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'Nurseries Aren’t Built With Escape Routes, and It Was Clear What Was Happening'

Twenty-four years had passed since I had been in the nursery where I had spent my first few days of life. Now, there I was again, a third-year medical student on the first day of my pediatrics rotation and nearly as clueless as my initial stay.

My attending was busy with some administrative tasks and told me to go ahead and examine a baby. It had been many years since I had held an infant. As anyone with experience with infants will tell you, they are surprisingly tough and resilient. As anyone without that experience will tell you, they are quite likely to break into a million pieces if not handled with exquisite care.

Awkwardly, I unwrapped the little guy from his nursery blanket. Was the fontanelle really supposed to be that big? Were the testicles really supposed to be that small? Oh my God, what are these red splotches all over? As I finished up my poking and prodding, I glanced around at the perfectly swaddled bundles in the room. I tried thinking about how they wrapped my burrito at Chipotle.

Suddenly, there was a vigorous knocking at the nursery window. I tried to pretend I didn’t hear it at first, but it soon became clear that that would be impossible. There was a young woman standing on the other side of the glass pointing at me. I could see her mouthing the words, “Who is that?”

I froze. My heart sank, and my stomach lurched. Great beads of sweat leapt from every gland on my body. I saw her in the periphery of my vision briskly walking around the corner to meet someone at the secure doorway as I frantically tried to finish my burrito wrap. I needed to find an escape route.

But it was no use. Nurseries aren’t built with escape routes, and it was clear what was happening. Without her consent, some incompetent imposter was manhandling her baby, maybe even trying to steal him. This mom was coming to kill me.

I heard a mumbled conversation around the doorway as I desperately tried to maintain continence. If there had been a paper bag within reach, I would have breathed into it. In a few minutes that seemed like eternity, my attending came around the corner smiling.

“She wanted to know who you are,” he said. “She wants you to be her baby’s pediatrician when she’s born. She liked the way you handled the baby.”

Relief flooded through me, and I giggled nervously at the discordant perceptions the woman and I had of my baby-handling. I happily rode my adrenaline high the rest of the day. But later I’m not sure exactly when (but long after my pits dried out) I came to realize what a wonderful lesson this mom-to-be had given me about fear and caring.

If you ask patients if they would rather have their doctor be a jackass medical genius or merely nice, many say they would put up with the jerk for the expertise. But I’m not so sure the survey results tell the whole story. In the real world, patients don’t possess the tools required to evaluate a physician’s competence. They do, however, know if their physician cares.

The mom-to-be that day in the nursery clearly knew nothing of my competence. All she saw was a few moments of me handling a baby like a Ming vase, and in those few seconds her mind was made up on who her baby’s doctor would be. She saw I was concerned. She saw I cared. And that was enough.

Thinking of that day now, I remind myself to carry a little fear for my patients with me. I remind myself to ask if the fontanelle should really be that big or if the testicles should really be that small. Most importantly, I remind myself that it’s OK to let a little of that fear show to the patient. 

J. Lane Wilson is a full-spectrum family physician at the Brody School of Medicine at East Carolina University in Greenville, NC. He is married to another family physician and is the father of three. He enjoys hiking with his family, running, and is a Major League Soccer fanatic.

Image: Zurijeta / shutterstock

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