I have reflected on this question, which was asked of me, for quite some time. In a sense, it is asking about a significant portion of my life and life’s work.
Different paediatricians may give different answers based on viewing this as a job role or a vocation in life. In addition, society’s perceptions clouds the issue. Society holds some occupations as having more value than others. But this is not true.
Many jobs are meaningful and important, even if they do not have ‘status’ and prestige accorded them; for example, the individuals who grow food for us, those that clean our workplaces, and offer us transport services are all vital to our society.
It is important not to become a specialist or paediatrician for the status, power, prestige, or societal recognition that it brings. As Thomas Merton aptly articulates, “People may spend their whole lives climbing the ladder of success only to find, once they reach the top, that the ladder is leaning against the wrong wall.”
What is important as individuals is to listen to our hearts and find the vocation that brings us joy.
The word ‘paediatrician’ is derived from the Greek words ‘pais’, meaning ‘child’, and ‘iatros’, meaning ‘healer’. As paediatricians, there are basic roles or functions that we have to perform. These include:
- Day-to-day clinical care of children and families – both children with acute and chronic illnesses. This also means networking with our colleagues to access support and therapeutic options for children.
- Developing support systems for children and families – we constantly need to grow our clinical services to adequately meet the needs of children and families. This includes developing prevention programmes.
- Training is an important part of the job, and we have to support the clinical growth of juniors and other staff members.
- Planning for department development in terms of manpower, equipment, and infrastructure.
- Personal development and research must be a paediatrician’s essential traits. We need to grow our knowledge, capacity, and skills, and use data to solve problems and implement child health programmes.
But beyond these basic roles we need to ask ourselves and look at the deeper significance of “what does it mean to be a paediatrician”. It is not just the job you do but more importantly, it is the person you are becoming.
I would like to outline how becoming a paediatrician has shaped and changed me — in essence, what I see as my core roles and purpose in this vocation. They are not arranged in any order of importance, as all are valuable.
Being In Service Of Colleagues (A Family At Work)
Quite often, we have models of leadership that ‘lead from the front’ with almost ‘autocratic’ authority. While we need to become strong leaders, it is important that we also become ‘servant leaders’.
There are negative connotations associated with the word ‘servant’, but it comes from an old French word ‘servir’, which means ‘to serve’ or ‘to be in service of’.
As paediatricians, we need to support our colleagues and staff members, and support their emotional and psychological needs. This means that we are available to listen to their problems and concerns, and offer meaningful guidance and practical support.
It could be struggles with work (e.g. losing a child we have been caring for is very painful), or problems handling work and home responsibilities.
This will eat into our time, but when the staff members are more at peace, the services we can offer children and families can be significantly enlarged in capacity and depth.
In essence, we are developing a family-at-work, and this will spill over into more personalised care to children and parents. The quality of relationships must be the core of any department, and are a key marker of its success.
We Are Recipients As Much As Givers
Quite often, we feel drained at work, always giving and meeting the needs of ill children. We will always have added responsibilities, since everyone, including junior staff members, look to us for guidance to improve the outcomes of ill children. or those with a chronic disease or disability.
In addition, parents and staff members need emotional support. Therefore, we can become exhausted because we fail to be recipients at work. This means changing and learning to receive from children and parents (and junior colleagues).
Over the decades, I have recognised that the children and families I have been caring for have changed and shaped me, offering much support, often unconsciously, at a deep place.
There is much to learn and receive from children (see my comments on joy at work). I first learnt this from Mother Teresa during a visit to see her work in the late 1970s. Once we become recipients, as much as givers at work, we will then find the task not as exhausting or daunting.
We Are Child Advocates
While we have a responsibility to the organisation we work for, ultimately, we are advocates for the children and families we care for. This is enshrined in the United Nations’ Convention on the Rights of the Child and our Child Act.
The United Kingdom’s Royal College of Paediatrics and Child Health states “As child health professionals, child protection plays a role in everything we do.” We are required to give a voice to children, to speak out on behalf of a child or family.
This could mean fighting for better local services or for unmet needs. Advocating for disadvantaged children is our daily responsibility. This requires us to have a ‘bigger picture’ outlook.
Remember that health institutions and systems are largely developed for doctors and administrators, rather than for the community they serve.
We cannot be cloistered in our ivory towers, ignoring the desperate needs of children in the community. The essence of all paediatricians is that they are child advocates, fighting for child rights and services.
Pain Will Transform You
As paediatricians, we will meet children when they are most vulnerable and hurting. We will also meet families during their time of greatest anguish and when they are most concerned about their children.
The most difficult of these encounters is facing the death of a child, or dealing with a dying or terminally ill child. Those working in paediatrics will know that pain is a reality when caring for children. Not everyone can deal with this kind of pain.
Others would want to be there for these children and support them and their families. When we face this pain and work through it, you will find that it transforms us for the better.
Although it never gets easier to lose a child in your care, we are able to find some measure of peace in having been there for the child and family during their darkest moments, and having done the best we can.
Enjoy What You Do (Not A Job, But A Vocation)
Recently I responded to a British Medical Journal request to pen some lines on “What brings you joy at work?”. I would like to share what I wrote, as we need to find joy at work if we are going to continue to be paediatricians:
“As a paediatrician, many things bring me joy at work; the smiles or giggles of a child, the friendship of families, and the bond between colleagues.
The obvious situation where we experience joy is when a child recovers fully from a severe condition. This brings much happiness and relief to the family and to all of us who have been caring for that child. But many children don’t recover fully, many are left with chronic debilitating conditions and disabilities. Here the joy comes from seeing the family reach a more wholesome place. When we can help overcome many difficulties in the child’s life as well as alleviate any pain the child may be experiencing, then the family can move forward and we feel a sense of joy seeing this happen.
Joy also comes from working with a good team. When the work location is not just a workplace but a family, then coming to ‘work’ every day is filled with expectations of meeting with like-hearted individuals and sharing in our common endeavour to support children, families and the community.
Finally, and paradoxically, there can be some measure of joy even when a child dies. When we have experienced, over a long time, the courage and strength that a child has in facing a difficult condition and the challenges the family has gone through, then that journey, even when it ‘ends’, brings some measure of peace and joy. We treasure the opportunity to have been given the privilege to be involved in the journey of this child and family. We grieve with the family but are also empowered by the relationship we had with the child and family. It has enriched our lives and somehow made us want to be better than we are.”
Remember, in paediatrics, there are no exciting cases, only exciting children and parents, and interesting colleagues.
Not every paediatrician will want to travel the journey I am advocating. It does not mean they are paediatricians of a lesser order. Remember that this is a progressive journey, and each of us will travel it in our own ways.
Some will be called to be shining lights, while others will do their good work quietly. Neither is greater than the other, and both categories are equally valuable. My hope and dream is that all of you will grow to discover who you truly are and live in that reality.
Dr Amar-Singh HSS is a consultant paediatrician.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.