Father’s Day: Better dad makes for better doc

A sure way for me to get told to pound salt is to come home from a long shift on the job and try to run my castle as if it was the emergency department (ED). It should work; my daughters tell me about their problems, just as patients do. I quickly analyze their problems and search for remedies, just as I would for patients. Then I present my daughters with clear orders for carrying out the appropriate remedy to their problem. Just like the ED, right? The difference is that when I tell my patients what to do they don’t roll their eyes up so fast they get eyeball whiplash, then walk out of the room muttering “Whatever” under their breaths.

From those moments and many others I have learned a lot about being a father from being a physician, and a lot about being a physician from being a father. As a result I have often been at my best as a father when I treated a daughter more like a patient, and at my best as a physician when I treated a patient more like a daughter.

The hardest part of being a physician and a father was learning that everything you saw at work was not going to happen at home. While my wife was pregnant with our first child, for example, I was studying human embryology in medical school. I spent hours reading textbooks which described every genetic train wreck that could happen in the development of the human embryo, then hours wondering what would go wrong with our embryos. Nothing did, and I have since learned that little of what I see in the ED is likely to befall those creations on this side of the womb, either.

Despite that I still want to protectively shrink wrap our daughters. I want them to call as soon as they get back from a dangerous trip to the supermarket, avoid men as the plague of testosterone and heartbreak I know them to be, and to carry emergency surgical instruments and snake bite kits in their purses, just in case.

Perhaps my first conscious understanding of the dilemma and value of being a father and a physician was also one of the worst. I was a resident in training watching CAT scan images come up on the screen as the patient, a 5 year old girl, lay in the scanner. We were scanning her brain because she had come into the ED with a seizure. My own children, then 6 and 3, were at home in bed as the first CAT scan image showing a probable brain cancer popped onto the screen. If an x-ray picture could have screamed, that one would have.

As I talked to the child’s parents about the results I struggled with my composure and my role; they needed both my knowledge as a physician who knew what this meant to the patient, and my compassion as a father who knew what this meant to the parents. Sometimes the greatest challenge for a physician is to be smart and heartbroken at the same time.

Nowhere have I made better use of my two roles than in the minefield of adolescent female sexuality. It was in the ED that I learned you had better be able to talk to your daughters about sex, menstrual periods, and what can and cannot get you pregnant, if you don’t want them learning about these issues from their friends. (Those would be the kind of friends I had who told me a woman cannot get pregnant if she has sex standing up.) I learned that a young woman’s commitment to abstinence before marriage is best backed up by a commitment to condoms before intercourse, just in case life happens on the way to the altar. I learned that if finding a lost tampon in a female patient in the ED is no big deal, then neither is talking to my daughters about periods.

It was as a father that I learned most about the modesty of young women, so I knew female patients were much more likely to listen to a physician after a pap smear if they could first trade the skimpy patient gown for their own clothes. It was thinking as a father that made me realize a young woman who has gotten pregnant unintentionally needs a kind heart to lean on, not a lecture about the appropriate use of birth control. That said, I still mistake too many listening moments for lecturing moments.

Being a physician taught me that when it comes to parenting young women, fathers are there for the ride, and not to drive. After all, if daughters always did as their fathers instructed I would be treating fewer daughters in the ED. A father who tries to drive the lives of his daughters all of the time will simply drive them out of his life. The day they come home at age 21 with some piece of jewelry through their beautiful belly buttons a father had best remember those are their belly buttons, and that fathers have teeth so they can occasionally use them to bite their tongues. The term “That’s, uh … nice, sweetheart” was invented for such moments.

Finally, I learned about the best gift I get every Fathers’ Day from both my patients and my daughters; that if daughters and patients believe you will always care deeply about them they will care for you even when you get it wrong. That’s a darn good thing, because I still have a lot to learn, in the ED and at home, as a physician and as a father.

Erik Steele, D.O., a physician in Bangor, is chief medical officer of Eastern Maine Healthcare Systems and is on the staff of several hospital emergency rooms in the region.