Thursday, October 15, 2009

It's all guesswork in a white coat.

"I'm glad I didn't listen to you."

Ryan had his annual check-up today, and this is how I opened the conversation with Dr. Handsome.  Ryan has been seeing the same pediatrician since the day he was born. I like him, I trust him. He approaches parental freak-outs with either a "don't worry, this happens all the time" or a "this is what has worked for me with my kids, maybe it will work for you" approach. And you can always reach him or one of the other doctors in his practice on the phone at all hours of the night.

Last year's check-up was maybe a week after Ryan's Board of Ed evaluation, but before he had started receiving therapies. I was raw. I told the pediatrician what was going on, and he said, "You know your child best, but he's interacting very well with me, he's using words.  Evaluations can't hurt, but I don't think he's a spectrum kid." This was nice to hear, and I left the doctor's office a little more calmly than I had entered.

Then came the storm of professionals telling me my baby was abnormal: developmental pediatrician, speech and language pathologists, occupational therapists, teachers, special ed teachers, social workers.  They all agreed that his speech and social behavior were delayed.  They all agreed that he probably had PDD.  They handed me photocopies of photocopies of "Welcome to Holland."

As the storm passed and I educated myself a little, I realized how little our pediatrician knew about autism. I began to question other advice he had given us over the years.  Knowing that Ryan had reflux, constipation, and eczema, why didn't he recommend we have him tested for a milk allergy?  Should he have noticed the developmental delays? I recalled the moment I came to the terrifying realization that my parents were merely human and didn't have all the answers. And I kicked myself for trusting that any one doctor could have all the answers I would ever need. I realize this is something of a parlor game, like Find the Autism, but it's a little different, because while we can't change the past, we can always find a different doctor.

So today when we went in for Ryan's four-year check-up, I felt the need to inform Dr. Handsome that he had missed some signs. I wish I could say it was for altruistic reasons, like, "maybe he'll be more aware of XYZ in the future and will be able to help another patient get services sooner." I wish I could say that, but really, I just felt the need to call him out.

"I'm glad I didn't listen to you when you said Ryan was fine."

He became understandably defensive of his practice. "I would never tell someone not to get therapy if they needed it!"

"But you did say you thought he was on track."

"At 18 months, he was labeling his toy animals, making eye contact..."

"You said this when he was 3."

I decided to let it go at that point. He hadn't see the signs, just like I hadn't seen the signs. But part of me feels like someone with years of medical training should have seen them.

Dr. Handsome looked in his ears, tapped his knees with a hammer, gave him shots, asked the usual questions. As he finished up, at the point when he would usually say "Everything looks great, see you next year," he said, "I'm certainly glad he's getting the help he needs."

I crumbled a little inside. Ryan's developmental delays and abnormalities are now so obvious, there's no pretending he's typical.

1 comment:

  1. I was directed towards your blog from a mutual friend of ours. I also have a spectrum child, though he wasn't diagnosed until he was 7. For years my husband and I have been struggling to pinpoint the "problem" and a lot of people have acted like WE'RE the problem, they just don't see it! It can be so hurtful when people ignore your concerns when you know there's an issue!!

    I look forward to following your blog!!

    Mary M


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