Paediatrics (Part 3/5, RETROSPECTIVE POST)

"Max" (ADHD): My most favourite interaction in Paediatrics was with an ADHD Child called “Max” (not his real Name).  When I opened the door, the first thing Max said to me was “Are you Somalian?” in which I said that I wasn't, without getting offended at all. Whilst the Paediatrician was talking to the Mother about Max's Medication regime, I tried to engage with him by asking him about school and his interests which included video games. I tried to ask questions about his favourite video games but soon exhausted my “Repertoire”. He quickly got bored and proceeded to play with a few styrofoam Cups.

I tried to engage him again by making up a little game where he had to stack the cups in various configurations of progressively increasing difficulty. Every time he successfully made a cup tower, I said “Well Done!”, and he called for his Mother's Attention for similar Praise. Eventually he reached a ceiling point of his ability, so to prevent him from feeling really bored again, I decided to show him how to make “Cup Wheels” by connecting two smaller Cup Ends together with Cellophane Tape, so they can roll on a flat surface smoothly. He got really excited about this novel invention and kept rolling the Cup Wheels down a slanted surface, and then decided that he could make a Cup Tower, so the Cup Wheels could smash into it, with the Cups spreading across the table. The stimulation was enough to sustain him for a few more minutes but soon he got bored again.

I tried asking about his interests, but surprisingly he remembered our conversation and said “You already asked that.” He then ran outside of the room and I went after him. He wanted to urinate but didn't want to use the normal Toilets, preferring to urinate outside. I asked if he wanted to wash his hands, but he didn't, saying that it's “yucky”, which I suspected was a sensory issue relating to water. He then wanted to race me back to the Outpatients room, and I agreed. I outpaced him and reached the room first, but he falsely accused me of having a Headstart.

I really didn't want his hands to contaminate anything else in the room, so I tried to get him to clean his hands with the Debug (an Alcohol / Chlorhexidine Hand Rub) by cleaning my hands with it to set an example. I asked Max if wanted to try catching the Debug while I squirted it like a game, and he said “Yes!”, so I kept on squirting it until he “scored” and was happy. But this happiness was shortlived, for the cut in his hand started to burn from the Alcohol, and he was moaning (LOL). By then the Paediatrician was done with the appointment and he had to go.

It turned out that Max didn't get an increase in his Medication as he desired. As the Paediatrician and Max's Mother exited the room, the lights were switched off, and Max was staring at the computer screen, totally silent. I looked at his face and it looked like a mixture of blankness and disappointment. I suspected that it was due to him ruminating over the Medication issue.

I said to him, 
“I know you are thinking about [ Medication ], and that you want more of it, right?” 

Max slowly said,

 “Yes.”

                         
“You didn't get what you want and that can make you sad or angry. Dr. X is the one who gives you the [ Medication ]. If you want a higher dose of [ Medication ], you have to tell him next time, and say why.” 
                          
"Ok."

            I wrote on a scrap piece of paper the Medication, the desired dose, and his reason as a memo for him to use in his next Appointment before leaving the Room and waving Bye Bye.

I was very pleased but drained that I was able to adequately distract Max during the entire appointment so he wouldn't disrupt the Paediatrician's consultation as usual. The Paediatrician said, 

“You did well, but this is one of his good days.” 

“Thanks”, I said. But I wonder how Max would've behaved if I wasn't there to distract him??? : P