“Just a Virus:” What Your Doctor Meant to Say

If you have children (assuming you’ve taken them to the doctor), you’ve been there. I’ve been there. Your child has been coughing for days; he hasn’t slept in 3 nights (which means that you haven’t slept in 3 nights); he has a fever; he has morphed into a living snot factory; and he has a God-awful rash that you think might be leprosy. Or smallpox. Or poison ivy.

So you call the pediatrician and beg for an appointment. After much protest, the receptionist tells you that the on-call doctor “can squeeze him in.” Like he’s an inconvenience. Thanks.

You finally manage to get your little man out the door while juggling your keys, your phone, a box of tissues, and his iPad. When you arrive, you are ushered immediately into that germ-ridden purgatory we call the “Sick Child Waiting Room.” You threaten to kill your child if he touches anything (quietly, because let’s be real–nobody needs a DSS report). Because no matter how sick your kid is, the ones that were there before him might have been sicker. The nurse eventually releases you and escorts you to the exam room, where you get to wait another 20 minutes.

And then the doctor comes in. He listens patiently to your story for all of 12 seconds, does a quick physical exam from as far away as his arms will allow, and scribbles something on your check-out sheet. “It’s just a virus. He’ll be fine.” And off you go, grateful and enlightened–wondering what exactly “just a virus” is supposed to mean, and quite confident that your child is far from “fine.”


 

So what, exactly, is “just a virus?” Well, a virus is a certain type of microorganism (or germ). Viruses have certain properties that distinguish them from bacteria and other less common infections, but unless you own a microscope, a lab coat, and a Petri dish, you probably don’t really care. I’ll let you read about that somewhere else, if you choose to.

Calling something “just a virus” is really misleading, because there are some pretty wicked viruses out there. HIV, Polio, and Ebola are all viruses. The herpes virus (yes, that one) can cause brain hemorrhages, seizures, and death in infants. Viruses can lead to cancer, liver failure, and heart failure.

Fortunately, most of them don’t. In fact, most of them don’t cause any symptoms at all. Most of the viruses that do produce symptoms will cause some nasal congestion or a sore throat. Really, the vast majority of viral infections are more inconvenient than harmful. But calling something “just a virus” is a bit like saying saying something is “just an animal.” It could be a cuddly puppy or a pissed-off wolverine; you really need to know more about it before you choose an approach.

Of course, when your pediatrician diagnoses your child with “just a virus,” he’s implying that it’s one of those that doesn’t typically cause much harm. There are thousands of viruses out there that can cause cold symptoms, and we don’t tend to test for them. It would be ridiculously expensive, it wouldn’t change what we do, and you probably wouldn’t get the result until the symptoms had gone away.

He’s also implying that it’s a problem he can’t do much about. In contrast to bacterial infections, which are typically treated with antibiotics, most viral infections are successfully stomped out by your immune system in a few days. There are a handful of viruses that we can immunize against, often with very good effectiveness. There also are a few that we can treat directly, but these tend to be the bad ones–not the ones that cause colds.  For the rest of them, you just have to wait it out.

It’s never really the wrong decision to take your child to the pediatrician. There’s always a chance that there could be something else going on. (Click here to see why NOT to go to the emergency room.) But for most viral illnesses, your child would probably do just as well at home. If you do take your child to the doctor for a virus of the “just a” variety, she may be diagnosed with a “viral syndrome,” “upper respiratory infection,” or “acute viral rhinitis.” These are all super-secret doctor terms for “a cold.” (I might get shunned for telling you.) You see, when you go to the trouble of bringing your child in, we don’t want to seem like we are downplaying your concerns. So we use big words instead.

After making this diagnosis, the doctor will probably “provide reassurance” and recommend “symptomatic care.” This means fluids, rest, humidifiers…things you were probably doing already. I promise, it’s not that we don’t understand how miserable “just a” viruses can be. Trust me, we’ve all picked up more than our share from your snotty little kids (or our own). It’s also not that we don’t care. It’s just that we have nothing else to offer. But don’t worry. It’s just a virus. He’ll be fine.

As always, your comments are welcomed (even if you happen to disagree). I'll get back to you as soon as I can. Please try to keep it civil--I reserve the right to delete comments that are offensive or off-topic.

6 thoughts on ““Just a Virus:” What Your Doctor Meant to Say

  1. “To cure sometimes, to relieve often, to comfort always.” – Dr. Edward Trudeau (1848-1915)

    Funny how that really hasn’t changed. Can I cure most of the stuff that comes though my door? No. Not even close. Almost everything cures itself. But curing isn’t really the job, is it?

    • Exactly. This is one of my favorites (and even a few years older):

      “The art of medicine consists in amusing the patient while nature cures the disease.” -Voltaire (1694-1778)

  2. This article, as it appears in last Sunday’s Washington Post, contains an error. It says that pertussis is a virus, which, of course, it is not. Thanks, Jennifer Ward, a Mom

    • Jennifer–thanks for pointing that out. It’s already been revised, as you can see on the online version. What happened is that the editor asked for examples of diseases that could be prevented by vaccines (as I hadn’t included this in the original post), and I provided examples without thinking of the overall topic of the article. You are absolutely correct that pertussis is caused by a bacteria.

      I make every effort to provide accurate information, but we all make mistakes (sometimes, even embarrassing ones). I’m happy to admit mine and correct them.

      Thanks for reading.
      -Chad, a Human

  3. As a pediatrician and mom, I will be the first to say… “it’s just a virus” really also means the following:

    1. Right now, he looks really well. I’m not worried based on what I see RIGHT NOW. Now, PLEASE listen to what CAN happen so you know what I would be worried about. I repeat them all day, and every time you come in. Please pay attention and do not assume that what I am saying is, “there is nothing you can do.” Because, if the doctor can help treat it, it’s more serious. And you and I both don’t want antibiotics, anti-virals, or even ibuprofen given to your child if they don’t need it. What I AM saying is, “YOU can treat this. He needs hydration, love, and a caring provider to watch for signs of worsening illness.”

    2. Depending on the child, the virus (and a host of other factors that I cannot know), YOUR CHILD MAY GET SICKER with ear pain, shortness of breath, dehydration, or a host of other things. It could happen next week, tomorrow, or even later tonight! Yes, he may be back tomorrow with ear pain having developed overnight. I really hope he gets through this one (and every other virus he contacts in the next year) until I see him at his next physical! However, if anything worries you, I hope you will come back immediately. Don’t assume that it can’t get worse because yesterday the doctor said it was just a virus. A “superinfection” like pneumonia, ear infection, sinus infection could still happen.

    3. We hope you feel better soon. Viruses are no fun. They are gross, they interrupt everything, nobody sleeps, and you all will probably catch it. Even if you try really hard. I’m REALLY sorry about that, but it will probably all be okay. Oh, and, WASH YOUR HANDS!

    4. And finally, if we see you tomorrow, you will still be asked for another copay. This wasn’t my medical error (most likely), this was the course of his illness. You will still be asking for my medical advice based on how he looks tomorrow. Please don’t assume that I can see the future. I haven’t gotten that “telling the future” chip (or the “X-ray” chip!) installed in my brain yet.

Comments are closed.