What Happens After Pediatrics?

I walked into the exam room as with any other visit. He sat tall and slim on the exam table, hair freshly washed and combed, parted on the side.  His shirt was neatly pressed; he wore a tie and a big smile.  He seemed calm and a bit nervous.

He had grown - many inches. “When did I see you last?” I thought to myself, and then asked. 

His Dad sitting in the chair seemed small now.  “Hello”, he said as he stood partially and shook my hand. 

“Wow, it’s been a couple of years.  Are you a Senior now?”

“No, I’m in college”, he gulped, looking over at his Dad as if for reassurance. 

He told me why he wanted to go out for the water polo team and was worried about his asthma.  He had come to see me on this day, a little awkward in some ways and quite polished in others.  We talked about what might help and what he could do to take care of himself.  He thought our plan would be helpful.  He was all set. 

He’s ready to fly out into the world, I thought.  He’s arrived, ready to move on from Pediatrics.  

But then what?  Would he still be nurtured in Adult medicine, in college, out in the world?  I hope his new doctors listen to him and are patient with him.  I hope they’ll ask him how he’s doing.   

Are we finished adults when we turn 18?  Are we supposed to know how to take care of ourselves?  What is it like when we turn 28 or 38?  How about 58 and 78?  

My patient seemed to be good to go.  His Dad seemed to be the one who now might need some guidance.  I wonder if the nurturing skills of a pediatrician could still be helpful later in life, in the elder years, even as we near the end of our lives. 

What do we need as adults?  Do our bodies keep changing? Do we change? Our development may not be as well marked as being born, rolling over, crawling, walking, talking, toilet training, going to Kindergarten, etc.  Even after 18 we can choose to do new things just like kids do.

What would it look like to continue to support people and families through adulthood? 

Anticipatory guidance through the ages and stages. 

Could we continue to have the experience of being heard and cared for until the end, like we did when we were in Pediatrics – our wishes expressed, our family’s questions answered, our needs cared for?