My name is Uchenna Umeh, fondly called Dr. Lulu by my patients. I am a pediatrician and a mom of two teens and one young adult. I like to think of myself as a Momatrician because I have been blessed with not only my own biological children, but I have also been blessed with the opportunity of jointly raising my patients along with their parents, a role I take extremely seriously, as part of the village it takes to raise any child. I have been in clinical practice for almost 30 years now, and though the last 7 years of my life has brought with it, a divorce, a short sale of my beloved private practice, a 4-year active duty tour in the U.S Air Force as a Lt Col, and a move across the country with three young sons, all in all, it has been a great run.
In my time, I have seen many patients grow up and grow out. I have seen them come and go, some have even done me the great honor of bringing their children to see me as their pediatrician, causing me to also refer to myself as a Grand Doctor. As a pediatrician, I also double as a social worker, a counselor, a confidante, a friend, an adversary, a buddy, an educator, an advocate, and a lactation consultant, to name a few. I have loved being a physician, and enjoyed counseling pregnant moms, attending high-risk deliveries, performing circumcisions, counseling new moms and dads, performing routine physicals on children, teens and young adults, taking care of acute ailments ranging from asthma to head lice to ringworms to pinworms, dealing with teen anxiety about college, to parental anxiety about their teens’ departures to college. I have tended to broken hearts and tended to broken Barbie dolls. I have had to tell moms their sons are gay, and dads their daughters have been raped. I have even had to tell a guardian grandmother that her only grandson was HIV positive.
I have testified in court and attended funerals for patients and their family members. I have counseled a teen mom to keep her unplanned and unwanted pregnancy and supported another whose obstetrician had suggested a termination of the pregnancy when the fetus was simply not viable. I have lent a shoulder to a mother crying about a cancer diagnosis in her child and listened helplessly as a mother recounted the story of how her “formerly healthy” football player-son fell to his death during a game from the rare condition called commotio cordis. I have mourned a mother’s pregnancy that ended in a 36 week stillbirth and rejoiced with a 46 year old mom who after 19 years of marriage, finally had her first baby girl, exactly 10 months after she adopted another. I have attended graduations of my college-bound high school seniors, and watched teary eyed, as fathers give away their beloved daughters at weddings. I cried with a mom whose daughter ran away after repeated sexual abused by a family member and rejoiced when another mom was awarded custody of her children following a difficult divorce court battle. I have tried to explain to parents why their teens behaviors are considered normal and tried to justify the treatment of ADHD with stimulants whose side effects might not be all that desirable. I have tried to convince “non-vaxxers” that vaccines are not part of a huge conspiracy theory; they are actually necessary and effective, and talked till I was blue in the face about breastfeeding and the concept of “breast is best”. I once had a grandmother who knew instinctively that “something was wrong with her granddaughter’s eye” even though two separate visits to an ophthalmologist missed the retinoblastoma diagnosis and have tried in vain to convince patients that acne on their child’s face is not caused by “acid from sodas”. My war against indiscriminate use of antibiotics is now at epic proportions and these days I am having to continuously prove to people that my medical degree beats that of Dr. Google…!
I remember staying up all night during a call as an intern back in Nigeria, performing an exchange blood transfusion on a baby born with life-threatening ABO incompatibility (his blood type and his mother’s blood type were severely mismatched), only to return the next night, to learn that the baby had succumbed to the disease. I also remember performing a routine circumcision on a baby at my office here in the US (a procedure I had performed numerous times before) which ended up with significant blood loss enough to almost cost the little baby his life. I could go on and on, because there are many more where these stories came from. Like the time a 9yr old girl was brought in by her concerned grandmother seeking a second opinion in relation to the patient’s recent bouts of urinary tract infections. She had-had a total of six infections in the last few months. During her exam, I discovered an abdominal mass the size of a 20-week pregnancy. She ended up having a stage 4 cancer that had originated in her pelvis and spread to her lungs. She fought that menacing disease like an Amazon, and survived 5 years, a rare feat in a cancer of that stage. I still think about her to this day.
Of all these cases which enrich my memory and story bank, none of them got to me like that of little “Miguel” a 6 year old boy whom I met for the first time in May of 2018 after he attempted suicide not once, but twice. I shall come back to Miguel’s story later.
I love medicine, I really love pediatrics. I often say I will first bleed pediatrics, then red blood, followed by a mix of red blood and pediatrics if I ever sustain a laceration. I have been blessed to find a career which I love and actually have a passion for. So why then am I quitting medicine? Why would anyone who has as much love and passion for what she does, ever think of leaving it? My wife and a few friends and family members and co-workers (okay, pretty much everyone) tell me as often as they can, that I am one of the few adults they know that truly found their calling. I don’t only love to practice pediatrics, I also love to teach pediatrics, and have taken pride in molding many residents, medical students, nurses, mid-level providers and even my colleagues in the practice of medicine my way. Then why did I put in my 60 day notice on the 18th of August 2018, with no intent to go back?
I experienced the first completed suicide of a patient, 15 year-old “Gavin” (name changed) in 2008. Gavin had come in to see me in the company of his mother that day early in the year. I had met Gavin and his sister before. I had seen them in the office multiple times. I knew their mother fairly well. She was a good mom, a hands-on mom, usually had a slight air of anxiety when it came to her kids. That afternoon, she was concerned that Gavin might be experimenting with drugs and wanted to know for sure, asking me to do a urine drug screen. While I obliged her, I also had a good talk with Gavin, and it turned out that he was not experimenting with drugs, he was depressed. I arrived at my diagnosis the proper way, with an independent interview, and a PHQ-9 (modified teen depression scale) screen. His scores were nearly off the chart. I circled back to his mom with my findings, and she said “oh, depression?”, “that’s all he has?”, “I too was depressed, and I did OK, he is going to be fine”. She opted against any medication or any counseling at that time. Fast forward to 4th of July that year, Gavin reportedly walked into the front lawn of his family home, in front of his festive unsuspecting family members, placed the nozzle of a double-barreled shot gun in his mouth and pulled the trigger. I am still tormented by that picture to this day.
Since Gavin however, I have noticed a steady increase in the number of patients presenting to my office with depression, anxiety, self-harming behavior and suicidal thoughts. I have had so many cutters, too numerous to count, I have had children attempt suicide in various ways; I had an 11 year old attempting to jump off a window ledge from their 2 story home when she was accosted by her mother. I had a 16 year old female attempt to hang herself in her closet, saved only by the timely snapping of beam, she fell to the ground, discovered passed out on the floor, by her very alarmed mother. I even had one 19-year old male sleep for 36 hours following an attempt by overdose with a bag of his friend’s mother’s Xanax; just to mention a few.
However, it was the visit from Miguel and his mom, an attempted suicide by my youngest patient so far, that got me rethinking my calling as a clinician. The way I see it, I have had a phenomenal career as a clinician, but maybe it is time to do something different. Something still connected to my medical practice, only not quite comprising of staying in the office and seeing patients. Something out in the fields where these hurting patients are. I decided after Miguel, to change lanes a bit and go out into the communities, into the schools and the YMCAs, to meet these children and their parents at their local hangouts and speak to them about this dangerous trend. I mostly tackle bullying, at the elementary and middle school level. Cutting, and ostracization at the middle school level, and then depression and suicide at the high school and college levels. Thankfully, the reception has been phenomenal, and I recently launched my website teenalive.com, as well as started a weekly Sunday afternoon Facebook Live series called “Ask Doctor Lulu” where I discuss hot topics affecting teens.
I am thankful that I am not alone in my observation of this new trend in mental health issues in the youngest amongst us. Scores of pediatricians and other medical practitioners are also singing the same tune, but I am definitely one of a select few speaking about it in this way. Recent articles like the one from the New York Times stating that suicide rates among African American children aged 5-11 year has doubled in the past few years, help keep me focused on my new (much less traveled) road ahead. I am also acutely aware that the prevalence of suicide has increased among all age ranges (especially the elderly) and all works of life, even amongst doctors, so the work is plentiful, and we could certainly use more laborers in the vineyard. I still practice medicine through telemedicine, and recently got a 3 day a week job with a locum tenens company, all to practice medicine my way, and I am proud to say, traditional medical practice has now become my side gig. I am glad for the opportunity to continue making a difference in people’s lives. And if by my words, at least one child, one teen or one young adult can be saved, then it was well worth it. What do you think?
Uchenna Umeh, MD is a pediatrician with nearly 3 decades of clinical experience. She is a wife and a mother of three sons and lives with her partner in San Antonio, Texas. She is also a blogger and a budding author. She recently quit her 9-5 to start public speaking to raise awareness for child, teen and young adult depression and suicide. You can find her on Facebook and Instagram as “ask doctor lulu” and she is on Linked In and Twitter as Uchenna Umeh.