What a child taught me about tolerance and labels

As an internist, I treat many adult patients for mild depression and anxiety. They often ask for medications to get them through a rough period, though at the same time they shun the hammer of a stigmatizing diagnosis. Many are afraid that, if word gets out they are being treated for a psychiatric illness, they won’t be as respected by their peers. Co-workers and family members may question their ability to function.

As a physician, I feel vital in my role, calming fears with information, issuing directives that hopefully help my patients. But I am also a parent, and when evaluating behavior and issuing directives as a parent, I lack the same armament that helps me as a physician. As a parent I am helpless, riding the waves of my own fears.

In my son’s kindergarten class, a boy, whom I’ll call Ira, was labeled as a behavior problem. The other parents were worried: Was this child’s silly and impulsive behavior something that would rub off on their children? Would all the children in the class misbehave and try to be like this unfortunate child? As a doctor I wondered if the child had been given a diagnosis such as attention-deficit hyperactivity disorder or if he was simply troubled and undisciplined.

Regardless, something was wrong. The boy’s parents were asked to provide a permanent teacher, and the other parents didn’t want their children to play with him. In my son’s class, Ira erratically hugged or pushed other children, and maybe they were never quite sure which was coming.

Ira’s full-time teacher tried to make it look as if she wasn’t assigned only to this problem child, so the other 5 1/2-year-olds didn’t quite catch on.

Even though I thought Ira to be a sweet child, I found myself automatically joining the bandwagon of parents who protested to the school that this child should not be allowed to be in the same class as our kids. We lost that battle, and I was dismayed when my son listed Ira in the group of his favorite friends.

On parents’ conference night, the teachers told me my son was normal but that he was now considered silly. I tried to blame the silliness on Ira’s influence. The head teacher said no and told me my son was the ringleader.

“I’ll try to stop that,” I responded.

At home I explained to my son that silliness is a way to get attention that may cost him respect. “Class clowns are not respected,” I told him.

He seemed to understand and promised to be more serious.

As a parent, I view myself as a captain attempting course corrections whenever the ship of childhood veers too far from the charted waters.

I also told my son not to play with Ira. I felt mean, and I could see the pain taking hold in my child’s face, but because the teachers wouldn’t acknowledge Ira’s influence to me, I did not relent.

A few weeks later, at father’s day at the school, the teachers told me my talk had succeeded, my son was no longer silly.

But I noticed that the other parents avoided me along with Ira’s father. I suspected I was being lumped into a group with him -- “fathers of the silly kids, better stay away.” As a parent I couldn’t talk openly about this, the way I could if I disagreed with a patient.

One night at home my son blurted out that Ira was out sick, he was having an operation. My son added, “one of the teachers is missing too.”

“Is that Ira’s own teacher?”

“I don’t know. I think so,” my son said. The information of Ira’s operation stabbed me with pain and sudden clarity.

“I’m sorry, son,” I said. “I was wrong to tell you not to play with Ira. You can play with him all you want. And I hope and pray that he gets better.”

Relief washed over my son’s face. “Thanks, Dad.”

From that day on, I asked my son if there was word about Ira. We suffered through it together, until the day when Ira and his special teacher returned to the class. My son said everyone was happy, including the children of the forbidding parents. None of the kids thought they could catch what Ira had.

Now I no longer care whether these parents approve of either me or my son. I take this lesson to work with me as well, appreciating my patients’ vulnerability more, worrying about their approval of me less.

I am learning the same lessons: that caring is nonjudgmental, that people are not diagnoses, that fear is contagious but so is friendship.

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Dr. Marc Siegel is an associate professor of medicine at New York University School of Medicine. He can be reached at marc@doctorsiegel.com.