Does having children make you competent?

This blog becomes increasingly personal, but mainly because there are some things that just infuriate me.

So, here it is. Outrageous statement of the week/month/year…

I’m a paediatrician, and I don’t have children.

Naively, I didn’t think this was important as say, listening to my patients and their parents; I didn’t think it would reflect my competence as a doctor.  I didn’t believe that (some) of my colleagues would treat me as former Families Minister Sarah Teather has been treated by her colleagues. 

But somewhere during my first paediatric job as an FY2, I was told quite distinctly that unless I was a parent, there was no way I could be a good paediatrician because I couldn’t understand how the parents felt.  Having children, I was told, changes your perspective on things.  It changes how you think as a doctor.  I could only put myself in that parent’s place; understand how they were grieving for a child; accept totally their decisions if I had children of my own.

This sticks in my mind for so many reasons, but the two professional ones are these:

1. My patient is my patient.  Not their parent. I know this is still a bit controversial in paediatrics, so let me clarify.  Parents/families/siblings/friends – they are all hugely important in understanding about a particular child, and making decisions together is vital.  But the thought (as suggested above) that I would change my practice because what a parent wanted would become more important to me than the wishes and needs of my patient is something that I find terrifying.  (To put this into context, this was said during an end-of-life situation where the senior suggestion was that we kept going with futile therapy that was painful for the child because it would make things “easier” for the parents. No)

2. There is the suggestion that having a child of my own would somehow make me understand other children and families.  Well, it’s 5 years down the line.  I don’t have children.  I don’t know if I’ll ever have children.  I hope it hasn’t made me a worse doctor; I don’t think it would necessarily have made me a better one.

I might not know what it’s like to have children of my own; maybe I’ll never know.  

But I know enough to know that each child is unique, and each family is special.  Just because I might understand my own (hypothetical) child and their needs, doesn’t mean that I would understand every patient who comes through the door.  

Children are special, and magical, and unique.  They’re individuals.  They live in families that are as individual as they are.  And they deserve that we see them as the individuals that they are, rather than presuming that all children are the same, or that knowing one child intimately will somehow give you a special insight into a completely different one.

Maybe I would be a better doctor if I had children (seeing my friends, it would have to make me a more organised one!), but that really isn’t a good reason to procreate.  

Whatever happens, I don’t want to lose the belief that I should treat each patient as an individual, even if they’re not an adult.

Because I will never be a child again.  I will never “know” what it’s like to be rushed into hospital; to have smelly, noisy masks pushed on your face; to have needles in your arm; to be so utterly terrified that you’re too scared to ask what’s happening in this strange new world that you have no reference points for.  

Having a child isn’t going to help me “know” that.

Listening to my patient, and remembering they are precious and unique will.



4 thoughts on “Does having children make you competent?

  1. I agree with bells on. Does anyone tell male O&G trainees they will not be good surgeons until they have a gender reassignment?

    I’m sure having children makes you a different doctor by making you a different person.

    The differences must go both ways. We can’t put our medical knowledge and doctor perspective aside when we reproduce. Are paediatricians more or less worried than other parents about a fever turning out to be meningococcal sepsis? Do most parents have a stethoscope at home and the mobile numbers of doctor friends in a variety of specialities? I will never bring any child of mine to A&E terrified because I can feel their xiphisternum and don’t know what I have found, but that doesn’t mean I can’t try to empathise with someone who would.

  2. I think you’re very right about this one. I think you can be a marvellous doctor who is empathetic and understanding without going through every situation that your patients go through. Patients and their families, I guess. And you’re not the only person who has experienced this – a GP once told me that she felt like a bit of a fraud advising parents about ‘what she would do’ if it was her child. But it was what they wanted to hear and understood, and so it was what she said, even though she didn’t have children.

  3. Hmmm.

    I don’t think having children makes you a better doctor/paediatrician; it just makes you different. either are OK if you are a caring, empathetic person who can put your patient* at the centre of your care.

    But, there’s another side to it, too. there is something about not having distance that can actually be difficult for parent-doctors to deal with. if you have the immediacy of a relationship with a child, I think it can make some of the “emotional stuff” much more subjective. I used to be relatively normal, but will now find myself sobbing at adverts about babies growing up (don’t even talk to me about *that* John Lewis advert – you know, the one where the little girl in the red dress grows up into a granny…). It’s an extension of overwhelming love; makes the rational part of me realise that parent-doctors are sometimes very vulnerable in that respect.

    I remember trying to have this conversation with an O&G trainee who got very uppity about it; she turned to me an said “so, you’re trying to suggest I care less than you about a baby who ends up brain damaged?”, which wasn’t exactly fair; it wasn’t what I was trying to explain. It’s not about caring more or less; it’s about a recognition that a parent-doctor can contextualise what some of the non-medical experience is. And, having experienced the vulnerability of having a new-born baby, I can find myself back in that moment in a trice.

    There is nothing that will prepare you for the weird joy/anxiety/horror/mundaneness/happiness/raw love that comes with sproglets. It’s fab/awful/lovely/yucky/heart-breaking/amazing…

    *and/or population, of course 😉

  4. Pingback: Kinder, Küche, Kirche | Academic Dissonance

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