Sunday, October 31, 2010

on being "that parent"

Perhaps this is an overly strong sense of introspection on my part, but reflecting back on our dental experiences of late, I wondered if I was being "that parent;" that is to say, the kind of parent that, as a former peds resident, I dreaded. You know...THAT PARENT. One thing that I appreciate now (that I didn't appreciate when I was a peds resident, because I didn't have kids yet) was that the many of the parents that I found difficult to deal with were simply tireless advocates for their children, parents who had been around the block enough times that they realized how fallible the medical system and the people behind it really are, and as such felt the need--or perhaps to obligation--to push and prod and question every single move. As residents, people still growing into the notion that we truly belonged in those white coats, this advocacy from parents tended to rub us the wrong way. There's nothing that exposes the naked insecurity in a young doctor more than a patient (or the parent of a patient) questioning whether or not we really knew what we were doing. Do I know what I'm doing? Of course I know what I'm doing! I went to medical school! See this nametag? Says "MD" on it right here! M fucking D! Now let me go hide in a corner and consult my Harriet Lane obsessively.

Cal's doing really well, by the way. He rested on the couch after his dental appointment, took a long nap that afternoon, and since that time has been basically back to normal, with the exception of a puffy lower lip where, I think, some instruments were positioned. His gum abscess looks much, much better, and we're just going to finish out the antibiotic course for the rest of the week (as counseled by our dentist) and then return to business as usual. I did have a slight fear that our dentist would be somehow annoyed at us ("Ugh, those parents!") for starting the antibiotics in the first place, or for overstepping our bounds in some way, but since he basically told us, "Thank god you didn't wait to start him on that Augmentin" in so many words, I'm a little less concerned at being perceived as a practitioner's worst nightmare--that is to say, overly protective parents with a key to the apothecary.

I also don't know why I'm so worried about perception when it comes to me and my level of participation in my own children's medical care. The few times that I haven't spoken up in a clinical setting with my kids in an effort to be polite and unobtrusive, I've regretted it. Is my desire to be a "good patient" at odds with my efforts to be a "good parent"? Are they necessarily mutually exclusive? Part of me feels like the answer is yes: I recognize the inherent hypocrisy but I know there's nothing that a doctor loves more than a patient that just nods and says yes and defers to your every decision. We've thankfully been very lucky in that our interfaces with the medical community have been brief and goal-oriented, and we've never disagreed with any of the medical decisions that our practitioners have made, but it certainly makes me think about where the boundaries are when you are both the medical practitioner and the parent. Anyone have any insight? Where do you draw the line? For example, I personally would never administer anesthesia to a family member or someone I was close to--I think emotion gets in the way of clear-headedness. But outside of the OR, I'm still not really sure.

Anyway this entry is starting to meander and it's a school night so I'll just close with this last: I am not above using toys to defray trauma from endured unpleasantness, and this latest visit to the dentist office was no exception.

It's Cal's first Lego set. I know a lot of kids play with Legos, and it's not like he's some kind of prodigy or anything, but I really was impressed with his ability to assemble these, because some of the pieces are very, very small, and there is a fair level of complexity to these designs. (He just followed the instructions that came with the box, not like he synthesized them from scratch, but with minimal adult assistance--I just came back in the room after an hour and there they were.) I think it's going to be a Very Lego Christmas around here.


  1. thus it begins. before you turn around, this could be your kid, too. (you described how ours started precisely)

    cal and mac are lucky boys. you're both wonderful parents. ♥

  2. Cal is talented! (And adorable.)

  3. I agree that Cal is pretty clever to assemble those all by himself.

    I hate being THAT PARENT, but the only thing worse than that would be to not say anything and have my child suffer needlessly.

  4. I agree as well that Cal is clever to assemble those. He is almost the same age (maybe four months younger?) than my cousin's son, who is also a very smart child. And while my cousin's son has a bunch of lego sets and builds them into all sorts of things, he is not patient enough or quite clever enough to follow the directions and build them correctly. Maybe another year or two...

  5. Anonymous2:19 AM

    I think doctor-parents are not the hardest to deal with. They may have lots of questions but they are also smart and can understand medical concepts (even if these are not within their fields) easily.

    The hardest parents to deal with, IMHO, are lawyers.

  6. or teacher-parents! I don't know why exactly, it's all anecdoctal, but they are.

  7. Nice work to Cal. Lego's are great toys when you can keep them up off the floor. About being THAT PARENT, if you feel an error is being made, you should speak up. You are there to advocate for your child, not to be liked. Of course be polite, but you know your child better than the doctor does. Every time I have demurred from being THAT PARENT or THAT PATIENT I have regretted it.

  8. If it's going to be a Lego Christmas - a goal I heartily applaud, as a fellow mother - I would urge you to prepare in advance. By that I mean that from reading your blog all these years, I know you have a tendency to like things...orderly. Arranged just so. It will make you crazy to see all the little parts to all those little sets tossed willy-nilly into a box, and then even crazier to be begged to come help find "this little red piece. No, not THAT one! That goes with the Rescue Helicopter. I'm looking for the Coast Guard boat piece!"

    In short, my advice is to stock up now on those plastic boxes with all the little divided compartments (they have 'em at IKEA) to keep the sets straight. Eventually, Cal won't care and will probably prefer to have everything tumbled in one box together, and if he can't find that red piece, oh well. But if he is anything like mine were when they started out with Lego at the same age, it is all about *being able to lay hands on each piece when needed*

    Glad to hear the dental situation worked out!

  9. I can't speak from a physician-parent standpoint as you ask, but I can tell you it isn't just residents that want to say "I know everything - don't question me" to a parent or a patient for that matter.

    I become so weary of being talked down to, to questions not being answered, to being threatened [yes threatened] when I want a second opinion or question a method of treatment by one of my doctors. I am educated just not in the medical field. My apologies, but MY body.

    I am glad you realize the need to question and be questioned [as a doctor]. I hope you never lose that.

    Bravo for Cal and his Legos - best toy in my opinion. Well next to an erector set my son had - but with Mack around, maybe not just yet. :)

  10. I can't speak from a medical standpoint either, however I learned the hard way with my oldest daughter - I went along with a diagnosis that I felt in my gut wasn't right. I didn't want to be "that parent" either, didn't have that many parenting miles under my belt at the time, but should never have doubted my mom instincts.

    Long story short, my 4 1/2 year old daughter logged over two weeks in the hospital with vancomycin resistant pneumonia (along with effusions). She didn't have "just a virus" and I have so regretted that I didn't stand up to that doctor that day.

    Trust me, if I had the keys to the apothecary, I'd use them...

  11. Anonymous12:45 PM

    Are we allowed to prescribe, period, to family members? I've never done it. Can you comment Michele? Did you learn that this was kosher? My understanding is that we aren't allowed to do this, even though my mom, a pediatrician, liberally prescribed to all of us well into adulthood (one reason i won't do it.) :)

  12. Anonymous6:36 PM

    I think that all of us who have expertise in a given area tend to use it for our children's benefit - and hopefully the benefit of our family and friends, too. Medical knowledge is one of the most impenetrable for outsiders and I think many of us wish that we had more to help ourselves and our loved ones.

  13. i was thinking the same just yesterday. we had a peds GI appointment for my 16 month old who still spits up into his mouth at least oh, 30 times per day.... i preempted with " first, i'm a family med resident....and i'm not here to make something pathologic that's not...." i'm sure the fellow was thinking "OH GOD, one of THOSE parents!" ha ha.

  14. Isabelle8:31 PM

    Ohhh, been there. I'm an epidemiologist, every decision I make has to be evidence-based...and I was THAT OB patient when I was pregnant with my second child. When they suggested Betamethazone at 20 weeks (somewhat dilated and effaced) I had to argue that since (a) was a one-shot type of thing ; (b) that is very short lasting and (c) that I had no other symptoms of labor (other than having a thin cervix) that I would rather wait being in "real" labor. It was frowned upon and agreed that I would hurry back to get it if needed. I delivered at 38 weeks... But I did feel like THAT patient. Haha again.

  15. Nikki3:16 PM

    I have a friend who was "that patient". She was getting a PhD in physiology/pharmacology at the time she went to the doc for migranes. He wanted to percribe med X - she denied based on the blood pressure side effects (contraindicated for her normal blood pressure). When he suggested med Y - there was some other issue she had. I'm not sure how many meds they went through, but he finally asked her what it was she wanted. It might have been exasperating for the MD, but it's not like she got her information from or something.

  16. Anonymous8:22 PM

    Just de-lurking to say that my 6 year old son recently had two root canals (what!? I'm 39 and have never had a root canal!) and we spent a bunch at the Lego store not only to defray unpleasantness but also to guarantee return to the dentist to complete the work over several visits. Yay for Legos!

  17. Totally identify with this post. When I was in training for psych it was "those" parents who drove us nuts--the ones who called, pestered, or generally questioned our judgment. Now that I'm a parent, I have divided loyalties in that I'm torn between identifying with the doc and also feeling the need to advocate for my kids. If I don't ask questions or assert myself on behalf of my kids, I'm clearly doing them a disservice. It helps to have a husband who has no fear and feels totally entitled to ask whatever he wants. But really that's not a long-term answer--I have to step up to the plate, too.

  18. Anonymous8:51 PM

    I've always felt that if you are in a situation where you are sick enough to need hospitalization or emergency / specialized care, you should have someone alongside advocating for you - family, spouse, trusted friend, etc. Sometimes we as ADULTS, when sick, need that extra voice asking our health care professional if they've considered this,' or, 'did you know that ?' about the patient.

    How much more so does a child who cannot vocalize for himself need such an advocate? And who is more qualified to do so than his or her parent - no matter what the parent's profession??

  19. Anonymous2:02 PM

    This has so been my life this week. My daughter got brushed off by and ED doc after closed head injury followed by a seizure. Hint: never trust any medical professional who uses "finger quotes".

  20. Now we must take great care with doctors and anyone exercising without even having a previous study, and prescribed painkillers everywhere, so it is advisable to be trusted doctors or hospitals trust where health care is the priority.

  21. Anonymous12:49 AM

    As a pediatrician, I've come to have much more empathy towards THOSE PARENTS since I've become a mom myself. There are still days when I roll my eyes when I see THOSE PARENTS show up on my list for the day - not so much those parents that advocate for their children or question a diagnosis or treatment (as I feel that that is both their job and my own), but usually those who refuse to immunize, to give their kids dairy, vitamin D, etc.

    I find that I do lose objectivity when it comes to my own child, so when they are sick with anything more than a cold, I do get a second opinion from a "real pediatrician."

    P.S. i think we are allowed to prescribe to family and friends therapy that is within our area of expertise. Not ideal, but I think allowable in a pinch. Some of my colleagues have been very reluctant to phone in a prescription for my child without seeing them first, but others have no issues.