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The Informed Parent

You Have To Laugh: BRAT diet

by Louis P. Theriot, M.D., F.A.A.P.
Published on Jan. 01, 1997

By the look on our office manager's face, I had a distinct feeling that I didn't really want to be here. For a fleeting moment, the thought crossed my mind that I'd best get back in my car and go back to the hospital. After all, I hadn't even closed the door behind me when I was met by not only my office manager, but standing right behind her was one of our phone persons who too, had a solemn and grim look on her face.

There was a brief pause when no one spoke...and my heart seemed to stop. My mind raced about all of the catastrophic things that could have happened. The office manager, sensing my panic, broke the silence by saying, "Everything is O.K.. But we have to talk." With that little assurance, my heart started to beat once again as my anxiety level dropped a notch. Making my way to my desk to deposit my stethoscope on a stack of journals she started, " We have a problem! Mrs. X. is very upset."

Once again my heart raced as did my mind. Mrs. X....Mrs. X. Why would Mrs. X. be upset? She hadn't been in the office for a while, and her daughter was doing just fine to the best of my recollection. An immediate picture of Mrs. X. and her daughter Ashleigh popped into my mind. Mrs. X. was a reasonable person...a very precise and particular person, a bit serious perhaps, but I figured that was why she was such a successful executive. Why would she be so upset I wondered.

All of this took place in a matter of seconds, but it seemed like minutes. Just then our phone person spoke up and broke the silence. She was visibly shaken and her voice cracked, " I am so sorry, but I somehow upset Mrs. X." This phone person has been with us for ten years and she is the most patient, sympathetic and caring person I have known. I have only heard praise from our patients about her performance. I was curious to know what could possibly have happened.

"Mrs. X. called and was concerned about Ashleigh who had diarrhea for two days," she started. "Ashleigh was terribly fussy...being a real grouch," she went on. Our phone person appropriately asked about fever and a list of other possible symptoms. There was no fever, cough, ear pulling, rash etc., just diarrhea and fussiness. With that, I suggested that she might try giving Ashleigh a BRAT diet. "Mrs. X. went absolutely ballistic and yelled at me and said how dare I! Before I could get a word in edge-wise, she slammed the phone down," she painfully confessed.

Knowing Mrs. X. as I do, it became clear to me just what might have happened. I assured our office manager that I would deal with this issue. I picked up the phone and dialed Mrs. X who had somewhat regained her composure. In a defensive voice, she informed me that although Ashleigh was being fussy, she was IN NO WAY a brat, and resented the mere suggestion. This confirmed my suspicions. I let her vent and when she was finished, I told her, "Mrs. X., there has been a terrible miscommunication here. The BRAT diet is a commonly used anachronism used in pediatrics. It stands for banana, rice cereal, apple sauce and toast. These are the foods that we recommend when a child has diarrhea. They tend to be constipating and will relieve the diarrhea."

I could feel her blush through the phone. There was a long pause after which she said, "Oh! Oh my gosh, thank you for explaining this to me, but I feel just awful. I am so embarrassed. I owe the phone person an apology. Could you connect me with her? And while I am at it, I may as well make Ashleigh's appointment for her 18 month visit."

I picked up my stethoscope and started down the hall to see patients. What other surprises were in store for me I wondered.

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