Had an interesting experience the other day; well it was interesting to me! I developed a very odd pain/sensation that as even a doctor I could not explain. It woke me up from sleep and lasted for hours. As I lay there wondering what it could be, playing out the following mornings hospital visit if it didn’t go away, I started to think about all those people who are not doctors, those who perhaps never understand their pain. Then I started thinking about all the children we see with horrible painful conditions, do they understand their pain?
Many doctors are not good at communication. One hears stories over and over about how badly bad news was broken and doctor’s seemingly uncaring attitude. We do a lot of teaching of medical students and realise that perhaps it is not that they don’t care but rather that they are afraid; afraid to be honest; afraid of how much the truth will hurt. If it is hard to talk to an adult, how much harder is it to talk to a child?
How many parents out there lie to their own children to protect them from the truth? We meet many parents of very ill children that will say, “please don’t tell her that she has cancer; she won’t cope with that.” “she doesn’t need to know how bad it is.” The interesting thing for me is that through experience and research, we now understand that children already know, but don’t always understand. What they imagine can be 10x worse that the truth. They pick up very quickly what is a ‘safe’ topic and what is not. A sick child will spend a lot of time trying to protect their parent from the pain. How often have I hear from a child, “Doctor, don’t worry about me, it’s my mom who needs help. Can you help her to feel better? “ Children like this can end up very alone in their suffering, too scared to talk about it for fear of upsetting others, particularly their parents.
I hope that most of us will never experience the trauma of having a very sick child but I do think it is time for a paradigm shift. Children that question, debate and negotiate tend to do better in life than those that are shielded and protected from truths that they probably already know.
As frustrating as all those questions are, perhaps before we fob off our child with a platitude, we should find out what they are really asking and how being open and honest will better prepare them for a healthy happy future.