I entered physical therapy school at Emory, inspired to learn and give back to patients just as my previous therapists and mentors had done for me. Following graduation from physical therapy school, I began working in a hospital-based outpatient pediatric and adolescent sports medicine clinic. What could be better? I treated young athletes who were healthy, vibrant and motivated to get back to their sports. I saw athletes from every sport you can dream of: from Irish dance to fencing; competitive kayaking to synchronized swimming. I often marveled at the fortune of knowing every patient in the room was under age 21. As specialists, we always made sure therapy was kid-friendly, fun and sport-specific. The kids were motivated, we were motivated, and we knew we were doing a good thing.
Now, some people would not consider elements of this setting to be fun. For me, I love the “teenage attitude.” It is entertaining. Add that to the paradox of the parent who is struggling to contain the attitude, and we have a real winner in my book. Most kids are pretty good, but I’ve encountered some real gems in my time:
(1) My favorite response to receiving the all-star eye roll from a 13-year-old girl: “So, when you roll your eyes like that, is it because you’re really dizzy or something? I’m just wondering because you’re doing it a lot and I’m concerned for your health.” She never rolled her eyes again.
(2) Show up late to therapy because you were giving your mom a hard time? You owe me a pushup for each minute you’re late.Try it! They’ll show up early and ask you to do pushups for each minute they were early!
(3) Don’t do your home exercises because the dog ate your theraband? Wall sits for 10 minutes. The next time they come they’ll tell you about how they magically found the theraband under their bed.
It’s interesting to hear about the struggles each teen and family member face: from middle school dance to studying pre-algebra; prom dress shopping and recruiting for college sports. It’s a small glimpse into a life that many could classify as far from reality. But to them, it’s their reality. We have to recognize and respect that.
I’ve probably learned more about how to Tweet, use Apple products, Snapchat, braid my hair, paint my nails, wear leggings and Uggs, and dream of the Elf on the Shelf from my young patients than I could ever imagine learning through my own life experiences. Prom dresses are now preferably short and Instagram likes are the new marker of 7th grade popularity. Let’s be honest, I specialize in this field simply so I can keep up with current events.
As an undergraduate psychology major with a special focus in developmental psychology, the pediatric and adolescent age group has always fascinated me. It’s interesting how quickly changes occur in this cohort, and how we can capitalize on developmental processes to create positive outcomes. We can literally help pave the way toward a successful adulthood, including positive physical and mental health. I want my young patients to avoid becoming the adult with chronic sports-related injuries, like me.
Despite my love for this setting, I eventually moved out of the pediatric hospital setting and into private practice. This allowed me raise the bar on exercising my passions and work alongside some of my most valued mentors. Given that I no longer worked for an exclusively pediatric clinic, I inherited some adult patients too. “Grown-ups,” if you will. Prior to starting my current job, I recall having nightmares about this unchartered territory. How on earth was I to work with grown-ups? I was barely one myself!
Eventually, I noticed that I could really treat grown-ups the same way I treat kids and teenagers. In my book, most grown-ups are just big kids. Grown-ups will tell you they don’t generally recall magically becoming adult-like at age 18 or age 21. People in pain are stressed, regardless of age. They have stressed family members, too. And yes, sometimes those family members just may back you into a corner and yell at you.
Grown-ups are motivated and many are athletic, just like kids. Sometimes, they tell me the dog ate their theraband. They show up late too, and sometimes it’s still because they were giving their moms a hard time. Interestingly, an anecdotal trial over several months showed me that most grown-ups still love receiving stickers and prizes for good behavior or good work. My colleague Kate has also figured out that some grown-ups also like hugging a teddy bear when receiving uncomfortable manual therapy treatments.
It was comforting to see my new practice this way and my nightmares decreased, but I felt like I was out on an island. I encountered professional conversations with adult specialists about how treating kids can’t be very different than treating adults.
I believe that while adults can often be classified as big kids and often respond to similar treatment strategies I use on younger patients, the adage doesn’t necessarily work in reverse. Say it with me folks: Kids and teens are not just small adults. Now repeat that 100 or 1000—or however many times it takes until it sinks in. Kids’ and teens’ brains and bodies are literally wired and built differently. They have different physiologies and priorities. Still not convinced? This excellent editorial sums it up quite nicely.
That’s not to say kids’ priorities are any less important. It takes a savvy mind to recognize that kids’ issues aren’t any less important to the kid than issues that an adult may consider more realistic. Yes, kids live in a different world and on a different planet. They aren’t supposed to see the world the way we do. I’ve been told “Oh, it’s a kid, they are so easy to treat because they are so healthy and don’t have chronic problems. Their issues just aren’t as big.” Every statement in that phrase is generally true, minus the word easy. Both groups bring their own unique challenges. They are very different animals–apples and oranges, if you will.
Sometimes I just want to say “Try spending an hour with someone who only speaks in a language of tweets, facebook walls, OMG, selfies, besties, next weekend’s school dance, the trip to summer camp, and the PSAT.” You think that’s easy? Think again. With treating kids comes the responsibility of maintaining an influence as a positive role model, but also doing your homework (every day) to stay on their level. And let me tell you—my young patients think I am sooooo cool as a grown-up because I have a Twitter account. Score!
After working on my pediatric-adolescent-adult island for a while, I stumbled across this article. “AHA!” I thought, “someone from the New York Times is with me on this whole grown-ups and kids thing!”
In addition to treating kids for who they are, I also often face the question of which specialist a kid or teen should see. Parents and colleagues may ask “What does it matter if the child sees a pediatric specialist?” or “Should I take them to an adult specialist instead of a pediatric one? That specialist works with professional athletes, therefore he/she must be better.” That’s the same logic as going to see a veterinarian for your bronchitis. Per the astute philosopher Cosmo Kramer, veterinarians must be better because they have to be able to cure a lizard, a chicken, a pig and a frog all in the same day!
Because it is an adult specialist, does that make him or her a better clinician for your child? Unlikely. Medical specialists come in all shapes and sizes and have all different types of training. Pediatric-trained specialists understand the unique needs of the child & adolescent body and mind. What’s most important is matching a child with the clinician who can best suit his or her needs given training and experience. And most importantly, pediatric specialists can tolerate the continuous all-star eye roll and keep up with the latest and greatest about One Direction and Instagram. But it’s not all fun and games. They can usually come up with every kid-friendly term and metaphor in the book to explain scary and complicated medical concepts to their patients. And guess what—those kid-friendly terms and metaphors work great for grown-ups, too.