us as long as needed, and I directed them to The Children’s Hospital emergency department. Milo was operated on that night -- acute appendicitis.

He’s back home, resting, and will be joining the mosh pit soon enough. This simple interaction turned into a series of “you saved his life” sentiments from the neighborhood. It got me thinking, we never know when we have the opportunity to make a difference, nor for whom.

So many of us have had the good fortune to care for friends and neighbors, many who start with, “I don’t want to bother you.” We spend our days caring for people we don’t know, so isn't it nice to care for people we do?

Seeing poor Milo sick and suffering, and then intervening—not in the cold halls of the ER or hospital, but on a sun-soaked cushion in our backyard—filled me with gratitude for the gift we have as physicians to listen, to attend—even to attach—to others.

I wasn’t compensated. I didn’t have to document or deal with a computer. No regulators were inserted into our interaction. It felt so nice to help a friend. Really, it was that simple.

Could my son’s dear playmate have gotten worse, sicker? Could his appendix have perforated? Could he have become septic, even died?


These thoughts passed through my mind. The sadness of that possibility is unimaginable. But by imagining that outcome, I feel the relief and gratitude for simply observing, for extending a hand to a neighbor to exert some expertise—as well as some compassion.

What simple pleasures can come from the skills we have.

By Daniel Meltzer, MD