Once again, a poignant moment occurred when hearing from a patient rather than in the classroom. Of course, it should not surprise me by now that I don't get flashes of insight when reviewing the five different causes of diarrhea. I'll spare you the "running" commentary. Sorry for the pun, just had to get that out . . . Ok, I'll stop.
This time we were hearing about a 14 year old kid whose life changed when he learned that he had a blood disorder that would require a bone marrow transplant. We were taken through his story by his doctor, who recounted how the boy's biggest concern was whether he would be out of hospital in time for his senior prom. It was at this point that the doctor shifted in his seat, looked right at us and said pointedly "This is the difference between kids and adults (and why I love working with kids). Kids worry about living; adults worry about dying." This loaded statement got me thinking. Is the transition to adulthood about moving to an "anything but that" worldview? Giving a speech becomes about NOT looking stupid. Interacting with others becomes about NOT embarrassing yourself. Working about NOT losing your job. Parenting about NOT having your kids misbehave. Living about NOT dying. While kids think maybe I can jump that far; I'll try it. Maybe that kid wants to play. Popcorn right after cake? Sure!
It's an easy cliche of course, to talk about the disinhibition and creativity of children versus the social straitjacketing of adults but if life is to be lived fully it's worth looking at those who might not yet have forgotten how to do that. If adulthood is about having a much deeper and richer knowledge of everything of that can go wrong, why grow up?
Of course as doctor, I will have to consider what CAN go wrong. I owe my patients that information. But hopefully I can also imagine brightly everything that can go right and convey that to my patients so that they can believe that they will not only not die, but live.