E ssa ys from Practice

Appendectomies for and Madlon

“In an old house in Paris that was eat his entire supper (which I later his arrival in the emergency depart­ covered with vines/ lived twelve little realized included his favorite dish), I ment. I knew he was ready for dis­ girls in two straight lines.”1 So be­ decided that we would just watch charge when he walked down the gins the classic children’s story Made­ and wait. After all, a cardinal symp­ hall to the vending machines to get a line, by . I had tom of appendicitis is anorexia. The bag of chips. (Still no anorexia!) He read the book as a child, and thought next day Aaron seemed to feel a bit did receive a helium balloon, and I of it occasionally when my last name, better, and he even walked to the rented his favorite videotape. After 2 Madlon, was mispronounced. The neighborhood store for a treat. Still days Aaron returned to school with a actual plot of the story, however, I no anorexia. But that evening he had note excusing him from gym and re­ had long since forgotten. more pain and a fever. So we “drove cess. He was quite annoyed at his I was recently reminded by my out into the night” to the emergency teacher’s solicitousness. 8-year-old son, Aaron, that Made­ department, with Aaron complain­ In a wonderful picture, Made­ line’s most famous adventure was an ing of pain with every pothole we line stands on her hospital bed, appendectomy! Aaron had just had hit. proudly showing her scar to her fas­ his own appendectomy and was ea­ Aaron was moved quickly from cinated schoolmates. Although she is ger to compare experiences. (He had the emergency department to the op­ turned so that her scar is not visible, already heard about his grandmoth­ erating room. The surgeon was not it is probably larger than Aaron’s er’s appendectomy, performed by his fooled by Aaron’s response that, yes, neat 1 '/2-inch line. Nevertheless, great-grandfather, a physician.) he could eat a Big Mac right now. Aaron’s scar easily impressed his Madeline lived in a convent Although Madeline’s diagnosis classmates and inspired exclamations school in the 1930s. “In the middle and treatment were rapid, her hospi­ of “awesome!” and “gross!” of one night” Madeline sat up in bed talization was lengthy. On the tenth Some things never change! and “cried and cried.” The doctor postoperative day her 11 school­ came soon after, announced, “It’s an mates visited her “with solemn face, Contributed by appendix,” carried Madeline to the with some flowers and a vase.” They Diane Madlon-Kay, MD ambulance, and “they drove out into “then said ‘ahhh,’ when they saw the St Paul-Ramsey Medical Center the night. Madeline woke up two toys and candy and the dollhouse St Paul, Minnesota hours later, in a room with flowers.” from Papa.” Later that night “all the Aaron’s diagnosis and treatment little girls cried, ‘Boohoo, we want to were not quite so timely. When he have our appendix out, too!’ ” complained of right lower quadrant Aaron’s hospital stay was too Reference pain, my initial thought was also “It’s short for any thoughts of secondary 1. Bemelmans L. Madeline. New York: Vi­ an appendix!” When he proceeded to gain. He went home 24 hours after king Penguin, 1977.

89 The lournal of Family Practice, Vol. 37, No. 1, 1993