So We Meet Again, The CroupCommentary • Opinion • health • ISSUE 46•16 • Apr 20, 2010 By Dr. James Whorly, Pediatrician How very curious. The patient seems to be displaying some highly unusual symptoms. There doesn't appear to be any swelling of the lymph nodes, yet I detect signs of a fever and the boy complains of nausea. Hmm, I wonder. Clearly, this is no common cold I'm dealing with here. No, something about this child's sickness is almost reminiscent of…could it be? Why, yes, of course! How could I have missed it? That distinctive barking cough; the constricted breathing; the hoarseness of the patient's voice. It could only mean one thing…It is the vile handiwork of none other than my greatest adversary, acute laryngotracheobronchitis. Or should I call you by your real name, The Croup?My old nemesis. Well, well, well. I thought I had seen the last of you back in the Washington Heights Children's Memorial Hospital. I watched as white blood cells aided by steady doses of corticosteroids tore you apart. There's no way you could have survived! Thanks to the quick-thinking mother who recognized your symptoms in time, I had you just where I wanted you. Or so I thought.What was the name of that case? Ah, yes, it was "The Case Of The Young Boy Who Caught The Croup."But alas, it appears you escaped your just fate yet again. I can't say that l'm surprised. Naturally, I was thrilled to have finally bested you once and for all. And yet, now that I am confronted with you once again, I sense that old feeling returning to me: that intoxicating surge of adrenaline that seizes me each time we enter into our delicate dance of good and evil. It is exhilarating, is it not, The Croup? Of all the vile foes I have battled in the past—Chicken Pox, Rubella, The Mumps—none has challenged me quite like you. Part of me, I must admit, almost…missed you.It's impossible, really, to imagine a life without you, my age-old archrival. Even though you're a respiratory illness that tends to strike young children and I am a twice-divorced pediatrician in his mid-60s, some might say that we're two sides of the same coin, you and I.It's as though we were made for each other.Ah, who could forget our first thrilling duel in Eugene, OR? I was only a medical student back then, but I recognized immediately that you were no simple ailment of the air passages. Your cunning and resourcefulness were so utterly devious and yet so exquisite. And what about our epic battle of wits in Toledo? How fondly I remember that particular encounter. You didn't really think I would fall for the old "I'm just a mild case of Whooping Cough" routine, did you?You underestimated me, my friend!But what you did to that young boy in Austin 10 years ago was unspeakable. Why did you do it, The Croup? Why? It was me you were after, not the boy. The memory of that dire day haunts me always. That is why I will never rest, never give up until I have expunged your heartless villainy once and for all.And now, the hour of your defeat is finally at hand. Look around you, The Croup. There is nowhere to turn now. No upper airways for you to retreat into. Why, whatever is the matter? Are you…scared? Do you sense your victory is slipping away from you? You sense yourself weakening, don't you? Yes, yes, your astonishment is filling the room. You are asking yourself, "How did he beat me?"It is simplicity itself, my dear Croup. Allow me to explain:You see, I always knew you would be back. I knew you couldn't resist. So, over the past six months, I have subtly let my guard down just enough to lure you back in. And now, thanks to a little help from my trusted colleagues at the Merck corporation, I have secured just enough precious Decadron to foil your dastardly plot. Once again, The Croup, it was your arrogance that was your ultimate undoing.Until we meet again, my darling adversary…Mrs. Weiss, give Brian two of these every day for at least a week and make sure he gets plenty of fluids and rest and he should be fine. Take care, now.