10 Things Parents Hate to Hear from their Pediatricians

Cutting up with my sibs and cousin last weekend, I was inspired to make this post. There are just some words and phrases that should not be in the vocabulary of a health provider. Call it wanting to inspire confidence or using common sense but docs and nurses should be careful in the words they say to patients and their families. There are other phrases that are necessary but often received bitterly by parents. Consider this list the conglomeration of "10 Things Parents Hate to Hear [that I have overheard this year] from their Pediatrician"; The first 5 are ones that should never be uttered, the latter 5 are phrases that are necessary but never received well:

1. "Well...we'll keep our fingers crossed!" This phrase quickly became a pet peave of mine when my hematology/oncology attending kept using it with patients on her service. Maybe on the wards floor or clinic, this might be somewhat more acceptable, but on the oncology floor? Really? Really, Dr. C? We're going to lead our cancer patients' families to believe that their hope rests on the status of our index and middle fingers? Really?

2. "You've got me stumped." Another line that I have heard (and cringed afterward) this year. Even if we are not sure, let us let our patients know that we are going to keep reading and that we are not, in fact, giving up.

3. "Now don't go searching on the internet about this..." Okay, so it is always a bit annoying when your patient's parents go looking up information on words (or parts of words) you have said in the room. A little bit of knowledge can be dangerous, right? Yes, but it is also encouraging to see self-motivated families that care enough to be informed. This request would not sit well with me as an interested parent.

4. "Oh...right..." in response to a parent asking if my ER attending had given any numbing medicine before beginning to suture a young girl's lip. My attending, a nurse, and I were wrangling a 5 y/o girl with a lip lesion; In the chaos of an unbelievably small room, the attending began sewing without numbing first. When her oversight had been caught by the parents, she began numbing copiously as she repeated over and over, "Lots of numbing medicine, guys...lots of numbing medicine." Too little, too late.

5. "Oh, CRAP! (or other expletive)" Whether in the operating room or not, this classic is never reassuring.

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And 5 necessary that never sit well...

6. "Do you smoke?" Perhaps this is such a big problem because I am doing pediatrics in Kentucky where nearly everyone seems to smoke. I can often see the bolus of guilt, angst, and then dishonesty make its way up parents' throats before I have finished this question. Some simply deny it as they wipe their dishonest mouth with tar-stained fingers. Others admit to their habit but quickly spell out their plan to quit. Most of the rest quickly assert they "only smoke outside." I have not met a parent yet this year who smokes in the house.

7. "This is a teaching hospital." Although the premise is nice and the argument could be made that patients get better care in such facilities with the latest and greatest, some families take this comment to mean that their kids are guinea pigs. One mother stapled me up one side and down the other with reasons that she would not allow any student nurses in her son's room that night. Despite my best efforts to explain the hierarchy and safety nets of a teaching facility (even making the above assertation myself), this lady was not having any of it. "My son is not an experiment! He is not a science fair project..."

8. "It's probably not ADHD." Coming into my residency, I did not expect so many parents to actually want their children to be diagnosed with ADHD. I do not know if it is because people want a label, medicine, or an explanation but so many of my parents come into the clinic with this self-diagnosis. These conversations usually go something like this: "Doctor, my kid is ADHD." "Ma'am, your son is two years old." "I know, but he's got it...he's got ADHD. He runs around and fights with boys/his siblings, and is just generally uncontrollable." "Ma'am, it sounds like your son is...a boy," I always want to say...but usually I respond, "Ma'am, ADHD is a diagnosis that is made when a child is a bit older after at least 6 months of at least 6 symptoms of each inattentiveness and hyperactiivity/impulsivity in at least 2 different settings.." and so on. Usually the diagnosis has already been made...

9. "Can you step out for a few moments." This is always an awkward one to say to those parents of tweeners and teenagers in order to get "the real scoop" on what is going on. When we broach the topics of "sex, drugs, and rock 'n roll" as one attending puts it, how do we really expect honest answers without speaking privately with these kids? Well, usually my parents, after realizing that I was not kidding the first time ("Oh, you really want me to...uh...leave?"), oblige without issue. However, one tough grandma in April flatly refused me. "No, I want to hear what she say...I ain't leavin'!" With the young girl's approval, I had to say, "As you wish..."

And finally...

10. "It's a virus." This one has become comedic to my friends and I. This phrase has become synonymous with "yeah...we got nothin' for ya..." Because viruses are by far the most common cause of respiratory and gastrointestinal infections, the tough answer is often the true answer.