My face

I’m a pediatrician, and sometimes, I forget to smile. My brow is furrowed. My lips are pursed. This happens when my patient is sitting across from me. Their legs dangling off the exam table. Their parents almost holding their breath, waiting to hear what’s wrong with their child. And then comes my sigh.

Sometimes, the silence is too much for the parent, and they find something to apologize for. The holes in their kid’s pants. The dirt their kid trekked in. The toy cars and dolls scattered all over the floor like an obstacle course between me and the exam table. Their own messy hair. The aroma of chicken nuggets filling the room. The aroma of a poopy diaper. Really, these are all signs of a happy, healthy kids – including the occasional happy meal.

My thoughts

And then we both let out a nervous collective laugh. I promise the parents I’m not judging them. I’m not concerned with any mess, any wardrobe, or odor. Honestly, even whiff of marijuana. They don’t take up rent in my brain. What does? I assure the parents – I’m deep in thought trying to decide the best antibiotic to use, trying to determine if their child should begrudgingly go to the emergency room or the monitor at home, trying to siphon complex behaviors into the next one step to recommend in a lifelong mental health journey.

And far from the parents’ judgment of my perceived judgment of them, at the same time of making a recommendation, calculating through many permutations, I’m also scanning for the patient’s and their parent’s strengths. I’m gleaning for what they are doing well, and figuring out how they can build on that. No, I’m not judging the messy bun. I’m amazing at the sacrifices the mom made to make healthier meals for her kids. No, I’m not judging the dirt on the ground. I’m so proud of mom for giving her kids opportunities to run around in nature. No, I’m not judging the toy filled floor. I’m ecstatic to see a parent getting on the floor to play with their child without screens kid or parent!

My priorities

As a pediatrician, I have 3 jobs in every office visit. First, I have to listen, and I have to check to make sure my understanding of the situation is accurate. I do that by offering the family a summary of the situation. Then, I have to provide and explain next step options for the child and family. I always check for their understanding by pausing for questions and asking – “what questions do you have?” Last, my job is to empower parents and the kids to advocate for their needs and trust their medical decision making. We talk about their goals and brainstorm strategies that fit their preferences and circumstances. These priorities keep me quite busy. So busy that I really can’t be bothered to judge clothes or smells.

Smile more

Juggling all these things in my mind, I sometimes forget to smile. But one thing I never forget to do, is laugh. Standing outside my rooms, my staff can attest that loud bursts of laughter is heard almost every visit. We find humor. Sometimes the kids, especially the teens who have known me a long time, roast me. Sometimes I roast their parents and call them out for hovering or for speaking over their kids. More recently, we’ve been laughing over 6-7. Laughter is medicine, and I never forget that. But smile more? Yeah, I’ll try to remember that, too. But if I don’t, know that my vexed facial expression carries the weight of every medical decision I make.

If you want to see more of the thoughts behind this RBF, follow along the journey >>>here<<< for my tips as a mom and pediatrician, trying to keep my own kids healthy, and keep ALL the kids healthy.