July 29, 2020
In the summer kids usually come in for their check-ups. This is an opportunity for doctors to touch base with families and see how their kids are doing. This day was no different than others, and the next family hurried in. A 14 year old girl, tall and lean, walked in with her little sister. The young girl, turning 12 in a few days, followed closely behind and sat herself on the exam table. The mother followed.
I love seeing families in the summer. Usually the kids and the parents are more relaxed than during the school year, when they are busy with school, sports and other extracurricular activities. I get to hear about summer vacations and camp. I also get to learn about how things are at school and if there will be any changes in the coming year for the kids.
The little girl was sitting on the exam table with her head down, fidgeting with her fingers. I smiled at her and asked her about her summer and what she had been doing. She went on to tell me that she had been spending her days cooking and practicing basketball, which she loved.
I asked her to give me more details about what exactly she was cooking and what kinds of foods she enjoyed the most. Her eyes lit up and she went on and on about how she loved finding new recipes to try on the internet and looked for you-tube videos showing people making different dishes.
Then I asked her about basketball and she explained how this was her favorite sport. She was enjoying a summer camp that focused on helping kids perfect their skills and she “LOVED IT!”. This year, she was excited because she was trying out for the basketball team at school and she couldn’t wait.
Finally, I asked her about school. This is when her face quickly changed and her eyes hit the floor. Her mom jumped in. “She isn’t trying very hard in school”, “We know that she can do better, but she doesn’t have any interest in school.” The little girl didn’t say a word. I tried to change her focus and asked her what her favorite subject was. She told me it was Science.
Ah! A girl after my own heart! She explained to me how she had an amazing Science teacher that loved to teach them about their bodies, nature and the ocean. She told me that this teacher was her absolute favorite teacher ever!
As we finished her exam and discussed healthy habits, I reminded her to read over the summer and keep her math skill sharp so that when the new school year began, she would be ready. She nodded and jumped off the exam table.
Her older sister was next and we began her exam in the usual way. Her interests were different and the mom quickly jumped in to tell me how wonderful she was doing in school and how she had achieved the Honor Roll every semester. She smiled and shrugged her shoulders.
She told me that her passion was History and English and that she was participating in a writing camp over the summer because she loved to write. The mother beamed. She went on to tell me about how proud she was and how she ALWAYS put forth her maximum effort. She then went on to say that she wished that her younger daughter would have at least half the interest in school that her son had. She told me that she knew that she could do better, if she only applied herself.
The little girl sat next to her mom, staring at her nails. Her nails were chewed and little was left. Her mom then told me about how she wouldn’t stop biting her nails. That her hands “looked terrible”.
The visit ended and I spoke to each child and mother alone. I always like to speak to tweens and teens alone to see if they have any concerns or questions about their health. Sometimes they do and sometimes they don’t, but I think they like when a doctor addresses them directly and gives them the opportunity to talk. Sometimes they do reach out, but even when they don’t, they know that they can if they decide to in the future.
I asked the little girl about school and she started crying. She told me that she did try but that school was hard for her. She told me that her older sister was the smart one and that she was just dumb. We talked about how she wasn’t dumb and discussed a little more about what exactly was happening in school.
I won’t get into the details but I then went to speak to the mother alone, explaining to her that I was worried about how her daughter was feeling. The mom then began to cry. She told me how she had tried everything and that nothing seemed to work. She agreed that she needed help but that she just didn’t know what to do.
We discussed some options and I encouraged her to have her daughter have a formal evaluation to rule out possible learning challenges. She agreed. At the end of the visit, I explained to the girl how we all learn differently and that she was not dumb. The secret was finding out how SHE learned best so that she too could succeed in school. She wiped away her tears and smiled a tiny smile.
These visits sometimes feel so rushed, since we only have a few minutes with each patient, but there are so many things that run through my mind when I see a family like this. It’s actually more common than you think and it pains me when I know kids are suffering in silence and well-intentioned parents just don’t know what to do. It’s impossible to fix these issues in a simple well check up and my hope as a pediatrician is to at least begin the process of healing instead of letting these issues spiral out of control. These circumstances can often lead to anxiety and depression later in adolescence and into adulthood.
The take away from this story I’m sharing with you is that we are all unique. We are all born with talents and as we grow, our focus should always be on learning more about ourselves. Finding out what doesn’t work for us is sometimes even more important than figuring out what does.
The best gift a parent can give a child is to help them figure out what their unique gifts are and resist the use of labels to describe them. We are so much more than those labels, and those labels are sometimes carried for a lifetime.
Have a wonderful week!
Elizabeth Vainder, M.D.
Some Signs of anxiety in children:
- Difficulty concentrating
- Difficulty sleeping, or waking in the night with bad dreams.
- Not eating properly.
- Often angry or irritable
- Constantly worrying or having negative thoughts.
- Feeling tense and/or fidgety
- Stomach aches/ Headaches
Symptoms of Generalized Anxiety Disorder:
- Trouble falling asleep.
- Fear of being alone.
- Picking at skin.
- Nail biting.
- Strong startle response.
- Being overly self-critical.
- OCD-like behaviors (e.g. checking and rechecking the door to make sure it is locked, etc. )
- Refusing to go to school or having a hard time at school drop-offs
- Difficulty participating in class and interacting with peers
- Excessive worry about everyday things
- Trouble answering questions when called on by the teacher
- Disruptive behavior
- Frequent trips to the nurse (with complaints of headaches, nausea, stomachaches, or even vomiting)
- Avoiding socializing or group work
- Not turning in homework
Please remember that like everything, if your child has some of these behaviors, they can be normal ways of managing stress. If you are noticing multiple symptoms or all of the behaviors described above, please talk to you pediatrician.