Miami, Florida, United States
|The Infant Hercules, ca. 1785–89. Sir Joshua Reynolds, British. Princeton University Art Museum. Museum purchase, Surdna Fund.|
I began my first clinical rotation excited but fearful. Medical students are taught about pediatric pathology and developmental milestones, but nothing about working with children and their families. I had heard the constant refrain that “children are not just little adults” but as I started preparing for pediatrics, I had to wonder: If not little adults, what were they?
To assuage my fears, I should have read about development or psychology, or maybe gained some practical experience. Instead, I read a philosophical essay, thinking like Wittgenstein that “a philosophical problem has the form: ‘I don’t know my way about.’”1 Perhaps I recognized that my worries with pediatrics were not about skills I lacked, but because of messaging that told me that children were some alien species of human, evolving into full persons at some point determined by doctors, lawyers, and car rental companies. To find my way, I turned to Joel Shuman and Brian Volck’s essay “What are children for?” that focuses on the moral and ethical implications of modern desires for children.2 Their great help to me was in identifying ways that people think about children, thus making some sense of the pastel-colored world I was about to wade into.
Jackson Lears observed that “Victorians transformed children from miniature adults to superior pets.”3 Shuman and Volck go further to suggest modern children are treated like consumer items. They quote Amy Laura Hall, comparing images of children from Anne Geddes’ photos of babies dressed as fruits to Norman Rockwell’s chaotic drawings: “. . . if you know anything about toddlers they are constantly covered in food. These pictures are children that do not consume; these are babies that we consume. And those icons of childhood are indicative of a dominant culture in America that sees children as a way to accessorize and fulfill one’s own life, rather than as interruptions into our own hopes, dreams and goals.”4,5
Looking back, some of my worries about my rotation must have come from this kind of thinking. It paints a picture of pediatrics as the delicate work of handling parents’ prized possessions rather than caring for whole persons themselves. Pictures of children dressed as pumpkins—like those once adorning the walls of my childhood pediatricians’ office—belie the strength of a real human child and create a laughable irony when you juxtapose these images with real children in the clinic. In my first few days with pediatricians, they warned that children are stronger than expected, especially when threatened with an ear exam.
The children I encountered on the hospital wards may have been in precarious circumstances, but they were by no means fragile. I found my teachers—both the pediatricians and Hall—knew what they were talking about when I encountered real children and parents covered by more than just food and exasperated by illness. By the time I rotated in the pediatric emergency room, I had grown to see and hear the signs of pediatric disease, but I had also learned to appreciate the strength propelling a child’s Rockwellian chaos.
One thing that I took from my reading and into my rotation is that children are interruptions deserving patience, especially children in the hospital. Of course, children are more than just interruptions, and I needed more help in making sense of children. As Shuman and Volck continue, they explore thinking about children as gifts and as strangers—asking what it means to receive and care for a gift or a stranger. As a student out of place among experienced staff and faculty, I could identify with being an interruption and a stranger. Armed with this philosophy, it turned out that it was not so hard to welcome a child just as I hoped to be welcomed; I could gladly meet a child on her own terms.
By the time I got to my final week of pediatrics, I was excited about the most feared species of children—babies. My youngest patient started to cry when I slowly worked my way through my first newborn physical exam. He had just as much experience in the NICU as me, so I had to let him know: “Don’t worry, buddy, it’s my first time here too.”
- Wittgenstein L. Philosophical Investigations. 4th ed. Hacker PMS, Schulte J, eds. and trans. Wiley-Blackwell; 2009: 55.
- Shuman J, Volck B. “What are children for?” In: Reclaiming the Body. Brazos Press; 2006: 79-93.
- 3. Lears J. No Place of Grace: Antimodernism and Transformation of American Culture, 1880-1920. University of Chicago Press; 1981: 144.
- Keller C. An interview with Amy Laura Hall. The Other Journal. 2004. https://theotherjournal.com/2004/10/10/an-interview-with-amy-laura-hall/
- For further discussion of such images, see Hall AL. Conceiving Parenthood: American Protestantism and the Spirit of Reproduction. Grand Rapids, MI: Wm B. Eerdmans Publishing Co; 2008.
CANON BRODAR, MA, is a fourth-year medical student at the University of Miami Miller School of Medicine and a former Theology, Medicine, and Culture Fellow at Duke Divinity School (2015-16). He graduated from Duke University in 2013 with a BS in Biology and Philosophy.