Thursday 31 October 2013

How to drive away patients


Today was Ryder’s 2-year well-baby checkup. Anyone who has spent time with us recently might understand why I almost considered canceling: we’ve got a lot going on these days, time and money are precious, and I consider Ryder to be a very healthy and happy little kid. Why waste energy being told what I already know? But I also have a little judgemental cartoon character in my head that scolds me if I consider doing things of which a “good mother” wouldn’t approve.

The visit started out fine: Ryder was a great sport about getting measured and weighed, and waved and smiled to all of the nurses as we walked to our exam room. We had fun identifying colors and objects around the room as we waited for the doctor. Then, the doctor arrived and spoiled everything.

It began when we looked at Ryder’s 3 growth-chart datapoints (most of his measurements were done in Australia, so his US chart is a bit sparse). These showed a seemingly precipitous drop in his size-for-age, sometime in the past year.

“My, my,” said the doctor. “Worrying indeed.” He proceeded to list off some terrifying ailments Ryder could have to explain this trajectory. Then we discussed his eating habits, including the fact that he was an overly-avid breast-feeder until almost 18 months, and would sometimes refuse to eat at daycare, waiting to fill up on milk. “The Australians definitely let you down, if they saw this drop-off in percentile and didn’t warn you to make changes. But then again, Australians are cavalier croc-wrestlers who don’t go to the doctor unless they are missing a limb.”

“Clearly, though, this shows that Ryder has some severe behavioral problems,” said Mister Doctor. “At that age he didn’t need your breastmilk, he just wanted comfort. This indicates he is much too attached to you, and he also manipulates you,” he said, casting a disapproving eye at Ryder, who was at the moment cuddling on my lap.  

Look at this naughty child, whom I've entrusted with a ceramic cup in a tile-floored coffee shop. Clearly a hooligan.

First, he decided to refer Ryder to a pediatric counselor to address his behavior problems (“of course,” he added, “really this will be to teach you how to parent him properly”). Then, he lectured me on needing to place Ryder into a full-time preschool to help him detach from me and become independent (because, you know, 2 year olds really should be completely ready to fend for themselves, obviously).

“Now, the other thing we should discuss is how his potential growth has been curtailed by this malnourishment before he stopped breastfeeding,” the doctor continued. “He’s not going to be as tall as he could have been. Being tall is important for boys. He’s going to have problems socially, and it will probably even impact his ability to secure a good job.”

What. The. Actual. Fuck.

While my response to this in person was to burst into tears (causing the doctor to send in a counselor to discuss the fact that I should also be referred for family counseling because obviously I can’t keep my shit together) here is what I would have liked to say to him, had I been given time to compose myself:

1. Your data is shit. Three data points are not enough to infer anything. Who’s to say that the first high-percentile datapoint wasn’t marked down incorrectly? (If I could find anything in this house, I’d compare all of his Australian measurements…but I have no freaking idea where they are).

2. It’s not Ok to say that there is a correct way to parent. Parenting is extremely personal, comes from the heart, and I believe should ebb and flow to fit the needs of each particular family. Obviously, there are ground rules: feed and bathe the child, give them love, and don’t hurt them. Beyond that, I have a hard time believing there is a proven “best” way to parent, much like the objective “best” chocolate chip cookie is not possible to quantify (I like them soft and chewy, but maybe you are weird and like crunchy ones. Fine.)
Geez, look at this lack of social ability.

3. Telling me that I screwed something up irreversibly in the past, and have thus destroyed my child’s chance at a good future is not particularly useful, unless your goal is to destroy all of the self-confidence I hold as a mother. Give me advice on how I can support my child’s health and well being in the future, given his current and past health history. Don’t berate me for something of which I was unaware and have no power to fix.

4. You don’t know a flying lollipop about Australian people or the Australian health-care system.

5. Making judgments about my kid’s current behavior based on what I told you about how he behaved almost a year ago is ridiculous.

6. Behaviors I find upsetting in children include hitting, biting, stealing toys, throwing tantrums to get candy/toys/whatever, lying, breaking things, harming animals, screaming randomly, and generally being irritating. Ryder generally doesn’t do any of these things, and is generally kind and gentle and sweet, and I am therefore not inclined to try to change his personality.

7. My kid likes to cuddle and has good reason to be wary and want to sit with me in doctor’s offices (if you remember, Doc, the last time we were here you convinced me that we should take a blood sample from the perfectly healthy babe because you are insane and I didn’t realize it at the time). When he goes to daycare, or to other people’s houses to play, he doesn’t cling to me: he happily goes off to enjoy himself, barely giving me a wave as I leave for work. If that is overly attached, so be it.

8. Yes, it would be great if we had more friends with kids Ryder’s age. But I’m busy, and it’s hard to make friends, and I still feel like we just moved back across the ocean. So give me a freaking break.

No, we won’t be back, doctor.

3 comments:

  1. I am so so sad about this. I think this is literally going to keep me up tonight. I can't believe how upsetting this is. I can't even imagine going through something like that and am so so sorry that you had to go through this. Wow. Unbelievable. That is the worst bad pediatrician story I have ever heard. What a total bastard. Shit. I'm so sorry. Don't believe any of it. Ryder is the best. Truly and amazing kid. And so are you.

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  2. Wow. I hope you find a new pediatrician. And that one should be reported. Horrible.

    Also, please don't take what he said to heart.

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  3. This made me cry! What a horrible experience, I'm so sorry.

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