Saturday, February 18, 2006

Convincing

It happened again this morning. I was speaking to the mother of a baby we were transferring to the NICU, and she spoke to me as if it were my fault the baby needed to go there. This has happened many times before. Almost all parents are worried when their baby has to go to the NICU. Some, however, remain kind and grateful for your work. Others get angry, and take the anger out on you, and it’s a little hard to take sometimes.

I know I’m being petty. I know the parents are just upset and aren’t really mad at me (usually.) I know if my own baby were sick I might not be on my best behavior either. I also know that since many of my patients are African –American and I’m not, they have good reasons historically to be a bit mistrustful.

But I, like most physicians, just want what is best for the patient. Why wouldn’t I? I like babies and kids and otherwise would not have gone into pediatrics and neonatology. It gets a little wearying to have to talk the parents into letting you do what’s right for the baby. Sometimes I just want to say to them, “Look, it’s not my fault your baby is sick.” (I actually did say that once. Trust me, it wasn’t helpful.) So I just try to do my best to be patient and put myself into the parent’s shoes. Usually the parents come around and are fine later on.

It would be nice, though, if they were that way from the beginning.

8 Comments:

Blogger Fat Doctor said...

Good insight. As a physician, I, too, want what's best for my patients and feel a bit peeved when they interpret that as my trying to punish them.

But as a patient, and the mom of a NICU grad, I understand the primal fear that feeds inappropriate anger.

Unfortunately, our doctors are often the ones in the line of fire when the fear/anger boils over.

Today, whenever I see the two docs who cared for my Son those long 28 days, I cannot thank them enough.

Keep your chin up. You know those babies need you. The parents will come around later, even if you never hear about it.

9:44 AM  
Blogger neonataldoc said...

Thank you! You have a unique perspective as parent and physician.

3:41 PM  
Anonymous colleen said...

I'm sure it's a little crazy to be commenting on this two months later, but you wrote this the day my daughter came home from the NICU (five days after she was born) and it hit home with me. Not because I was rude to or angry with the neonatal staff who came to get my daughter. Rather, because I was completely blown away by my reaction when they took her away. My daughter was being admitted to the NICU to rule out bacterial sepsis, and while I was concerned, I also knew that she'd been doing well during and since delivery, and that the antibiotics I'd had during labor and the antibiotics she'd get once admitted would likely prevent her from ever getting seriously ill. The instincts at least some women (me, for one) have for protecting their babies and staying with them are astonishing strong, even without you being much aware of it beforehand.

If you had asked me two minutes before the NICU staff arrived how bonded I was with my daughter, I would have said I didn't know -- I was thrilled, and enthralled, and captivated by her every squeak and movement, but I also felt like we'd just met, and I could hardly believe she was mine.

And yet as the door closed behind the NICU folks I burst into tears, and had to resist the urge to run after them and snatch her back out of her bassinet and get us both to someplace "safe", because oh my GOD those people TOOK MY BABY AWAY! That was my emotional and physical reaction, even though I was not beside myself with worry, and actively wanted her to go to the NICU. So don't underestimate the influence that instinct (not too mention hormones and exhaustion) have on the parents of your patients. I can't imagine dealing with that situation and also being terrified for your child and not really understanding what was going on.

12:02 PM  
Anonymous Anonymous said...

Yes, this is much after the fact but I know that when my baby was taken to the NICU before I could even see him (and I didn't see him for twelve hours) I was suicidal. My guess (and I am not a doctor) was that hormones played a great deal in it. I just desperately wanted my baby back. I know they were saving him. I know they were helping him. But I just wanted to hold him. Or even see him.

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