Thursday, May 15, 2008

Thoughts on Parents

In college, I was most interested in pediatrics because a) I like kids; b) I have 3 younger siblings whose ages range over a 12-year span; and c) most of my community service in high school and college reflected working with little kids or mentoring adolescents.

Feeling comfortable with babies, toddlers, preteens, teenagers has helped me enjoy my pediatric rotation, so it's funny how by the end of my year finishing clinical research at Stanford, my career interests had changed course and my interest in oncology grew. As a patient population, I really enjoyed working with an older age group of patients who had pancreatic cancer -- they had diverse backgrounds, interests, and personalities tied together by an unfortunate and often tragic illness.

One thing that worried me about pediatrics was the hearsay that it's not just the patient whom you have to worry about...but often their neurotic and demanding parents who are understandably worried about their most precious charges. Hearing that argument, I was turned off by the idea that maybe I could not treat the patient directly, but would spend much of my time negotiating diagnoses and treatments by proxy. Another common argument one often hears is that pediatrics can sometimes be "veterinary medicine" (I don't like this phrase), since nonverbal children cannot articulate their symptoms or discomfort.

During my pediatrics rotation, I have found that my worries about Parents (with a capital P) have been exaggerated. Although some Parents can be bossy, demanding, and overly histrionic, I have more often found myself touched by the love, dedication, and sacrifice that each parent demonstrates for his or her child. An infant who received a liver transplant practically lives in our inpatient ward with his parents and older brother, who spend every hour with him, sleeping on chairs and air mattresses every night and never leaving his side for days without a word of complaint or resentment. A mom who cries because her son has anorexia and will not eat anything she offers. Another mom asking about the cognitive effects of whole brain irradiation on her 10 y/o son with Down's syndrome and ALL. Parents who take showers in the hospital, sleep on chairs every night, pour every ounce of energy into supporting their children, no matter how sick the child is or how hopeless the situation may be.

So now I find that Parents tug at my heartstrings as much as their children do, and everything that I have always loved about kids remains the same. Children perceive the world differently, they are more pure of heart and have cute miniature body parts.

Adolescents are an interesting age group, too, they have such a unique set of concerns, risk factors, and half-formed perceptions of the world and how it should be. At best, their preoccupations and insecurities amuse and touch me, at worst, their teenage angst and myopic, self-conscious and self-centered views of the world impede effective medical care.

Overall, however, both pediatric patient groups demonstrate an acute vulnerability that makes me want to take care of them, and their little Parents too.

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