I had an 11 year-old girl a few months ago who was so freaked out about getting her throat swabbed. We were concerned about strep throat so it had to be done. I tried a variety of approaches but nothing seemed to work.
At first I explained to her the procedure. Showing her the soft round edges of the cotton swab, I reasoned how such an instrument could not induce pain. Yet she resisted.
I tried normalizing the potential of vomiting after swabbing. I see it all the time, I said. People just run to the sink and throw up. No big deal. She still wasn’t convinced.
After almost 10 minutes of her Mom and I trying to coax her, I was feeling impatient. I would next try coming across as stern. If you don’t open your mouth I will have no choice but to use this! I held up a tongue depressor which looks like an oversized popsicle stick. She shook her head. Apparently, I wasn’t threatening enough.
Mom was now telling her she would be grounded if she didn’t do this. She started to tear up a little bit. She slowly nodded her head as if to give me implicit consent to go in. Her mouth even opened a bit. However, just as my tongue depressor entered her mouth, she quickly turned her head away from me. I would reposition myself but she would then turn her head completely in the other direction.
I had tried reasoning, normalizing, reassurance, and assertiveness. Nothing was working. I threw in the towel. I informed Mom to opt for supportive care and return to clinic if she develops a fever.
The Rest of the Story
She returned to clinic later that day but not because of fever.
When I went into the room she didn’t look angry, frustrated or anxious. She had a calm look on her face. This time she opened up her mouth willingly without any persuasion. I took a swab of her throat which turned out to be negative for strep. It was easy. She was a different girl this time around.
What made this 11 year-old change her mind to trust me enough to stick something down her throat?
Sandals. Cute white sandals. For $7.
Apparently, Mother was in the store with her and she noticed some white sandals she wanted to buy. Mother told her she could not have the sandals because she didn’t undergo the throat swab.
This girl was determined to get these $7 white sandals. In fact, on the drive back to the clinic, she took her mother’s ear scratcher. Personally testing her gag reflexes she poked the back of her throat with the ear scratcher. She would be ready for the real thing!
Reflections
Watching this 11 year-old girl taught me three lessons about learning to trust.
- Learning to trust takes courage. Trust is scary. For this girl, it was letting a stranger stick something in her throat. I saw this girl go through all the emotions – fear, sadness, anger, bargaining, frustration – in order to finally come to acceptance. How many times have I found myself going through those same emotions to finally come to a point where I could accept a situation and trust in God?
- Learning to trust takes creativity. The girls’ mother and I had tried every trick in the book to get her trust us: reasoning, reassurance, normalization, even intimidation. The thing that would ultimately work? Some form of bribery. Sometimes it takes several different angles to get to the point of trusting. One of the unique ways I’ve had to learn to trust was living in a garage.
- Learning to trust takes love. The main element undergirding this whole experience was not me or even the desire of this girl to get better. She was moved to trust because of the loving relationship with her mother. Though it was difficult, the girl knew how much her mother cared for her well-being. As a result, she was driven to trust.
As Christian physicians, the art of learning to trust is learned over a lifetime. Next time, I have a difficult time trusting, I’ll remember the ear scratcher, sandals and the 11 year old girl.
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