“Choices, Gentlemen”

Lorraine Walker saw her daughter get married and her son finish high school. Not long afterward she was at it again. She and her husband, Ted, adopted two young boys.

Six-year-old Sam and his four-year-old brother Tobias had been in foster homes for two years when Ted and Lorraine adopted them. Sam has a low IQ and is generally a quiet, introverted boy, except when he gets into it with little Tobias, who has a genetic mosaic with several minor physical abnormalities along with attention deficit–hyperactivity disorder and some anxiety.

Tobias had gone through a comprehensive evaluation at a child development clinic just before I became the boys’ family doctor about a year ago. Reading between the lines of the massive report, you could sense the reviewer’s concern for his future; Tobias seemed to have challenges in every sphere, yet being around him you couldn’t help being smitten by his exuberant personality.

I remember the exam room was bedlam the first few times I saw the two boys, but Lorraine was calm and dispassionate. She made it perfectly clear what was acceptable behavior and what was not. With admirable consistency she made Sam and Tobias take the consequences of their actions.

Tobias’ most visible physical abnormality consists of a flexion deformity of his fifth finger on both hands. The child development clinic reviewer thought he would need surgery and recommended an evaluation by a pediatric orthopedic surgeon. Fortunately, the hospital we refer our patients to has a very seasoned specialist, who was wonderful with Tobias. He reassured Lorraine that Tobias would have enough dexterity, in spite of his deformity, that it wouldn’t limit his career options, even if he wanted to be a concert pianist or a pediatric orthopedic surgeon.

We once got chatting about how common it is for parents not to follow through on their threats, like “we won’t go for ice cream if you tease your brother again”. Watching Lorraine Walker, you know she means every word she says, and the boys don’t take very long to mend their ways when she reminds them.

Just about old enough to be their grandmother, she is secure enough in her role as an adult and a parent that she doesn’t take responsibility for things the boys themselves are old enough to be accountable for.

“I made a lot of mistakes with the first two that I’m not about to make again”, she once confided. “Anne and Jeremy are turning out okay, even though Ted and I were a little too lax with them. Sam and Tobias have enough challenges that we need to help them develop their character and their common sense so they can reach their highest potential. I’m not helping them by compensating for them – I need to help them grow up to be solid citizens.”

The last time they were in, little Tobias started to spin out of control, egged on by Sam, who sat in a corner and made faces at him. Lorraine had been talking to me. With a quick turn of her head she caught their attention. It took three little words in a quiet voice for her to change the energy in the exam room into one of peace and order:

“Choices, gentlemen – choices…”

1 Response to ““Choices, Gentlemen””

  1. 1 louisvillechiropractor February 1, 2010 at 3:11 pm

    very nice to read about parents who understand the benefits of structure and discipline with children. it is not always about responding like a tyrant. calmness and consistency go a long way. We appreciate these kinds of parents and children in our waiting rooms.

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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