I live in a small town, so I often have the opportunity to get follow-up on the children I cared for in my previous job. Walking down the street this morning I heard a voice call out "Hi Dr.Gold!!" I turned to see the mother of a child I had seen for a number of years. Similar to the child I described in the previous post, this child had experienced significant trauma in her early years. To protect privacy I will not go into detail. This family had come to me for medication for ADHD. While the child clearly met diagnostic criteria, and ADHD medication helped her to stay in school and not fail completely, it was obvious from the start that she needed more intensive help than I could offer. Yet her parents resisted. There were many reasons for this, ranging from transportation issues to a wish not to address some very painful subjects.
My leaving that practice actually forced the issue. The only person who would prescribe medication was a psychiatrist in a nearby town. She has a practice policy that anyone on medication must be in therapy.
When I run into families I know in public, I am hesitant to talk about our work in order to protect their privacy. But this mother seemed positively joyful, so I was moved to ask, How's Jane? (not her real name) ""She's thriving!" was her response. "We have her in therapy and she's on some new medications. I don't know why I resisted for so long!!"
This morning I also received an email from a pediatrician colleague bemoaning the fact that so many pediatricians have become simply drug prescribers. She asked: "Can we wipe the slate clean and start again? - maybe by listening and telling the stories over and over again; perhaps. Slow and steady." I like this cautious optimism, and believe strongly that it is the only way. We cannot give up on these kids!!