PEDIATRICS
by Ben Dobson

Having recently taken a course on the "Fundamentals of Interpersonal Communication," my observational pleasure of observing people at the physician's office has only compounded itself. Now, when people behave like morons, I can actually attach a formal diagnosis to their disorders, such as "My, that mother suffers from fundamental attribution error," or "That father simply polarizes the ethnocentrism that had led to his negative interpretations of his wait here amongst the rest of the in-group members."Yes, I am waddling in pure delight, as you might imagine. And, as one patient told me this summer,

"Life is like a hemorrhoid. You never know when it's going to erupt...."

Classy.

I felt bad that we didn't have any pediatric samples of "Tucks" to offer her. As I think I just demonstrated, some of the things I witnessed during this latest stint have left me glad that I don't have any children that I know about.

We begin this year with a story of a mother. A woman who has made it into this essay since its first edition in January, 1998. She arrived surprisingly peaceful for an 11:30 am appointment. Soon after the receptionist turned her back to take care of another matter, this mom strolled right up to the desk. She removed the stack of pink sheets (designating a patient's place in the queue) from her doctor's bin and started looking for her place in line. A good three or four people witnessed this, including some shocked patients in the waiting room itself. Maybe their jaws dropped because this woman had such blatant disrespect for patient confidentiality. When confronted about the matter, she first denied any involvement. When told that there were eyewitnesses, she conceded,

"Oh.... yeah.... well... yeah,"

and chased after her miscreant son. I think that the balls on these people have been reinforced with titanium steel.

I have found that people, especially house-bound mothers, like to talk. To me. About their problems. A sampling:

"My daughter just sneezed boogies all over the car."

"My child won't talk to me because he likes clowns and I don't."

"I think I must have forgotten to have my tubes tied."

"My husband doesn't like the smell of our baby's poopie."

(Mom to the child:) "The doctor's office is where grown-ups work. But most of them aren't as smart as the doctors."

There seems to be a fundamental need for prompting. In other words, if something is not suggested, a parent will stand motionless (glaze-eyed and comatose) in a state of "patient equilibrium" which can only be changed when an office staffer suggests an idea to them. For example:

Patients need to be prompted to make their next appointment. Then half of those will assume that we automatically make their follow-up and well visits for them. That, of course, makes perfect sense in the "patient equilibrium:" We are sorcerers capable of magic by which we automatically book them an appointment that fits seamlessly into their lives without ever asking them first. Right.

Patients need to be prompted to make their co-payment. The line to check-out may be eight bodies long. But none will have their payment ready when they get to the front of the line. I'll take their bill, glance down and up, and uh oh ... the patient has lapsed into "patient equilibrium" once again. They will just stand there until I casually suggest,

"Do you have a co-pay?"

To the patient's sudden amazement (I think the idea of a co-pay shocks fully 2/3 of our patient body) they do. And that instigates a flurry of activity of either digging out crinkled bills or writing out check. Meanwhile, the line has grown to ten people, and no one else seems to have any clue that I am going to ask for money...

Patients need prompting to care for their children. A baby will have a gushing head wound. But the equilibrium kicks in, and a patient will do nothing until we tell them to go get stitches. And that is only for the smart ones who prompted themselves to call in the first place.

I also get a kick out of those who think I am their doctor. For example, when booking an appointment, a patient went into a whole long story about how their child's finger had a "shaft prismoid in form and curved longitudinally on the metacarpal bones." At that point, I smile and ask

"Are mornings or afternoons better for that re-check?"

But in general, the average patient is filled with questions rather than medical terminology. Usually, they come up to the counter bug-eyed and eager with questions that they fear might be "dumb." And it is our never-ending job to reassure them that they are only doing the right thing by asking. Now, we are entering my first interactive essay. I will provide you with the genuine question (some of you may have already answered it! No cheating!!) and you provide me with the answer. It may be serious or comical. You simply must be able to say it non-judgementally in real life. I am looking forward to your responses, and I will post my favorites here later. A selection:

"Is it natural for me to want to shake my baby?"

"Are green stool samples good?"

from anonymous@williams.edu: "That's just not right."

"Is pee safe enough to drink in case my daughter accidentally drinks her sample?"

"I won't have to pay my co-pay if I don't pay today, right?"

"To take my baby's temperature, where is this so-called ‘rectum'?"

"Why doesn't my insurance company like me?"

"Is a long wait here considered more than five minutes?"

"If it takes two weeks to fill out a camp form, when do you think it will be done?"

Then there is the patient who told us that "If you fill out my camp form so I can have it today so I can bring it in early, I get a $5 rebate off of the camp's tuition!" Too bad there wasn't anything in it for us!

Finally, our robust economy has managed to create wealth. Especially for some of the patients surrounding one of our offices. They tend to be "snooty." As a matter of fact, I have heard of one dad who apparently doesn't trust our pen and ink filing system. He prefers to get in everybody's way taking notes on his child's height, weight and blood pressure, and subsequently entering them straight into his Palm Pilot. And never forget the patient who "...is very wealthy, and can't be kept waiting." Oh, but that was two years ago. With the double-digit gains in the stock market lately, I'd imagine she's "extravagantly wealthy" now.

Oh, just wait for the next recession, sister. That's it for this round. Good luck in the fall. The viruses should really be out in force, what with that nasty West-Nile Virus in the neighborhood. Enjoy fielding those questions......