Tuesday, September 23, 2014

A Well Child Physical for Two Sisters

I had two little girls for check ups, ages 3 and 6, and their efficient-appearing mother. When sibs appear like this I generally do “double physicals” – that is, sisters together. That's always a nice thing to do, do it together. You can cover the things that apply to both, you can take a topic and make one comment for age 3 and another for age 6.  This is the way a mother thinks, anyway: column A for one and column B for the sister.  You can compare and contrast.  You can watch how the family interacts. It's a nice family thing.

So I didn't hurry; I felt like doing a really good job. They were nice little girls.  The 6 year old maybe wants to be a doctor, so I showed her how to wash her hands before you see your patients. I talked to them quietly and with some humor, as is my wont. I had them jump together. I asked the 6 year old to show the 3 year old how to hop, which she did quite well. I did some developmental queries, which were normal. I asked them both if they pooped every day, and if they had belly aches – they did, and they didn't. We looked at the growth charts, which were normal.

I imparted wisdom. I told the mother how we can say all we want to, but most of our children's behavior will mirror our own. If we are nice to people, they will be, too; if we are mean, so will they be. In the end, our knowledge of our impact on our children is a prime motive force for us to clean up our own act.

I asked them if they could swim – a prime safety concern. They can't yet. The mother can, however, which is good. I sympathized how it is hard to mobilize to get to a pool, lessons, etc., but opined that it was worth doing, and why. I asked about physical activity, which they get a lot of. I asked about screen time, which is limited in their house.

The mother objected when I tactfully examined the 6 year old's pubis while she lay down, saying she didn't want males to look there with her kids, and she didn't know why she had been assigned a male doctor. I told her that I get a little edgy examining the older girls myself, and usually urge them to switch to a female sometime after 11 years old. But while it's important to be careful – Uncle Phil might not be a safe babysitter – here we were with a doctor and being chaperoned by her, the mother. I thought it would be important for the girls to be able to feel safe with a trusted male, for their own future benefit. I hoped the point got across.

I took my time with the visit, not rushing, although you can never cover everything. I felt that I was really doing a good job with them. And then I said, “Is there anything else you would like to talk about?”

To my surprise, the mother responded, “Actually, I didn't know it would all take so much time. I thought I would just get the form signed and get out of here. Are you done?”

“Yes,” I said, “sure. I do think it's important for you to feel that you have a trusted source of care to come to here at Bayside.” In other words, there is something at stake in making a personal connection here.

And she said, “I do.”

“And I hope that the girls feel secure with their source of health care also.”

“Yes, they do,” she said.

So that was it. Kinda funny. There are forms people need filled out, and we take advantage of that obligatory visit to foist good health care upon them. Who knows, maybe I did some good. Who knows?

Budd Shenkin

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