A child's gift.

We had a family in today, the father had to work so it was just the mother and the kids ... 3 girls, ages 1 to 8, and the boy, 16 days old. They are a very poor family, with hardworking and caring parents who take the bus to their office visits. This visit was primarily for the newborn, he had blepharitis and had lost 6 ounces. The girls all had rhinorrhea, and the oldest also had some tonsilar/cervical lymphadenopathy with a low-grade fever. The viral sisters needed to stop kissing their little brother on the face, basically. Anyhow, I saw them first and managed well ... no easy task to see 4 kids at once, I can assure you.

My preceptor, a very good PA, had worked a long day operating on a shorter nights sleep. After she came in to wrap things up, the 8 year old held out something to her, a piece of paper with something on it, that she had just ripped out of some book she was holding.

My preceptor didn't respond harshly, but she didn't take the paper. Instead she fussed at the child, slightly berating her for ripping a page out of a book. We finished up, and I opened the door and started to move out into the hallway. The older girl came out behind me, and she held the paper out to me, saying, "do you want this?" I took it from her as I started going to get a broom and dustpan from the hall closet, to clean up their tortilla chip-droppings.  I didn't look at the paper, as I looked over my shoulder to tell her that she shouldn't rip pages out of books. I put it on a shelf in the closet without looking at it, took out the broom and went to clean up.

I saw a few more patients, and then the day was at an end. The front room was littered with crumbs and what not, so I went back to the closet to get the vacuum cleaner. I opened the door and saw the paper resting there on the shelf, so I picked it up and looked at it. She had drawn a picture of my preceptor, writing on her prescription pad and saying, "you come do". And there next to her, she had drawn herself, saying, "thank you". Actually, it looked more like "yoU CoME dO" and "THaNk yOu", but anyhow. I saw too that the 'book' the paper had been torn from had simply been one of those cheap, disposable crossword type coloring books for kids ... hardly a work of literature that was intended for repeated readings by too many more sets of eyes.

I vacuumed and cleaned up, and then sat and waited until my preceptor got off the phone with the pharmacy.  I approached her gently, showing her the paper and the drawing. Her eyes lowered and she stated how terrible she felt, for having not taken the paper and having only offered discipline. She taped the drawing up on the wall, in full view. They'll be back next week for follow-up, and I really hope I get to be there when that young girl sees that her message of appreciation was heard.