I let out a huge sigh as I picked up the next chart in clinic. “Chief complaint: Behavioral concerns” was typed out on the top of a thick packet of papers. My young patient was sitting on the exam table comfortably. His parents sat stoically with furrowed brows in the chairs next to him. They were nervous, rigid, clearly concerned.“What’s been going on?” I asked. Apparently he had been acting out at his elementary school. I sifted through the papers, chock full of documentation from teachers, detailing his behavior. He was on the verge of expulsion. His parents expressed understandable frustration to me given his remarkably normal behavior at home.
I gathered my history per usual, directing my questions toward him as he swung his legs back and forth on the exam table. I did not seem to be getting anywhere when I happened to ask, “Is anyone at school making fun of you?”