Before every upper endoscopy I spray a local anesthetic in the mouth to minimize a child’s gag.  It’s pretty nasty tasting stuff.  So I have this little charade I pull before every scope:  I apply the spray, look at the bottle, then announce in shock that the nurses have mistakenly given me bug spray.  As quickly as I deliver the punch line I make it clear that there’s actually no insect spray involved.  Invariably the kids get a kick out of it, the parents laugh and it tends to lighten the situation.

A couple of weeks back, however, I had a mother who didn’t appreciate my routine and suggested that I shouldn’t be referencing insect spray in the clinical setting.

I have delivered this routine hundreds of times and hundreds of times it has brought levity where it was needed.  Once it made a parent uncomfortable.  So beyond apologizing individually for a miscue of this type, how should I handle things on a going forward basis?

Not much differently, I’m afraid.

The problem with misunderstanding

You can argue from the comfort of your armchair that I need to find another way break the ice.  But this isn’t about bug spray or breath spray (another analogy I’ve used in this situation).  It’s about human interaction and how we understand one another.

The problem is this:  While we should be sensitive to the potential for religious and cultural misunderstanding, it’s impossible to predict how people will react to our own natural ways of engagement.  And when you interface with thousands of different parents every year you will inevitably encounter misunderstanding.

I can offer a thousand other circumstances where parents could potentially misinterpret my intent.  From the variations in language used to get through to a withdrawn teen to my countless analogies on everything from delayed gastric emptying to stool witholding, parents can potentially see or hear a comment very differently from the way it was meant.  While I like to feel that my inborn emotional intelligence can read the temperature of a parent’s mindset, there’s an unavoidable disconnect that happens from time-to-time.  It isn’t often, but it happens and I accept it.

We can’t change who we are

Beyond misunderstanding, part of this disconnect stems from the natural texture of our personalities which, in the right circumstance, can create subtle tension with another.  Sure we can eliminate those stories, analogies and silly routines.  We can neutralize our individual elements and sand down the granularity of who we are in order to present the safest, most neutral face possible.  But then it stops being human.  Then we’re technicians.

While we have to understand who we are and how we’re perceived, we can’t change who we are.

So for now I’ll muddle on with my routine.  And if your child is scheduled for an upper endoscopy, let’s keep this whole discussion to ourselves.  I’ve learned that the bug spray routine only works when there’s the element of surprise.