Tuesday, September 2, 2008

Inspiration from the Little Ones

Pediatric patients are the kind that can in one single instance of brilliance and simplicity brighten your day. Their naivety, sincerity and curiosity can turn any situation into a smile. They will play with you even though they don’t know your language or customs. The following are stories of the little ones:


“Mr T” was one that made you smile without him even doing anything—I mean how can you not when you are looking at a papua new guinea kid replica of Mr. T?. His mother came to the ship for surgery and while recovering he found it fit to wheel her around the ward, a feat that he was not that good at, yet he persisted. At the helm of the wheelchair “Mr. T” scooted his mom into many a table, bed, or pillar before she finally brought him under wraps. Mom said that she finally caved in and gave him this haircut because Mr. T is his hero.


The twins (in green) and their little sister (in red—that’s not ptosis you’re seeing) are a feisty lot. Their dad is a big burly guy who runs the boxing club in Port Moresby. They came to me for a physical examination to “see if it was okay for them to box.” These girls were in great health, and at the end of the exam I decided to have one final test. They each wound up and were told to take a hard swing at my shoulder the way their dad taught them to do. After the second punch I was nearly knocked off my flimsy plastic chair.


I was walking down CasRec when I saw this little girl scooting around in circles, shuffling her feet and cooing with excitement. She had commandeered her mom’s sandals and was parading on the newly waxed floor. You can’t help but stop and watch her regal procession. Soon there was a crowd of 4 or 5 of us. The picture doesn’t capture it all, but sufficed to say she is a cute one.


Sometimes the kids don’t come with smiles and excitement. Sometimes they are scared, apprehensive, guarded, and crying. You learn very quickly that the child is in control of the visit and will only let you do what they are comfortable with. Your job is to earn their trust and confidence. This is one of my favorite challenges in pediatrics. The first thing you have to do is establish trust and an amiable relationship with the parent. Ignore the crying child, and focus on the parent first. Children are smart and very observant, even when they are crying. Establishing rapport with the parents, talking with them, shaking their hands, examining them, all tell the child that you are a safe “stranger” that mom and dad are okay with. Next you address that child. Tricks of diverted attention, systematic desensitization, magical wizardry, and of course bribery are employed at this point. For example, I always show them my stethoscope and have them hold it to show them it is not dangerous. If they are old enough I ask them to put it on their heart. I’ll show them what I’m going to do first on mom so that they see its safe. I’ll give them things to hold and inspect while I hold and inspect them. I’ll show them my pen-light and shine it through the nail of my pinky finger, turning the tip an orange-pink, making an ET effect. If this fails, there isn’t a kid around that doesn’t finally crumble their outer shell to accept a nitrile-glove-balloon-man gift.


Bon Voyage,
~Nic

1 comment:

Beth said...

These kids are too cute! Mr. T has to be my favorite, though...

BTW, I'm Beth and I work with Jean Ah Lee here in Guatemala and she recommended your blog to me. :) You have a new reader!

My blog, if you're interested in Guatemala: tecoteca.blogspot.com