View from the ground, by Toni Hazell
‘Hi Toni, it’s the school nurse here. Simon is in my room complaining of feeling sick—did you know that he was ill?’
The dreaded call from school. My son had mentioned a bit of a tummy ache that morning, but had eaten breakfast and seemed OK, so I sent him to school and thought nothing more of it. After looking pea-green in assembly he had been sent to the nurse; by mid-morning he was vomiting and on his way home. Great impression to make as a medical parent, in his first term at a new school—my sincere apologies to the nurse in question, if she is reading this.
I find it really difficult being a medical parent. Friends have said that my children are lucky; they have access to an opinion from a GP, day or night, without having to battle through reception for an appointment. But it’s very difficult to set aside our extra knowledge and be objective. In primary care, we often see patients present time and time again with a cough and sore throat that would have been best managed at the pharmacy. Maybe seeing what appears to be over-medicalisation of normal childhood illnesses day in and day out, combined with the strong pressure not to call in sick as a doctor, has a tendency to make us under-estimate illness in our nearest and dearest. I suspect that my daughter’s asthma might have been diagnosed a bit earlier if I hadn’t taken the view that it’s pretty normal for kids to cough a lot during the winter months. Or, maybe, those early days of coughing were just viral upper respiratory tract infections and she was appropriately diagnosed? It’s difficult to say.
I do know that it isn’t just me, having chatted to a consultant orthopaedic surgeon with an interest in paediatric trauma; his family will never let him forget how his son went to school for 4 days with a greenstick fracture before it was noticed. As an adult, there is a fine balance to be struck between not taking time off work at the first sign of every sniffle, while also knowing when we are ill and need to stay home; doctors tend to err on the side of coming in at all costs, knowing that the service will suffer if they don’t. Maybe we need to be a bit more balanced, both for ourselves and our children.
The other aspect of too much knowledge is that it’s easy to over-react. I vividly remember how scared I was when one of my children had a persistent hacking cough as a small baby and I needed a lot of reassuring—no doubt the recent chain of emails in my inbox about a local death of a neonate from pertussis had something to do with my worries. Less knowledge would have been a good thing then.
Our children don’t get to choose whether or not to have medical parents—for good or for bad, they are stuck with us. But how does it work the other way round? Does being a parent make me a better doctor? To that, I can categorically answer yes. I am better at assessing kids and putting them at ease, and I understand a bit more about what it takes to be a parent. I have seen my own children look at death’s door at home, then skip through the door of the surgery (to my utter embarrassment). I also remember the mind-numbing tiredness of early parenting; I am more likely to proactively offer a place to breastfeed, or to give tips on how to get eye drops into a toddler.
But this isn’t intended to imply that doctors without kids are less empathetic. We all bring our own life experiences to our work. Having a father who died of dementia made me understand the pressures of caring to a deeper level than I had before. Other doctors will have had experiences of chronic pain, disability, infertility, mental health problems, or having a child with a long-term illness—they will bring their own unique skills to every consultation. That’s why medicine is an art, not just a science.
Dr Toni Hazell
Part-time GP, Greater London