Last Friday, as I sat finishing up notes on the last of my almost 30 physicals (this number is never any surprise for us pediatricians this time of the year, it’s back to school week, so every Thomason, Dickinson, and Harrison is lining up for sports physicals and regular physicals and all sorts of clearance and medication forms that need to be filled out and turned in “yesterday.”) I took a deep breath and exhaled, my mind filled with the events of the day. As is customary, my beloved patients often postpone their physicals all summer, in search of sandy beaches and clear blue vacation skies, so it’s usually a mad rush the first week of school.
I found myself reflecting on the patients I had seen that day as I often do at the end of my day. Most of them were mundane well-baby and well-child checkups, nothing really of note, a few of them had minor issues to clear up before returning to play … but one of them stood out clearly like a lily in a field of carnations … a 16-year-old we shall call “Maya.” I have met Maya only a couple of times in the past, and I have known her to be a troubled teen, plagued with depression and anguish, never really smiling, not much eye contact, not much of an effect — just sad. I have tried to manage her depression the best I can with counseling in the office and referral for proper psychotherapy. My good friend and child psychiatrist sees her regularly and has placed her on an appropriate dose of antidepressants. And she reportedly goes to counseling regularly, all with little or no change in her mood.
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