Shirah Vollmer MD

The Musings of Dr. Vollmer

“Dad, I Have A Stomachache”

Posted by Dr. Vollmer on January 14, 2011

    Milly, fourteen, just lost her mother, Penny,  to metastatic melanoma. Penny had been sick for five years, on and off. When Penny passed, it seemed sudden, despite her poor prognosis. There was a memorial service; three hundred people attended, told Milly how sorry they were. Milly went to school the next day. She continued participating on the dance team, hanging out with her friends, and doing well in school. Brad, Milly’s father asked me “what should I be worried about with Milly?” “Keep an eye out for signs of distress. It may happen soon, but it also may happen weeks or months from now,” I said, trying to explain that reactions to death have no precise time frame. Brad leaves with a feeling of uncertainty, trying to deal with his grief and Milly’s grief at the same time.

      Three months later, Brad calls me and says “Milly is having stomach-ache.” “You should take her to her pediatrician to rule out any gastrointestinal illness, but at the same time, I am wondering if she is now expressing her feelings about Penny’s passing.” I say, thinking that Milly’s stomach-ache may be her ticket to discuss her internal distress about losing her mom. Brad, somewhat robotic, says “OK, I will call her pediatrician and then I will take her into see you.” “I could see her before you take her to her pediatrician,” I respond, emphasizing the time urgency of the situation, since Milly seems ripe to talk about her feelings. Brad agrees, again in a robotic fashion. Brad sounds scared and overwhelmed by Milly’s stomach-ache. “It is just a lot for me to handle,” Brad says, implying that dealing with Penny’s death has been overwhelming. “Well, maybe if we can help Milly feel better, that will help you feel better too,” I say, trying to say how his whole family is hurting, so dealing with one part will help the other parts. I also think that Brad could benefit from psychotherapy, but I don’t feel it is the right time to bring this up. “Thanks for seeing her,” Brad says to me in a kind and grateful tone. “Your welcome,” I respond, thinking back to our earlier conversation when he asked me when Milly was going to express her grief. Brad seemed to feel reassured that my prediction that Milly will react to Penny’s passing at a time when Brad least expects it, came true. Some things are obvious to outsiders and mysterious to those living through it; Brad and Milly were such a case.

2 Responses to ““Dad, I Have A Stomachache””

  1. Shelly said

    Interesting. Why would you encourge Brad to bring Milly to talk about her feelings to you before checking her out medically with her pediatrician? I understand that the time “was ripe” for her to discuss her mother’s death, but on the other hand, perhaps there was a medical reason for her stomach aches. I would have expected the order to have been just the opposite: first the pediatrician, and then the psychiatrist.

    • Most stomachaches in kids are related to anxiety. Having said that, it is important that a child with a stomachache be evaluated by a pediatrician. I did not need to see her first, it was only that I was more available than the pediatrician and I did not feel I had to wait until after Milly was evaluated to begin my assessment.

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