Last week I delivered my last baby. I have been delivering my patients for the past 25 years. I am hanging up my Bugs Bunny T-shirt that I have worn for almost every delivery. The first face a baby should see apart from its parents’ is Bug’s mug.
It is a privilege to participate in one of life’s most memorable family moments as well as an enjoyable and rewarding experience. For the last few years I entered the Twilight Zone of delivering the babies of the babies I delivered. Adding to the fun is the music playlist that I bring in and play during the labor and delivery. It creates a side game of anticipation; during what song will my baby make their grand entrance? (Rebel Rebel was an apt description for one little boy!)
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There have been three generations, sometime four, being present in the delivery room. I see these infants grow and develop. It is a special relationship between the physician, patient, and their family.
Every Wednesday, my baby and prenatal day, I get to make infants laugh, tickle the toddlers, and witness the happiness of childhood. It is without exception the best day of my week. I get to see them grow and develop and marvel at the changes.
One of my longstanding patients, whom I have known since he was a toddler, came by to see me this week. Now in his early 20’s he wore the travails of life on his face of a much older man, slightly bearded, gaunt, unkempt, sunken eyes, and exuding deep sadness. He looked tired and beaten. He had just found out that his partner had cheated on him. There were physical ailments that concerned him because of this. What struck me was the contrast between this happy boy I watched grow and develop over 20 years and the general unhappiness that played out in his body language and face.
Why the change? It was not just his partner’s infidelity. It was a deeper more ingrained change. It was as if his original life path deviated away from that happy boy of childhood. I do not presume to know what led up to these events or what changed in his life through the myriad of interactions and influences one experiences in our non-linear world.
He is obviously not alone. Some kids turn out as they were when they were children, happy with their lives and on track to continue to have enjoyable ones. Others are not so lucky. And yes, there are many social scientists, psychologists, and academics who take the time to study the influences that alter our lives including socioeconomic factors, parenting, school experiences, and illnesses among others.
But despite all those studies and our understanding about causality (or at least our interpretation of such), it did not provide my patient with any advantage nor did it change the emotions I felt for him. I wanted to be able to fix his situation. I wanted him to be happy. One should not be carrying the weight of the world on one’s shoulders in their early 20’s.
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Many of these influential changes do stem from our experiences during adolescence. We bore witness to this during our weekly visits to Canterbury High School through the auspices of the Adolescent Medicine Teaching program for family medicine residents at the University of Ottawa. We would provide medical services and even more importantly have access to the classrooms wherein we would answer any question thrown at us. These anonymously written questions would be chosen at random so no teen would be identified. The questions dealt with drug use, sexuality, general health, mood disorders, abuse, relationship issues, and contraception among many others. Many of our experiences can be read here from columns I wrote for The Medical Post.
I also included the option for students to accompany me to see a live birth with their parent’s consent. In agreeing to do so, they could be called day or night and had to get themselves to the hospital to meet me. Despite the thrill of seeing the birth and the imprinting of that experience in their lives, it did wonders for the contraception message!
We see some strides in adolescent health issues but they continue to be from afar from the student’s perspective. One of the advantages of the school-based program was that we became a permanent fixture and trusted source of information and assistance. We did not go into the classroom with an agenda. Their questions drove the discussion; we listened to them.
Unfortunately the Adolescent Medicine Program ended with budget cuts about ten years ago. Some of the students followed us to our practices for ongoing care.
As physicians we see snapshots of our patient’s lives despite the continuity of care we try to provide. Sometimes we see them only once a year. You tend to remember them as they were instead of who they are now. I still see the happy laughing carefree faces of the children I have delivered. Some do retain their childhood personalities. Others have grown darker and sadder.
The latter may not be children anymore but I wish some of that childhood followed them. Such is life but the parent in me is overwhelmed by the empathy I have for them. I just can’t get the image of the happy boy I remember out of my mind and the visceral reaction I have seeing him so sad now. Should we ever?
