Teaching kids about illness: when vague explanations just don’t cut it

My son just never ceases to amaze me.  And my daughter, too.  And also, how different they are.  In yet another installment of “My child is a genius,” I bring you this story.  It really belongs in the “Sh*t my son says” section, but it’s too long and too great to stick there.

First, a question.  Where do they pick up half the sh*t they say?  He stuck a card to his forehead today and said he was practicing “mind control, which is like hypnotizing.”  I assume this comes from some Pokemon or Power Ranger, but it’s still startling to hear.  Likewise, my daughter busts out at dinner: “If you eat an ice cream sandwich, you’ll have a heart attack!”

“What’s a heart attack, Princess?” I say.

“I don’t know!” she says almost flirtatiously, and starts dancing some kind of twirling waltz with two of the many ponies she has in her collection.  That’s about all I can get out of her.

I don’t know where she heard about a heart attack, but clearly, she just thought it sounded pretty, and didn’t really concern herself with the actual meaning.  Munchkin, on the other hand, is intrigued.

“What’s a heart attack?” he asks, all concerned.

“It’s when the heart stops working,” I answered, foolishly thinking this might be it.  I swear to God, it’s like I’m new.

“Why does the heart stop working?”

Where do you even start to answer this question?  I tried to get away with the classic, “Because it’s sick,” but again, I should have known better; honestly, it’s like I’m new or something.  That is obviously not enough.  So, now I’m forced to consider how far back in human physiology and pathophysiology of disease I have to go to explain it to him in a manner that he would find acceptable.

“Well…” I begin, “you know how we need oxygen to live…?” Yes, I went that far, all the way to oxygen, and breathing.  Talked about blood and heme, and arteries, veins, and organs, and ended with, “Sometimes, though, the arteries can get clogged.”

He regards his wrists. “I have lots of veins,” he says.  “Wait, what’s ‘clogged?'”

“Like, there is something in the way…” and I panic, thinking, oh Cheeses Crisis, now I’m going to have to get into cholesterol plaques, and the shoulder region, and platelets, and clots… stable vs unstable… I’m reaching here, folks. Reaching.  I think I gave a talk about this on my surgery rotation some 15 years ago.  I probably got rid of this information when I had to make room for the new treatment of hepatitis C!

Fortunately, he nods understandingly and says, “Is it like a blockage?”

“Yes, exactly like a blockage.  So, the blood can’t get to the heart, and the heart gets sick and kind of… goes to sleep or stops.”

“And then what happens?” he says, his already wide eyes widening even more.

“Well, if you don’t fix it, you could die.”

“But you can fix it? How??”

“There are various ways.”

“What ways?” he insists.

“You can put a little wire in the artery that’s blocked and clean it out.  The pathway is restored and blood comes back to the heart, and it starts working again.”

“Does that hurt?”

“I don’t think so.”

“Ok.  You said ‘various.’  What are the other ways you can fix it?”

“You can give special medications that will go to the blockage and bust it up.”

“Do the medications taste good?”

“I never thought about how they might taste, since they go in the vein,” I tell him, in a futile attempt to make a joke, but I should have known better.

“Does it hurt to put the medication in the vein??”

“No,” I say, collecting my face back into a serious expression.

“Ok.  Are there other ways? What do you do if the heart is really stopped?”

“You could shock it back to life with electricity…”

“What?!  How?!”

“With a special medical machine,” I cop out, after a brief contemplation of how I would explain what a defibrillator is.

“Does that hurt?” he demands.

“I don’t think it’s pleasant,” I say, “but it’s life saving, so…”

“So, it’s not pleasant, but does it hurt?” This kid let’s me get away with nothing.

“I have heard people say it feels like getting kicked in the chest.”

There is a brief pause, and for a second there, I feel like maybe the pimping session is over.  I even take a moment and recognize that I am objectively impressed with his thinking process; like a scientist, or, dare I say it, like a doctor.  And subjectively, I take a deep breath, because I was actually sweating.  I was breaking out in hives.  I really felt like I was getting pimped in rounds.  What the eff, kid.

andwhynotshesaid.comBut here is where we get to the crux of the matter.  The thing that is REALLY bothering him.

“Do kids get heart attacks?”

“No,” I say, “Most people are over 50 when they have heart attacks, so we’re safe.”

You’d think he’d be relieved, right?  Nope.  Not this one.

“You say over 50, and we’re safe” he says, and pointedly glances towards his father, “but…. he‘s 49!”

Now I couldn’t help but laugh.  Seriously, dude?  That’s quick thinking.  I explained about doctors, physicals, stress tests, and he seemed appeased.

Meanwhile, my daughter kept dancing and dancing with her two ponies, all the way to bedtime.

Anyway, this little exchange had me thinking hard not only about how much of a genius my son is (if I do say so myself), and not about how my daughter must have an artistic and creative personality because she’s not interested in concrete learning (that’s another topic), but also about how children understand way more than we give them credit for, and think in ways that we don’t believe they can.  Sometimes, it’s not enough to speak in vague theoreticals.  Sometimes, “Grandpa is an angel in Heaven” doesn’t cut it.  It’s true that kids “aren’t just little adults,” as the saying goes, but sometimes they do surprise you.  My suggestion is: give your little ones some credit and talk to them like grown-ups.

And now I have to go protect someone from the dark.

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6 thoughts on “Teaching kids about illness: when vague explanations just don’t cut it

    1. He’s 7!! He asks better questions than my grownup patients…. find the post about how he got hernia surgery. It was the same and he was even younger then.


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