Attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder enters the book not as a confirmed diagnosis, but as a dispute over how a child’s behavior should be understood and who has the knowledge to judge it. The psychiatrist dismisses the teacher’s suspicion about his son, only to have his wife expose the limits of his confidence: he is a specialist, but scarcely present in the boy’s daily life. The unresolved concern becomes part of the book’s examination of expertise, family care, and the unequal costs of responding to a child’s needs.

The School’s Concern

By the time the psychiatrist’s son starts school, his mother has arranged a tightly managed routine around her work. Nannies have cared for him, and after school he attends a program before going to a dojo, where his taekwondo master picks him up and supervises him as he practices and skips rope. His mother says she finally has time to breathe. Before the summer vacation even begins, however, the school summons her: the boy has stuck a pencil into a classmate’s hand.

The teacher describes other troubling behaviors. The boy walks around during class, spits into his soup and eats it, kicks other children in the shins, and curses at teachers. His mother is shocked. At home and daycare, he had sometimes cried when he did not want to go or when he did not want her to leave for work, but the adults around him had regarded him as a well-mannered, good child. The contrast between that earlier impression and the school’s report makes the concern consequential without resolving its cause.

The teacher suspects attention deficit hyperactivity disorder. The psychiatrist disagrees, and the teacher will not accept his dismissal. The account does not report that the boy receives a diagnosis or treatment for the suspected condition. Instead, the episode turns on the difference between an educator’s observations in the classroom and a father’s professional certainty at a distance.

Expertise and Parental Attention

The psychiatrist invokes his own authority as a specialist and challenges his wife’s willingness to believe the teacher over him. Her reply shifts the question from credentials to contact. A clinician, she argues, looks at a patient and listens; her husband spends perhaps ten minutes a day with their son, and even then remains absorbed in his phone. She asks how he can know what is happening with the boy under those circumstances.

The psychiatrist concedes that her criticism is true. His practice has relocated and expanded, and he has been busy monitoring work messages and emails on his phone. He insists that he does not play games or chat, but that defense does not answer the central charge: whatever occupies him, his attention to his son is limited. The scene makes his disagreement with the teacher more than a clash between professional opinions. His status as a psychiatrist cannot supply the everyday observation he has not made.

The concern also exposes a division in responsibility. The teacher’s proposed response is for the boy to have a stay-at-home mother, at least through the first half of elementary school. The psychiatrist’s wife takes a break from work. She rises earlier than she did when employed to make breakfast, wake and wash their son, feed and dress him, and take him to school; she also picks him up, arranges art and piano lessons at home, and sleeps in his room. The story records these duties as the practical response the family adopts, not as proof that the child has ADHD or that his mother’s employment caused his behavior.

The Family’s Response and Its Cost

The psychiatrist’s wife says she will return to work when their son improves. She has spoken with a senior colleague and arranged a position for a future return, but calls not long afterward to cancel: he is not showing improvement. Her suspension of her career thus becomes open-ended in practice, despite the plan initially being described as temporary. The school’s recommendation is translated into an intensive domestic routine borne by her.

The book places this episode alongside the psychiatrist’s retrospective account of his treatment of Kim Jiyoung. He had initially suspected a dissociative disorder from Jung Daehyun’s description of Kim Jiyoung’s symptoms, then concluded after a session that she had postnatal depression that progressed to childcare depression. As treatment continued, he began to question whether he had diagnosed her too hastily. He describes sessions twice a week, lasting 45 minutes, and says her symptoms have become less frequent but have not disappeared; he has prescribed antidepressants and sleeping pills for depression and insomnia. His reconsideration does not establish that his son has ADHD. Rather, the adjacent accounts show a clinician learning that diagnosis cannot be separated from attentive listening or from the circumstances in which people live.

Narrative Significance

The son’s suspected ADHD remains a suspicion, while its effects on the family are concrete: the school reports disruptive conduct, the parents disagree about how to interpret it, and his mother leaves work to provide the care the school recommends. The psychiatrist’s initial reliance on professional standing is undercut by his wife’s specific account of his absence from their son’s everyday life. His eventual admission that she is right marks a limit of expertise, not a clinical resolution.

That limit matters in a book attentive to the way care is assigned. The teacher’s recommendation treats a mother’s withdrawal from employment as the remedy, and the wife assumes the resulting work in detail. The episode does not claim that this arrangement cures the boy or identifies the source of his behavior. It shows instead how the label under consideration becomes entangled with a family’s choices and with expectations about who should reorganize a life around a child. The psychiatrist’s later uncertainty about his assessment of Kim Jiyoung sharpens the same point: professional explanations can be useful, but confidence without close attention may miss the person and circumstances behind the symptoms.