Hung up on the cuteness

When I started medical school, I was not into kids. It was partly a matter of principle--I didn't want to do what everyone else was doing, and everyone else was loving kids, so it became my business to not like kids. Another part of my distaste was the spectacular humorlessness of so many people in pediatrics, their overall trend toward an inauthentic kind of hokey-jokey smileyness and their tendency to stare blank-eyed and confused at sarcasm. I was also rubbed wrong by the unspoken ethic--and not just in medicine--that kids deserve more care, more love, more forgiveness, more everything, just for their sheer cuteness.

I'm not hanging around with those moony-faced saps, I thought. Non-cute adults deserve tenderness, too, and I wanted to bring that to adult practice. By the halfway point of medical school, I had aimed myself squarely toward internal medicine.

When I did my obligatory pediatrics rotation in my third year, I spent most of my time in the pediatric intensive care unit (the PICU), where most of my patients were unconscious. As careful readers already know, unconsciousness isn't something I mind in a patient; in the PICU, my focus was, happily, my comatose patients' physiology. To my surprised relief, PICU docs-unlike other pediatricians-didn't call their patients "peanuts," or "kiddos," or "shmoopies"--they called them "patients." The disease process and the events around its acceleration crowded out any of the sentiment-real or false-that I found so unappealing among pediatrics types.

By the end of my PICU rotation, logic had gotten the better of me--I couldn't rationalize giving more to an entire segment of the population just because of their cuteness, but I also couldn't rationalize not giving them as much. And if the pediatricians in the PICU could take care of children without themselves acting juvenile, maybe there was hope for the others.

I never felt I was very good with children--I didn't tend naturally toward silly faces or voices, and because I always worried about breaking kids by doing something wrong, I never did much with them at all. Somehow, once I resigned myself to wanting to be trained in pediatrics and began interacting more with kids, I found that being "good" with them only meant wanting to be around them. And oddly, I did want to be around them. I couldn't really explain it, and I didn't try too hard. I was too busy trying not to get hung up on the cuteness.

I ended up in a program that combines training in both adult and pediatric medicine, alternating between three months of each. After beginning my intern year with three months of adult medicine, I switched last week to my first pediatric rotation, which is in a pediatric emergency department. I see anywhere from 10 to 15 kids in a shift, ranging in age from 2 weeks old to 21 years old. I put stitches into eyelids, take beads out of noses, and pull shoulders into place.

I don't make silly faces, and I don't do silly voices. I'm more patient with the crying ones than I ever thought I'd be. And, God help me, they are sometimes so cute I can hardly stand it.

The other day, I put four stitches in the finger of a four-year-old girl who had cut herself on a scooter wheel. Her parents had to hold her down so I could work, and I was certain I was participating in some kind of major traumatizing life event. But afterward, instead of shrinking away from me, she looked at her finger, then looked at me, and with enormous, sucker-producing blue eyes, said, "Thank you for fixing my boo-boo."

Oh my God! I'm one of them!

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