May 27, 2023
by Dr. Plastic Picker
A mother I know well came in this week and it has been a while since I had seen her. She’s really sick right now and has around a year left to live from a cancer diagnosis, and I have been the children’s pediatrician for well over a decade. It’s one of those relationships where I know them well, and my nurse knows them well – just because we’ve seen them since birth. The children are in with therapy and the supports and resources have all been deployed.
What does one say as a pediatrician to a parent? How should a pediatrician react?
There is no answer because each relationships is different, each family is different, each parent and each pediatrician is different. For me, it is about responsibility. I have been lucky to be there for all those moments in clinic. The first visit when the parents come in so nervous and exhausted, meeting their pediatrician for the first time. We teach them how to swaddle the baby, or reassure them about the pooping frequency. We ask them, are you doing okay? Being in the clinic rooms, I often feel like being on a sitcom (I often laugh in clinic with my patient’s families) or sometimes it’s more of a series of commercials. But those moments are so powerful, the first weight check, the bilirubin visits, the anxiety about the high fevers, the first viral rash, and first broken bone. The main characters are of course the little adorable toddlers, and it’s true for me – my little patients even when they are big and grown, are perpetually toddlers in my mind. They are the adorable 15 month olds that are so mischievous that you forgive them their tantrums and their scowls when you try to examine them. It’s hard to be mad at little beings that have such huge eyes. Toddlers are really the manifestations of anime proportions, round face and big eyes and perfect skin.
After being there for a lifetime of those sitcom episodes or the short commercial visits for very focused moments, you get to the point in your career after practicing for 20 years when one of the parents have died. And that for me, is something I’ve been mulling over the last year and had been thinking about and reflecting on. It’s hard for those families of course, and as a pediatrician – the more connected one is the harder it is for us. I’m a connected pediatrician to my families and my community, and I hope it’s true for most – I know my families and I care for them. And because of this, when Stephanie was diagnosed with cancer, when Nicole died in a tragic car accident on Christmas break, when Jonathan was murdered when he went back home to Detroit likely because he was a young black man – it forever affected the lives of their children and the pediatrician who remains.
I needed to write out their names to make sure I remember them, and to my families I do. I remember the arguments I had with Johnathan about Malcolm X and race issues, and found it amusing that he trusted a small Vietnamese-American pediatrician about vaccines – despite his mistrust of the world in general. I remember Nicole all the times you drove down from East County to see me, trusted your boys with me and we talked about just random things – but always really liking each other for some reason. And I remember Stephanie each visit you had with your two little ones, how blond they were and the interplay within your family and felt sad when your family separated and now after we talked – I know a bit better why since your life was more complicated as a child then I ever realized the first years I knew you. I needed to write this down because I remember. I was there with you, and you were there for me as well.
It’s powerful mindfulness and being present. Yesterday I had what was probably just a ho-hum clinic day, where I worked the late staggered shift. But there were the two cephalohematomas that I’m still worried about, attached to two set of parents. There was the stress of finishing three triplet wic forms and doing the third version of them because I dared to spell Similac incorrectly , and me wondering if the WIC office really had so little to do to perseverate over my spelling, but attached was a loving uncle that always wears a certain kind of shirt and sweater , and so lovingly holds one of the triplets when his younger sister who is the mother comes in.
I’m still here. And what I said to the mother that came in this week who is dying of cancer was simple. I’m so sorry that you and the kids and your family are going through this. Can I let my old nurse who knows your family too know? So that he can pray for you, because he goes to church? He transferred to Bonita about a year ago. Do you need more supports? I am so glad the kids are in therapy, and we have more social workers now. Do you feel comfortable reaching out to me if you need help? And of course I’ll fill out that camp form that you need and this is when I review things for the kids through puberty. Maybe we should talk about sex sooner than later, especially so you don’t worry about them not having had the talk before you go. And, I will be here for them Stephanie. I’ll be their pediatrician until they turn 18, and please let me know if you need anything. And what I didn’t say was “I really want to give you a hug but our relationship is different. So I didn’t hug you, but I hugged the kids after you left the room, because it really sucks when your mother has cancer.”