When it comes to children, my own included, I feel that I have always understood the psychodynamics in relation to injuries. When a child stumbles and falls, the first thing they do is stop and look back at the parent, searching for clues as to how they are to respond to the injury. “Hey, Mom…are you looking…should I cry?” they say with their eyes. Most of the time it seems the child won’t even react unless the parent responds. If the parent leaps with panic, the child will do the same. If the parent looks away, or doesn’t make a big deal out of it, neither will the child.
Show me a child whose parent always rushes over, kneels to the ground with a great degree of frantic animation, showering sympathy and comfort on a kid with a penny-sized abrasion to their knee, and I’ll show you a soccer player who rolls around on the grass, a baseball player who cries each time they strike out, or a basketball player who pouts about not getting the ball. Show me that parent and I’ll show you an inconsolable child with a half-inch scalp laceration, a screaming child with a sprained wrist, a terrified child with an earache, an obstinate child who will not take their medication, a child whose next visit to the ER will be as terrifying as watching The Exorcist in a dark closet; because they have been denied the opportunity to learn self-control.
Show me a child who is sheltered from failure, who always has to be paired with their friends on the winning team, who gets a huge applause after striking out so as not to have their feelings hurt, and I’ll show you a teenager who will be on Prozac by age fifteen. Show me a child whose parents sit for hours on end, hovering over their child as they do their homework, and I’ll show you a college dropout, a young girl with an eating disorder, a teenager on Ecstasy, or a juvenile alcoholic. Show me a parent who runs interference with every student-teacher or student-coach conflict, and I’ll show you a child with chronic fatigue syndrome, migraine headaches, fibromyalgia, and chronic absenteeism. Show me a parent who arranges play dates, and I’ll show you a child who does not know how to make friends. Show me a parent who arranges for their children to be in every specialized sports camp and travel team because they feel their child needs it to compete, and I’ll show you a child who will be kicked off his high school team for drugs, alcohol, grades, or attitude. Show me a child who is given everything their friends have, and I’ll show you a child who will grow to appreciate nothing, who will talk back to nurses, teachers, physicians, and those trying to help during times of crisis. Show me this parent and I will show you a child who will not visit them in the nursing home, who will move far away once grown, who will be nothing more than a next of kin on a nursing home sheet or a phone call from a state a thousand miles away. These are the observations of an ER doc.
As a parent, I feel my responsibility is to balance comfort and love while at the same time teaching my children a sense of self-control and self-reliance. My wife and I made it clear to our kids at an early age: “If there is not a bone sticking out or blood squirting from a major artery, then there is no whining. If you fall from a bike, stumble on the sidewalk, drop from a tree, you are to jump up, stick your hands in the air, and yell, “Ta Da,” as if it were all part of the show. I don’t do homework. I did my time in high school, college, medical school, and residency.
“Son, I’ll explain concepts to you but you better have exhausted all resources first. If there is a math problem wrong on your worksheet or a word spelled incorrectly, I’ll tell you…just not which one. You can stay up as late as you like as long as there is a book in your hand…and no, the computer does not count as a book.”
Now I don’t know if that’s the best way to raise a child, but I do know that it makes for a much quieter household, and lot less work. It’s also pretty entertaining when you watch them crash their bikes, tumble ten feet, come up in a bloody mess, and scream, “Ta Da!”, hop back on their bikes, and ride off. My kids don’t get too upset about losing, striking out, or making mistakes. Their accomplishments are their accomplishments, not mine. Their failures are their failures…not mine. A while back my oldest son, Max, won the school science fair. What made me so proud was the fact I did not even know he had entered it. He did the entire project by himself at school. He went to the regional final and didn’t win; that really upset him. He was angry and cried, and then told me there were tons of projects that could not have possibly been done by kids alone. He felt cheated. My response to him was the following: “Max…I could care less; quit whining and get over it. I would rather that you got last place with your own work than first place with mine.
I could not be any more proud of you than I am. Now get your shoes on and let’s go shoot some hoops…oh, by the way, life is unfair…there, now didn’t you learn a lot?”
He smiled and gave me a big hug. We grabbed a basketball and I proceeded to kick his butt in a little one-on-one. I haven’t heard another word about the science fair since. By the way, when that kid finally beats me at hoops he’ll know he has really won…so far, he’s zero for about a thousand.
I like to think I’m parenting the right way for me. I’ve never had to pull my kid off the field because he cried on the pitcher’s mound, missed a fly ball, and fell to pieces. They don’t throw fits when they get their immunization shots, their teeth pulled, or hair cut. They still come into my room when they have bad dreams, cuddle up, and find respite next to their parents. In that manner, I never turn them away. I was scared to death of the dark when I was a kid, so I’m pretty lenient when it comes to those kinds of fears.
Though they each have their own rooms, I let them sleep pretty much wherever they want. For the most part, they sleep together in the same bedroom, though they jump around now and then. They find profound comfort in each other, between their constant fighting, of course, which I think is very important. My father grew up loving one brother and hating the other. My kids will love each other no matter what, even if I have to cut them out of the will to do it.
When it comes to sports and my children’s accomplishments, I am a realist. We are short Jews. Short Jews are destined to become intramural point guards, decent second basemen, punters and place kickers, good tennis players and golfers. Okay, so Dolph and Danny Shays made it in the NBA. There was Sandy Koufax, Rod Carew, and Mark Spitz, too. I also know people who smoked their whole life and never got lung cancer. In reality, the chances are better my kids will own an NBA franchise before they play for one; which is precisely why I don’t understand parents today. I love sports, I mean I love them. I would watch celebrity goat herding if it were on television, I would even watch the French play soccer if I had to. But my own identity is not about my kid’s fastball or jump shot.
I once took care of a high school football player, a freshman mind you, who was hit so hard his grandkids will be born concussed. He was hit all the way back to the first grade, horribly confused. Fortunately, his CT scan was negative and he did not suffer any life-threatening brain injuries. When I informed the father he would most likely not be able to play for the next few months, you would have thought I had told him the kid had metastatic bone cancer. I actually had to pause and rehash in my mind if I had said what I had thought…did he misunderstand me?
“You don’t understand!” he cried and screamed at me.
“What don’t I get?” I asked, very confused.
“He’s a freshman!” he responded…more upset.
“He’s a freshman…and…that means what?” I asked. He glared at me as if I should know where he was going. I didn’t.
“He’s a freshman on the varsity, the starting punter,” he cried.
Now you might think this behavior is an anomaly; I assure you it is becoming more of the norm. I see children participating in sports at their parents’ urging while still profoundly ill or injured. I’ve seen children pushing the envelope of weight loss and gain with parental approval. I’ve watched parents refuse to discipline a child for drugs, alcohol abuse, and truancy, all for the fear of losing a spot on the choir, band, cheerleading, or the football squad.
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sp; The ramifications are that we have created a generation of parents who are afraid to punish, put their foot down, and only serve to make excuses for their child’s behavior. It is always someone else’s fault: the crowd they run with, the bad kid down the street, the mean teacher, or the racist coach.
I used to tell my wife that a certain high school on the north side of Indianapolis was a statistical anomaly in which it was the only school in America where ninety percent of the kids were in the top ten percent of their class.
Every weekend it is the same story: the anorexic teen, the suicidal teen, or the depressed teen. “I want my son tested for drugs; I want my daughter tested for sexual activity. Someone gave her Ecstasy; someone gave him vodka.”
I used to carry a card in my wallet for the parents. I would hand it to them if they started down the road of denial or excuses. It read:
He is in the top ten percent of his class.
She has never done anything like this before.
He is a good kid.
She has never been in trouble.
He is a great soccer player on the junior, national, regional… blah, blah, blah team.
She doesn’t drink; someone gave it to her…blah, blah, blah.
He’s never used drugs before; someone gave it to him…blah, blah, blah.
Most of the time they would hand it back, look at me, and respond, “Guess we’re not alone…you’re right, Doc, you’re right.” Sometimes they thought I was just being a prick so I stopped and let Social Services take over…it’s easier that way.
I’ve never read a book on parenting. I do know that it doesn’t take a brain surgeon to raise a child. I figure people have been doing it for what, 500,000 years or so, without too much trouble? There are probably only a few basic rules that stand the test of time, anyway. Love them. Love them some more. Spend quality time with them. Be their parent first, their friend second, and make damn sure they understand the difference. Talk to them every day, and hug and kiss them every day. Make sure they understand they are the center of your life…and if they aren’t, then make them the center of your life. Get them involved in volunteerism early, and teach them to respect you, God, and human dignity. But most of all, teach them to be self-reliant and instill them with confidence. Practice these things and they will honor you by being good people into adulthood and caring children when you can no longer care for yourself.
Chapter Nineteen
I’d Like to Buy a Casket for an Infant
The call for the code came over the hospital intercom, loud and mechanically, “Attention all personnel, Code One, the outpatient surgical waiting room.” The voice repeated the message three times with a sense of panic behind the static.
“Can’t be real?” I said. “Someone probably fainted coming in the outpatient surgery doors.” (This is a patient area located on the other side of the hospital). Non-emergency personnel tended to freak out at the slightest upset or injury, so every lightheaded family member who sees a spot of blood becomes a major episode. Typically, it was grandma getting a bit winded walking in for a procedure, or dad fainting when his child got an IV. A Code One in that area of the hospital tended to be nothing urgent. The ICU was a different story, though. Those were always real.
“Well, let’s go just in case,” I said, motioning to one of the nurses. The ER staff was responsible for responding to all cardiac arrests in the hospital, so we quickly grabbed the code equipment and defibrillator and started running to the farthest spot from the ER, knowing with some certainty that it would be nothing big. We expected to administer a pat on the back, a check of the blood sugar, and a quick, “You’ll be okay, let’s get you back to the ER just to check you out.” Was I ever wrong?
As I entered the long hallway leading to the outpatient waiting area, I could see a large crowd of white coats and blue scrubs in the distance. I was confused because everyone seemed to be standing up, not kneeling down like they normally would around a patient who has been helped to the ground. They were milling around a desk in the middle of the lobby, and most everyone looked frantic; some of the nurses were holding each other and crying. That’s when I saw him.
He was blue, cold, and dead. CPR was ongoing; an anesthesiologist who was nearby had placed a small breathing tube into the infant’s lung. Chest compressions were being performed by a terrified nurse, and another anesthesiologist, hands trembling, was hurriedly trying to get an IV in the child’s arm. This certainly was not the norm for most of them. Their patients were usually alive and pink with big plump veins. A young Hispanic woman lay collapsed against the wall, cradled by hospital personnel. All eyes immediately fell on me to take control and save this infant—a task I immediately knew would be impossible.
I grabbed the defibrillator paddles and quickly applied them to the infant’s chest to get a reading as to what this child’s heart was doing, to see if there was any hope, though I already knew what I would find. I also knew it was important for all present to see the flat, straight linear tracing of a silent heart, so that there was no confusion for this crowd of onlookers. Still, I went through the motions.
“You, continue CPR, increase your rate; you, hyperventilate this infant; you, get me an interosseous needle out of the code cart! Pharmacy, get me out some epinephrine and atropine based on five kilograms [about ten pounds]!” Everyone jumped certain that this ER doc was going to save the day; a sense of false relief came over the crowd.
I quickly cleaned the child’s leg and drove the interosseous needle into the soft bone marrow of the child’s tibia so as to get quick access to the delicate circulation. I pumped fluid and drugs into this child in a futile attempt to salvage an infant who, in all practicality, had been dead for some time. But it was important, not only for the family but the entire staff traumatized by this event, to feel that everything possible was being done. We continued down this path with me watching the monitor, ordering medications, pumping fluids, checking breath sounds, going through the motions of playing doctor to a crowd who had no idea that there was no, and I mean no, chance of survival.
Forty-five minutes later, on a cold desk in the middle of the lobby with hordes of onlookers, gawkers, and hospital personnel, this child was declared dead.
By this time, Mom had been escorted to a waiting area outside of the lobby and was sitting with our clergy. I thanked everyone involved and covered the child with a small blanket, gently lifting him and placing him on a gurney. I reassured everyone that they could not have done anything different to save this baby, that this child was dead long before they had entered the wrong doors of the hospital. I think they found this comforting. Next, I walked through the surgery waiting room filled with the family members of other patients having various OR procedures. All of them were well aware of the goings-on outside the waiting room door. They all looked at me searching for the answer to the question: had the baby died? They saw the answer in my face. Many of them held each other’s hands and quietly sobbed as I walked into the private consultation room off to the side.
Mom spoke no English, but I could speak Spanish fairly well. In the 1980s, pre-med programs pushed French, German, or Latin as the language of choice. Just for this reason, I was glad I chose Spanish. I had never treated a German or French national who did not speak English, and as far as I knew, Julius Caesar had yet to step foot in our ER. Learning Spanish had been a godsend and made me that much better of a physician: I even feel it should be mandatory today for all pre-medical students.
As expected, the mom had collapsed into a palpable despair that hung like a fog over the waiting room. It was thick and humid as we wheeled her and her dead child back to the ER. Dad showed up shortly thereafter and fell to the ground crying with heart-wrenching sobs of pure life-altering grief.
His name is Carlos, and I now consider him my good friend. It turns out that Carlos is one of the longtime bus supervisors and a short order cook at Sullivan’s, my favorite steakhouse in the city. There was something about his despair, his
absolute love for the small infant that hit me like a brick: It was how I felt about my children, and I felt his loss . . . I felt it deeply.
The clergy sat with the grieving parents and comforted them. By that time we had called the coroner and the funeral home. It turned out that this was most likely a classic case of sudden infant death syndrome, in which the child probably had a severe respiratory virus and had been bundled and put in the crib facedown, and most likely suffocated. The coroner did not feel that an autopsy was warranted, and thus, we could release the baby to the funeral home. I told the clergy that I wanted to help with the funeral and asked if he could get them on the line.
“Hello, my name is Dr. Profeta; I’m one of the ER physicians at St. Vincent Hospital. I would like to buy a casket for the infant who just died here. How much would that cost me?” The funeral director told me that if I would buy the casket, he would donate the plot and the stone. “You got yourself a deal,” I told him. With that, I bought my first casket.
I didn’t go to the funeral. I didn’t even look for it in the paper. The clergy from the hospital officiated at the burial and filled me in on the event. I asked him not to tell anyone in the hospital; I was afraid people might think I actually had a heart. He told me the family was very appreciative of my generosity.
Perhaps four months went by until I finally worked up the courage to tell my wife that I wanted to go back to Sullivan’s. I asked if Carlos was working, not wanting to startle him. The manager recognized my name and thanked me for helping Carlos (all the employees at Sullivan’s like him and felt for him). Carlos visited our table and, in the middle of the restaurant, cried and hugged me. He told me how grateful he was for all I had done and informed me of the good news: his wife was pregnant again.
The Patient in Room Nine Says He's God Page 11