Approach to cough

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The waiting room was full.
Some patients were scrolling on their phones, others tapping on tablets, a few reading.

Then, suddenly — one patient coughed.
Just once. A dry cough.

The silence that followed was insane. Then the discussion began.

Doctor A: “That cough sounds deep. You should sit down, elevate your feet, and you will need a chest X-ray, CT scan and PET scan, immediately. I had a cough like that once — turned into a nine-month investigation. No one ever found the cause, but I still feel it sometimes. For example, right now.”

Doctor B: “You need to go to the ER right now. Dry cough, possible shortness of breath — classic start of a PE, anaphylactic shock, or even cancer. I read a paper last night about a disseminated TB that started with this exact cough. Honestly, you should call your parents.”

Doctor C: “Can we just relax? Maybe it’s dust, or a mild allergy, or stress. You look stressed. Are you stressed? No problem, take the day off.
Wait — no, if you take the day, you’ll have to reschedule, and then I’ll have to reschedule, and that’ll mess up my whole week, and I need money because I don’t want to lose my house. Great. Now I’m stressed.”

Doctor D: “First, sanitize your hands. Then your chair. Then your airspace. Actually, here — I have wipes. And if you cough again, use your arm to cover your face for eight seconds, otherwise it’ll feel wrong.”

Doctor E: “Hearing you cough made my throat tighten. I can’t breathe. My voice—wait—my voice is gone. Great.”

Doctor F: “Ignore them. It’s not your lungs. It’s the microchip they implanted when you got your flu shot in 2020. Try covering your neck with oil — it blocks the signals.”

The psychiatrist sighed and used the intercom:

“Next patient, please.”


AI image generated (thank you chatGPT)

👦 Natasha Ruth Saunders, Anne Kawamura, Olivia MacLeod, Alexandra Nieuwesteeg, Claire De Souza, Somatic symptom and related disorders: Guidance on assessment and management for paediatric health care providers, Paediatrics & Child Health, Volume 30, Issue 4, July 2025, Pages 331–337,




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