Parenting

Jimena Roquero, Lumina/Stocksy

There Are Downsides To Being A People Pleaser At The Pediatrician — I Lived Them

Parents like me, who shy away from questions in an attempt to seem low-maintenance, are a common phenomenon.

Let me paint you a picture of how I used to roll up to the pediatrician’s office: approachable smile. On-time arrival — or, if I’m running late, a heads-up. Four to six apologies. When I got inside, I’d ask how everyone was doing — I mean, yes, my kid’s got an alarming rash, but I need an update on that koi pond, Judy!

If I saw the waiting room was busy, I kept my follow-up questions minimal. I always took wet diapers home with me to throw away, per the sign. Then it was time to go: four to six thank yous, a couple take cares. A lollipop-worthy performance, but I wasn’t in it for the Dum Dums. I was building a reputation. Saving up easygoing, mellow cred. That way, I figured, if I ever thought something was very wrong with my child, the pediatrician would lift his head and say: “Hang on, this is which mom? Megan Angelo? She of the inestimable chill? This must be really serious. Judy, hold my calls!”

Then something did go wrong with my child. And that wasn’t what happened at all.

Dr. Z was a man of few words, which I took to mean he was decisive. No noise. No excess. I felt like a genius. What was actually going on was that my boys were just healthy.

The pediatrician himself — let’s call him Dr. Z — reminded me of the doctor I saw when I was a kid. He’s older, with a quiet manner, a light touch, and the kind of soft voice that’s intrinsically comforting to the ear. A family member referred me to him, but it was his old-school vibe that sold me. When I had my first child, back in 2014, I felt stressed by some of the mothers around me, who seemed to approach medicine with great confidence in their own authority. “We don’t vax,” I overheard one mom say, in BuyBuy Baby. In the OB waiting room, I watched a fellow patient turn in a birth plan four pages long. I heard women talk about formula like it was the devil’s full-sugar Coca-Cola.

My instinct was to find a pediatrician who cut through all of this noise. That phrase old-school was something I had in my head before I met Dr. Z. It skewed my view a little: I shouldn’t have been happy that the doctor’s office didn’t use computers, for example, but I kind of was. And for nearly six years, across the toddlerhood of two sons, I felt validated in my choice. We zipped in and out of the doctor’s office with full trust and zero drama. Dr. Z was a man of few words, which I took to mean he was decisive. No noise. No excess. I felt like a genius. What was actually going on was that my boys were just healthy.

Then my daughter came along, and I learned something that shouldn’t have shocked me in 2019, when plenty of conventions were crumbling and I was marching with signs to encourage it: If someone is old-school in good ways, they might be old-school in bad ways, too.

“Your pediatrician may see themselves as being on equal footing with you, but you still see them as an authority figure and second-guess yourself.”

I didn’t have a name for the feeling I had when my daughter, Lucy, was born, but Dr. Laura Brown, who’s a pediatrician, assistant professor, and mother of three, does. “I call it mama gut,” she says. “And mama gut is real. I’m not saying it can’t be wrong — sometimes we’re crazy and we’re tired — but it’s such an important piece of things. It should never be ignored.”

Lucy was the kind of infant that nothing was quite wrong with: born early but not quite preemie, weighing in as tiny but not quite concerningly so, eating poorly but not quite poorly enough to qualify as NICU material.

What Brown would call my mama gut started to churn almost immediately. Lucy didn’t make a lot of noise. She didn’t move around in her crib a lot. When she woke up, she didn’t cry like a demon roused by a Super Soaker, the way my sons had. At her early wellness appointments, I didn’t talk about this with Dr. Z. He examined her, and thought she was fine, so what was there to say? Maybe big babies and small ones were different. Maybe boys and girls were. Maybe my sons were demons. (There was some evidence to support this.) Or maybe I was just weighing whether these vague concerns were worth cashing in my chill-mom credit over. It was like I’d decided I only got one golden ticket of worry with the doctor, and I wasn’t quite sure if I should be spending it yet.

When I look back at this, I think: What was I so afraid of? What was the worst thing that could happen? That Dr. Z would go in the back and stick a pin into a voodoo doll of me? Brown laughs, when I bring this up. What moms like me don’t get, she says, is “the parents who are overly concerned, those aren’t the ones who get talked about. Nobody cares! The true nightmare parent is the one who’s under-worried, who doesn’t take their kiddo seriously.” The words “I guess I felt bad” are on the tip of my tongue when she adds, “I see moms who, [when they bring up concerns], say, ‘I’m sorry, I’m so sorry.’ Stop being sorry! Wellness checks are supposed to be a conversation.”

But the doctors I spoke to for this piece all said moms like me, who shy away from that in an attempt to seem low-maintenance, are a common phenomenon. Especially, perhaps, in the case of the old-brusque-male paradigm I sought. “I talk a lot about power differentials,” says Dr. Victoria Wilkins, M.D., MPH, a pediatrician and mom of four who also trains health care professionals in family-provider communication. “Your pediatrician may see themselves as being on equal footing with you, but you still see them as an authority figure and second-guess yourself. So you try to keep your powder dry for when you really need it. There’s a people-pleaser element to it.”

People-pleaser? Me? Never. Don’t check my references, please.

There’s a phone call Dr. Mpasi says she gets, on the regular, from her closest friends who are moms. They tell her that they were just at the pediatrician’s, that they expressed a concern, and felt it was dismissed.

I found my voice around month two with Lucy. In the car seat, in her crib, in anyone’s arms: Her head only turned to one side. It didn’t matter what I did, what I sang, what I jangled. It was twisted to the left or tilting to the right.

“She needs tummy time,” Dr. Z said, when I reported this.

“Right!” I said. “We’re doing that. We’re doing lots of tummy time.”

More tummy time,” he said.

His office might not have used computers, but I did. I had Googled the sh*t out of Lucy’s symptoms. Torticollis torticollis torticollis, my brain went.

“OK!” I said. “We’ll try more tummy time. So nice to see you.” I packed up Lucy’s dirty diaper and went.

It went on like that for four more months.

You must feel one of two ways at this point in the story. Either you’re currently Googling my home address because you want to come smack me, or maybe you feel a little like you’re looking in the mirror. When I spoke with Dr. Priscilla Mpasi, a general pediatrician at Children’s Hospital of Philadelphia (CHOP) and a child health policy adviser, she assured me that I’m far from alone. There’s a phone call Mpasi says she gets, on the regular, from her closest friends who are moms. They tell her that they were just at the pediatrician’s, that they expressed a concern, and felt it was dismissed. “I’ll say, ‘What happened next?” Mpasi tells me. “They’ll say, ‘Nothing, I just left.’ ‘Why did you leave?’ ‘Well, because the doctor told me this.’ And then I’ll say, ‘But I know you aren’t satisfied. Because you’re calling me.’”

Often this happens because we moms don’t know what to say. Mpasi urges parents to use specific language when worries linger. “Use words like ‘How long would you wait to refer, if this is something concerning? What kind of specialist would we see? What should I look for that would make me say, I have to come back?’”

This is a far cry from anything I said at Lucy’s next wellness checks. My language was more like “I really think” or “I just feel.” Each time I talked about the head tilt, Dr. Z said Lucy would grow out of it. Oh, and had he mentioned that I should be doing plenty of tummy time?

Part of the way Dr. Z responded, Wilkins says, is rooted in the nature of the specialty. “Pediatricians have a wellness bias,” she says. “Most of their kids are healthy. If you have 2,000 kids in your panel, only a handful will have something impactful. And we do meet parents who overmedicalize their children. How do you weed out the parent who comes to you 25 times for a spot on a fingernail from the parent who’s noticing something real and evolving? It gets very, very tricky.”

See, there it is, my strategy crystallized: I was trying to avoid the first category, in order to be sorted into the second. And it may have worked, if Lucy had been a patient of Drs. Brown, Wilkins, or Mpasi. Mpasi points out another thing she would have factored into her own reaction: “This was child number three for you. You have a baseline. I will say, I would have looked at it more closely. ‘This is different than what she’s seen in her last two children. I’m going to trust that competency.’” She adds: “Six months is a long time to worry about your child and not be heard.”

Yeah, six months. That turned out to be the magic cutoff for me. At the six-month wellness check, I was ready. I’d gotten second opinions from medical professionals in my family and social network. I’d done more Googling, which meant I’d lost more sleep.

I asked Dr. Z to refer me to Early Intervention, the state-run program that can diagnose and treat disabilities in kids from 0 to 3. It wasn’t the first time I’d brought it up, but it was the first time I did it without hedging. The other times, he hadn’t responded. This time — grudgingly — he said all right.

A woman from EI was at my door within days. She diagnosed that Lucy did have severe torticollis, a condition in which the neck muscles are twisted, causing the head to twist or tilt to one side. I learned that Lucy was likely to have developmental delays, due to the way the condition was trapping her overall motion — not to mention all she’d missed, cognitively, with her range of vision restricted over six months. She needed PT, stat, preferably both through EI and a private source. Abashed and bewildered, feeling like a real bottom-5% kinda mom, I drove Lucy a few towns over, to the torticollis-guru physical therapist. The therapist took one look at her flat head and said, “She’s going to need a helmet.” Then, she took off her diaper. She pointed at an extra fold near her labia and said, “See that?”

It turned out that, all these months, Lucy had a good reason for keeping pretty still. The ball of her right hip had never been in its socket. They missed it in the hospital. Dr. Z missed it at every exam. This isn’t unheard of. Hip dysplasia can be hard to diagnose. Anyone can make a mistake. But still — my child’s hip had been in the wrong place for six months and nobody had noticed.

That was my mindset when I called Dr. Z to report the therapist’s concerns. I was livid, and scared, and completely overwhelmed, but I got my crying out on the car ride home, then put on my “hi, Judyvoice once more. I couldn’t be combative; Dr. Z was the doctor, and I needed his signature on a prescription.

On the phone, I told him about Lucy’s appointment with the therapist, that the therapist suspected her hip was dislocated, that I needed a prescription for a helmet. He said he didn’t think so. That he didn’t like helmets. And then he hung up on me.

Two minutes later, my phone rang. It was Nurse Judy, with whom I had a good relationship, because I’d f*cking worked at it. “I’m so sorry,” she said. Her voice was hushed, as if she was afraid Dr. Z would hear her. She said not to worry, that she would figure something out, for the helmet prescription. “He’s just having a really bad day,” she told me.

“I want to start by saying,” one mother wrote, “that I do not overuse the doctor’s office.”

Since August 2019, Lucy has had one helmet, two braces, one set of orthotics, countless hours of therapies, and one big ass plaster body cast, applied and worn for three months after surgery. Her hip was set into place at CHOP, a facility where every person, from the parking attendants to the surgeons, is — objectively and journalistically speaking — a beautiful angel. (On an actual objective and journalistic note, Mpasi works at CHOP but has not treated Lucy.) Lucy is 2 now. She does have delays. She didn’t sit up until she was more than a year old, and her feet and gait still have some kinks (hence the orthotics). She can’t really talk yet, outside of the essentials (“Elmo,” “cheese”); she is still in therapy. But the big questions — Does she have craniosynostosis? A genetic abnormality? — have been mostly asked and answered in reassuring ways. I’m grateful for that. It probably goes without saying that all of my kids have a new pediatrician, in a practice that’s all younger women. Sometimes, before I go, I write out a long list of questions.

Speaking of long lists — it only occurred to me recently to look up Dr. Z’s Google reviews. There were lots of four and five star ratings, to be fair. But there were also a few reviews that followed a similar pattern: Dr. Z hadn’t listened to a parent, and something very bad had very nearly happened. “I want to start by saying,” one mother wrote, “that I do not overuse the doctor’s office.”

The question is: Can I teach my tendency toward politeness to take a back seat to my mother’s intuition? I really hope so.

Not long ago, I did a post about Lucy’s challenges on Instagram, which isn’t typical for me. I was flooded with messages from friends, even close ones: “We didn’t know. You never talk about it.”

Because it’s my fault, I thought.

And I still think that, though all the doctors quoted in this piece kindly tried to talk me out of it. “This is not the way it’s supposed to be,” Brown told me, flatly. “You did nothing wrong.”

Yet it’s hard not to look at my cool-girl approach through the lens of my own weaknesses, both personal and systemically wrought. I am a good girl. I don’t like confrontation. I want everyone to like me. Some of this is just who I am. Some of it, I learned. The question is: Can I teach my tendency toward politeness to take a back seat to my mother’s intuition? I really hope so. Mercifully, these days, I’m low on time to self-analyze. Lucy just started running.

Three Pediatricians On What They Wish Parents Knew:

Your kid’s pediatrician might be one of the most important choices you’ll ever make for your children. But choosing a doctor — and communicating with them effectively — can be fraught. Here, three pediatricians talk about what they wish parents knew about them.

  • They aren’t going to be mad if you’re pushy. “From where I stand, the parent doesn’t do anything wrong unless they are not moving forward in care that was medically recommended,” says Mpasi. “Advocating for your child is your job.”
  • You don’t have to stick to the wellness schedule if you’re plagued with worries. “If I feel a parent is uneasy, I’ll be more inclined to do a follow-up much faster,” Mpasi says. “Sometimes I’ll be driving home and thinking about a patient, and I’ll just call the parent and say, ‘You know what? I know I said a month, but come back in two weeks.’”
  • Google away — but do it judiciously. “My families come to me sheepish sometimes, saying, ‘I know you’re not supposed to Google, but…’ We all Google!” says Dr. Brown. “It’s zero judgment from me. It tells me what they’re worried about.”
  • It’s fine to assert your own opinions — just be aware that you’re talking to, you know, a doctor. “Lay out your thoughts while acknowledging the pediatrician’s point of view,” advises Wilkins. “You can say, ‘I understand you’ve seen a ton of these kids before, but her torticollis seems out of proportion with what I’ve been reading.’”
  • Make your own record of what you’ve said, and when you’ve said it. “Keep receipts,” says Wilkins. “I don’t say that to be punitive. People forget and get busy. Follow up with an email or just write it down for yourself, for next time.”
  • It’s not a binding relationship. You don’t need a huge reason to switch practices. “If you’re not vibing, if you don’t like the doctor’s style, you should go,” Mpasi says. “You would switch hairdressers if you didn’t like how they cut your bangs. Why wouldn’t you do that for your care?”