What do you want to be when you grow up?
By Arne Vainio, M.D.
They were late to the appointment and I almost wasn’t able to see them. A five-year-old girl missing one of her top teeth and her mom, single and taking the day off for this appointment. She was in college getting her general requirements done and one day hoped to go into nursing. She worked at the casino and had been there for several years.
The girl had a cough for the last week and her mom thought it was getting worse. She was coughing off and on as I was getting the history from her mom, but she was also singing songs from one of the animated princess movies and she was dancing and doing pirouettes and wearing a billowing blue princess dress.
She had a beautiful singing voice.
I showed her the ophthalmoscope and let her look into my hand with it and showed her how it magnified my fingerprints. She turned her head so I could look in her ears and both of her eardrums were fine. I looked in her nose with the scope and could see some puffiness in her nasal passages and the back of her throat looked fine.
I checked the lymph nodes in her neck and told her how they were part of her immune system and how they can get bigger when they are fighting an infection. I listened to her lungs in four different places on her back and told her how her lungs move air in and out and how they sounded normal without any wheezing or sounds to suggest pneumonia. I listened to her heart and told her as I was listening to each of the four valves how her heart beats over 100,000 times per day, every day and it never stops.
I checked her abdomen and told her as I followed along her large intestine and palpated her left kidney, then her spleen and her stomach and her pancreas, then her liver and gall bladder and her right kidney and then her appendix, then her small intestine in the center of her abdomen and she listened to every word.
“You have a cold. Antibiotics will not help this and it just has to run its course. Cough syrups are fine and it’s OK to take medicines to help with fevers and achiness. Chicken soup and a mother’s love are what you need most and the chicken soup is optional. You have a beautiful singing voice and I don’t know when I’ve seen someone who could stand on their toes so gracefully. I’ve known you since you were born and I know that you’re bright and I know you’re a good reader. What do you want to be when you grow up?”
“I don’t know.”
“It’s not too early to start thinking about it. Those big movie studios that make the princess movies want you to buy dresses and clothes and they want you to buy dolls and all the things that go with them. They want you to want all those things. But they also want you to think that your greatest value as a girl is how you look. When you go to the mall, look around. Everything there is telling you that you need to be thin and you need to be pretty and you need to be giggly and superficial. The songs you listen to are telling you the same thing. Everything around us wants you to be a helpless princess and it wants you to be saved by a prince who rides in on a high-stepping horse. Almost all of the shows on TV are trying to tell you the same thing.
Right now you like to read and I know you understood when I was telling you how many times your heart beats. Someday, someone will try to tell you reading is hard and math is hard.
It isn’t. Math is rules and learning the rules isn’t hard. Science is mostly noticing the world around us and wanting to know how it works. All those things that want to turn you into a princess are meant to make it harder for you to do what you want to do.”
“But I like being a princess.”
“It’s OK to be a princess sometimes, but you need to be a doctor. You need to stay smart and you need to make sure your mom studies and makes it through college. Have you seen how hard she works at it?
She needs you to believe in her.”
“Sometimes she cries when she isn’t ready for tests.”
“Everybody cries when they aren’t ready for tests. The important thing is that she’s working hard to make a better life for both of you. Good parents always want their kids to do better than they do and that’s why she works so hard in school. She wants to be a nurse so you can be a doctor.”
“Is that true, Mom?”
Her mother was crying. “It is true. I just want the best for you and I never thought about you being a doctor. I’m always proud of you and I would really be proud if you were a doctor.”
My pager went off and it was time for me to see another patient. I turned to the girl and said, “Remember, this cold is going to get better. You keep reading and getting good grades and I will do whatever I can to help you be a doctor. One day a frog is going to tell you if you kiss him, he’ll turn into a prince. He’s going to be very convincing and they always are. Do you know what you need to do?”
“Leave him in the swamp. He’s just a frog.”
She was laughing and she started singing as she pirouetted toward the door. Her mother reached up and squeezed my arm as she walked past.
“Thank you, Dr. Vainio. It’s hard doing this alone and sometimes we barely get by. I’ve thought about dropping out and I have cried when I’m not ready for tests. But this is important and she needs to see me finish. Thanks again for talking to her. I think I needed to hear that as much as she did.”
Arne Vainio, M.D. is an enrolled member of the Mille Lacs Band of Ojibwe and is a family practice physician on the Fond du Lac reservation in Cloquet, Minnesota. He can be contacted at firstname.lastname@example.org