Sometimes, the minute you step into the room, you just know it's not going to go well -- as it didn't with the mother of this teenage girl.
Her daughter sat quietly on the exam table, coughing. Next to her was Mom, probably in her mid- to late 40s, but by her clothes seemingly clinging to her youth -- tight jeans, bright pink sweater; it looked as if she shopped at Forever 21 in her local mall. Her hat, a puffy billed urban thing, belonged on a hip-hop star's head instead of on her blond, well-to-do suburban one.
I'd barely had a chance to sit down when Mom started right in. She had a snooty tone, the kind that says, "I know exactly what's wrong with her," while she told me her kid's story. (Wasn't the kid old enough to tell me herself?)
"She's been coughing for two weeks. Nobody's sleeping at home, and now I'm getting it too. I've given her half a bottle of cough syrup, but it's not working. Her dad had it and his doctor gave him codeine cough syrup, and even though he's still coughing, he's sleeping better."
I cringed. I had been in this room less than two minutes, and in less than 30 seconds, I knew I didn't like this woman. My glare hardened and my lips curled in as I replied.
"If that's what you want, you won't be getting it from me," I told her sternly.
The cough syrup she wanted, promethazine with codeine, is no better than over-the-counter stuff, and the only reason it makes people sleep is because it contains a fair amount of alcohol.
I suggested the mother might as well buy her kid a drink before bedtime instead.
I know. I shouldn't have said it. I'm usually much better at talking to parents, even demanding ones, and negotiating some kind of agreement. I should have explained to her, professionally and courteously, that prescription cough medicines have not been shown to be any more effective or safe than over-the-counter ones, and that there have been reports of young people taking promethazine-and-codeine cough syrup and dying from respiratory failure.
I even could have told her how a few years ago, one mother in my practice kept calling and demanding the same medicine for her kids from me and my colleagues. She turned out to an alcoholic who was drinking bottles of the stuff herself.
But, irritated, I didn't do any of those things. I told her, basically, that she was out of luck. Her demand for medicine was not negotiable.
