A headache at the end of the day

This essay presents a family medicine office visit with a child and both parents; details have been modified to protect patient and physician confidentiality. A child's headache, which has gone away before the start of the office visit, provides a window into the relationship between the parents and into the sources of their worries about their child's health. The essay highlights the multiple medical and behavioral concerns that the physician must keep in mind during relatively brief office encounters, and the intellectual challenge of maintaining appropriate attention to all these threads, and understanding their interactions, while completing the visit in a timely fashion.