Dear ER Doctor: Don’t Tickle Your Patients

February 4th, 2014 by Dionna | 1 Comment
Posted in natural parenting, Use Nurturing Touch

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The following is a letter I sent to the Patient Advocate of Children’s Mercy Hospital, where Ailia was seen recently after she fractured two bones in her right leg. The letter will be shared with the doctor and the appropriate supervisory team.

I wanted to share it here to help empower other parents. It is up to us to stand up for our children, even to medical professionals. I wish I had said something to the doctor in the moment, but I didn’t. Hopefully this letter will help influence the doctor’s treatment of future patients.

Ailia cast

Dear Dr. ____________:

We saw you last week after my daughter (Ailia, 25 months old) fractured her leg. We have some concerns about your examination of our daughter that we wanted to share with you. Please understand that we do not believe you meant any harm, but it is important to us you understand how Ailia felt after her examination.

When you began your examination of Ailia, you asked me how she’d hurt her leg. You then moved on to check Ailia’s eyes and ears, then you listened to her chest with your stethoscope. After you listened to her chest, you gave her (bare) stomach a little tickle and asked her if she liked to be tickled. As her mother, I could tell that her response was negative, but I failed to speak up for her. You then tickled her all down her bare legs. At one point she jerked away and whimpered (near where her fracture is).

When you left the room after your initial examination of Ailia, she said, “mama, I no want that doctor come through that door.” I asked her why, and she said, “I no like he tickle me!”

I know that you were trying to build camaraderie with Ailia by tickling her. But I’d like to suggest something that would be more appropriate and respectful: simply talk to your patients, even babies and toddlers. I’m fairly certain that the first time you spoke directly to Ailia was when you tickled her stomach, which probably frightened her and was definitely an invasion of her personal space. I’ve always appreciated our family doctor, who takes time to establish a dialogue with our children at every visit – sometimes friendly and casual (“you’ve grown so much your legs are sticking out the ends of your pants!”), sometimes inquisitive (“now tell me how you got hurt?”). Before he ever attempts to touch my children, he looks them in the eye and he talks to them. He recognizes that children are people. And when he touches them, he does it gently, respectfully, often explaining what he is doing and/or why he is doing it. My children have never been scared of an exam with our doctor.

But our main concern is the tickling itself. Uninvited tickling to a child is confusing and potentially damaging. In a world where around 1 in 5 children are sexually molested, I don’t want my daughter to think that she has to allow anyone – even a doctor – to touch her in a way that makes her uncomfortable. Unlike other parts of a medical exam – palpating a sensitive spot, for example – tickling is not necessary to a diagnosis.

Think about it this way – if you went to see your doctor, you would expect the doctor to communicate directly with you. And you would be very taken aback if your doctor tickled you. While I understand that doctors may need to employ special techniques to examine young children, they should not use techniques that would be deemed inappropriate if used on an adult. Trying to get the child to laugh? Understandable. Tickling a child’s stomach? Inappropriate.

Under any circumstances, tickling a patient as part of a medical examination is not proper. But under these specific circumstances, it also caused Ailia further pain, as evidenced by her jerking reaction when you tickled her near the fracture. Tickling makes people jerk and move around, not something that would be very comfortable to someone with a fractured or broken bone.

Finally, Ailia’s experience at Children’s Mercy has made her nervous about doctors. While we waited for the orthopedist at another Children’s Mercy facility the next day, Ailia said to me (completely unprompted), “this doctor don’t tickle me!” I responded, “no, I won’t let this doctor tickle you.” She said, “I don’t like it!” She was also reluctant to let the orthopedist touch her.

Kids are bright. Kids deserve our respect. Kids deserve bodily integrity. I know that you must have a heart for children, since you are working at Children’s Mercy. And that is why I wanted to share this with you. I hope that you consider it in the spirit it was intended – not as a harsh criticism of your work, but in an effort to pass on a deeper understanding of your patients.

Thank you,

Dionna & Tom Ford

One Response to:
"Dear ER Doctor: Don’t Tickle Your Patients"

  1. Kelli

    Wow. What an incredibly well-written letter. Nice work, you guys. Way to advocate for your kid! Just wonderful.

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