waaa!

A child has a great memory for details.  Like wet cement, unencumbered by years of routines, every new experience is pressed firmly into their foundational memory bank.   So what do we do at a child’s first eight well-child visits?   We look in their ears with shiny gadgets, gag them with a popsicle stick, then smile, as we stick needles into their muscles and inject a stingy liquid that makes them cramp in pain.

Most infants catch on within a few visits.  Well-meaning parents often bribe their child with treats to gain their cooperation. But when an intelligent child with a good memory raises concerns (by screaming, hiding, or kicking), they lose the promised treat, which of course goes into the child’s memory bank.  This “memory bank baggage” from prior unpleasant visits makes each consecutive visit more difficult.   It takes years for a NP to re-gain a child’s trust, just in time for the next round of vaccinations.

I could hear these blood curling screams from two rooms away.  Not unusual in pediatrics, but when I checked, this was this particular infant’s first visit.  When the tech came out of the room, she shared, “I didn’t even touch him before he started to scream.  I’m not sure the weight is accurate and I had to go with an axillary temp. ”

Hearing the screaming subside I ventured in, taking off my lab coat, holding a stuffed animal.   My reputation as the “Baby Whisperer” was about to be tested.  The little boy was cradled close in the arms of his grandfather with no parents in sight.  I hadn’t finished introducing myself before the blood curling screams began again.

I tried ever calming trick I knew, certain that I would break this kid like so many others before him.  I sang, I rocked, I averted eye contact, I tried swaddling, then finally I had to give up and gave this terrified infant back to grandpa.  I settled for a very expedient exam –completed in beat with the blood curling chorus.

This intense, unusual reaction came from day zero.  It made no sense.  This child had no prior contact with medical providers.  We wondered if it might have been the cultural shock of a white caregiver so the next time he came we tried bringing in staff with darker skin –to no avail.   We wondered if it was the lights or the absence of the parents.  But the grandfather was the primary daily caregiver so that was also ruled out and turning out the lights never helped either. The child was doing well in all aspects of development, interacting normally outside of the medical office so that ruled out any autistic spectrum issue.

Visit after visit, nothing changed.  The same pitch and volume – right up to the age of three!  One day, the grandfather needed a form completed so I had them wait in the waiting room where he always settled down.  When I brought them the form, there was dad, outside the building, pacing, too afraid to enter.  This was why the grandfather always came alone into the office.

We teach our children by example!  This child was very bright and was able to sense dad’s intense fear before he ever set foot in our building.   Think what must have gone on in that little mind as they were driving over?  Where are they taking me?  Why do I have to go?  It has to be really, really bad for dad to not go in!   All wonder he had blood curling screams, who wouldn’t?

Studies have shown that PTSD level anxiety can be genetically transmitted – and fortunately also eliminated with time and/or therapy.  Perhaps if we realized that the one we needed to work on was dad –for the baby to lose his fears — things might have improved!   A lesson for the next time.

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