Redefining family

Abstract

An attending on my paediatrics rotation once asked me and a group of my peers, ‘What is the single most important thing you should try to identify during every patient encounter?’

‘Is the child “sick or not sick”?’ a bunch of us responded, quoting the oft-cited paediatrics buzz phrase. ‘Are their ABCs intact?’ someone else chimed in.

‘Those are both crucial questions to be asking’, the attending concurred. ‘But the single biggest thing I care about is, does this child have someone in their corner fighting for them? Whether it's a parent or someone else, does this child have an adult in their life who cares deeply about their wellbeing?’

Having just finished my paediatrics rotation, I was struck by the variety of family structures that existed among the patients I had the privilege of treating and learning from. Media has historically portrayed the traditional family as a heterosexual couple with biological children, usually a boy and a girl. This was the first definition of family that I learned as a child. As I grew older and saw the world around me, the definition of family expanded to include more than just this initial version. And most recently, on this rotation, my understanding of family has continued to expand even further.

When I think about family, I think about the teenage boy I cared for who, prior to his hospital admission, was living with his older brother because his father had died years ago and his mother had moved out of the country. Only a few years older than the boy himself, the brother visited him in the hospital nearly every day to try to make those dreary days a bit cheerier, while Mom—who spoke limited English—did her best to try to understand her son's complex medical workup through a telephonic language interpreter.

I also recall the two moms I met in the NICU, who had overcome so many obstacles to achieve biological parenthood together, now facing yet another challenge: their newborn's hypoxic birth injury. They read the consent forms for each procedure with careful precision, determined to make the best, most-informed decisions possible for their family.

Lastly, I remember the divorced dad and his growing son. Dad worked three jobs to secure just enough money to support both his son and him with basic living necessities. Mom, who lived in a separate state, drove all the way down to join her son's annual well-child visit and check up on him. The parents argued in the examination room about how best to take care of their son as he awkwardly watched the interaction. As difficult as it was, I could tell the tension came from a place of love and wanting to do right by their son.

No single family fit the societally ingrained definition of a ‘perfect family’, yet all cared deeply for the children in their lives and overcame immense barriers to pursue the best possible care for them. What I observed only further proved that families come in all shapes, sizes, colours, and numbers. Some families include biological children. But others consist of a couple adopting children. A same sex couple can get help from surrogate mothers or sperm donors. Interracial marriages bloom. Marriages are torn apart by divorce or death. Love reignites and new marriages blossom. There are single mothers and single fathers. There are stepparents and half-siblings. And let's not forget about pets. Family consists of those who love one another and care for each other's health and wellbeing. These individuals, whomever they may be, are especially impactful for our paediatric patients.