Doctor's Note

Snot Policy | 🤧 no. 014

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A picture of a picture: Our room at the urgent care.

My son is turning four in August. He still has those charming features he’s had since he was a newborn: The big, kissable cheeks and his soft little belly. But he’s steadily transforming from a toddler into a kid. As I gratefully welcome the next phase, I can’t help but feel some sadness that my first born’s baby phase has reached its twilight.

His fourth birthday has been looming as a developmental benchmark for a while now. I’ve read or been told so many times how autistic children who don’t speak by age four likely never will. I’ve accepted my son may never speak—and I certainly haven’t given up on helping him communicate in whatever way works best for him—but the thought of never having a conversation with my son or to never hear him say “I love you dad” continues to pierce my heart on an almost daily basis.

There are times when I drop his younger sister off at daycare and, opening the door to her classroom, I’m greeted by a group of talkative little boys. Walking back to the car, I often find myself imagining what it would be like to hear my son talk to me about his toys. Alone and driving to work, I give myself permission to feel sorry for myself. Then, I feel bad for feeling bad.

Yet, with his fourth birthday approaching, my sadness carries with it practical concerns, and their immediacy eclipses any of my self-centered grief about the conversations that may never be. As my beautiful boy shifts from baby to kid, the way the world interacts with him also begins to shift. Strangers tend to be forgiving and loving toward babies and toddlers—but patience and grace wane as children age out of their veneer of innocence and blame can more readily be assigned: Don’t you know better?

In my son’s case, once his neurodivergence becomes noticeable, once he can no longer pass as a “normal” kid, he is subject to the caprice of folks’ interpretation of his difference and how they choose to respond to it.

I recently found myself at the urgent care with my son after he was sent home early from daycare for having green snot. Although I understand the policy, it’s frustrating because I know the snot is a lingering symptom of a cold that has long since passed. I know he isn’t contagious—just fine, in fact, based on the laps he’s been running around the house—but now I need a doctor’s note corroborating my intuition before the daycare administration will let him return to school before the end of the week.

My wife and I both have full-time careers, and we desperately need childcare. So, here I am at urgent care in need of a doctor’s note to tell me what I already know.

The kind woman at the desk tells me it’s only a 45-minute wait and takes down my phone number, saying I’m free to wait outside.

For this, I’m grateful.

The waiting room isn’t full but still modestly occupied, and I feel folks looking at me as I hold my son, his loud yells and noises drowning out Drew Carey’s voice as he takes bids on a dishwasher in an episode of The Price Is Right. But I’m not worried about the noises so much as I feel self-conscious about holding him—he’s nearly 40 pounds and getting tall—and I imagine some of the parents in the room are wondering why he’s in my arms instead of walking around the waiting room on his own.

If I let him run around, I know he’ll only stop to put random objects in his mouth and chew, and I know he’ll climb onto furniture and sweetly grab for strangers’ hands.

Yes, I can set him down, but if he really wants to run, I can only hold his hand for so long before it becomes a tug of war, and then I become self-conscious and worried about holding his wrist too tightly or pulling on his little arm.

Most alarming, and what the folks in the waiting room don’t know, is that he’ll run away from me if I put him down. Elopement, they call it. I know there’s always the potential for him to run outside when the doors slide open, and it’s happened to me before: I’ll never forget the primordial fear that gripped my chest as I once ran after him with my heart and stomach in my shoes, watching his blonde hair swing from side to side with joyful, childish glee as he ran down the middle of the street.

And, as I learned that day, no amount of panicked screaming can make him stop.

So, I hold him in my arms, and he rests his head on my shoulder like he has since he was a baby, and we step away from the eyes in the waiting room and out into the surprising warmth of an Indiana spring afternoon.

The real struggle begins when we find ourselves with the nurse: My son won’t stand still long enough to have his weight taken, nor will he lean against the wall to have his height measured. His agitation and confusion grows with each failed task.

Once we’re in a room, the nurse puts a clip on his finger, and he promptly removes it—again, again, and again—now crying and flapping his arms. Understandably, the nurse is getting frustrated. She leaves and returns with a different clip, one to put on his toe this time, and he kicks furiously until she gives up.

I do my best to help. I restrain him. I offer treats. I put Cocomelon on my phone. I play a lullaby—nothing works. He just wants to be left alone, and I get it.

Boy, do I get it.

More than anything, I want to tell him so much of life involves putting up with nonsense, being poked and prodded for no particular reason.

I think of the small sign I used to read while washing my hands in my childhood home:

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

I don’t think this is going to work right now. He’s too upset, I say to the nurse as my son wipes his green snot on my shoulder. The folks at daycare definitely weren’t lying about that.

Defeated, she leaves with her clips, and it’s a long time before anyone comes back.

The next person to enter the room is the doctor, a sharp looking woman with red-rimmed glasses and a blonde bob yielding to a barely discernible encroachment of gray.

Mercifully, the extended silence paired with the tears and struggles have put my son to sleep in my arms, and he breathes loud, rattling, snotty snores in my ear as the doctor comes by and gently holds the stethoscope to his rising and falling back.

“You’re a good dad,” she tells me, surely having seen this situation before and no doubt sensing the exhaustion pervading the room.

I suddenly find myself fighting back tears—there’s no way I’m crying in front of this doctor—but I wonder if she knows how badly I needed to hear a stranger say that? Maybe that’s why she said it.

I always feel like I’m failing my son in some way, failing to do something that would make his life easier or more manageable given his challenges—some infinite thing I’m missing.

And I’m so tired.

In this moment, her compliment heals me.

With the exam completed, we get the doctor’s note: He’s not contagious. No cold, no flu, and no COVID as the test results later reveal.

He can return to school.

Walking to the car, I’m grateful we both received the care we needed today.