In general, I’m a pretty hyper- and passionate doctor. I took care of premature babies for 25 years and, when faced with a medical problem in one of my tiny patients, I needed to act quickly and decisively. Those precious few moments could decide how a child would turn out for the rest of their lives; whether they might have mental retardation, cerebral palsy, chronic lung disease or any number of possible maladies. That was then.
So, today I was examining a four year old patient who has not been improving as much as I (or the parents) would have hoped. Speech and language continues to be the biggest challenge, though “stims” and lack of focus are certainly among the family’s chief complaints. The mom has tried many of the alternative therapies that I have suggested, and continues to do a great job getting the most out of her young son.
When faced with the mother’s wishes to “remain natural” in my further care, I sort of, well, wasn’t as kind or compassionate as I should have remained. My background as a “fixer” made me want to snatch the child out of her hands and do as I pleased with the further medical care. My explanations included trying to produce analogies so the patient could better understand my point-of-view, but instead they merely worsened the situation as the patient became upset that I was “talking down” to her.
The point that I want to bring to my patients and readers is this: Autism is a medical condition, and sometimes we need to use actual medicines to help. In some cases, the only way to tell if a medication will work is to try it out. This is not uncommon in ANY medical condition. Asthma is sometimes helped by inhalants, and other times by oral meds. When treating diarrhea, doctors will go from changes in foods, to supplements, to oral medications to stop the symptoms. Your doctor sometimes has to be trusted that he/she knows (and has discussed the risks of medication), and so the patients’ “investigation” into the safety of the intervention will be no more helpful, and will waste time as symptoms continue.
Anyway, I neither did a good job of supporting my position, nor encouraging the patient that their child would be safe. Even at 60+ years old, it’s still a “practice” and I can still improve.
Thanks to all of my wonderful patients who listen to me, and even those who don’t.
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