There Should Be a License for Parenting … or Maybe a Test

If I only had a dollar for everytime I have seen people in the ER who wouldn’t be able to properly parent a goldfish, yet for some reason have 2-3 kids; I wouldn’t be working right now. Really though, I think a whole blog could be devoted to the subject of inadequate parenting. Yet, the following story really stood out in the sea of poor parenting that I see on a daily basis.

I get a call from police who tell me that they are bringing in an 11 year old. I thought it was a prank and asked them if he was a little tough for the force to handle. Then they told me no, that it was serious. They had been called out to a home by a mother who stated that her son had gone crazy and started to beat her. They came out the first time and settled things down and left. Then they were called out again for the same issue. This 11 year old clearly wanted to put a serious hurt on his mother. The second time police came though, he started to scuffle with them as well. And so now, he was coming to the ER for what sounded like a transfer to a psych facility for adolescents.

When I get around to seeing this young hellion, I am surprised by how small he is sitting in the psych room chair. The very experienced nurse who had triaged him told me that he wasn’t telling her anything. No comments whatsoever. So before going in, I did a quick check on adolescent psychiatric beds in the state. The closest available bed was 4 hours away. I use that technique a lto because it is amazing how cooperative a person can get when they realize how far away they are going to be sent. I have often wished I could transfer to another country – that should really get them to cooperate.

So now it’s time to talk. I make it straightforward and simple for this young man. I spoke to him in a stern, no nonsense manner. If you don’t want to talk to me, that’s fine. I already have a place for you to go and it won’t be quite as comfy as home. If, on the other hand, you want to plead your case and explore other options, then you had better talk. And so he opened up to me with great reluctance. What he said though, I didn’t at all expect.

Doc: So, why were you beating on your mom?

William: Why shouldn’t I? Everyone else does?

Doc (shocked): What do mean everyone else does?

William: All her boyfriends hit her before when she didn’t listen. So I told her to do something and she wouldn’t listen, so I hit her.

Doc: And you don’t think that its wrong to hit her.

William: No.

For me, that was totally unexpected. Obviously, this boy’s mother had been in more than one relationship where she was domestically abused. We put a lot of focus on the women in these cases, but sometimes we underestimate the effect this has on the children. Children learn so much from watching what we do – the main reason why in parenting we always encourage parents to do what they say. You can say whatever you want, because children are going to learn more from your behavior and actions than from your words. Your words will have the most impact when they are backed up by supporting actions.

So, now I was stuck. It wouldn’t be entirely right to penalize this boy now, since he was only doing what he had been taught. I’m sure he was very confused since he had not only never been taught that this was wrong, but was actually shown that it was right. So, mom and I had a little conference to discuss this matter.

I explained to her that clearly, she had been part of the wrong message to this boy. She totally agreed with me and said that she had made some poor decisions and that she had furthermore always given this little boy decision making capacity in the home. He was, for lack of a better term, the man of the house and the head of the household. She errantly thought that allowing him to make decisions would be a good step in helping him mature, but what it had done, in this particular environment, was give him the idea that he was in charge. He was the boss, at least in his own mind, and no one had yet challenged that concept. That explains why he even scuffled with police. He was probably asking himself why they were getting involved in his private domain.

At the end, I got through to him that he should be his mother’s protector. He doesn’t want someone to slap him around, why would he allow someone else to do that to the mother he loves so much? Worse yet, why would he do it himself? I told him that he had one chance to make me a believer and that I would give him his golden opportunity to convince his mother to take him back home. When his mother went back to give him the chance to apologize, I saw the behavior of a true 11 year old child. He wept and went down on his knees telling her how sorry he was for hurting her and how he should have protected her. They both cried and I felt as if we had made an impact. We had changed the course maybe before it was too late. Only time will tell.

We get a user’s manual with every product, no matter how trivial. We are required to have a license to drive a car, to undergo safety training when it comes to firearms, to attend job orientation when we get our first job bagging groceries. Yet for the most important job in the world, most people think they need no training at all. If we want a brighter future, me thinks we need to make a bigger effort in this issue today.

For your consideration:

But really, on a more serious note:

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12 Responses to There Should Be a License for Parenting … or Maybe a Test

  1. Marco says:

    What’s ironic is how many hoops one has to jump through in order to adopt a child, whereas any fertile pair of idiots can just get pregnant. In my ideal world, contraceptives would be in the water supply, and people would have to apply for the antidote!

  2. Lou (Linda) says:

    I’ve worked ERs with doctors like you. I stayed at one because of doctors like you. It would have been easy to clear the kid and ship him off. Involvement is difficult. You don’t get training to do what you did. You are a good doc, the kind who does what needs to be done because you are there and it needs doing. One can only hope that the message sticks with this kid and his mom forever. Well done.

  3. TUNDE says:

    IT IS CERTAINLY SAD WHAT IS HAPPENING TO CHILDREN B/C OF THE IGNORANCE OF THE PARENTS.
    UNFORTUNATELY THESE EXPERIENCES WILL CARRY ON FOR THE REST OF THEIR LIVES. THESE YEARS ARE THE FORMATIVE YEARS AND THEY COPY EVERYTHING AROUND THEM. UNFORTUNATELY PEOPLE SEEM TO FORGET OR JUST TOO BUSY TO SEE BEYOND THE OBVIOUS, LIKE THIS CASE. FORTUNATELY, HE DID GET SOME COUNSELING AND HOPEFULLY THE DOC’S TALK REACHED THE MOTHER’S HEART AND SHE MIGHT EVEN BE ABLE TO CHANGE. THE SAD PART IS, IN ER THERE IS ALMOST NEVER ENOUGH TIME FOR COUNSELING, WHICH IN MOST CASES HELPS MORE THAN ANY OTHER MEDICAL INTERVENTION.

    • ER Doc says:

      Thank you Tunde. It is very sad how often we are called upon to make serious social interventions. Just like someone else said, institutions aren’t the right place for so many of these people. They’re just confused about how to live life and make poor decisions. I have sometimes given out my personal # (I know its crazy) to people who I honestly think are ready for change. Unfortunately, I have disappointed far more often than I have been validated. But we continue to try and we always keep our hearts open.

  4. Medic3 says:

    Good call in dealing with the kid. His mother’s dealing with him and adult men will have the bigger bearing on his future behavior. An institution is unlikely to have affected him as it is a different environment/situation.

    The problem with needing a license to reproduce is the people/agency responsible for issuing said license. Picture the DMV-like process that would be involved, likely including right-think about whatever the current .gov-approved parenting recommendations are. I prefer the right to raise my children my way, even if it means that complete idiots also get to raise theirs. Freedom means freedom for everyone. Preventing the idiots from reproducing also means that perfectly adequate parents would have to profess the current .gov belief structure about raising children. In that scenario, no one is free, even those who agree with their government. They only think that they are.

    • ER Doc says:

      Thanks for the comment Medic3. The idea of getting a license though wasn’t literal. Just wish people would put more thought into raising their kids than they do deciding what to have for dinner.

  5. Nurse K says:

    Sorry, dood, no 11-yr-old boy should be told to protect his mom because when she gets hit again, he’ll blame himself or else get hit himself trying to get in the way.

    Sure, his brain is wired now to think hitting someone is what you do to get your way, but “do onto others” should be a good enough speech, I think. He kid needs obvious counseling to find other ways to respond to frustration and she needs to quit exposing her son to abuse/violence.

    • ER Doc says:

      Hi Nurse K! – The intended meaning was not that he should intervene if someone was striking her, but that he should not be hitting his mother. Knowing the position he was being put into in this little family, the statement worked well with him because it gave him something to strive for. Intervention certainly also doesn’t mean physical, but protecting her can take many different roads like advising her (she was already asking his opinion for many other things), calling police if something happens and so forth. Counseling is something to be considered as well, but counselors are like friends – some are a great fit and others aren’t. A bad counselor who doesn’t understand or “lectures” a child with this background can do just as much damage. The biggest problem I saw in this relationship was that of the mother expecting too much of her son. Even before they left, I asked her a question and she immediately said to her son, “Well what do you want to do?” I told her right away, “You are the mother. You make the decision. He needs to understand that you are in charge.” He needed to be a kid for a little while and she was treating him like the man of the house.

      • Nurse K says:

        At the end, I got through to him that he should be his mother’s protector. He doesn’t want someone to slap him around, why would he allow someone else to do that to the mother he loves so much? Worse yet, why would he do it himself?

        I appreciate your concern, but I dunno, I just had a little issue with your phrasing there. Why would YOU allow it? YOU should protect your mom, YOU should call the police, etc. No, he should not be doing any of that. Mom should not be putting him in that situation. She needs to leave or not allow abuser back in the house, and anything else short of that should be unacceptable.

        If your county has domestic abuse advocates, one of those should have been called (help w restraining orders etc)…I know you are in BFE right now, so, absent that, helping her to leave/keep her and her child safe is the best thing. Abuse re-wires the child’s brain and just one encounter with a sympathetic ER doc isn’t going to be the fix-all. He’ll need ongoing help unfortunately.

      • ER Doc says:

        She actually did leave the abuser a few months back, so a lot of this was from when they were in that situation and how she has handled their relationship since. But I do see where you are coming from entirely.

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