For Better or Worse

March Third Year:

I was on call last week during the snowstorm. We always work the afternoon/evening acute care clinic when we're on call, and, ostensibly because of the bad weather, the schedule was mercifully light. However, as we were preparing to pack-up, a mom and her 6 year old son (we'll call him Joe) walked into the office hoping to be seen. Joe had been snowboarding when his right under-eye area wound up on the wrong end of an encounter with a board edge. The half-moon gash wasn't deep but was wide enough to leave a permanent scar. Mom brought him in to find out if he needed stitches. Joe was terrified of this possibility.

I took a look and delivered the bad news, "There is going to be a much smaller scar if I put a few stitches in there to hold it together." Joe started crying. Mom looked distressed.

"Oh," she said, "I was hoping it wouldn't come to that. But I guess we'll do what we have to do." Her son was quivering at her side.

"I'll be right back after I get together my supplies."

Before I walked back in, my attending suggested I bring in the papoose, 'just in case'. The papoose is, um, sort of what it sounds like. You strap a kid to a backboard, and it allows you to do things (like stitch up their faces) that any self-respecting 6 year would normally kick/scream/yell/thrash around to keep you from doing.

I entered the room and set up my supplies. Mom picked up her purse. "I'll be in the waiting room."

And then she bailed.

?????

I was flabbergasted. Her terrified son was sitting on the exam table, looking at me like I was the firing squad. And he was alone. Now I had to be mommy and doctor. I sat next to him and smoothed his hair while he cried. "It's going to be okay, Joe. I promise you. The numbing medicine is going to sting a little, but then you won't feel anything."

I spent the next 30 minutes in a song and dance routine with Joe. I'd get close to his face with my needle. He'd bravely say it was okay. My needle got closer. He suddenly darted away. I'd comfort him. He'd say, 'okay, try again'. He'd change his mind. Tears kept flowing. I'd say 'maybe I should get out the papoose.' He'd somehow get brave again. Finally, the numbing medicine was in. And even though he was through with the worst, we went through the routine all over again when it came to sewing his wound closed. There was just the nurse and I during this time: comforting, talking, doctoring though we'd only known Joe for a matter of minutes.

I was so relieved when the stitches were finally in. I went and got mom. She also seemed relieved. She kept hugging her son and saying, "I need a hug!" And I'm thinking, 'Lady, your son needs the hug. You need something else entirely.'

In talking to my colleagues afterwards, I expressed dismay that she would leave her son alone during such a traumatic experience. My attending said, "Well, maybe she knew she would faint or something." Like it was no big deal.

But it is a big deal. I mean, I realize that sometimes we want parents out of the room. When we do spinal taps on babies, for example. It's easier for everyone. A baby has no idea what's going on and often looks at the parent with betrayal. "How could you let them do this to me?!"

Joe was not a baby. He was a 6 year old, fully aware of what he was about to experience. He, at such a young age, had to pull it together and get through a difficult experience. But his mom didn't? What message does that send to the child? "This is going to be so bad that I can't watch. But good luck with that!"

I don't know. I guess I just feel like it's part of the job description. As a parent, you have to be there for your kid when the going gets tough. You have to force yourself to do uncomfortable things. I had stitches when I was 12. My dad was there with me and it made all the difference. I remember burying my head into his shoulder and clenching his hand until it was through. I can't even imagine what it would have felt like if he'd bailed on me.

So, I pose the question to you dear readers: is it okay what that mom did? Is it okay to leave a child alone for a difficult procedure (and let's leave babies out, since I do think that's different)?

I think you know where I stand. ;)