Losing track of the big picture

Something that happens quite frequently, especially in pediatrics is a lack of acknowledgement of the child as a person. This unfortunately also becomes a lack of acknowledgement of the parent as a person.

As a team of consultant, senior and junior residents and medical students, a herd of eye balls moves room to room in the hospital. The herd parks outside the patient's room and talks about the most recent blood work, biopsy results or imaging. They engage in an intellectual discussion about the findings and what they will mean to the patient's prognosis or treatment plan. They enter, usually without knocking and
discuss the plan for the day. Hopefully, this discussion includes the patient and family.

Families are often starved for a sense of being a part of what is happening. They can feel like animals at the zoo. They deserve better.

Medical students often feel like we are bothering the family when we want to ask more questions. There are lots of things that these families can teach us and allowing them to be medical teachers in a teaching hospital allows them to feel less out of control of the situation they are in.

Obviously not every family feels this way. The easiest way to find out is to say something like "hi, I'm the impostor, would you mind if I learn bit more about your child, her illness and what's been going on for your family?". If they have had enough, they will either say no or answer in short terse phrases. Thank them and wish them well.

If however they start to glow and want to tell you everything about the presenting signs of illness and the path taken to get them to your hospital, listen, ask questions and enjoy the experience. I've learned so much from parents.

By the time the child is worked up and on the floor, the reason their parents first brought them in can be lost in the shuffle. Leukemia can first present as sore feet. Cardiac arrhthmias may act like nausea and vomiting.

I've also learned that kids hate a 'pity party'. They want you to ask what sports they play, what video games they have, compliment them on their pajamas. They hate it when we come in, head tilted to the side and with a gentle sigh ask how they are feeling. Treat these kids, especially the cancer kids, like regular kids. They'll tell you if they need something else.

Final lesson, introduce yourself. Telling people your name seems only fair when you know everything about their child. It lets them know you see them as a person rather than just a file.

And frankly, not doing so is just plain rude.