Monique Canonico, DO

Accompanying artwork: Seamus Heffernan

Perm J 2018;22:15-208 [Full Citation]

E-pub: 10/22/2018

This is a story and illustration from the upcoming book 100 Little Stories of Big Moments published by The Permanente Press.

Most of the stories and poems were written by clinicians in 15 minutes in writing workshops about meaningful moments in their work and life of practicing medicine. Professional artists were asked to create a visual representation of the story.

I sat in the cramped, beige exam room of the military hospital’s pediatric neurology clinic. I gazed at the rambunctious 5-year-old boy who was being referred for possible oppositional defiant disorder. He wore a red Pokemon t-shirt. There was no question that he was a funny-looking kid—his eyes were set close together, and his lips were a thin, pink horizontal sliver of quiver on the lower face. Someone, perhaps his father, had insisted on a crew cut. His harried mother, who was holding a wide-eyed toddler, gave me the lowdown.

Cody had been expelled from preschool for biting and for consistently resisting all authority. He picked fights with kids in the neighborhood who were twice his size. He made no eye contact, but he was transfixed by the stuffed Kermit the Frog puppet I had on my office shelf. After listening to the mother’s complete story, I asked, “What seems to be the one thing he’s good at?”

“Well,” his mother said, “he’s strong, brave, and independent, and he’s got street smarts you wouldn’t expect from a 5-year-old boy.”

Cody imperiously stared up at me and told me he liked Kermit. He liked him a lot. Cody’s mother and I discussed plans, and therapy, and interventions that could help Cody comply and become obedient, but I sensed this wasn’t a hidden sociopath lying in wait, ready to shoot a robin with his BB gun and then pluck its wings off while it lay dying on the cement. No, this was a misunderstood little boy. I calmly explained our plans to his mother and told her as much. “Jenelle,” I said, “with our interventions, Cody will be fine. He just marches to the beat of a different drummer.”

She looked initially forlorn, but then she stared thoughtfully at me. She realized it was true. There was not much wrong with him. “He needs understanding,” I said. “Sometimes we need to listen to a different drumbeat to understand the music.”

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How to Cite this Article

Canonico M. FLK. Perm J 2018;22:15-208. DOI: https://doi.org/10.7812/TPP/15-208


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