Best interest

 A dense broth of tedium, a sprinkle of annoyance, and a dash of trepidation – these are the ingredients of the mental soup that simmers in my head when I answer a middle-of-the-night parent phone call.

At least they were until the task of solving the community’s nighttime phone “crises” fell upon the able, eager shoulders of our new interns.

Every now and then, the universe throws up a surprise. One night, my intern was placating a very angry man who was upset with his inconsolable baby. He was the foster father of a baby with neonatal abstinence syndrome (NAS) who had been discharged earlier that day.

“I feel like this baby’s been thrown at us! He wasn’t ready to go home!” he cried. Having never met the baby (foster mom had taken the baby home), this man had returned from a long work shift to find a screaming baby at home. He was aggressive and rude as he ranted at my intern. She empathized and explained that other symptoms might include rapid breathing, irritability, sleep problems, etc.

Although she handled the call with consummate grace and professionalism, afterward an uneasy feeling crept over us. An angry, tired man pushed to his limits, and a very difficult, strange new baby at home was a setup for the perfect storm. Our duty in this situation was clear – we were the protectors of this baby’s best interest. That was all that mattered.

With a rising sense of dread, we juggled frantic phone calls between Child Protective Services, the attending physician, the foster family, and the nearest emergency department. All I could think of was how badly we had failed this baby. Something somewhere had gone horribly wrong for this innocent child to be in danger now.

An hour later, when I finally got through to the foster father, he sounded calmer. “We can’t do this,” he stated simply. He informed me he had called Child Protective Services himself. The baby would come back to us temporarily, while we found him a safe home. Relief swept over us.

Perhaps the baby should never have gone home with this family. Perhaps we had no way of knowing this would happen. Perhaps the family did not realize the responsibility they were assuming. We are all only human. We make mistakes. But we pick up the pieces and we try again, guided by the best interest of the children we swear to protect. This desire to keep trying is what makes all the difference in the world. By making the call himself, this man reaffirmed my faith in the process in which we all play a part. May the quest for the best interest of our children endure forever.

Dr. Behere is a third-year resident in pediatrics at Children’s Hospital at Dartmouth-Hitchcock, Lebanon, N.H. E-mail him at [email protected].

 A dense broth of tedium, a sprinkle of annoyance, and a dash of trepidation – these are the ingredients of the mental soup that simmers in my head when I answer a middle-of-the-night parent phone call.

At least they were until the task of solving the community’s nighttime phone “crises” fell upon the able, eager shoulders of our new interns.

Every now and then, the universe throws up a surprise. One night, my intern was placating a very angry man who was upset with his inconsolable baby. He was the foster father of a baby with neonatal abstinence syndrome (NAS) who had been discharged earlier that day.

“I feel like this baby’s been thrown at us! He wasn’t ready to go home!” he cried. Having never met the baby (foster mom had taken the baby home), this man had returned from a long work shift to find a screaming baby at home. He was aggressive and rude as he ranted at my intern. She empathized and explained that other symptoms might include rapid breathing, irritability, sleep problems, etc.

Although she handled the call with consummate grace and professionalism, afterward an uneasy feeling crept over us. An angry, tired man pushed to his limits, and a very difficult, strange new baby at home was a setup for the perfect storm. Our duty in this situation was clear – we were the protectors of this baby’s best interest. That was all that mattered.

With a rising sense of dread, we juggled frantic phone calls between Child Protective Services, the attending physician, the foster family, and the nearest emergency department. All I could think of was how badly we had failed this baby. Something somewhere had gone horribly wrong for this innocent child to be in danger now.

An hour later, when I finally got through to the foster father, he sounded calmer. “We can’t do this,” he stated simply. He informed me he had called Child Protective Services himself. The baby would come back to us temporarily, while we found him a safe home. Relief swept over us.

Perhaps the baby should never have gone home with this family. Perhaps we had no way of knowing this would happen. Perhaps the family did not realize the responsibility they were assuming. We are all only human. We make mistakes. But we pick up the pieces and we try again, guided by the best interest of the children we swear to protect. This desire to keep trying is what makes all the difference in the world. By making the call himself, this man reaffirmed my faith in the process in which we all play a part. May the quest for the best interest of our children endure forever.

Dr. Behere is a third-year resident in pediatrics at Children’s Hospital at Dartmouth-Hitchcock, Lebanon, N.H. E-mail him at [email protected].

 A dense broth of tedium, a sprinkle of annoyance, and a dash of trepidation – these are the ingredients of the mental soup that simmers in my head when I answer a middle-of-the-night parent phone call.

At least they were until the task of solving the community’s nighttime phone “crises” fell upon the able, eager shoulders of our new interns.

Every now and then, the universe throws up a surprise. One night, my intern was placating a very angry man who was upset with his inconsolable baby. He was the foster father of a baby with neonatal abstinence syndrome (NAS) who had been discharged earlier that day.

“I feel like this baby’s been thrown at us! He wasn’t ready to go home!” he cried. Having never met the baby (foster mom had taken the baby home), this man had returned from a long work shift to find a screaming baby at home. He was aggressive and rude as he ranted at my intern. She empathized and explained that other symptoms might include rapid breathing, irritability, sleep problems, etc.

Although she handled the call with consummate grace and professionalism, afterward an uneasy feeling crept over us. An angry, tired man pushed to his limits, and a very difficult, strange new baby at home was a setup for the perfect storm. Our duty in this situation was clear – we were the protectors of this baby’s best interest. That was all that mattered.

With a rising sense of dread, we juggled frantic phone calls between Child Protective Services, the attending physician, the foster family, and the nearest emergency department. All I could think of was how badly we had failed this baby. Something somewhere had gone horribly wrong for this innocent child to be in danger now.

An hour later, when I finally got through to the foster father, he sounded calmer. “We can’t do this,” he stated simply. He informed me he had called Child Protective Services himself. The baby would come back to us temporarily, while we found him a safe home. Relief swept over us.

Perhaps the baby should never have gone home with this family. Perhaps we had no way of knowing this would happen. Perhaps the family did not realize the responsibility they were assuming. We are all only human. We make mistakes. But we pick up the pieces and we try again, guided by the best interest of the children we swear to protect. This desire to keep trying is what makes all the difference in the world. By making the call himself, this man reaffirmed my faith in the process in which we all play a part. May the quest for the best interest of our children endure forever.

Dr. Behere is a third-year resident in pediatrics at Children’s Hospital at Dartmouth-Hitchcock, Lebanon, N.H. E-mail him at [email protected].