Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Sips And Gulps


Patients may need a clinician’s help with things that seem easy or obvious, like how to swallow pills.

I was trying to swallow my pills for the umpteenth time. My daughter handed me a glass of water. I took a couple sips and started coughing. No luck. Again. 


The next morning, my granddaughter, Rebecca, knocked on my door. She came in and grabbed the basket of magazines and began to browse, her regular routine. “Nana, Mommy’s going to practice taking pills with you this morning using M&Ms. She says you must be doing something wrong that causes all the choking. I’m going to help, too.” 


I put another dab of blush on my cheeks and combed my hair into a better position. “I know your mother thinks that. I’ll try, especially since you’ll help, but it seems pointless.” 


At breakfast, my daughter said, “I thought if Rebecca and I watched you, maybe we could see a problem and help. These M&Ms will be perfect to practice with.” 


“I’ll try, but I don’t think it will be much good. The doctor doesn’t seem to have answers either.” I put two candies in my mouth and took a sip of water. Immediately, I began to cough, and choked a couple times. No luck.  


“Let me try putting the candies on top of your tongue, Nana,” my granddaughter said.  


“I never put them on top of my tongue. How peculiar. I put pills under my tongue and then flip them to the top,” I said. 


“What?  Under your tongue? Let’s try again and put them on top of your tongue about halfway back. And take a big gulp of water, not a sip.” 


I took a gulp. “They went down! I did it! Why didn’t anyone ever tell me to put them on top of my tongue? And gulps! I only ever took sips of water. When I was little, someone told me it wasn’t lady-like to gulp.”  


My granddaughter hugged me. I thanked her for suggestion to gulp instead of sip. 







This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.