Primary care: Easing trepidation is a full-time job

One night while on call, I was sitting in a loud downtown restaurant when I received a phone call from the hospital. I didn’t think I would be able to hear the call, and so I scurried around to find a place to speak. The bathroom appeared straight ahead, so I rushed into the first empty stall, locked the door and took the phone call. After wrapping up with the call I walked out of the stall calmly, and to my surprise saw three women whispering to each other. Awkwardness ensued, and I asked, “Umm … am I in the women’s bathroom?” They all nodded a shameful yes. I stared down at my shoes and said, “Oh, OK. That’s not good,” and I walked out of the bathroom.

I honestly never thought I was in the wrong bathroom. My brain must have been in pediatrician mode (which is apparently an incredibly goofy mode). Being a pediatrician, I come across many people in medicine — be they nurses, nurse practitioners, physician’s assistants, other doctors, and students. Often I am asked the same questions over and over again: “Do you like being a pediatrician? Isn’t it just a bunch of colds and well child check-ups?”

To me, this question ignores an important aspect of health and maintaining well-being. Human beings are made to worry. Pediatrics especially deals with people’s worries because it involves the healthcare of children. Anyone that lives a worry free life probably hasn’t had children. (I am in my thirties, yet my parents still worry about me).

I remember as a child once camping in the Anza-Borrego desert. My cousin and I were racing on our bicycles. I decided to drive my bike over a ditch in the road, flew off the handle and proceeded to land square on my chin. Luckily, my father is a pediatrician too. He called his friend to bring him stitches, and I got my chin stitched on a picnic table in the middle of the desert. To this day, I still have a scar on my chin marking the memory. Maybe it is because of that kind of incident that my parents still worry about me.

Sometimes we all forget that a crucial part of health care is maintaining the times we are actually healthy. In other words, health care is not only about sickness, but also involves encouraging well-being. Part of the way we do this is by reducing the worries people have in life. A large part of pediatrics is about easing worry. From the moment I walk in and see a baby born in the hospital this process starts: “Doc, is the breathing normal?” “What’s this spot on the back?” “How much do we feed?” “Do you do vasectomies?” (A father actually asked me this right after their baby was born.)

It is vital to the state of medicine that we have people capable of soothing distress. This is especially true in an age where a simple Google search convinces one they have cancer. Calming fears eases the burdens on the emergency room and specialists, and it allows those of us who are actually sick to get the care we need. I am no politician, but I do know that we need more people in primary care.

Part of this process includes talking about primary care in a more positive light. While I do see colds and well-child checkups in my office, in reality dealing with those routine elements does not come close to capturing the importance of pediatrics. Its importance cannot be measured, but is rather found in my relationship with my patients and their families.

A thought-provoking moment that always causes me to pause at work occurs when a family comes in and tells me that they are expecting another child. It’s always humbling when a family chooses you to care for their child, but when they choose me for a second or third time it makes me feel like I’m part of the family. I may not be able to sit next to anyone at the dinner table, but I’m like the strange uncle who you go to for advice. We need more people in the front lines of the medical field. Easing trepidation is a full-time job. I’m just as human as the patients I look in the ears of, and therefore worry follows me everywhere. It once even followed me into the women’s bathroom. Let’s hope that happens less often.

Ahmad Bailony is a pediatrician who blogs at A Bunch of Bologna: Life Lessons in Pediatrics.

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