Imagine you bring your 7-year-old child to get her Covid vaccine.  You are so happy this is finally happening.  Your daughter has underlying anxiety and is also very strong-willed - a challenging combination, to say the least.  You know this isn’t going to be easy.  In fact, you set up two separate appointments a few days apart so that you can give her a choice – she can get it over with today, when her brother gets his, or come back a few days later with no option B that day.  You know that giving her simple choices helps her to feel more in control, which sometimes helps in these situations.  When you arrive for the vaccine, she says she isn’t going to get it today.

You sigh (as inwardly as you can) and hope that when she sees her older brother handle the vaccine like a champ (and get Oreos afterwards!), she will change her mind.  She doesn’t.  You do a little coaxing, and she gets more and more firm about her decision NOT to get the vaccine today.  Your anxiety now increases.  So does hers.  The staff is ready to help hold her down for the vaccine and asks you what you want to do.  Meanwhile, your daughter starts screaming (I mean really screaming, an angry determined scream that you’ve never heard from her before) that you promised her she could decide, and now she can see you were lying to her the whole time. 

Time stops.  You’re embarrassed.  Everyone in the room is watching.  You know that she needs the vaccine, and normally you would be fine with holding her down because unfortunately, this is one battle you simply have to fight.  You’re tired, and the last thing you want is to have to come back in a few days and do this all over again.  Plus, you want your kids protected by the vaccine as soon as possible.  But, in this instance, you did make a promise, and you never lie to your kids.  You never tell them something won’t hurt if it will.  You never spring unwanted surprises because you don’t think that is fair.  You are a woman of your word. 

This could be a book out of my kids’ favorite series:  Mother vs. Strong-willed Child.  Who Will Win????

You start putting on her coat, telling her you are all leaving.  No shot today.  She made her choice, and you made your promise, and you are standing by it.  You tell the nurses that you need her to be able to trust you.  If you force the shot today, her trust in you will be lost.  As you walk out, you feel like you are being judged by everyone in the room.  You feel as if you have no control over your child.  You wish you hadn’t even pushed her as hard as you had but you are just a teensy bit strong-willed yourself.  Surprise, surprise.  You feel helpless as she struggles with her anxiety. 

Now imagine that you are not only this child’s mother, but you are a pediatrician in your own right.  Does this reflect on your professional capabilities as well?  If you can’t get your own child to cooperate with getting a vaccine, why the heck should anyone trust you with their child?  Are you really able to give sage advice about setting boundaries with your children, enforcing limits, setting rules and expectations, if you yourself are “giving in?” 

You probably figured out by now that I am this mom.  I am this pediatrician.

And, I am human.  In both the mom role and the pediatrician role, I am constantly asked for answers, and I find that there rarely is one true answer.  There is rarely a “right way” or a “wrong way” to do things.  When I first decided to go into medicine, I remember thinking that it was perfect for me because there were clear guidelines and procedures for everything.  I just needed to follow directions, and I was good at that.

How wrong I was.  Weaving itself through every single algorithm and protocol was nuance after nuance (after nuance).  Medicine, like parenthood, is an art, and that art is learned over time, by feeling your way along, learning from your peers and your patients;  asking questions of those around you, and questioning yourself and learning from your own mistakes or perceived misjudgments.  I have had to let some of my own strong will get fluffier, allowing myself to really see my patients (families included) and my children for who they are and striving to do my best to guide and seek answers together as we fumble our way through life. 

And I try to be OK with feeling guilty sometimes.  And feeling like I’ve let someone down.  Or like I’ve missed something or looked at something the “wrong” way.  I don’t like feeling that way, but I’ve learned that that is how I grow, and it will ultimately make me a better pediatrician (and mother).  So many of my struggles with my children have helped me help my patients – if not by giving “sage advice,” then by being able to empathize, commiserate, and hold their hands through the tough moments.  If I have “missed something” in medicine, I know I will never ever “miss” it again.  If I react in a way not so becoming of a mother to my anxious child, I count to 10, take a few deep breaths, and then lean down and look her in the eye and tell her “I’m sorry.  I didn’t handle that as well as I could have.  I’m still upset with your behavior, but yelling wasn’t a helpful way for me to respond.”  They call this a “repair” in the therapy world.

In the case of the Covid vaccine debacle, after taking my deep breaths I tried to remain firm but also understanding.  “I know this is very scary for you.  But we do need to do it, and I will try to come up with ways to make it less scary next time, and no matter what I will be there with you the whole time and I will love you no matter how much you fight.”  My daughter expressed how bad she was feeling about herself after the whole experience, and I was struck at how much her self-esteem was affected by her anxiety and the limitations it causes her.  Someday, her perfectionism and strong will with lead her to move mountains.  In the meantime, my husband and I will keep searching for the right therapist, the right medication (if needed), and the right words to support her. 

It is only by being vulnerable that we grow, learn, and truly connect.  And that is what being a mom and pediatrician is all about.  By doing this and allowing myself to be human in my role as both parent and professional, not only will I grow, but my children will learn that it is OK to live with some imperfections, some uncertainties, and even some scariness in our lives.  I don’t have, and would never claim to have, all the answers.  By allowing this to be OK, we will all win in the end.