Sir.—The following dialogue occurred in a pediatrician's office:
Pediatrician (after physical examination of child): "I heard a little heart murmur that I am pretty sure is innocent, but just to be sure I am going to make an appointment for Johnny to be seen by a pediatric cardiologist."
Mother: "Is it something to worry about?"
Pediatrician: "No, there is probably nothing wrong, but just to be on the safe side..."
Mother (thinking to herself): "He must have heard something bad if he is sending Johnny to a heart specialist. I wonder what could be wrong with his heart?"
Dr McNamara's editorial1 in the November issue of AJDC raised for me the question of how much needless parental worry, and even significant harm to children because of parental overprotectiveness, results when the specter of heart disease arises from these innocent referrals by primary care pediatricians. The term heart murmur