The worst of Pediatrics

You can never say you've dealt with a difficult parent until one educated/impatient/emotional/highly strung one has shouted at you in front of the ward.

I started out with an avid liking for Paediatrics as a medical student, despite repeated warnings by many predecessors that the deal with Paeds was really more about the parents than the kids themselves. It has only been 2 months. And sadly, as much as I would have wished for so otherwise, my interest in this specialty has lost much of its initial sparkle and somewhat dwindled due to a several number of nasty experiences.

I've bore the brunt of a full blown words of anger raised at me for failing to set an intravenous plug in a patient twice in the middle of my night call. I remember for most the account, being so shocked to the extent I was rendered dumbstruck and speechless that I was unable to refute any incoming argument that the angry father threw towards me. All I could muster was a few words of my apologies, sputtered pathetically in staccato as I stood frozen to the ground, and widened my eyes like a guilty idiot who was close confessing to her crime. Needless to say, it took a significant amount of will power but I held back my explanation, with the knowledge of the fact that often in such intense nerve-wrecking situations, logical explanation would fall off the ears of those who are too emotional to be rationale.

But then again, was it even a crime? To have failed despite trying my utmost best to set an intravenous plug in a chubby infant with difficult tortuous veins?

I've had yet another unpleasant experience that taught me, never ever to allow a parent, no matter how persuasive and insistent they are to accompany the child, into the treatment room to witness the painful procedure of setting an IV plug on their child.

My scarring experience was with an emotional mother of a kid who needed an IV plug for medication following a recent diagnosis of Kawasaki disease. The young mother insisted on accompanying her fretful child, who had already started wailing and bawling her eyes out even before we entered the treatment room. We wrapped the child in blankets and pinned her down to minimize any physical struggling that would be disruptive to the needling procedure. It was a intensely challenging task, to keep the writhing child forcibly still, insert a IV plug into non-existent veins that really did not appear prominent against the colour of her skin, under the watchful ominous glare of the kid's anxious mother.

What ensued during the next few minutes was uncontrollable bursts of sobbing and tears punctuated by spells of high pitched shrieking and spillage of blood amidst the frenzied exchange of needles, drip sets and tubes between several pairs of hands. It was utter chaos. So when the young mother eventually lost control of her emotions, she pleaded with tearing eyes and told me not to ''torture her daughter any more'' as it was painful for her to see her daughter ''suffer''. It was heart wrenching, yet in spite of all explanation to the mother as to why the IV plug was needed for the bigger picture (i.e treating the underlying condition, reducing morbidity and mortality from fatal complications that may occur if this was left untreated.) I could only apologize profusely for the amount of pain inflicted on her daughter during this much needed procedure.

The whole episode ended terribly, with the younger mother demanding for another senior cover to do the IV plug setting instead (as she doubted my experience and ability) and another hot-tempered nurse who grew increasingly patient and stormed out of the treatment room before we completed the procedure.

I spent a good number of weeks reflecting on these experiences, feeling miserable and depressed about my inadequacies as a junior doctor and incompetency to deal with difficult human behaviour. And sometimes I do wonder if I seriously love communicating with crazy parents enough to pursue Paeds as a career. I guess every job as its ups and downs. What makes this current posting more unbearable then it already is, lies with the interaction with a stereotypical Singaporean parent who often tends to be frequently impatient, stubbornly unforgiving, at times blunt and rude. The ones to be really feared are the educated affluent parents, who have the means and resources to file a lawsuit for every unsatisfied expectation and every unmet demand.

Alas, Dad's right when he said that 2 hardest things in life to manage 1) People 2) Money