David Neighbors, M.D., appeals from the trial court's final order entered on March28, 2000, denying his motion for a new trial. We affirm.

Colin Koehler was born on April 2, 1992. After Colin's birth, the doctors in theoffice of David Neighbors, M.D., were designated as his pediatricians, and so Dr. Neighborsand his partner provided Colin's medical care from his birth.

On May 16, 1992, Dr. Neighbors examined Colin in the emergency room at St.Joseph's Hospital in Breese, Illinois. Six-week-old Colin presented to the emergency roomwith a 102-degree fever. Following the physical exam, Dr. Neighbors ordered blood tests,X rays, and a lumbar puncture to assist in diagnosing the cause of Colin's fever. Based uponthe examination and the test results, Colin was diagnosed with viral pneumonia andquestionable cardiomegaly.

On Friday, June 5, 1992, when Colin was nine weeks old, he developed anotherfever. In the morning, the fever was low. Colin's father, Mike, stayed home with him whilehis mother, Jane, went to work. Later that morning, Mike determined that the fever wasmuch worse. He called Jane at work to tell her that Colin's fever was over 104 degrees. Jane called Dr. Neighbors' office, but she learned that Dr. Neighbors' office was closed onFridays. She then contacted St. Joseph's Hospital, and a representative provided her withthe necessary information to reach Dr. Neighbors at home.

Ultimately, Jane was able to talk to Dr. Neighbors later in that afternoon. Sheinformed him that at that time Colin had a 104-degree temperature. She asked for guidance.Dr. Neighbors asked some questions, and Jane answered them, advising Dr. Neighbors thatshe and Mike had not observed any other abnormal symptoms. Dr. Neighbors prescribedinfant Tylenol and asked Jane to contact him immediately if she should notice any abnormalsymptoms. Otherwise, Dr. Neighbors wanted to see Colin in his office on Monday morningif the fever persisted through the weekend.

Over the next 48 hours, Mike and Jane followed the instructions given and madeefforts to lower Colin's body temperature. Neither parent slept much because of theseongoing attempts. Despite their efforts, Colin's temperature never fell below 102 degrees. At 4 a.m. Sunday morning, Colin began grunting. At one point early Sunday morning, Janethought that Colin's head looked somewhat enlarged, but when she and Mike looked closerunder the light, they decided that she had been mistaken. During this same time frame, Janenoticed that on one occasion Colin's left arm stiffened. For most of Sunday, Colin'sbehavior was not terribly unusual, although he did sleep more and eat a little less than usual.

At 4 p.m., Colin began staring blankly and his breathing quickened. At that time, hisparents took him to the emergency room at St. Joseph's Hospital. He was admitted to thehospital at approximately 4:45 p.m. The emergency room physician notified Dr. Neighborsof Colin's admission. After dropping his son off at their home, Dr. Neighbors made the 15-minute drive to the hospital, and he immediately went to examine Colin. The physicalexamination revealed an abnormal blood pressure, a temperature of 105 degrees, a distendedabdomen, and a bulging anterior fontanel. Dr. Neighbors later testified that after seeingColin on that date, he believed that Colin could have meningitis. He noted the abnormalbreathing pattern and the grunting, and he testified that Colin's condition implied that he wasexperiencing seizures. Additionally, Colin was nonresponsive to verbal stimuli, and hethought that perhaps Colin's neck was stiff. In his professional opinion, if Colin did notreceive immediate care, Colin would not be expected to live. Dr. Neighbors performed aspinal tap, noting that the spinal fluid was cloudy, another meningitis indicator. Colin wasstarted on intravenous antibiotics to fight the infection and steroids to help prevent anycentral nervous system damage. After the diagnosis of bacterial meningitis was made, Dr.Neighbors arranged for Colin's airlift transport to Cardinal Glennon Hospital in St. Louis,Missouri, as Colin was far too ill to be cared for at St. Joseph's Hospital.

Colin remained at Cardinal Glennon Hospital until June 23, 1992. He was dischargedwith seizure disorder, hearing loss, cerebral palsy, and mental retardation. For months aftercoming home, Colin experienced pain and would not allow anyone other than his motherand sister to touch him. Since that time he has undergone several surgical procedures. Colinis severely limited in his mobility and communicative skills. Colin's conditions arepermanent and have required constant care and education.

At the trial, two pediatric experts testified on behalf of Colin and his parents. Theyboth agreed that if an infant is less than three months of age with a history of previous illnessand presented with a 104-degree temperature with no other symptoms, then a doctor shouldexamine the infant and order diagnostic testing to determine the fever's source. If thediagnostic tests showed no obvious cause of the fever, then antibiotics should not necessarilybe prescribed. These physicians provided opinions that Colin had occult bacteremia in hisbloodstream on Friday when Jane initially contacted Dr. Neighbors. The occult bacteremialater progressed to bacterial meningitis. One of these physicians specifically testified thatif Dr. Neighbors had ordered diagnostic tests on Friday, the results would have revealedabnormalities indicating the necessity of antibiotics. Both physicians testified that if Dr.Neighbors had examined Colin and started him on antibiotics on Friday, Colin would nothave developed bacterial meningitis and suffered its consequences.

Expert physicians also testified on Dr. Neighbors' behalf. One of these expertstestified that he believed that Colin was already suffering from insidious onset meningitisand that, therefore, a prescription of antibiotics on Friday would not have helped. Both ofthese experts also testified that an automatic physical examination and diagnostic testing inan infant presenting with a 104-degree temperature would only occur in infants less than twomonths of age. In other words, since Colin was nine weeks old, and thus older than twomonths of age, his temperature alone did not necessitate an examination and testing. Bothphysicians testified that Dr. Neighbors did not deviate from the appropriate standard ofmedical care.

From the testimony of all of the physicians, it became clear that there is a split ofauthority on when an infant with an elevated temperature must undergo a thorough physicalexamination and diagnostic testing. Dr. Neighbors and his experts cited authority for theirposition that such treatment is not required when an infant is more than two months of age. The physicians who testified on Colin's behalf provided authority for their positions thatsuch treatment is required until an infant reaches three months of age.

Colin and his family also presented expert testimony to the jury on the issue ofdamages. One expert presented an extensive life-care plan for Colin. This life-care planonly extended to the age of 45 and began at the age of 21, and depending upon whetherColin lived in a nursing care facility or in a home, the cost ranged from $1.7 million to $2.1million. Another expert testified as to the present cash value of Colin's care and his earningpotential. The present cash value of Colin's earning potential if he completed high schoolwas $864,061, and if he completed college, it was $1,161,402.

The parents testified to Colin's ordeal, including his pain and suffering upon hisdischarge from the hospital and his ongoing care and education.

We do not know the precise amount of the medical bills incurred by Colin's parents,as the parties do not list the amounts in their briefs and no trial exhibits were included in therecord on appeal.

At the close of all the evidence and arguments, the jury was instructed on the law. At one point the jury sent out a note indicating that the members were confused about theissue of proximate causation and particularly about two instructions they were given. Thetrial court proposed to simply reread those instructions to the jury with more emphasis. Defense counsel objected to any rereading of the instruction, stating that the jurors shouldsimply be told that they had their instructions on the law. The trial judge acknowledged thatthe jury should be assisted in cases where the members had questions regarding the law. However, the trial judge felt strongly that rereading the instruction was simply all that wasrequired. Counsel for Dr. Neighbors also wanted one of the instructions altered to removea potentially confusing optional portion. Counsel for Colin and his parents did not agree tothis modification. The jury was brought back into the courtroom, and the trial judge rereadthe instruction at issue with additional inflection. After the jurors returned to theirdeliberations, counsel for Dr. Neighbors sought to make a record on the issue. He tendereda version of the instruction without the optional portion. The trial judge noted that theversion of the instruction given to the jury had not been objected to at the originalinstruction conference. After much discussion, defense counsel withdrew his proposedinstruction.

Ultimately, the jury returned with a verdict against Dr. Neighbors in the total amountof $1,858,000. The jury awarded no damages for Colin's resulting disability, his past painand suffering, his future pain and suffering, his past medical and medically related expenses,his past assistance expenses, or the present cash value of future assistance expenses. Thejury awarded Colin $1,393,500 for the present cash value of future medical and medicallyrelated expenses and $464,500 for the present cash value of future earnings lost after Colinreaches the age of 18.

Dr. Neighbors filed a posttrial motion, which the trial court denied on March 28,2000.

Dr. Neighbors initially argues that the trial court erred in failing to direct a verdict inhis favor at the close of Colin's case and at the close of all the evidence.

The standard of review we must follow on this issue is whether all the evidence,when viewed in the light most favorable to the opponent, so overwhelmingly favored themovant that no contrary verdict could possibly stand. Pedrick v. Peoria & Eastern R.R. Co.,37 Ill. 2d 494, 510, 229 N.E.2d 504, 513-14 (1967).

Dr. Neighbors argues that Colin failed to establish that his injuries and damages wereproximately caused by Dr. Neighbors' neglect. He correctly argues that Colin and his familybear the burden of proof in a medical malpractice case and must affirmatively prove that Dr.Neighbors was negligent and that his conduct fell below the established standard of care. See Boey v. Quaas, 139 Ill. App. 3d 1066, 1071, 487 N.E.2d 1222, 1224-25 (1986). Theymust further prove that such negligence caused Colin's injuries. See Boey, 139 Ill. App. 3dat 1071, 487 N.E.2d at 1224-25. He specifically argues that Colin's experts testified thatColin did not have bacterial meningitis until Sunday and therefore implicitly that there wasnothing for Dr. Neighbors to diagnose on Friday. This argument ignores other portions ofthe testimony of the experts where they opined that Colin had occult bacteremia in hisbloodstream on Friday and that had Dr. Neighbors followed the standard of care for infantsless than three months of age, he should have physically examined and tested Colin onFriday. One of these experts further indicated that he believed that some of the diagnostictests would have yielded abnormal results and that antibiotics should have been given onFriday. Both of Colin's experts testified that Dr. Neighbors deviated from the applicablestandard of care.

Accordingly, we do not find that the evidence so overwhelmingly favored Dr.Neighbors such that a contrary verdict could never stand. The trial court's rulings againstDr. Neighbors' motions for directed verdict were appropriate.

Dr. Neighbors next argues that the trial court should have granted his posttrial motionfor a judgment notwithstanding the verdict.

A judgment notwithstanding the verdict should not be granted unless the evidence,when viewed in the light most favorable to the opponent, so overwhelmingly favored themovant that no contrary verdict could possibly stand. Pedrick, 37 Ill. 2d at 510, 229N.E.2d at 513-14. A judgment notwithstanding the verdict is inappropriate in situationswhere " 'reasonable minds might differ as to inferences or conclusions to be drawn from thefacts presented.' " McClure v. Owens Corning Fiberglas Corp., 188 Ill. 2d 102, 132, 720N.E.2d 242, 257 (1999) (quoting Pasquale v. Speed Products Engineering, 166 Ill. 2d 337,351, 654 N.E.2d 1365, 1374 (1995)). The trial court should not reweigh the evidence andset aside a verdict just because the jury could have drawn different conclusions or inferencesfrom the evidence or because the court feels that another result would have been far morereasonable. McClure, 188 Ill. 2d at 132, 720 N.E.2d at 257 (quoting Maple v. Gustafson,151 Ill. 2d 445, 452, 603 N.E.2d 508, 512 (1992)). Similarly, the appellate court should notusurp the jury's role on questions of fact that were fairly submitted, tried, and determinedfrom the evidence which did not overwhelmingly favor either position. McClure, 188 Ill.2d at 132, 720 N.E.2d at 257 (quoting Maple, 151 Ill. 2d at 452-53, 603 N.E.2d at 512). Onreview, we apply a de novo standard to determinations on motions for judgmentsnotwithstanding the verdict. McClure, 188 Ill. 2d at 132, 720 N.E.2d at 257.

Without detailing all of the evidence that the jury heard and that is detailed in thefacts portion of this order, we simply cannot find that the evidence overwhelmingly favorsDr. Neighbors. The jury was presented with two very different opinions about the standardof care relative to a nine-week-old infant. It heard consistent testimony that Colin did nothave bacterial meningitis on Friday when his mother had the phone conversation with Dr.Neighbors. However, it heard different testimony about whether there was a form ofbacteria within Colin's bloodstream on that Friday and whether diagnostic testing wouldhave revealed an abnormality necessitating treatment. As we are not in a position to reweighthe evidence, we cannot usurp the jury's decision based upon that evidence. Accordingly,the trial court's order denying Dr. Neighbors' motion for a judgment notwithstanding theverdict was proper.

Dr. Neighbors next argues that the trial court erroneously denied his motion for a newtrial.

The trial court's ruling on a motion for a new trial should not be reversed on appealunless the party who is seeking the new trial can affirmatively show that the court clearlyabused its discretion. Maple, 151 Ill. 2d at 455, 603 N.E.2d at 513. In determining whetherthe trial court abused its discretion, we must consider whether the jury's verdict wassupported by the evidence and whether the complaining party was denied a fair trial. Maple,151 Ill. 2d at 455, 603 N.E.2d at 513.

Dr. Neighbors contends that the verdict is contrary to the law and evidence, pointingto several trial court errors.

The first error to which Dr. Neighbors draws our attention involves the jury'sconfusion over the proximate-causation instructions and the trial court's refusal to providean additional instruction on the issue. Initially, we note that defense counsel did not objectto the wording of either proximate-causation instruction. While the trial court and attorneysstruggled with the issue, they focused on one of the two instructions. The instruction atissue defined proximate cause as "any cause which, in natural or probable sequence,produced the injury complained of." Illinois Pattern Jury Instructions, Civil, No. 15.01 (3ded. 1995) (hereinafter IPI Civil 3d). This instruction also contained the following optionalsentences from the pattern instruction: "[The cause] need not be the only cause, nor the lastor nearest cause. It is sufficient if it concurs with some other cause acting at the same time,which in combination with it, causes the injury." IPI Civil 3d No. 15.01.

The trial judge proposed to counsel that he simply bring the jury back in and rereadthe instruction with inflection. The attorney for Colin and his parents indicated that he hadno objection. Counsel for Dr. Neighbors initially said that his only problem with the trial judge's proposal was how the court would handle additional questions from the jury on theissue. Then he objected to the proposed rereading on the basis that the jury had already beengiven the instruction once. The judge replied that case law required him to affirmativelyrespond to the jury's questions on matters of law. People v. Childs, 159 Ill. 2d 217, 228-29,636 N.E.2d 534, 539 (1994). Provided with no other option, the trial judge determined that the objection would be overruled and that he would reread the instruction to the jury. Afterthis ruling, Dr. Neighbors' attorney proposed removing the optional portion of theinstruction. He argued that this optional language should only be used in cases where thedefense properly raises the defense of contributory negligence. He explained that Dr.Neighbors never pled or otherwise raised the issue of contributory negligence.

The trial judge called the jury back in, explained that proximate causation is adifficult concept, and reread the instruction with inflection. The jury retired for continueddeliberations.

After the jury went back to continue its deliberations, Dr. Neighbors' attorney soughtto make an additional record on the issue of the one instruction. He offered a version of theinstruction excluding the optional section. The trial court noted that the record revealed thatdefense counsel had not objected to the instruction with the optional section when itoriginally was proposed. The trial judge and counsel for Colin and his parents took note thatdefense counsel conducted his cross-examination of witnesses in a manner which broughtout the issue of the parents' potential contributory negligence in failing to bring Colin intothe emergency room 12 hours earlier when his health clearly began to deteriorate. Defensecounsel then explained that he argued in his closing argument that Dr. Neighbors was in noway seeking to blame the parents for what happened. Counsel for Colin and his parentsnoted that closing arguments could never be construed as evidence and that the jury hadbeen instructed that the arguments were not evidence. He then proposed that Dr. Neighborsexecute an admission on the subject that could be read to the jury. The trial judge agreedwith this idea and began drafting such an admission. Faced with the prospect of anadmission, counsel for Dr. Neighbors formally withdrew his proposed instruction onproximate causation without the optional section.

To the extent that the instruction with the optional language was given to the jurywithout objection, Dr. Neighbors waived any subsequent complaints about the inclusion ofthe optional language. While Dr. Neighbors, through his attorney, objected to the trialcourt's rereading of the instruction, the objection was either on the basis that no instructionshould be reread or on the basis that the optional language should be removed. Allowingthe jury to stand on the original instructions when faced with a direct question on a legalmatter is clearly contrary to the law of the State of Illinois. Childs, 159 Ill. 2d at 228-29, 636N.E.2d at 539. Similarly, removing a portion of the instructions that have already beengiven to the jury is not appropriate. Factually, defense counsel withdrew the proposedinstruction without the optional portion, and so that issue is really not the object of Dr.Neighbors' complaints on appeal.

On appeal, Dr. Neighbors contends that in light of the obvious confusion, the judgeshould have offered additional instruction to the jury on the issue of proximate causation. See Childs, 159 Ill. 2d at 228-29, 636 N.E.2d at 539. It is incumbent upon the parties tomake a proper record. The issue of proper instruction still remains up to the parties, to theextent that the parties make recommendations to the trial court. If the parties disagree withthe trial court's proposed method of dealing with a jury question, then the objecting partyneeds to make the appropriate suggestion. The situation is really no different from when aparty complains on an appeal that the trial court should have given an instruction to the juryand that instruction was never proposed by the complaining party. No relief is warrantedin that situation. See Deal v. Byford, 127 Ill. 2d 192, 202-03, 537 N.E.2d 267, 271 (1989).

Generally speaking, when a jury sends out a question to the trial judge relative to amatter of law, more is required than simply rereading the instruction with inflection. Childs,159 Ill. 2d at 228-29, 636 N.E.2d at 539. Many times a jury's concerns or confusions canvery simply be addressed. The problem with the instruction and the legal concept at issueis that "proximate causation" is a legal concept with which attorneys and judges continue tostruggle. There is no simple definition. The instructions are designed to explain the conceptas easily as possible. It would be extremely difficult for a trial court to further defineproximate causation beyond the standard instructions.

In this case, after the trial judge reread the proximate-cause instructions withinflection, the jury continued its deliberations. The jury posed no further questions and wasable to continue deliberations to a verdict. Accordingly, we find no basis to conclude thatthe trial court's rereading of the proximate-cause instructions with inflection and withoutfurther explanation necessitates a new trial under the circumstances of this particular case.

Dr. Neighbors also argues that the trial court erroneously overruled his attorney'sobjection to a question to one of Colin's experts regarding the existence of occult bacteremia and its causal connection to Colin's fever. He argues that the question lacked foundationbecause, by its very definition, occult bacteremia is hidden and thus impossible to diagnose. The standard for a physician's testimony on such an issue is whether or not the opinion isbased upon a reasonable degree of medical certainty. This expert expressed his opinionpursuant to that standard, and therefore the question and response were proper. Furthermore, the decision to allow an expert to testify to an opinion is within the trial court'ssound discretion. Soto v. Gaytan, 313 Ill. App. 3d 137, 145, 728 N.E.2d 1126, 1132 (2000). We find no basis to conclude that the trial court abused its discretion in overruling defensecounsel's objection.

Dr. Neighbors next argues that the trial court erred in giving one of Colin's proposedinstructions related to circumstantial evidence. The instruction was given over defensecounsel's objections. This instruction stated: "A fact may be proved by circumstantialevidence. Circumstantial evidence consists of proof of facts or circumstances which giverise to a reasonable inference of truth of the facts sought to be proved." See IPI Civil 3d No.1.03. Dr. Neighbors' attorneys objected on the basis that since this is a medical malpracticecase, the elements of the offense cannot be proven by circumstantial evidence. Colin'sattorneys countered that the instruction was warranted because there was evidence fromwhich the jury could infer that Colin was bacteremic on Friday. The trial court agreed withthis argument and allowed the instruction. The determination of proper jury instruction lieswithin the trial court's sound discretion. Rowe v. State Bank, 247 Ill. App. 3d 686, 690, 617N.E.2d 520, 523-24 (1993). We will not reverse a judgment on the basis of improper juryinstruction unless we have reason to conclude that the instruction clearly misled the jury.Phelps v. Chicago Transit Authority, 224 Ill. App. 3d 229, 234, 586 N.E.2d 352, 355 (1991).Based upon this standard, we cannot find that the trial court abused its discretion in givingthe instruction, and there is simply no evidence that the jury was misled by thecircumstantial-evidence instruction. Even if this one instruction was improperly given, thisinstruction alone could not justify a new trial.

Additionally, Dr. Neighbors argues that the trial court improperly overruled hiscounsel's objections to Colin's negligence instruction that contained the allegation that Dr.Neighbors negligently and carelessly failed to order tests which would have led to thediagnosis of bacteremia. Defense counsel argued that Colin would have wound up withbacterial meningitis even if antibiotics had been administered on Friday. The trial courtdetermined that there was sufficient evidence about the particular negligence allegation andthat therefore the issue should be allowed to go to the jury for consideration. The trialcourt's reasoning is sound and does not constitute an abuse of discretion.

Dr. Neighbors finally argues that the jury's verdict was inappropriately high and thatthe trial court should have entered a remittitur.

The amount of money a jury awards "is peculiarly an issue of fact for the jury todetermine." Lee v. Chicago Transit Authority, 152 Ill. 2d 432, 470, 605 N.E.2d 493, 509(1992). A jury award will not be subject to a remittitur unless the award is excessive, fallingoutside the range of possible conclusions reasonably supported by the facts. Lee, 152 Ill.2d at 470, 605 N.E.2d at 509-10; Best v. Taylor Machine Works, 179 Ill. 2d 367, 412, 689N.E.2d 1057, 1079 (1997). An award would be found excessive if it appears to be the resultof passion or prejudice or is so large that it shocks the judicial conscience. Best, 179 Ill. 2dat 411-12, 689 N.E.2d at 1079. The use of a remittitur needs to be monitored on anindividual case basis, and the circumstances supporting the jury's verdict must be carefullyconsidered before a jury's verdict is reduced. Best, 179 Ill. 2d at 413, 689 N.E.2d at 1080. When the jury has received proper instruction and otherwise has a reasonable basis for itsaward, a reviewing court will not disturb the verdict. Lee, 152 Ill. 2d at 470, 605 N.E.2d at510. While there is no precise mathematical formula for determining whether a jury awardis fair and reasonable, the following factors should be considered: the extent of the injuriessuffered and the degree of the permanency of those injuries, the plaintiff's age, the possibilityof future difficulties, the amount of medical expenses involved, and the restrictions upon theplaintiff's life as a result of the injuries suffered. Epping v. Commonwealth Edison Co., 315Ill. App. 3d 1069, 1072, 734 N.E.2d 916, 918 (2000) (citing Richardson v. Chapman, 175Ill. 2d 98, 114, 676 N.E.2d 621, 629 (1997)). We will not compare Colin's verdict to othersimilar medical malpractice verdicts. See Richardson, 175 Ill. 2d at 114, 676 N.E.2d at 629.

The amounts awarded by the jury fall short of the amounts discussed in the experttestimony given on the issue of damages. Additionally, the jury determined that damageswere not warranted for several aspects of Colin's case. This was the jury's prerogative. Given the extent of Colin's injuries, the permanency of those injuries, his future projecteddifficulties, and the restrictions upon his life, we believe that the jury's award was quite fairand reasonable. Accordingly, we have no basis to conclude that the award is excessive andshould be reduced.

For the foregoing reasons, the judgment of the circuit court of Clinton County ishereby affirmed.

Affirmed.

CHAPMAN, P.J., and MAAG, J., concur.