Being a Parent and a Pediatrician

Originally published in the October 22, 2021 Transformational Times newsletter

Being a Parent and a Pediatrician

Cassie Ferguson, MD

Every weekday morning, I am confronted with my failure as a parent. Instead of filling my three kids’ lunchboxes with a colorful array of washed and cut, 100% organic, GMO-free fruits and veggies and a lean protein-packed sandwich cut into a dinosaur shape, I am typically frantically grabbing for a Dole fruit cup, an unnaturally colored yogurt tube, and a bag of Fritos. Guilt inevitably washes over me every time I shove a PB&J made with Skippy and grape jelly on white bread into their lunch boxes, and I cringe thinking about the teachers seeing what I knowingly

feed my children.

What you are to be, you are now becoming

–Carl Rogers

I don’t know if I feel this guilt more acutely as a pediatrician—as someone who spent nearly a decade learning about how to keep kids healthy and should “know better”—because I don’t have a different perspective to which I might compare. My first son, Ben, arrived two weeks after I graduated from pediatric residency. Will arrived as I finished my pediatric emergency. medicine fellowship, and Nick three years after I became an attending in the emergency department (ED) at Children’s. I became a mother as I learned to become a pediatrician.

While the guilt may be sharper, there were advantages to my training when it came to caring for my kids when they were little. The nurses in the well-baby nursery taught me how to swaddle a baby so that they couldn’t free their tiny little arms. I knew that 100°F was not a real fever. And I could assure my husband (and myself) that our child would eventually learn to pee in the potty.

There were distinct disadvantages, as well. I also learned about the randomness with which a four-year-old is struck with leukemia. About what it sounds like to hear a mother’s heart shatter when she learns her sixteen-year-old has died in the car crash. The health and safety ofmy own kids can feel so fragile; regularly witnessing the suffering of kids and their families makes it difficult to believe that my own kids would be spared, no matter the real odds.

Every system is perfectly designed to get the results it gets

–Arthur Jones

Most of the suffering that we witness as pediatricians, however, is not a result of random chance. Disparities in the utilization of health care services and in overall health spending, structural racism, and residential segregation that limits access to good schools, jobs, healthy food choices and green spaces for the majority of Black and Latino or Hispanic Americans directly translates to poor health outcomes for the families for which we care. Kids dying from gunshot wounds, physical abuse, asthma exacerbations, drug exposures; these deaths are not random. They are a result of the systems we have purposefully built in America and continue to support with our inaction.

A friend once described having a child as forever walking around with your heart on the outside of your body. As a mom and a pediatrician, I’ve discovered that my heart can be broken not only when my own child falls and breaks their arm, or is bullied at school, but by anything that harms children anywhere. I have come to see this as our superpower—this tenderness and vulnerability spurs my colleagues to fight courageously for the radical redesign of our systems.

We are called to disrupt the cycle of interpersonal violence in our communities, to address food insecurity in our ED, to protest the attempt to ban books about racism from our schools, and to ensure that the way we treat acute pain is equitable.

Hope is the thing with feathers

–Emily Dickinson

This calling can feel overwhelming, particularly when I am in the ED managing twenty very sick patients and a full waiting room, and then receiving a page heralding the imminent arrival of yet another child with a gunshot wound. On those nights nothing we do feels like enough; it feels as if we are digging a hole in the sand as the walls are caving in around us.

On those nights, I come home defeated, or angry, or fearful; overwhelmed with the perspective on how dangerous the world can be for our most vulnerable citizens and feeling powerless to protect both my patients and my own kids.On those nights I come home to my kids and peer into their dark bedrooms, staring at their sleeping forms from the door, surprised at how easy and regular their breath comes. I renew

my vow to do what I can to make them feel safe and loved and find grace in the belief that this love is perhaps more communal than I realize.

Cassie Ferguson, MD, is an Associate Professor of Pediatrics (Emergency Medicine) at MCW. She is the Associate Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education.