Your Child in the Balance is a non-fiction book containing many short vignettes. However, in twenty short chapters, it also contains the extended story of Rosie, an eight year old girl who refuses to go to school and whose parents struggle with what to do.
ROSIE
Chapter 1
Every first phone call holds a surprise.
"Hello, this is Dr. Kalikow. Is Mrs. Parker at home?"
"Oh, Dr. Kalikow, thank you so much for taking the time to call back. Dr. Rice, our pediatrician, gave us your name. My daughter, Rosie, is a patient of his. Rosie's been having some problems. I've never done this before-I mean, called a psychiatrist. What should I do? Do I just make an appointment or what?"
"Why don't you tell me in a sentence or two about the kind of difficulty Rosie's been having?"
"Sure thing. Rosie is eight. She's driving us crazy. Dr. Rice thought you could help."
"How is she driving you crazy?"
"She's been refusing to go to school. In the morning, she screams that she's not going to that 'f'in' school. I didn't even know she knew that word. She grabs the leg of this heavy chair in the dining room and doesn't let go. I had to pry her hands off it. All the while she's cursing and screaming that she hates my guts."
Mrs. Parker was at wit's end.
"When I finally get her walking to the car and I'm dragging my poor five-year old along, who only wants to finish his Pop Tart, she takes off down the street. And now I've got my five-year old crying, and I can't leave him alone in the car, but I can't let Rosie run down the street. And so I am chasing her past the neighbor's house wearing just my nightgown and slippers and my husband's raincoat that I threw on just to take her to school. She's running like a car thief, and I'm tripping down the street trying to keep the slippers on my feet and hoping nobody sees me. And meanwhile my husband's at work, and I can't get him on his cell phone, and I don't know what to do."
Mrs. Parker was not at wit's end. She was desperate. Without ever having met the woman, I felt obligated to try to help her out of this mess.
After she caught her breath, she went on, "Dr. Rice said you'd be able to help us. He said that you'd know what to do."
I explained to Mrs. Parker that while I greatly appreciated Dr. Rice's vote of confidence, these problems are sometimes difficult to solve. Let's keep the expectations reasonable and avoid the inevitable disappointment when Rosie is not skipping to school by Friday.
"Can I bring Rosie in tomorrow morning, Dr. Kalikow?"
I told Mrs. Parker that my soonest appointment was the following Monday morning at nine o'clock and that I would like to see her and her husband first. We would discuss Rosie's difficulties going to school and take a complete history. I wanted to understand how she does in school, how she does with friends and family, how she eats and sleeps, whether she has any medical problems, and so on. I explained that this would take about an hour and a half. Then we'd set up an appointment for Rosie.
"I'm not sure what there will be to talk about for an hour and a half, Dr. Kalikow. But I know you know what you're doing because Dr. Rice said so. Besides, you sound nice, and I really appreciate your talking to me on the phone this late at night. I mean you don't even know me."
Truth be told, I was eyeing my clock as Mrs. Parker was talking. I had been on the phone for about ten minutes, and I still had two calls to return before I left the office. I had done my job for the first phone call. I had been supportive and set up a first appointment. It was time to move on.
"Mrs. Parker, I'll see you and your husband next Monday morning."
"OK, Dr. Kalikow. But one last question?"
"Sure."
"Does my husband have to come? He's an electrician with his own business, and he's really busy in the morning. Is it OK if I come alone? I mean he's usually not home in the morning when Rosie goes to school anyway."
Beware of "one last question." It often tells the tale.
"If at all possible, it's pretty important for your husband to come in. He'll be able to tell me his view of Rosie. It will also be important to have him here to discuss our plan for treating Rosie."
"Well, that's just it, Dr. Kalikow. Pete doesn't really believe in psychiatry. He grew up in a pretty old- fashioned house where every problem was solved by a slap on the head. He thinks that Rosie just needs a whack to straighten her out. But I won't let him do that. Pete says that he doesn't want any daughter of his seeing a shrink--I'm sorry, Dr. Kalikow, I mean psychiatrist-- for the next ten years. He says that too many kids are being given given medicine, and he won't have any of that. You wouldn't use medicine, would you, Dr. Kalikow?"
Ah, just "one last question."
"Mrs. Parker, that's an important question, and I think it would be better to discuss that when you and your husband are here in the office, after I've taken a more complete history. I do have patients who take medicine, but I also have patients who don't. We need to evaluate Rosie and see what's best for her. There will be plenty of time to talk about medicine if we think it might be of help.
"But tell your husband that I would never and could never start Rosie on medicine unless the two of you agreed that we should."
I was still eyeballing the clock, but I was also realizing that these last questions needed to be dealt with in a sensitive and patient way right now. Despite Dr. Rice's superlative recommendation, patients expect their fears and opinions to be heard respectfully, and if I had any hope of fostering a working relationship with these parents, I had to take a minute to help quell their anxieties.
"Well, OK, Dr. Kalikow. I'll tell all this to Pete. He really cares about his daughter more than anything in the world and would do anything for her. He's just a little thick-headed and stubborn, but he's got a heart of gold and..."
"Then I'll see you both next Monday, Mrs. Parker."
"OK, Dr. Kalikow. We'll see you then."
