Nieman: Lessons learned from families over four decades

Epicitus, a well-known Stoic philosopher, observed that “You cannot learn that which you think you already know.”

In the Zen tradition, there is a word, “shoshin”, which translates to “a beginner’s mind” where students are encouraged to look at every situation they are placed in as if it is the first time.

And in the teachings of attitudinal healing, we are reminded that we are students and teachers to each other.

These wise words prompted me to work on my next book where the theme will be what I learned from families over the past four decades.

Our beginnings. When one considers the beginning of life, first in the womb and then at one of the most dangerous times in any person’s life – the birth process where so much can go wrong – I am amazed at the miracles of conception and birth. As the Dalai Lama once said, we should never forget that the odds for us to have been born were extremely low, and thus our presence can be seen as a major miracle.

The innocent lull. One of the joys when meeting parents is simply watching their body language when they observe preschoolers playing in my exam room. As I take the developmental history and compliment them on the great work they are doing in raising their children, I can tell how content they are which seems to be at a time when children are sleeping better, are out of diapers, and start to socialize more and reveal the way they are wired, perhaps a great degree of curiosity or maybe an entertaining sense of humour.

This is not the time of being bullied, getting calls from school about having bad attitudes toward learning and fellow students, or finding a teenager’s bed empty because they slipped out of the house in the middle of the night. For many preschoolers, books seem to still be the most enjoyable tool for learning rather than being glued to screens. My lesson here is that there is no need to rush childhood.

Time to Attend. When school starts, students are expected to sit still and pay close attention to the teacher. So often, pediatricians are asked to see a great number of boys, aged five to seven, to determine if they have ADHD. Sometimes, the diagnosis is indeed accurate, but far too often it is over-diagnosed and over-treated. As parents learn to navigate the often meandering path of raising a child with ADHD, I am amazed that quite often, through their child, they diagnose themselves with ADHD.

I have also met parents whose diagnosis of ADHD was made late in life. Independently they often utter these words: “I wish I were diagnosed earlier in my life. My life would have turned out so differently. I do not want my child to go through the same suffering.”?

Unexpected shifts. Autism in 2013 was redefined as ASD (Autistic Spectrum Disorder). Before that, the terms used were Asperger’s, Pervasive Developmental Disorder not specified, and Autism.

When I started as a pediatrician about 40 years ago, the incidence was close to one in 400. Now it is estimated to be 1 in 35 children, and no one has a clue as to why that is. Early diagnosis became a top priority, but ironically once it is diagnosed, resources to provide the proper and timely treatment are sorely lacking. I remain amazed at how parents adjust to this diagnosis, develop new expectations and remain resilient in their quest to find the best treatment.

Lack of choice.?Immunizations will always be a controversial topic for many families. The problem as I see it is that while most parents are responsible and wise, we have lumped all vaccines together as “immunizing your child.” Meningitis can cause permanent brain damage. Almost 100 per cent of parents understand this. And, yet, because they cannot opt for just this vaccine, they choose no vaccines due to fear that some other vaccines will have side effects.

Grandparents as parents. Being a new grandparent gives me much compassion for seniors who are asked to take over parenting duties full-time. Very often it is caused by mental health concerns in the biological parents which make the latter unfit to parent. My lesson here is that the love between grandparents and grandchildren runs very deep.

Notice me. I have learned that asking about pets can be a huge icebreaker when a nervous child meets me. When I ask young children “Do you have a photo of your pet?” they often come running toward me holding out the parent’s cellphone to “brag” about their beloved pet. My lesson here is that it helps to show an interest in the patient as much as the disease for which they are sent to see me.

Dr. Nieman is the founder of Centre 70 Pediatrics. He has written monthly columns for the Herald since 1999.