doctory

A few weeks ago I took Jake in for a pediatric appointment.  He's healthy.  43 inches and 40 pounds.  Vision 20/30 (which is okay because eyes aren't fully developed until age 8), perfect hearing, exemplary blood pressure.

I like the office and the people that work there.  I really do.  We've been going there since Jake was born.  The office is really easy to get to by bus, subway, car, and if we are feeling well enough to do so, foot from the house.  It's around the corner from my office if I need to run in to schedule something or cancel something or drop off something or pick up something.  School-aged children who play sports need lots of somethings dropped off or picked up.

The clientele is the sort that you'd want waiting in the waiting room.  We're like the poorest kids there, but that's okay. 

The office is closely connected with one of the best children's hospitals in the world.  That's always comforting.

The standard procedures for a 5 year old's Well Child visit?  Let's just say that I hope we didn't get the standard procedure.  The nurse stuff went swimmingly.  The height weight bp vision stuff.  Even the shots were quick.  It was the check up that went sour. 

The best of the worst was that there was no developmental assessment.  No name recognition, hopping on one foot, asking about bedtime routines or how mornings were.  No asking what he did during the day, no asking if he can ride a bike or what the best and worst things about school or home or in the neighborhood are.  Nothing. 

The worst of the worst was pulling his underwear down to check his penis and testicles while saying "it's okay if I pull your pants down, I'm a doctor. I need to check your area down here to see if it works".  Jake was terrified, and went stiff as a board as tears filled his eyes.  He asked me if it was okay, and I asked him if it was okay with him and he said yes, as long as I hold his hand.

And "to see if it works"? Seriously?  To a five year old child, the genitals "work" if they can pee.  What the hell is he supposed to do to prove whether they "work"?

After the check up Jake was told to put his pants and undershirt on, and "(she) hates being the bearer of bad news, but he had to get a few shots".  Then she left and we waited for 15 minutes until the nurse came in to give him his shots.

Well. 

You can imagine how those 15 minutes went. 

I took a few days to calm down before calling the office to set up an appointment with the office manager.  I needed a few days to calm down before calling the office to set up an appointment with the office manager.  It's one thing to be a Mama Bear, it's another thing to be a spastic asshole.

The woman who heads up the practice was genuinely appalled and contacted the lead physicians and the lead nurse and the lead lady with the alligator purse.
And she had Jake's school physical form, which usually takes 10 dollars and 10 days filled out in 10 minutes for free, so bonus points for that.

And then we sat and talked for a half hour.  I don't generally talk about my job in conversation, but I did tell her that as someone who does what I do, I am probably 100 times more sensitive to certain issues than someone who has a different job, so while most parents wouldn't be upset if the doctor didn't ask their child to write his or her name, or draw a person, or ask him to skip from the exam room to the scale, I'm the sort who wonders why they don't.  It's so simple, and it can save so much heartache and so many headaches for everyone in the future. 
I shared that I think it's very important for the doctors and nurses at this practice to remember that they may be the primary point of entry into early childhood services for most of the children seen there.  The parents who bring their kids to that office aren't the same parents who have social workers or nurses in the house.  They aren't the ones who attend community centers or Early Head Start programs or day cares who are federally or locally mandated to hire someone to be on the look out for developmental delays.  They need the doctor to be that person for them.  That gate keeper.  That whatever.

It's fun to do developmental assessments on kids.  It takes a little practice, but it's worth it.  It's fun for them because they get to show off what they know and it's fun for grown ups because you get to play a little while you work.  It's easy enough to hit the major stuff that just about anyone can do it while they do other stuff.  Even doctors. Even doctors checking ear holes and nose holes and knee jerks and stuff.

And the pulling down of the pants thing? 
Holy
Crap.
Any mother or father should freak.  And child should freak.  If your child doesn't freak, you need to sit down with your child and have a very poignant discussion with your child about his penis or her vagina and who is or is not allowed to touch it.  A five year old boy should be the only one touching his penis, unless there is a medical reason for a parent/caregiver or doctor to touch it and the parent/caregiver or doctor must have that child's permission first. 

And the thing with the shots?  How about telling Jacob that the nurse will be in to finish up in a few minutes, and if you must tell someone about shots tell me that Jake needs a couple vaccinations or immunizations.  Don't ever use the word "shot".  Ever.  Shots fall right under Closet Monsters on the "What Scares Small Children Most" scale.  We could have spent those 15 minutes playing with the cars I had jammed in my pockets.  Or drawing on the table paper with the crayons in my bag. 

Or processing through the underpants incident.

Instead it was spent screaming and crying and trying to hide and running in circles and spinning on the floor and snotting all over the place.  Not fun.

Take home message: be sure that the people who are supposed to be taking care of your child's medical needs are taking care of his developmental and emotional needs too.  And his or her need to feel safe.  And his or her need to feel respected.  And anything else that may come up, like your developmental and emotional needs.  And your need to feel safe and respected.