“What’s your name?”

I almost jumped out of my skin! A little boy that couldn’t be any older than three peeked into my office and interrupted me from my thoughts. I was in the middle of charting for my last patient.

“Kevin. What’s yours?”

“Michael. How old are you?”

“I’m 37.” I left out the half.

“Oh. Are you a doctor?”

I get that a lot. People see a man in scrubs and assume I’m a doctor. I knew that would happen going into this profession. I also knew that with this job, I would be surrounded by women. And I am, but I didn’t mind. That’s what I signed up for.

“No, I’m not a doctor.”

“Miiiiiichaaaaaaaalll! Where you at? Get your ass over here right now or else no McDonald’s.”

This is the part of the conversation where I get annoyed. Michael’s visit didn’t bother me at all but his mom’s shrill demands sure did. Five bucks says that when Michael has to come see me for being overweight, his mom is going to deny fast food completely.

“Michael, let’s go find your mom.”

I took his little hand in mine and we turned the corner. I handed him off to his mom who barely muttered her thanks.

I walked back to my office and as I stared at my computer to finish my charting, I continued to type the same words that I’m used to typing.

Excess juice
Inadequate water intake
Fast food 3-4 x per wk

Sometimes it seems like everyday is exactly like the one before it. I finished my note and grabbed the next chart. I’m a creature of habit so it doesn’t bother me too much. But sometimes I feel like I’m not really helping people. I just feel like I should be doing something bigger.

Working as a registered dietitian at a pediatric clinic was not easy. More specifically, working in the WIC clinic was not always easy.

Yes, on an easy day the work could be mindless but that’s not what I signed up for.

I didn’t become a dietitian to print vouchers and give them out. I did it to make a difference. I want to help lower the rates of childhood obesity. I want to be part of the solution, not the problem.

I want to teach these parents healthy eating habits to pass down to their children.

But eight of the ten people I meet could care less about what I had to say.

They just want their vouchers.

I glanced over the next questionnaire and realized that I had an exclusive breastfeeder on my hands. That always made me happy. I was ready to congratulate her and encourage her to continue.

I’ve always been a huge advocate for breastfeeding. I guess it’s weird for a man, but I try to look at the bigger picture. Not only is breastfeeding healthier for the baby and the mom, but it would also be a huge asset to the economy. It would help the healthcare system with lowered rates of obesity and other diseases.

I guess one of the biggest reasons why I support it is because it’s so natural. It’s a part of life. I remember watching my wife, Kristin, nurse our son and it was just beautiful.

Kristin always jokes, calling me a treehugger or a hippie. I guess I am!

I bring up breastfeeding with every pregnant mom, but somehow the “breastfeeding is not supposed to hurt” conversation doesn’t usually go over that well.

I took a sip of my coffee. It had started to get cold, but it was still so good. She always made me the best coffee.

Kristin and I have been married for about ten years now. She’s a dance instructor and has had aspirations to open up a studio for years now. The problem is that we just don’t have the funds to do it. Turns out dietitians that work in government programs don’t get paid very well.

So, she works nights at someone else’s studio and takes care of Mason during the day. It actually works out better this way than to pay for daycare.

When the economy took a nosedive a couple years ago, it hit us hard. I had been working for a consulting company for years. I made my own schedule, got paid for mileage, and had great benefits. Not to mention that the pay itself was really good. My days were never really boring either. I was in a different place every other day and then I didn’t go back there for another week or so.

Suddenly, I was laid off. We found ourselves looking for an apartment because living on unemployment wasn’t really cutting it. In the end, we chose to live with family for awhile. I am so blessed to have such a supportive family but talk about a punch in the gut! I thought I had everything and then we lost so much so quickly.

My cousin Brian was the one that came to the rescue. It seemed so odd being the one that needed help. He was my younger cousin, and I guess I felt like it should be the other way around. He lived in a large house with his wife, Leighanne, and their son, Baylee. Brian’s a gym teacher, but his wife had started a company selling purses and other accessories. The company took off, and now they’re pretty well off.

I’m extremely happy for them, but it’s really hard to swallow sometimes. I guess I can be a little too proud sometimes, and I find it hard to accept help. But I had a family to think about so I did what I thought was best for us.

I guess I’m just a little jealous.

But extremely grateful.

While I was living with Brian, I was constantly looking for jobs. I still remember the night when I saw a posting for this job up on Craigslist.

Looking for experienced dietitian to work at WIC

I started reading off the job description and qualifications to Brian. He got home a couple hours before, and he looked exhausted. But he always made time to catch up with me at night.

“What’s WIC?,” he asked me.

“It stands for Women, Infant, and Children. It’s a federally funded government program that provides food vouchers to low income families. It’s actually only for pregnant, postpartum, and breastfeeding moms as well as babies and young children. But they don’t just give out vouchers to them, the participants have to sit in on nutrition counseling. The dietitian counsels all high risk participants.”

I knew quite a bit about WIC. One of my rotations during my internship was at a WIC clinic, so I was there for a month.

“That sounds pretty cool. But how do you feel working in that environment? Weren’t you working in nursing homes or something?” He chuckled.

“Yeah I was working for a consulting company that contracted with nursing homes. But Brian, I did get educated on all of this stuff. I’m not paying off my student loans for nothing! I took an exam to become an RD. Plus you know, I do have a child.”

“You’re right. I’m just kidding with you. No need to get defensive!” He laughed, and I knew he was just kidding. I felt bad.

“I’m sorry. I know you are. I guess I’m just stressed, you know? I just don’t know about this. Working for government programs like this usually means low pay.”

“Well, you know you’re welcome to stay here for as long as you need. But this actually sounds like a pretty good opportunity for ya’ll. I mean, this job has been posted for a while and here you are looking for a job. ”

Maybe he had a point.

“You know…God knows what He’s doing, Kev. I know when you lost your job you thought everything went down the tubes. But look, here you are. You’ve got your beautiful wife and son. And you have this possible opportunity in front of you.”

Sometimes I was annoyed by my cousin’s overzealous spirituality. Other times I needed it. Like now.

“And you know you don’t have to move out right away. Wait til you get some paychecks and pay some of your bills off and then you can start looking. You know this house is big enough. You’re not in the way at all. And you know Leighanne is loving having Kristin around.”

“I’ll sleep on it Bri. I will. There’s just some things to think about. Thank you for everything.”

I stood up and hugged him tight.

“I love you.”

“I love you too, man.”

“And I really do appreciate what ya’ll are doing for us.”

“Forget it, cuz. You would do the same.” As he walked to his room, I started to feel a little better. He’s right. I would do the same. I guess that’s what family’s for.

And now, here I am. I was right…the pay isn’t good. At all. They’re taking CHUNKS out of my paycheck for health insurance. The schedule sucked, and it was far from home.

But what can I say? I’m employed. We got caught up and moved out to a place on our own. Which is a lot more than some other people have.

Not to mention, I love what I do. I’m passionate about child nutrition. I just wanted to know that it was working. I wanted to know that people were learning. I wanted to be a part of change.

The morning went by pretty quickly and the next thing I knew it was lunchtime.

I grabbed my lunch that I brought just like I do everyday. I walked into the kitchen to heat up Kristin’s leftover spaghetti, and then I headed to my car.

Everyday I couldn’t wait until my lunch break so that I can call Kristin to say hi to her and Mason.

I always spend my lunch break in my car. It’s quiet in there, and I can nap when I want. My coworkers are so obnoxious. In the five minutes that I’m in the kitchen I get “That’s all you’re gonna eat?”, “Oh my god, you’re eating a cookie today”, and my favorite “You’re the dietitian…are you supposed to eat that?”

I don’t come here to be judged on what I eat. I’m a dietitian because I love food, so I’d rather sit in my car and enjoy eating it, thank you. Plus whatever I have to eat is a hell of a lot better than the shit they eat.

Did I mention I can be a bit of a snob too? At least that’s what Brian always tells me.

I ate my food and called Kristin. No time for a nap today so I grabbed my water, wallet, and phone and headed inside to punch back in.

As I headed past the nurses’ office, I saw a pile of charts in the door that we needed to get to. I grabbed one on the way to my office.

It happened to be a pregnant woman. Her questionnaire actually doesn’t look too bad. She doesn’t drink enough water or milk. And she’s eating unheated lunchmeat. Most people get that one wrong.

But this is her first pregnancy, so it’ll probably take a bit longer than usual.

I opened the door and called her name. “Lauren Kitt!”

A tall blonde man jumped up. He looked young, or boyish I should say. He proceeded to yell across the waiting room. “She’s peeing! I’ll go get her!”

Seriously?

“It’s ok, you don’t have to disturb her. I’ll check back in a couple of minutes.”

I shut the door and walked back in my office.

I pulled out my phone to check it.

Call me later? We need to catch up.

That was from my best friend, Howie. We did need to catch up. I replied to him and set an alarm to call him later. Have I mentioned that I’m a little anal?

I walked back to the waiting room to call my patient back. But this time when I opened the door, the blonde guy was right behind it. I was so close to hitting him.

“There he is, babe! I told you he called you.”

“Hi Lauren, we’re gonna get your weight and height today. I also have to stick your finger to check your iron.”

“Ok, sure although I’m not too thrilled to stand on a scale.”

“Aw babe, you’re gorgeous.”

They seemed really nice. Maybe this visit would go well.

“Hi I’m Nick…I’m the baby’s dad…I mean her fiancé…I mean…nevermind.”

I chuckled as he reached out and shook my hand.

“Hi Nick. I’m Kevin. I’m the dietitian here, and I’m gonna get ya’ll setup. We’ll be about fifteen minutes, and you’ll leave with your vouchers.”

After we got Lauren’s measurements and iron level, I led them to my office.

“Ok Lauren, I’m going to start putting this information in the computer while I talk to you. How are things going? I saw that you are about twenty-five weeks now. How are you feeling?”

“She eats all the time. And she pees all the time, I mean, not in a bad way. But she does. Is that bad? Is something wrong?”

Poor guy.

“Well, her weight gain is right on track. Her iron level was a little low but that’s pretty common. Lauren, are you taking iron pills?”

“I have a prescription, but I haven’t been taking them.”

“WHAT???? Babe, you can’t do that. This is for our baby!”

“Are they making you nauseas?” She nodded.

“That’s pretty common. Try taking them at night before bed.”

“What if that doesn’t work? Can she just take my Flintstone vitamins?”

I was trying hard not to crack a smile. This man was a kid! An overgrown kid. I sometimes get annoyed by that behavior, but something about him was so endearing. I just wanted to hug him and tell him that it was going to be ok. He looked terrified.

“Well Nick, prenatal vitamins have all the nutrients that are necessary for proper growth and development of the baby. “

I then turned to Lauren, “If you’re really having a hard time keeping them down, I would suggest talking to the doctor.”

She nodded.

“So have you thought about breastfeeding? What are your thoughts?”

I glanced at Nick to see his reaction. I was hoping he would be on my side. He was a little surprised that I asked. He looked like he was waiting for Lauren’s answer as well.

“Well, I heard that it hurts and that it’s really hard.”

I then discussed the benefits of breastfeeding with the couple and addressed her concerns. As I was about to move on, Nick seemed to have finally realized what we were talking about.

“Babe, I want you to breastfeed. I mean, it’s good for the baby. Plus, Kevin said that it’ll be a good bonding experience.”

I love when the dads come in for the visit. I really do. Especially when it’s a supportive dad. As aloof as Mr. Carter here seemed, he meant well. And when we could get the dads involved and we get them in our corner, the moms feel supported and are more successful.

“I do wanna try, babe.” Nick smiled at her.

“I also see that you’re eating unheated luncheon meats. That’s actually pretty common, but we want to make sure that you’re not putting yourself at risk for a foodborne illness. Deli meats can actually have bacteria called Listeria and when pregnant moms get infected, it can be very serious. Just put the meats in the microwave and heat until steaming.”

Lauren nodded.

“Wait, oh my God! You had a ham sandwich earlier, babe. Maybe we should stop at the hospital on the way home just to be sure.”

“Well, I suggest you follow up with the doctor if there’s any concern but this is very common. I just want to make sure that ya’ll are aware of foods that may be unsafe. That’s all.”

Follow up with the doctor. That was my go to answer if they really needed reassuring. Not that I didn’t know what to say or do, but ultimately the doctors had final say. Not that they were always right…

I glanced at him and he half nodded back at me. Then I printed the vouchers and explained how to use them.

By the time they left the office, Nick had finally relaxed. Lauren also asked plenty of questions and was excited to try breastfeeding. I congratulated the couple and walked them out the office. I went to shake Nick’s hand but he turned and hugged me.

I couldn’t wait to see when they returned with their baby.

It’s visits like that one that make me feel good about my job. I knew that for every eight people that didn’t care what I told them, there were two that really did care and needed to know.

The rest of the afternoon started slowly, so I decided to search for a handout on gestational diabetes. When I first started here, I was told that I needed to provide my own handouts. I organized a binder of the ones I thought I would need but as time went on, I realized that there were some that I was definitely lacking.

I printed some great ones out from the American Diabetes Association website and started making copies. That is, until I heard an incredibly annoying sound.

“KE-VIIIIN!!!”

I ignored her.

“KEEEEEEEE-VIIIIIIIIIIIIIN!! ARE YOU BUSY?!!”

Ugh. I hated when she yells down the hall. I mean, seriously? How unprofessional. We each have a phone and an intercom system where we can call each other.

That’s Judy. She’s the coordinator here. Although she doesn’t seem to be coordinating much around this office. She spends her time counting the people that we see daily, ordering supplies, and checking her emails. And let’s not forget the cigarette breaks every hour.

I walked back to my office and buzzed her just to make a point.

“Were you yelling for me?”

“Yeah, Kevin. Are you busy?”

“I was just making some copies of my handouts.”

“Can you put that on hold and help me with the classes?”

These classes Judy “coordinated” were not hard to coordinate. You see, when families come to pick up vouchers they need nutrition education. We figured the best way to do this was showing a video (made by me) in a classroom. While the video played, Judy printed the vouchers.

The only problem is, our coordinator panics under pressure. And apparently our coordinator is under pressure with five people in the classroom.

I sighed. “Sure, I’ll help.”

The classes went off without a hitch. As expected.

As soon as I was done with the last class, I headed to my office for a sip of water. Suddenly I heard a short ring.

I was being buzzed. I glanced at the phone and realized it was the extension from the nurses’ office.

“Hey Kevin, it’s Gina. I just wanted to let you know that Wendy just dropped a couple of charts in the door.”

“Thanks, Gina. I’ll be there in a minute.”

When I first started here, there were three nurses and myself. They stuck me in this closet space as my office. No literally, it was a closet. I wouldn’t consider myself high maintenance, but I explained to them that there was no way I can work in this “office.”

It was true. I needed to shut the door for privacy, but once I did there was no room. And ninety-eight percent of the time, the mom brought a couple of kids. I found myself cutting visits really short because everyone was uncomfortable.

I didn’t think it was very fair, so I spoke up.

Soon after, I was moved to my own real office. I love it, but the problem is that it is away from the nurses’ office. The charts are placed in a bin that is attached to their door, so I have no idea when they were ready.

I either have to keep getting up and checking or have someone check for me.

In the time that I’ve been here, one nurse quit, and the other got fired. Of course they didn’t replace them, so there is only one nurse and I. That made the workload much greater.

I walked to the nurses’ office and grabbed the next chart. I got the paperwork ready, and input the data that I would needed.

Next, I studied the name on the chart. I found out the hard way that you must always study the name. Once that door is open, you open the floor up for people to start bitching.

SHAYNA FREDRICKS

Looked like an easy one to pronounce.

I walked around the corner and opened the door.

“Shayna!” No one stood up. Everyone was staring at me though. Damnit.

“Shayna Fredricks?”

A girl that looked like she was about 17 stood up.

“It’s SHU-NYA.”

I glanced back down studying the name. Is it possible for your parents to spell your name wrong at birth? Or maybe she just made up her own pronunciation. Whatever.

“Ms. Fredricks, I’m gonna need you to step on the scale so we can get your weight.”

She rolled her eyes.

I waited. And waited.

“I weigh one sixty-five. I just went to the doctor.”

“Did your doctor give you a piece of paper to give us?”

I can tell what the answer was by the look on her face.

“Well ma’am, to get your vouchers we need to get your weight.”

Finally she stepped on with a huff. Wouldn’t that have been a lot quicker if she would have just stepped on in the first place?

I just don’t get it. She’s going to leave here with vouchers for free food. All she had to do was come to the clinic, get some measurements and some free counseling. I really don’t get it.

I wish we qualified for WIC. Unfortunately we fell in the bracket of “too much to qualify for aide, but not enough to live comfortably.” The glorious middle class.

I glanced up at Shu-nya and realized that I had spaced out.

“Now what you people gonna do to me? You wanna keep my baby after I have it too? Damn.”

That didn’t even deserve a response. Needless to say, I kept that visit short and sweet.

When I was done with Shu-nya, I placed the chart in my “go back” bin, and I went back to the nurses’ office to see what was left. There were about four charts in the door.

I grabbed one to get started on because I didn’t actually have any appointments with me until 4:00. That is, if they even showed up.

Well actually, I grabbed two that were held together with a rubber band. We call these “two-fers.” Not sure why, but one of my coworkers made the mistake by saying “double” and everyone flipped out.

We were a bit busy today, and I noticed that this family had been waiting for a while so I started rushing to get the charts ready. When I opened them, I noticed custody papers inside. Looks like dad has custody. I’m always interested in the back story. Sometimes I get it, and sometimes I don’t.

I input the information and highlighted the things I needed to address with them.

There was actually quite a bit that needed to be addressed. These were two twin girls, Chloe and Caylee that were going to be four in a couple of months.

They were both drinking way too much juice and soda but not enough water. Sometimes with this custody cases though, things weren’t very stable.

I quickly walked to the waiting room and yelled.

“Mclean!!”

A little man covered in tattoos jumped up. He was wearing big white sunglasses, though I’m not sure why. He was also using a cane and his foot was bandaged up. Hanging off either side of him were who I assumed to be Chloe and Caylee. He hobbled his way near the scales.

The girls were adorable, but they were dressed pretty crazy. Chloe was wearing a black skirt with neon green tights that had tiny black skulls on them. Where do you even buy those for children? She had on a yellow shirt that said “Rockstar” on the front. Caylee was wearing black jeans with a white shirt and a hot pink skull on it. Her skull had a bow on its head. They all had black nailpolish on. Even Mr. Mclean. He must have noticed me looking at their outfits.

“I know, they’re dressed pretty crazy. But I let them pick out their outfits. I figure as long as they’re appropriate, who am I to say how they should express themselces?”

I nodded. “Alright dad, let’s get the girls’ shoes off so we can get their heights and weights.

“Sure. Girls you’re gonna have to help me and take your shoes off. You know daddy can’t bend over with this cane.” I bent down and helped the girls.

“You’ll never guess how I hurt my foot. Seriously, it’s embarrassing.”

I guess he felt the need to explain. I’m sure I couldn’t guess. This little man looked wild. Who knows what he was doing.

“No idea, and I don’t think I can take a guess,” I chuckled. Now I was curious.

“Well, you know how the circus was in town about a week ago? My best friend had gotten us tickets so I can take the girls.” Well there I go judging. He was with his daughters.

“After the show, the entertainers were just wandering around and well, I’m a little scared of clowns.” This is gonna be funny.

“Daddy is really scared of clowns! We’re not sure why though. We tell him they’re just people dressed up.” Both girls were giggling now. I was laughing out loud as well, but I was also trying to keep track of which girl was which on the scale.

“Wait, are you Chloe or Caylee?”

“That’s Chloe. She’s a tiny bit shorter than Caylee,” Mr. Mclean simply stated.

They looked the same to me. I put a tiny note on their sheet. Next to Chloe it simply said “skirt.” I always did this because it gets really hard to keep them straight, especially if they’re dressed alike. Can you believe I had a mom in here once that couldn’t tell the kids apart? We literally had to guess. She said that her husband was the only one that could tell them apart.

I was suddenly snapped out of my thoughts with Mr. Mclean’s gruff voice. “Well anyway. I started running like crazy when one of the scariest clowns I’ve ever seen started jogging towards us. I wasn’t paying attention to where I was going and I tripped on a sticky candy apple that had made its way on the ground. I fell and sprained my ankle. Can you freakin believe it? Who sprains their ankle running from a clown in front of their daughters? Me, that’s who. Told you that you wouldn’t believe it.”

By this point I couldn’t stop laughing. Mr. Mclean here was quite the character!

After we were done with all the measurements, we went to the office and sat down. I introduced myself to the family as he reached out his hand for a shake.

“I’m Alex.”

As I started putting in the girls’ weights, I noticed that Chloe hadn’t gained any weight in the past six months. That put her low on the charts and underweight. This visit just became high risk.

“So Alex, how are the girls doing?”

He glanced at them hesitantly. They were actually very well behaved. I could tell he really wanted to talk but needed a distraction. I pulled out some color sheets as well as some crayons that I reserved for the very well behaved children. The last thing I needed was crayon drawings all over the walls. I could just hear Judy yapping in my ear already.

I handed them over, and they seemed satisfied for the moment then I looked back at Alex.

“Chloe hasn’t gained weight recently. How are her eating habits?”

“Well honestly sir, the girls have been going through a lot of stuff at home. Their mom was well…” He looked back at the girls and then back at me. They were chattering loudly and coloring their interpretations of whatever Disney princess was on the page.

He started talking in a near whisper. “Their mom is in jail. She was busted on drug charges. She’s got a really bad drug habit and has had one for some time now. But we weren’t together and I didn’t realize it. She had full custody, while I was fighting for them. And now they’re all mine thank God.” He looked over at the girls with a small smile.

“I hate to think of the stuff they were going through while living with her. We’re still adjusting, but I’m trying the best that I can.”

I looked in his eyes as they welled up. I passed a tissue. I felt for this single dad. He really did seem like a good dad that was trying to be there for his girls.

I was trying to stay professional. I have a habit of getting a little emotional at times. It can actually be quite embarrassing.

“Well Alex, it’s common for children to change their eating habits when there are changes at home. You just want to reassure them that things will be ok. Offer three meals and two to three snacks daily. Make them good healthy snacks like cheese and crackers, apples and peanut butter, or yogurt and graham crackers. Stay clear of junk food. That’ll fill them up but not give them a lot of nutritional value.”

He nodded.

“Also, they’re both drinking a lot of juice. We want to only offer about 6 ounces a day.”

I pulled out a little cup that was labeled so that he can see how big that was. “Children love to drink all day. When they do, they’ll get full and not want to eat. If it’s juice, the sugars tend to cut their appetite as well.”

His face expressed understanding.

“Where are the girls during the day?”

“They stay with my mom. She’s really been a blessing. I work during the day and then I come home, and she works on the weekends. I guess I didn’t realize how much all of this would affect even their eating habits.”

I gave him some handouts and some healthy snack ideas. We also talked about the importance of family meals for stability. We came up with a couple of goals together. The girls will probably be starting preschool soon, but they’ll be in for another visit before then.

I think he left my office with a little more hope than when he entered. He truly seemed like a great guy though. I put an alert in the computer for them to visit with me at the next appointment. I couldn’t wait to follow up.

It always amazes me when I meet people like Mr. Mclean. When he walked in, I would have never thought that he was going through the tribulations that his family is experiencing. It just goes to show what a good attitude will do to a person.

Seems like I can learn a things or two from Mr. Mclean.

For every good day I had, feels like I had a couple of bad ones. Today started with me waking up late. I had a rough night with Mason, who decided that he was more interested in me reading Green Eggs and Ham to him repeatedly than in going to sleep.

I didn’t even have time to pack lunch today. I tugged on some clothes while brushing my teeth and grabbing a piece of bread on the way out. As I pulled up to work with two minutes to spare, I did a quick inventory. Clothes were on, had my badge, and had a bottled water. I ran in so I wouldn’t clock in late, and then I got to work immediately.

Halfway through the day, I had reached my ultimate annoyance level, and it all started with my first appointment. Jamie was referred to me for being overweight. His BMI/AGE was at the 98th percentile on the growth charts.

“So Ms. Hoffman, Jamie was referred to me because his weight is a little high for his height right now.”

“Well, he’s really tall.”

“He is really tall. He’s actually at the 80th percentile height for age. But this number actually factors in his height already. It’s his weight for his height. You mentioned here that he skips breakfast and eats snacks between meals. So why don’t you tell me what kinds of foods he likes to snack on.”

“He loves chips. I can’t stop him from eating chips.”

I never understood that. How can you not stop your child from eating chips? He’s only 4!

“Well, where does he get the chips from, Ms. Hoffman?”

Has she figured it out yet? Wait for it…

“I buy them.”

She looked bored.

“Well, why don’t you just stop buying them and that way he can’t find them in the house and eat them?”

“I guess. I never thought about that. But see, I like chips, and I’m not overweight. I don’t think I should have to suffer.”

Is it suffering when we can’t have chips now? Last time I checked, suffering was a poor child that is being made fun of for being overweight. Suffering is Type 2 Diabetes in children. Suffering is people in other countries that have nothing to eat and no government program to help. I still don’t think Ms. Hoffman gets it. Eating healthy isn’t a form of deprivation, it’s just educating them on how to take care of their bodies.

I can’t blame her completely though. You know something’s gone wrong in this society when we feel like we’re suffering if we don’t get junk food. I switched the food package to 1% or skim milk instead of 2%, and then I printed the vouchers and had her sign them. I typed up my notes and ended them with “Expect poor compliance.”

My thoughts were interrupted with the constantly ringing phone. Now that I think of it, it’s been ringing like crazy all day. We had a clerk whose only job was to answer the phone. I looked at the schedule and remembered that it was Jill who was on phones. She was probably in the bathroom again. I swear, I think she spent half the day in there. If you ask me, I’m pretty sure she can blame the Taco Bell she ate for lunch everyday.

Alright, I’ll take one for the team. I pulled up my computer to the scheduler tab.

“Good afternoon, Lexington Health Unit WIC. How can I help you?”

“Um, yes. I got my vouchers for my baby’s milk earlier this month but I already ran out. How can I get more?” I got her name and looked up the vouchers given so far. Sure enough, she had already received this month’s vouchers, and there was nothing I can do. This won’t end well.

“Well ma’am, you’ve already received this month’s vouchers. Unfortunately, there’s nothing we can do to provide more formula. You’ll have to wait until next month to cash the next month’s voucher.”

“What’dya mean? My baby’s hungry and you’re telling me you can’t give me more formula?”

“I’m sorry about that ma’am, but WIC does not necessarily provide your family with all foods needed. It is a supplemental food program.”

“So what am I supposed to do?”

The shit’s about to hit the fan.

“Well ma’am, you can buy it.”

“BUY IT???!!! DO YOU KNOW HOW MUCH FORMULA COSTS? I can’t afford that and thanks to you people I guess my baby’s just gonna starve!” That lovely statement was accompanied with her slamming the phone.

Wow. Funny how I knew how that conversation was gonna go. I know that formula is expensive, but it’s true. WIC is a supplemental program, and it’s not our fault that she ran out. I really don’t mean to sound callous. I walked over to where the charts were and noticed the bin was empty. Ok, looks like we’re all caught up.

I decided to walk around a bit and say hi to everyone. Sometimes I felt a little antisocial. I could blame the fact that my office was a little isolated. But to be honest, they weren’t really my type. They did a little too much gossiping and not enough working. Don’t get me wrong, I can joke around but I guess in a group of guys, I would be “the serious one.” I’ve heard that it comes off as snobby sometimes.

“Hey Cat! How’s it going this morning?”

“Pretty good, Kevin. Busy morning, huh? Seems like it slowed down a bit now.”

Cat was our front desk clerk this week. We have three clerks at all times, and they rotate weekly between front desk, phones, and income. She was nice enough. But she was young, and you can tell she talks about you as soon as you turn around. I decided to head back to my office. After looking at the schedule, I realized that there wouldn’t be an appointment for awhile.

I figured I could get information together for our next meeting, and in the meantime I can call Howie back. I must have missed the damn alarm the other night. I loved Howie like a brother, but I hated to call him out of the blue. I always felt like I was disturbing him because he has such a busy life. His wife, Leigh, just had a little girl named Caroline. And they already have a two year old, James. Howie and I went to college together. He was getting his degree in finance, and we ended up in an accounting class together. Who knew that a dietitian had to take accounting? Thank god he was in the class with me because I don’t think I would have been able to pass without him. After school he went on to get his MBA. Now he actually owns some hotels. Yeah, I said owned. They live in Florida, but we’ve always stayed in touch.

I was surfing the net when he picked up. “This is D.”

“Howie, you do have caller id…why do you pick up the phone like you don’t know who it is?” Howie is always all business, but is one of the sweetest guys you’ll meet.

“Hey Kev! I got a new phone and haven’t really switched everything over yet. I guess that’s lazy of me. See what having a new baby does to me? I’m so exhausted I can’t even think straight!”

He was serious. He can’t function without sleep. Any change in the poor guy’s sleeping patterns, and he’s lost.

“Congrats man. I’m sorry we haven’t made it out there to see her yet. Work has just been so busy that I haven’t been able to take the time off.” That was a lie. Truth was that we couldn’t afford the tickets. I didn’t want to tell him that because I know he would offer to pay, and I don’t want him to.

“It’s ok, man. You know how it is. She’s really just pooping, eating, and sleeping. But enough about me, how’s work?”

I sighed. “It’s going ok, Howie. I guess it’s just not what I expected. But when I have my good days, they’re really good. I feel satisfied and appreciated when they listen to what I say, you know?”

“Kev, you know every job has its ups and downs. You deserve to be happy, but keep in mind that no job is perfect. Really think about what you want to do. If your heart is telling you to look elsewhere, then you should.”

Yeah but it’s not like hopes and dreams will pay the bills.

“You know if you ever need anything, Kevin, you can call me.”

Did I say that last statement about the bills out loud? I swear, he knows me too well.

“I’m good, Howie. I think I’m just gonna stick with it for at least a year and see how it goes. I’m gonna have to start thinking though because I’m coming up on a year soon. Money’s tight, but we’ll survive.” I wanted to change the subject. I didn’t want us to be pitied. I hate that feeling. I mean, I know that Howie truly cares about my family but still…I didn’t need to complain to him.

“Well Kev, I wanted to talk to you to tell you that John and I will be in town to scope out a new area. It’ll probably be in a couple of weeks, but I’ll definitely keep you informed. I want to spend some time with you and the family. Cool?”

“Of course, Howie. I can’t wait to see you. Well I should go so that I can get back to work. Send my love to the kids and to Leigh. Is she breastfeeding?” I couldn’t help myself.

“Yes, she is. And if she wasn’t, I wouldn’t admit it to you.” We both chuckled. What can I say, I can make my opinions known when I wanted to.

“Good, Howie. Well, keep in touch and I’ll talk to you soon.”

“Later, man.”

A month had passed, and Howie had come for his visit. We had a lot of fun hanging out like old times. He ended up staying with us instead of a hotel. I think it was mostly because his brother didn’t end up coming. I felt good that he stayed with us because it’s hard to be friends with a hot shot when you’re not one. But Howie wasn’t like that anyway.

Well I had been in my job for almost a year, and my evaluation is later this week. I didn’t think it was fair to quit a job before the year mark. I felt like I needed to give it time. But now my deadline was approaching, and I needed to make a decision. Should I look for a more glamorous job with some higher pay? Or do I stick with my gut, and stay with the job where I really think I can make a difference?

Before lunch, I have a high risk visit. It’s s a follow up with an overweight child. The last time we had met, Matthew was at the 100th percentile, which is not good. His mom admitted to me that he was not very active, and that he was drinking chocolate milk all day. I always look at my notes before I call a follow up back. I figure it’s good to know what I’m following up with.

I called them back and got a new weight and height. It’s amazing how quickly children grow. We went to my office and as I typed in the updates, I asked the same question that I ask at all my follow up appointments.

“So mom, why don’t you tell me what’s changed since last visit?”

I know what I want to hear, and I know what our goals were. We discussed them, and we agreed on them together. But half the time they look at me like I’m stupid and reply with “nothing really.”

But before this mom can even answer, I glanced at the growth chart and saw the percentile drop down to the 78th. That doesn’t mean he lost weight or anything, but it means that his rate of weight gain slowed down. That was our goal. I never make a weight loss goal for a child. I was more than pleased as I looked back at Matthew’s mom with a smile. She still looked nervous. I hate that. Sometimes I feel like the principal-like the mom’s are scared that they’re somehow going to get punished if the growth charts don’t look better.

“Well, we cut back on the juice and now he only drinks six ounces a day. I did like you said. Instead of him getting his milk servings with all chocolate milk, he gets maybe one every other day or so and then eats other foods with milk like yogurt. And we’ve switched to one percent milk. He’s also in school now so he’s a lot more active than he was before.”

I looked at her in disbelief. Sure, this does happen sometimes. But it’s so rare that when it does, I’m overjoyed.

“Well Ms. Monroe, what you’re doing is working beautifully.”

I turned my monitor so that she can see the difference on the growth chart. She smiled with satisfaction.

“Thank you so much for all your help. I realize now that this is a lifestyle. Not a diet or any type of depriving. You know, my mom had diabetes before she died, and Matthew’s dad is obese. I don’t want that for him. I don’t want him to be sick, and I don’t want him to be made fun of.”

“Well you’re moving in the right direction. And now that you know what will work, keep up the excellent work. Let’s follow up at his recertification in three months just to see where he is.”

We finished our conversation and I felt completely satisfied. Most visits don’t end that way. But the one in ten that do end up that way make me feel happy with what I do. Everything else comes with the job of being a pediatric dietitian working in a public counseling setting.

Before I checked for another chart, I decided to glance at the schedule to see how many people we had left to see for the morning. I saw a name that looked familiar, but I couldn’t remember the specific details.

Lauren Kitt

I put her name in the computer and right away I remembered her. That’s mostly because of her boyfriend. He was listed as the proxy in the computer, and I recognized it right away for some reason.

Apparently the nurse, Gina, saw her earlier this morning. I read through her notes and noted a couple things. First, little Nick Jr. here was born early. But seems like he was in the NICU for a couple days and then released. Next, she was partially breastfeeding. Apparently, the hospital started giving Nick some formula to help get rid of the jaundice. It made her milk supply decrease. I hate when hospitals do that, but at least the baby is healthy. That’s great to know.

I love to follow up with people that I remember. It’s especially fulfilling when I was the one who educated them and talked to them about the pregnancy the first time they were in the clinic. As I sat there reading through everything, it all seemed to click and as soon as I got home, I discussed everything with Kristin. She didn’t have class tonight. We put Mason to bed and decided to take a bubble bath together. It was a perfect ending to a slightly stressful day.

“So baby, how do you feel about work now?”

“I wanted to talk to you about that. I know what I want to tell Ms. Charlotte at my evaluation. I’m going to be honest about the logistics of the job, and I’m going to let her know about Judy. She’s the only one that gets paid salary, and she honestly does the least amount of work. If I were the administrator, I’d want to know if my coordinator wasn’t doing her job.”

She nodded.

“I’m going to tell her how passionate I am about this job. Kristin, I’ve just had some really great, rewarding experiences lately. I’m sorry because I know this isn’t the best paying job, but it’s good enough for now.”

“Well I think you’re doing a great job, Kev. This is your passion. I think you need to stick with it. Those kids need you.”

“I guess I’ve never thought about it like that before, Kris.”

Truth is I feel for these families. And regardless of how these parents act, my job is to act in the best interest of the patients, especially the infants and children.

“I guess I just need to not take it personal. I just have to swallow the fact that some people don’t want to hear anything from me. They want their vouchers and that’s it. I’m still going to do my job to the best of my ability and continue to challenge myself.”

“I think that’s a great idea.”

We stayed there a bit longer, and then she went to bed. I had a little bit of trouble sleeping. As I lay in bed, I thought about everything we talked about. I was reminded of a conference I went to for WIC not too long ago.

The short little brunette stood at the front of the class describing counseling in the WIC clinic by comparing it to planting seeds. We thought it was a bit corny. But now, I can hear this part clear as day in my head.

“Every time we give information at these visits, I want you to think about planting seeds. Just like plants, not every seed will grow. Some people will hear the information but not really listen. They’ll continue to do the same thing they’ve always done until it does become a problem in the long run. Instead of preventing the situation, they’ll have to correct it. Or not. And some people, just like some seeds, will take the information and sprout. They’ll grow as people and learn more about themselves in the process.”

You know what…this job was worth my time even if only two people all day cared about what I had to say. As for the rest, I would just continue to plant those seeds and hope that some of them would sprout someday. If not with this child, maybe another child, or even a grandchild.

I used to think that I needed to be doing something bigger to feel important. Truth was, my something bigger was right in front of me. All it took was a different outlook.