North Star Conversations Transcript: Listening Beneath the Story—Rebecca Cho, M.D.
Dr. Rebecca Cho shares how she listens for patterns, context, and family dynamics to understand a child’s challenges over time.
Brandon Gimbel (00:00)
What do you listen to most closely when parents describe their child's challenges?
Rebecca Cho (00:05)
I'm looking for patterns, triggers, frequency, and context to try to understand a child or teenager's clinical presentation from a longitudinal perspective. How things have evolved because in psychiatric disorders, genetic elements, environmental, sometimes transgenerational factors all come together in sort of this onion-like way. The goal is to try to see it from that nuanced perspective.
Brandon Gimbel (00:41)
You're describing with the thousands of hours that you have, in doing this, you have developed pattern recognition for certain presentations. And you're trying to incorporate the patient's individual experience, a story for that person, but also the larger framework that the patient is in, including family dynamics, including, as you said, intergenerational dynamics that have developed over time. So you're talking about layering multiple stories and recognizing patterns within them.
Rebecca Cho (01:10)
And it's usually not a clear-cut process, as you might imagine. It's messy. And again, in the beginning, the goal isn't to understand all those complexities. It's to start getting a basic understanding and then to keep building upon that and adjusting treatment approaches, medications, therapy recommendations as we go along.
Brandon Gimbel (01:33)
As you both learn more and as things change.
Rebecca Cho (01:37)
Yep.