Thursday, November 12, 2009

in the office

This morning my pediatrician screened our 18-month-old daughter for autism. It's now standard practice to screen children at their 18-month and 2-year doctor visits. The questionnaire asks whether your child makes eye contact with you and if your child can play with toys appropriately as opposed to simply fiddling with them.

No such screening tool was used widely when Martin was coming up. I can't help but wonder what my answers would have been. Thinking back on that time, I remember that Martin could amuse himself for longs periods of time. As a 6-month-old he could play with a piece of paper for half an hour. When he was 18-months old, he built block towers about a dozen pieces high. These were signs, but we had no idea. We thought he was just bookish, which made sense given his parents. His ability to concentrate didn't seem odd as I was simultaneously sitting in a tiny office for hours each day pouring over 19th century New York legislative records. One person's weird is just another person's job, right?

Another aspect of a standard 18-month-old's pediatrician visit is immunizations. No matter how convinced you are that there is no basis for connecting autism to shots, no matter how much you trust the process of peer-reviewed science, it's a big, big deal to think about giving an MMR to your seemingly normal toddler when she has an autistic big brother. I'm fortunate enough to have a doctor who will talk these things out with me. He doesn't believe there is a tie between shots and autism, but he knows the stakes are high for families with a clear genetic predisposition to the spectrum. He also knows that there's little chance that Sasha will get the measles in the next 6 to 12 months. So unlike some mothers who've had doctors scream at them about immunizations, my doctor said, "Let's wait. Let's give it a year until she's a little more grown up. You have to feel good about what you do with your kids." It made me start to cry.

I've cried in that pediatrician's office before. The same doctor diagnosed Martin just over two years ago. But today I cried out of relief. Relief about caring for Sasha and relief about a doctor's solidarity. And more than that, relief that Martin is doing OK despite all the things I didn't know a few years back.


  1. Almost crying relief with you. When J. was a newborn we came from a rather unpleasant experience with one of Duke Hospital's lactation consultants to our first pediatrician appointment. The first words she said to us were, "so I talked to the lactation consultant from the hospital ..." Jo and I went to defcom 5 on the tense-o-meter ... "she seemed pretty abrasive!" Woosh. If our doc here in Toronto weren't pretty darn good, we'd probably consider commuting to Durham to see that woman.


  2. I don't even have children, and this story warms MY heart, Jen... only because I know how frustrating it can be to have a doctor treat you like you're hysterical and/or impossibly ignorant. In my case, it was my own health... not my child's. And in some sense, that probably made my frustration easier to deal with (if it were my child's health, I MIGHT become hysterical!). The problem was, it was MY intelligence that was being implicitly questioned... my EGO that was being implicitly insulted... and... well... yeah. Some people get angry when that happens. I just feel deflated. When I moved to DC, I happened upon a doctor who treated me like the intelligent, curious, capable person I am -- and it was unbelievable! I still really miss that guy... --MJF

  3. it's a really happy story jen... thanks for sharing

  4. MJF - What was the name of that Dr. in DC? Please email me offline at (We live in DC and my husband is on the lookout for a new doctor.)

    Jen - That's a terrific story. Can't wait to see you guys in a couple of weeks!


  5. It's so funny, we had a very similar experience at my daughter's 18 month checkup a few months ago. Her brother is only four, but they didn't have any such checklist when he was 18 months old, either. My husband took her to her appointment and he told me when he got home that he wished they would have had the same list when our boy was 18 months old, as he wouldn't have checked off one thing on it. We stayed on a regular schdule for both our daughters but I really understand what you mean by wanting to wait. I'm so glad you have a good understanding doctor!