For years, I hated when patients would ask if I had children. I consider myself to be a good pediatrician and trained at a highly rated medical school and residency. I work hard and I care for my patients. I can, however, be socially awkward and did not start dating until later in life. At its most innocent, the question triggered inadequacies about my social and personal life. At its …
How becoming a mother made me a pediatrician
I am exhausted.
Mentally, emotionally, physically.
I fear we are reaching our breaking point. We have run a marathon, hoping that we were nearing the finish line as we saw numbers decline in June, only to be told to lace up our sneakers and start over.
Work in outpatient pediatrics is always busy in the summer – seeing our patients for school and sports physicals, marveling at how much they’ve grown since we …
Physicians have gone from being heroes to villains
I am a board-certified pediatrician, wife, mother of four, and host of a podcast. I have been interested in nutrition and feeding practices for as long as I can remember. In my practice as a pediatrician, I was constantly bombarded with parent concerns about children’s eating habits. Commonly parents worried that their children were not eating enough, were eating too …
The surprising power of family meals
“Children don’t get as sick with COVID-19” and “only children with comorbidities get very sick from COVID-19” are two statements that have concerned me during the pandemic. They have been used as statements to support loosening COVID-19 prevention measures for children, like wearing masks, and rationalizing arguments opposing vaccinating children against COVID-19. It is true that children, for the most part, do not get as sick from COVID-19. Nevertheless, while …
A perspective on comorbidities and severity of illness in children with COVID-19
The page comes during a lull on an otherwise busy day in the well-baby nursery (WBN). My pager’s shrill cry rouses me like the blast of a starting pistol.
DI-DI GESTATION. 37 WEEKS. BABY A WITH NON-REASSURING HEART TONES. BABY B BREECH. OPERATING ROOM A. COME STAT.
Translation: Twin birth. Baby A is STRESSED. Baby B attempted a front flip but got stuck. HURRY.
The race is on, and I am determined to …
The Apgar Olympics: The race is on
Some pediatric practices refuse to provide care for children with vaccine-hesitant parents.
Those pediatricians are quick to offer rationalizations for this decision. Many of their reasons are compelling. I’m confident you yourself are thinking of some right now. This piece isn’t intended to be a deep dive into those reasons. No justification for refusing care to certain children changes the outcomes.
We assume that these families end up at organizations like mine: …
The non-acceptance of vaccine-hesitant families is a problem in pediatrics
Daily cries from parents, pediatricians, the press, and the public to reopen schools in the fall are certainly well-intentioned, but they are overlooking a critical opportunity to advance adolescent physical and mental health long after the COVID-19 pandemic is over. Delaying school start times for teens by an hour, or even two, could optimize a teen’s sleep and their ability to learn throughout the day.
Sleep is critical for teen health …
Teens need later school start times
The COVID-19 pandemic put a pause on institutions that we did not think were pausable, allowing us to ask critical questions regarding their relevance and necessity. One such institution is the United States Medical Licensing Examination (USMLE). During COVID-19, Prometric sites closed, delaying exams for many. In response to public outcry, Step 2 CS has become defunct. Before COVID-19, there had been calls to reform the expensive licensing exams, …
It’s time to end the USMLE Step 3 exam
“Thank you. You’re the first to say it’s OK for me not to breastfeed.”
These words have been said to me before by tearful, exhausted mothers. It had been sporadic, but now, it feels like I hear this every day in the clinic. Each time, I feel a rush of mixed feelings as I explain that other options had not been explored because of the known benefits of breastfeeding. I tell …
Breastfeeding is not the end all be all
The 2020-2021 residency application cycle was profoundly altered as a result of coronavirus disease 2019 (COVID-19) in the United States which led to a completely virtual season for nearly all specialties. At the time of this publication, pediatrics, obstetrics and gynecology, and ophthalmology have announced virtual interviews for the upcoming 2021-2022 cycle. Using lessons from the inaugural “virtual” cycle, many residency …
#PedsMatch22 and the social media imperative
An excerpt from Tenacity in Children: Nurturing the Seven Instincts for Lifetime Success.
Did you ever wonder why babies quickly develop a social smile and look you in the eyes? Is it surprising to learn that the muscles in your ears are set within the range of women’s voices at birth or that babies prefer looking at women’s faces …
Tenacity in children and the 7 instincts
“Why do they book your well-child checks for 15 minutes?” my medical student asked me yesterday. I laughed. I couldn’t help it. Gut reaction – like when you laugh instead of cry. I explained that all of our appointments are 15 minutes – well-checks (regardless of age), to colds, to suicidality or chest pain. I work for a large hospital system, and that is how patients are booked. I the …
We need to stop blaming the doctors
Part of your job as a parent is to teach your children, and there’s no way for a child to learn anything without making a few mistakes. Actually, a lot of mistakes. Sometimes these mistakes can be infuriating. They might be self-destructive mistakes. They might be mistakes that can cause harm to their siblings or classmates. They might be mistakes that happen over and over again. They might …
What happens to your child’s brain when you nag
During a casual scroll through social media, I often hear the voice of my friend and fellow pediatrician warning, “Do not engage!”
Generally speaking, this is almost always the correct advice. The rise of various social media platforms, the ability to rapidly share information and disinformation, the growing culture of doing one’s own “research,” and the apparent difficulty in separating reputable from non-reputable sources online has created the perfect storm. In …
How physicians can engage on social media
“But if thought corrupts language, language can also corrupt thought.”
– George Orwell
The “difficult” family
At 2 a.m., on my first night shift as a pediatric resident, a patient, Casey, transferred from another hospital. She had a rare, progressive chronic illness, was medically complex, and was currently receiving treatment for an acute systemic infection. Shortly after she arrived, she became difficult to arouse. When I asked her mother questions, I was …
Maybe life is happening: the power of language in patient hand-offs
An excerpt from Medical Myths: A Sceptic’s Journey.
It may be a long while since you’ve heard of a very small infant being found dead in the crib.
As a young doctor, I recall the encounters on cold February nights with devastated …
In Finland, lawmakers recently voted to make an existing ban on female genital mutilation more explicit by outlining punishments for such manipulation under the Finnish criminal law. This bill’s passage was widely applauded as it furthers the global efforts to eradicate female genital mutilation (FGM). While the bill received majority support in the parliament, a contentious debate ensued around an amendment in the …
Why male circumcision should be delayed
Throughout my years of pediatric training and being a mother, I have benefited from viewing medicine from both sides. I have also tried to hone listening to and understanding my patients’ parents and their perspectives. I have listed 10 things that I believe most parents wish their child’s pediatrician knew.
We are just worried about our kids
First and foremost, we are worried about and invested in the health and happiness of …
10 things parents want their pediatrician to know (from a pediatrician mom’s perspective)
A recent edition of Pediatrics has some disturbing research: “Trends in Capability of Hospitals to Provide Definitive Acute Care for Children: 2008 to 2016.” What the paper really does is document what many of us who work in referral hospitals have noted for some time: More and more community hospitals are transferring children who appear in their emergency departments to other, larger facilities instead of admitting them to …
Why are so many community hospitals transferring children to larger facilities?
I ring the doorbell, waiting patiently outside. I hear a weak “coming” and some shuffling. Who greets me is a mother in her robe, hunched over at the waist, supporting her protruding postpartum belly. Her hair is disheveled. Her mask is revealing exhausted eyes with attempted mascara to look a “little freshened up,” she confesses a little later.
“My husband is just getting the baby; please come in.”
I …
Now is the time for postpartum home visits
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