By Lisa Gilmer, MD, FAAP
“It’s a beautiful day in the neighborhood…” You can hear Mr. Rogers in your head, can’t you? This song plays often in my head triggered by various beautiful things such as the laughter from the school playground in my neighborhood or the colors of sunrise on a traffic free commute.
What about a day spent working in clinic or in the hospital? Does that trigger the familiar melody? During our daily practice of caring for children and families and attending to the same issues over and over, we may take for granted the beauty of our profession. We may overlook the impact of just being present. So how do we find space in our busy practices to appreciate that one moment, with that one patient, that makes a lasting impact? How do we recognize the beauty in the privilege and responsibility of being present in the lives of children? We see it through another’s eyes.
There was nothing out of the ordinary about the clinic. A combination of sick and well visits would provide a good clinical experience for the pre-med student scheduled to shadow me. Role modeling would be my primary teaching tool so I encouraged her to watch my interactions with families and to write down any questions so we could discuss them as we had time. We moved from visit to visit, the student standing quietly watching and writing down questions. Between patients, she eagerly described her observations and excitedly asked questions.
Our last patient was a well child visit with a 12-year-old girl I have cared for since birth. She looked like she’d been crying which I assumed was a result of having just received her vaccinations but as the visit unfolded, it became clear that there was much more going on. She timidly admitted that the anxiety and abdominal pain initially triggered by the death of her father a year ago had returned and school wasn’t going very well. I completed the well visit, provided counseling and treatment options and planned close follow up. I don’t remember doing or saying anything special but the look on the student’s face and her blank post-it note indicated that something extraordinary had happened, something I couldn’t see while in the moment, something beautiful.
An objective witness, the student described watching me push back from the computer to move closer to the exam table, placing my hand on my patient’s arm while making eye contact and listening for what seemed to her a very long time until my patient looked up and began to speak. She asked me how I knew to reach for a tissue for mom before she started to cry. She asked me how I learned to convey support with hope. I paused before answering that what she’d been a part of was simply being present. It’s experienced, not learned and, for physicians, being present is an unconscious act that comes from our hearts.
Fred Rogers said, “If we can be present to the moment with the person that we happen to be with, that’s what’s important.” On that day with that family and that future health care professional being present mattered and that’s a beautiful day in the neighborhood.