Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What medicine has taught me about children

Edwin Leap, MD
Physician
July 13, 2013
Share
Tweet
Share

I’ve learned a few things about children over the years.  While most have come from raising children, the rest have come from caring for them as patients.  Knowing children, knowing their hearts and their ways, gives me great joy.  I like to think that as I know them better, I become more like them, and while my time on earth may not be any longer for it, it may be richer.  Or perhaps one day I will simply wake in Narnia and find that I was always a child, dreaming dark dreams that will suddenly end.

So, in light of what I know, here are my tips for taking care of children when they are your patients. They are not given in order of preference or importance; and only generally in sequence.

First, walk into the room, look at them and smile.  Don’t give them that condescending smile you learned in medical school interviews.  Smile.  Watch them, because sometimes they’ll smile back.  Learn to wink.  Winking is very useful.  It conveys the idea that you are paying attention, even as you listen to the boring adults.

Move purposefully, but slowly.  No barging in, slamming down charts, jerking open cabinets or yanking things off the wall.  Modulate your voice.  If you need the nurse to get something, don’t yell.  Say it softly.  Give children at least the concern and demeanor you would give to a wounded stray cat or dog.  The children deserve it even more.

Sit down and talk, both to the child and to the parents.  Let your attention be a pendulum that moves between them.  They both have things to tell you. But first, complement the child.  Tell them you like their name, or the stuffed hedgehog they are clutching.  See what they are watching on the television.  (It is useful to have at least a passing knowledge of cartoons, so that you can tell them what your favorite is.  Or at least, what it used to be.  The Road-Runner will likely always be with us.)  At the right age, video games or sports (or in certain locales deer season) make great conversational topics to put the child at ease and show that you are not, actually, a monster.

At some point, complement the parents. Tell them what a strong, or beautiful, cute or brilliant child they have.  It suggests you noticed that their child is special.  Indeed, what child isn’t?

Ask your wee patient, “can I check you out?” If they say no, ask mom or dad to help.  But again, move gently and carefully.  Put your stethoscope on their knee first.  Use the otoscope on mom, dad or older sister. Or on yourself! Odds are, things will go alright.  If you aren’t kind, the child will scream and the screaming and kicking and fighting will get squarely in the way of your exam and assessment. And hurt your ears.

If screaming and fighting persist, be firm and have parents and/or nurse hold child in something reminiscent of WWF, but allowing plenty of air to pass in and out of lungs.  Children, like small animals, are not always rational and must sometimes be told and shown that they aren’t in charge  despite endless empowerment talk from experts.  You are smarter and bigger. And they need your to take charge.  Sometimes to save their little lives.

As you assess them, cultivate that thing we don’t discuss in medical school but the thing that makes for the best medicine.  Practice loving them.  Imagine them at home playing, in the yard running, in bed snuggling, in school learning. Imagine them well and pray that you can return them to that state as quickly as possible.  Unlike many adult patients, the children have no desire to be in the hospital.  To a child, disability means nothing except sitting in bed while other kids play.

Practice thinking also about how much their parents love them.  About how they were anticipated and how they are treasured.  If you sense that their parents could not possibly care less, then project love onto the child.  Show them that at least with you, an adult finds them to be of inestimable worth. Give them crayons, give them stickers.  Give them snacks if the situation allows.  Shower them with concern.  Occasionally, an infant or small child will climb into your arms and want to stay there. Or will hold out their arms, as if to say, ‘please take me away from these crazy people!’  You cannot do that. But you can still look at them with love, treat them with skill and try to discern if they are in danger.

If you must hurt them a little, try to explain why.  And tell them you’re sorry, and that you wish there was some other way to do it.  Talk to them endlessly, so that they know you are not a robot in white.  Learn what you need to know to save them, or ease their pain.  And if you find something terribly, terribly wrong, talk to their parents first.  If, G-d forbid, one of them dies, remember that for the child’s family, the universe suddenly collapsed and all good things ceased to be bright.  Either way, with grave illness or death, remember that the parents will suddenly be wounded children themselves.  Follow the above steps and be gentle.  It’s acceptable to cry with them.

Now, bear this in mind.  For all our knowledge and skill, all our education and cool professionalism, we were all children once. And because of dementia, strokes, accidents and illnesses, we may yet be like children.  Everyone you treat was a child.  Everyone you treat is afraid, and mortal, and suffering some unique wound of the heart or soul.  Don’t forget the child in everyone.

So, when you walk into the exam room of an adult patient, don’t forget to smile.  Make no sudden moves. Sit and talk.  Ask them about the things they love…And learn to love everyone, if you can, with the love that should be showered on every child on earth.  For on some level, we are all children still.

ADVERTISEMENT

Edwin Leap is an emergency physician who blogs at edwinleap.com and is the author of The Practice Test. 

Prev

Finding and keeping great front office staff

July 13, 2013 Kevin 4
…
Next

An ovary removed instead of an inflamed appendix: What happened?

July 13, 2013 Kevin 19
…

Tagged as: Emergency Medicine, Pediatrics

Post navigation

< Previous Post
Finding and keeping great front office staff
Next Post >
An ovary removed instead of an inflamed appendix: What happened?

ADVERTISEMENT

More by Edwin Leap, MD

  • The emergency department crisis: Why patient boarding is dangerous

    Edwin Leap, MD
  • Hospitals at a breaking point: Lack of staff and resources leave ERs in chaos

    Edwin Leap, MD
  • Trapped in a cauldron of suffering, medical staff are weary

    Edwin Leap, MD

More in Physician

  • How I learned to love my unique name as a doctor

    Zoran Naumovski, MD
  • What Beauty and the Beast taught me about risk

    Jayson Greenberg, MD
  • Creating safe, authentic group experiences

    Diane W. Shannon, MD, MPH
  • How tragedy shaped a medical career

    Ronald L. Lindsay, MD
  • A doctor’s guide to preparing for your death

    Joseph Pepe, MD
  • How policy and stigma block addiction treatment

    Mariana Ndrio, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • How new loan caps could destroy diversity in medical education

      Caleb Andrus-Gazyeva | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why doctors struggle with family caregiving and how to find grace [PODCAST]

      The Podcast by KevinMD | Podcast
    • Locum tenens: Reclaiming purpose, autonomy, and financial freedom in medicine

      Trevor Cabrera, MD | Physician
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • How trust and communication power successful dyad leadership in health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why Hollywood’s allergy jokes are dangerous

      Lianne Mandelbaum, PT | Conditions
    • How I learned to love my unique name as a doctor

      Zoran Naumovski, MD | Physician
    • My first week on night float as a medical student

      Amish Jain | Education
    • What Beauty and the Beast taught me about risk

      Jayson Greenberg, MD | Physician
    • Creating safe, authentic group experiences

      Diane W. Shannon, MD, MPH | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What medicine has taught me about children
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...