“Come on sweetheart. Let the nice doctor take the stitches out!”
The four year old with dark curls was sobbing hysterically. Her mother was trying to soothe her. I was standing there awkwardly by the counter with the suture removal kit in hand…. still waiting.
“I can get some help with this….” I said quietly, trying to catch mom’s eye so I could mouth holding her down.
Mom shook her head no.
“I’ll buy you a toy if you let her,” Mom pleaded. “Anything you want…”
The kiddo pondered this. She held her arm out, warily. “Ok, ok. I’m ready.”
The wild look in her eye and the huge quantity of snot pouring from her nose told me otherwise.
I took one step forward with the forceps and little scissors and the sobbing and screaming started up again. We had tried this five times already. I was done, my patience worn thin.
I took a step back.
“How about if I leave and come back in a few minutes, let her calm down a bit?” I had three other patients already in rooms and two more still in the waiting room. I had already spent 30 minutes of a fifteen minute appointment (and they had shown up 12 minutes late to start with) explaining what I was going to do over and over again, even going so far as to let her hold and touch the scissors, all to no avail.
“Yes, please!” Her mother sounded grateful.
Relieved, I left.
I knew from experience that with kiddos like this it was not going to work without restraining her. Once she realized after the first snip that this was going to be fine, she would relax and it would all be OK. It was clear that she had been tricked before. She knew not to trust adults, especially in this context. She was bound and determined that she was not going to be tricked again. She didn’t know me from Adam. All she knew was her past history.
I couldn’t blame her.
I also knew that I could not do that restraining without parental permission. It was looking like I was not going to get that permission.
Grumbling under my breath, I reviewed the next patient’s chart in the computer. I saw a couple of patients and then taking a deep breath, went back in.
“Are you ready to try again?” I smiled.
She nodded her head. Her puffy eyes and tear stained cheeks still said otherwise. Sure enough, as soon as I picked up the scissors, hysterics again ensued.
“Do you want me to get help?” I looked at mom. Please, please let me get help. She emphatically shook her head no, again.
“Sweetheart, do you want to come back again later?”she asked.
“Yes!” The water works stopped immediately and she hopped down off the table, smiling. She was at the door, hand on the knob, in half a second.
Of course she said yes.
I started assigning codes and printing the super bill. There was still going to have to be a charge for the visit.
Her mother stared at me.
“She does not need those sutures left in indefinitely. That will increase scarring. Try to schedule in the next day or two…”
Her mother opened her mouth but hesitated like she wanted to say something.
“You want me to go ahead and grab some help?” I asked for her.
“Yes, can you? I really don’t want to pay another copay or spend another hour or two here again. Let’s just get it over with.”
So I did.
There was ear splitting screaming and that munchkin fought like a well trained ninja initially but she relaxed after the first suture was removed and stopped crying by the third. She was holding her hand out by herself for the last three.
When we were done, she beamed proudly at what she had accomplished and literally skipped down the hall and out of the clinic afterwards, curls bouncing, chattering away happily, no worse for the wear.
It is terribly difficult for me to remember this with my own kids, that letting them experience something scary and overcoming it makes them stronger and happier and less anxious later in life.
“Mommy I can DO it!” my son said as he started across by himself. All of the what if’s flew through my mind and my hand reached automatically for his. He swatted me away. “Let me do it!” He took one careful step after the other with me trailing close behind, but still letting him do it on his own, growing more confident with each movement forward, each step away from me.
Practice. That is what it is. Practice. And we all need it, early and often, though not necessarily in stitches…