The Ouch Paradigm

Ignaz Semmelweis, so history tells us, was the preeminent obstetrician in Europe in the 1840s. Educated, credentialed, and well-read, Semmelweis was the Big Kahuna of baby delivery doctors two centuries ago.

Except that the babies he delivered died at a disproportionately higher rate than those delivered by folks who didn’t work at the fancy-schmancy hospital.

The babies delivered by midwives who never set foot in the hospital were more likely to survive. The babies delivered by Semmelweis and his staff were significantly more likely to get infected with fevers and die.

Here’s the link to the Wikipedia article if you want the numbers and the charts. (https://en.wikipedia.org/wiki/Ignaz_Semmelweis)

How could this be? Semmelweis considered and eliminated every possible factor that could be contributing to the differential mortality. Was one clinic more crowded than the other? Was one clinic colder than the other? Were the religions of the woman in one clinic different from those of the women in the other? There was no difference in any of these factors. What was causing the babies delivered in the hospital to have such bad outcomes?

Semmelweis determined that the doctors in the hospital came into contact with cadavers during their training while the midwives did not. Even though there was no “germ theory of disease” in those days, Semmelweis figured out that he himself was the problem, that he and his staff were transmitting the infections that caused so many babies to die. “Iatrogenic” is defined as “illness cause by medical examination or treatment” by Merriam-Webster but I think of iatrogenic as harm caused by trying to help. Semmelweis instructed his staff to wash their hands after working on their cadavers before delivering babies. Problem solved.

Consider a parent deciding which summer camp her neuro-typical kids should attend. A generation ago, the determination would have been made as follows: “Hey, Liz!” a neighbor would call out across a backyard fence. “What was the name of that summer camp that your cousin’s kid went to? You know, the one with the lake!” And that would be the end of it.

Today to the contrary, it is not uncommon for a parent to take off work, get on a plane, and visit half a dozen venues.

(Or as one of my running buddies pointed out, “This woman visited six summer camps across the country? I spent less time figuring out which house to buy.”)

Or consider the mother of a fourth grader asking her son’s teacher if the math homework had been corrected yet. “No, it was just turned in a few hours ago,” the teacher responds.

“Then could I have it back? I want to correct a mistake that I–er, ahem, of course I meant ‘he’–made on the second subtraction problem.”

The teacher gently suggests that ten-year-olds should be doing their own homework. Oblivious, the mother goes on to ask if she can borrow the key from a different fourth grade teacher. Her intention is to sneak into the classroom, steal the homework. and correct the errant problem.

Before you suggest that both moms described above have “too much time on their hands” and that they are destroying any chance their children might have of growing up independent and responsible, consider the mom’s perspective. They just want to help.

I would not presume to guess what is going on in the mind of the woman traversing the country to count the bathrooms in cabins. Nor would I be so presumptuous as to guess what the homework-stealing mother is thinking. But I wonder if a psychologist might suggest an interior monologue like the following: “See what a good mother I am? See how hard I work to make sure you have every advantage? See how much time I spend ensuring that everything goes easy for you?”

As long as mom is hyper-involved with controlling every potential bump in her son’s life, she doesn’t have to consider her own stuff. Maybe her marriage is plagued by infidelity; maybe she has substance abuse issues; maybe she would do well to be looking inward.

But as long as her son is the one who needs care, as long as she has a ‘job’, there is no reason for her to consider her own concerns. Her son has stubbed his toe, yet mom is the one to say “Ouch!” While she is visiting summer camps and stealing homework, neither mother nor son is likely to experience growth.

Perhaps Ignaz Semmelweis 175 years ago was not the only one doing harm by trying to help.

Loving parents today would do well to consider Winnicott’s “good enough parent.” Doing too much for our kids can be as harmful as doing too little. We should communicate to our children that ultimately, the responsibility for their finding fulfillment and contentment will be theirs and not ours.