Sunday, April 10, 2011

Thoughts on Pediatrics from a Cemetery

"Thickly Settled," read the yellow triangular traffic sign. Not the usual warning variety, I'll admit, but it works for Hancock Village, a double row of houses and a Baptist Church situated almost right on the state line between Western Massachusetts and New York. Greater Hancock extends further north, past Jiminy Peak Ski Area, to Williamstown, but the Village itself is smaller. I'm writing, on this warm, quiet-as-a-grave, Sunday morning, appropriately enough, from the Hancock Cemetery. It isn't that I'm particularly fond of cemeteries, but my guess is the dead are less likely to bother interrupting me to ask what I'm doing, so as long as my computer battery holds out, here I sit.

There's nothing like a rotation in pediatrics to remind you how little you know about children. What's this got to do with cemeteries? Nothing, really, I just wanted to share where I was writing from and how I'd gotten there. My real topic is pediatrics. So, anyway, six years as a Scoutmaster I thought might give me some expertise and I suppose it did, at least where boys age 11-18 are concerned.

Theirs was the generation of Arrowsmith and Guns N' Roses and my Bronco II rocked to their beat along the highways and hedges of Texas. Among their fellows I can count my classmates and future colleagues. Does that make me feel old? Hardly -- they got me out of myself and into life in ways that endure to this moment. Because of them, my CRV rocks to Lady Gaga and I'm not afraid to walk into an examining room with a kid with undiagnosed ADHD, bouncing off the walls.

Some things you don't get in the rarefied atmosphere of Scouts. For instance, a little guy who tinkered with the tiny flashlight at the end of my stethoscope, a trinket I claimed from Army recruiters who visited my school a couple of years ago, before allowing me to listen to his breathing. His mother said, more than a little surprised, "He's afraid of men, but he's good with you..." I resisted pushing the envelope to look in his ears. He didn't like the idea and I wasn't willing to risk our nascent therapeutic alliance, shaky as it was already. Besides, the nurse practitioner would have to do it immediately after me and once was my patient's limit. I'll see him eventually for a follow-up visit and hope the rudiments of our friendship are still intact.

There are little girls, seven going on 27, and others so shy they can't tear their eyes away from the shadow of daddy's chest and it's a challenge to do anything. We manage, sometimes with tears and mostly without, for which I'm grateful. A visit to the doctor can be traumatic even when there's a lollypop waiting at the end of it. Kids need to know coming to see the likes of me isn't always a reason to be sad.

It's more the therapist in me than anything else, whispering the wisdom of Carl Rogers, i.e. every patient deserves unconditional positive regard, whether they're old enough to put it into words or not. A smile, a wave goodbye, or the five year old who insisted I get a sucker, too, it all spells out the same. We find a space outside fear and uncertainty where we can connect.

I'll walk to my car sometime around five or six in the afternoon, dog tired.

And feeling good.

(Photo of historic Hancock Cemetery copyright2011 by the author)
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