19 month girl with 1 day history of cough

Today took its toll on me. My 1st patient was a 2 month old whose mom attributed his fussiness to an ear infection when in fact his symptoms were due to withdrawal from his prenatal exposure to methadone. She had recently stopped administering his phenobarbitol.
And the last patient broke my heart. The appointment was booked as "19 month girl with 1 day history of cough". But when I got to the exam room I found a little girl still dressed in her winter coat, face streaked with snot and tears, clinging desperately to her 7 year old brother and crying for mommy. The kids were accompanied by a DCF social worker (Dept of Children and Families) who had taken custody of the kids just hours earlier. He had to be certain that the girl was healthy enough to be delivered to a foster home tonight.
Obtaining a history of the illness was fruitless. The social worker had known her for little longer than I had so I relied on her 7 year old brother to help explain how long his sister had been sick, her symptoms, whether she had been eating, drinking, peeing, pooping and what medicine she had been treated with. He conducted himself with maturity and stoicism while his baby sister buried her head in his chest and sobbed.
The girl was so disconsolate that the physical exam was difficult, bordering on impossible. But my limited findings made me reasonably confident that she was sick with nothing more serious than a cold, and my preceptor agreed. I was relieved that I wouldn't have to traumatize her further with more invasive examination.
Unfortunately, more trauma was unavoidable: she and her brother were being sent to separate foster homes.