$#*! My Pediatrician Says

Steven: Apologies to Richard Marshall, my true pediatrician who has always been a sane voice and a trusted friend in my forays into the world of American Pediatrics.

Today I took dear little Gil to the pediatrician for some loose stools. Diarrhea, really. Now, I'm not an alarmist. I know how to look for signs of dehydration in a newborn, I know how to Google "newborn diarrhea" and "what should my baby's poop look like." But his stools were really getting watery and then he slept 5 hours without waking last night, which normally would be a cause for a small sacrifice to the God of Nighttime Feedings, but since "lethargy" is a sign of dehydration, I thought a visit to the local pediatrician was in order.

As it turns out, I had already made an appointment for tomorrow because the adoption agency requires a one-week check-up. So I just went to that office (quite near to us) (they take Texas Medicaid, or so I thought) which I knew had walk-in hours from 9-10am.

Well, after filling out reams of paperwork, and being told that the office didn't take the brand of medicaid that Gil has (he automatically gets Medicaid because his mother was on it and I thought it would be simpler to use that insurance rather than my MA-based Tufts insurance...OK, OK, maybe I thought it would be cheaper -- it's a genetic affliction, I swear), I was shown into a very nicely appointed examination room by a lovely woman who failed to introduce herself or tell me what her role or title was, but she then proceeded to weigh and measure Gil. (He lost 4oz since birth... pretty normal. He also lost half an inch, which shows you how inaccurate those measurements can be.) Oh, and did I mention that the secretary didn't introduce herself either when I checked in? Oh, and they don't take his brand of Medicaid. (Don't get me started on single payor systems...)

So after brief wait, a middle-aged (and by that I mean somewhat, but not excessively older than me) portly man came in. He definitely had the air of a pediatrician, meaning he was carrying a chart and looked kind and knowledgeable. But, alas, he failed to introduce himself either. He then asked me about Gil and I reported a brief, but sensible history. He asked about the pregnancy and I dropped enough medical jargon into my answer that he should have suspected that I was a doctor, but even then he did not ask me anything about myself. OK, it's forgiveable: I'm there for the kid.

Then he says the first thing that rubs me the wrong way: "How much experience do you have with newborns?" It wasn't so much the words as how they were coated in a patronizing drawl that irked me. So I told him that (a) I had a newborn before and that (b) I was a physician, but not very worried, just thought I should have him checked out.

Okay. Then he seemed to like me more. He asked some pointed questions about the adoption, though, which were odd, bordering on offensive, like "It's basically like buying a baby, isn't it?" (Now, it actually is rather like buying a baby, but do you really ask this when you first meet a stranger in your office who may be concerned about his son's bowels?) Anyway, I used it as an opportunity to raise his consciousness about adoption and difficulties that gay parents face and how my agency in Houston was especially committed to finding children for "alternative" families. I tried to make it all sound matter of fact and casual: "Oh, yes, I'm down here with my partner. He's back at the hotel with our other son."

Well, it turns out his consciousness really did need to be raised. As I was leaving he said, "You know, we don't hate liberals down here, we just don't understand you."

I wonder what class in medical school he learned that this was ever an appropriate thing to say to a patient. (Note to self: use this in one of my ethics and professionalism classes.)

In the end, I'm glad I went; Gil is fine, his diarrhea seems to have cleared up and he's been so sweet and peaceful today. I'm not sure they teach doctors and nurses to introduce themselves in Texas. I had the exact same experience when I took Kofi to the pediatrician here too a year and a half ago. It makes me sad for my profession, but so glad I practice with the people I do who focus on the needs of the patient in a way I've found lacking in my healthcare interactions here.

And all day, I've been looking at the people I pass -- on the street, in the mall, at the hotel -- and wondering if they are conservatives and wondering how they think and if I can understand it and if they can understand me.