Conscious Biases of a Pediatric ICU Physician

I admit that I have conscious biases from being a pediatric intensive care physician. My perspective has been skewed by my experiences and I freely admit that my decisions are not without prejudice. However, at least I am aware of how my profession has affected my decision-making for better or for worse. Nevertheless, bringing these biases to my conscious awareness did take time.

What are these conscious biases? Well, for starters, any source of accidental injury causes me to feel uncomfortable. Pools, skateboards, grapes, balloons, and any sharp object that a child has access to are examples of things that will make me shiver. The drownings in pools, choking on grapes or balloon pieces, and physical injuries by skateboards or sharp objects that I have witnessed in my professional life have made me keenly aware of the unintended hazards of unassuming objects and routine activities in life outside the hospital.

Also, understanding the spectrum of severity of illnesses, I have a bias of not getting too anxious about those that do not represent a threat to life or limb. I don’t get excited about coughs, fatigue, fever, or body pains from illnesses unless they represent respiratory distress, a degree of decreased responsiveness, impending cardiovascular collapse, or a true medical or surgical emergency. The situations are also contextual in that they are based on coexisting health issues of a child, presenting physical symptoms, and age-related physiologies.

While these biases have served me well in my professional life, they sometimes cause a little friction in my non-professional life. When my kids were small, I was terrified of pools…yes, terrified. My experience in the pediatric intensive care unit with childhood drownings made me hypervigilant with my own kids and their contact with pools. After seeing bad outcomes with choking hazards, I was obsessive about my kids avoiding small ingestible food items or objects lying around the house that they could potentially choke on. On the opposite end of the spectrum, I was not easily phased by the occasional rash, fever, or cough that was not life-threatening. One could say that my level of empathy for these symptoms should have been a little greater than it was at the time.

It is sometimes difficult to avoid how one’s professional medical experiences affect experiences in one’s personal life outside of medicine. While I understand that the chances of bad things happening is low, the risk and potential outcomes are still very real. I occasionally wish that I could switch off my biases in these situations. However, if something ever happened because I was too dismissive or too over-reactive in situations where my professional experience and judgment told me otherwise, I would never forgive myself. For better or for worse, I am resigned to the fact that I have biases in medical situations. But, at least I am more aware of them so they may not affect my personal life as much as they did in the past.

Do your experiences at work affect decisions that you make in your personal life outside of work? If so, how?