Skin Rash

Being a child of medical parents brings special challenges. For example, such children grow up with a unique idea of appropriate dinner conversation. When I exclaim, “Guess what I saw at work today!” my children interrupt to inquire if my story has blood or something “gross” in it. And they regularly yell, “HIPAA!”—a reference to the federal patient privacy regulations—even though I always deidentify patients.

Children with medical parents also learn, through osmosis and subconscious hearing, about certain parts of medicine. Sometimes these children will drop multisyllabic medical vocabulary into discussions. Or will have a precocious understanding of biological processes and the health care system.

Everyone knows that parents become uncool during the teen years—unless their children need money or permission to do something, when parents’ coolness increases marginally. Medical parents, however, have special powers. They can complete health forms, prescribe medications, diagnose symptoms, and advise their children or their kids’ friends how to feel better. This is true in my home, and my children have brought many friends over the years to meet with me.

Last spring, one of my children’s friends had a rash, and I was asked to take a look. Pleased by the prospect of spending a bit of time with my child and their friend, I obliged. I asked my usual questions to take a history, then performed an exam. I shared my conclusions and treatment recommendations. I noticed that my child was chuckling throughout this interaction. “I’ll tell you later,” they said, when I wondered aloud what was so funny.

My child later elaborated: “You did exactly what I predicted you would. You said hello and chatted, then asked questions about the rash. Then you asked permission to look at the rash. Then you asked if you could touch the skin—not the rash, but the area around the rash. Finally, you asked if you could touch the rash itself.”

My child felt as if they’d nailed the habits of their predictable mother. I, on the other hand, was blown away by their observations. First, I had evidence that I was not always persona non grata. My child was not only watching me, but observing me carefully. Second, as a preceptor of medical students and residents, I delighted in the fact that my child was learning the art of the bedside manner, without any awareness they were doing so. And finally, my heart swelled with hope for the next generation.

Pamela Adelstein
Newton, Massachusetts