Pediatricians and the clinicians who care for children writing on KevinMD about child health: childhood illness, development, vaccines and the parents who refuse them, breastfeeding and the pressure around it, childhood obesity, prevention, and the realities of caring for young patients and their families. Most contributors are pediatricians. For a maintained record of what pediatricians have said about children's health since 2004, from fever and sleep through obesity, abuse, teenagers, and Medicaid, see Children's health: what pediatricians say, in their own words. For what physicians have said about vaccines and vaccine hesitancy, from the autism claim through measles, exemptions, and federal policy, see Vaccines: what physicians say, in their own words. For what child psychiatrists and pediatricians have said about children's and teens' mental health, see Mental health: what psychiatrists and physicians say, in their own words. For what pediatricians have said about breastfeeding and postpartum care, see Women's health: what physicians say, in their own words.
We have a vaccine crisis in the this country. Not just the one caused by anti-vaxxers like Jenny McCarthy, scaring Americans away from life-saving childhood vaccines with pseudo-scientific claims about autism. Instead, I’m talking about a bigger crisis, one caused by a dangerously thin supply of vaccines. Wise parents who ignore the blatherings of people like McCarthy may soon arrive at their pediatricians’ offices prepared to vaccinate their children, only …
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The vaccine crisis we’re facing isn’t the one that you think
My thoughts settled on the Frank Sinatra song, “My Way,” when asked about necessary resources for rural health care to survive. Seven years ago, my father and I changed office buildings. We closed the office that Friday to allow three full days to get settled. However, we ended up seeing sick patients in the parking lot (seriously), while the movers were loading up the truck.
“All we need is a stethoscope, …
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How this pediatrician practices medicine. Her way.
When our daughter Florence was born, we were shocked that a tiny, seven-pound beauty could turn our household (and our entire lives) upside down. Why was it so difficult to deal with one human being, when we often took care of a department full of ill patients? How could someone so cute induce a state of perpetual anxiety, forcing us to question every single action we took?
It was disconcerting to …
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The ER physician approach to the crying baby
As a pediatric resident, I have the joy of building relationships with families and watch their children grow while providing them with anticipatory guidance at every visit. From newborn visits to toddler visits to teenager visits, they come, and we all grow together. (They grow chronologically and as a family, I grow in my experience and knowledge.)
The questions come in such a wide, but expected, variety: “When can I introduce …
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Anticipatory guidance for dark times
Dustin Ouellete grew up a bit the other day.
I had known Dustin as an infant, and his mother before that. Several years ago, the Ouellete family moved away to the big city, but last summer they came back.
Dustin came in a few times with his father, and his main concern was migraines. Dustin’s father, a quiet man who seldom smiles, was concerned that the headaches were keeping his son from …
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The day a young patient took charge and grew up
Recently, the CDC announced that its Advisory Committee on Immunization Practices (ACIP) voted to stop recommending the nasal spray flu vaccine, FluMist, for anyone. Bottom line: it doesn’t work. Though their recommendation against the use of FluMist still has to be approved by the CDC director to make it “official,” it’s pretty much a done deal. The AAP’s president has already endorsed the announcement, too.
Bye, Flumist. We’ll …
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The demise of FluMist is a victory for science
The patient arrived in the pediatric intensive care unit one summer early in my medical training. The weather was still warm, although the unforgiving heat from earlier in the season had mercifully passed. The whole thing had been an accident: The child, a toddler, had been left in the car outside her father’s office, discovered several hours later when the father returned to retrieve a document from the back seat. …
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Always check the back seat before you leave the car
This story has been on my mind for many years, but each time I have sat down to write it, the words would not fall into place.
The other day, a family mentioned having their “rainbow baby” referring to a child born after a tragedy. To me, rainbows symbolize that even after the roughest storm, things can get better. To see a rainbow, there must be moisture, like falling rain, in …
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Providing comfort to another tiny human being is absolutely breathtaking
As a pediatrician I come across lists of “what to ask the pediatrician” and routinely meet with inquiring parents who are in search of a pediatrician. Occasionally they come with a list of questions but most often they are not sure what they should be asking. I always tell my new parents that the interview visits can tell you if I’m a normal person and if you can get booked …
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Essential tips to choosing your next pediatrician
To the American Board of Pediatrics:
I took and passed my recertification exam in Washington State last fall and would like to express my sincere gratitude to your organization for setting up more hoops for pediatricians to jump through under the guise of helping us stay up-to-date. The first hurdle was the exam application and the second was the testing day experience, which was one of the most humiliating of my …
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The humiliation a nursing physician faced during her board exam
“Someone else will lend a helping hand,” a physician told me once, when asked to help with an emergency in public. As a PALS instructor for more than a decade, I have always responded when possible. In the last decade, there have been three in-flight emergencies, two elderly individuals who passed out in church, and a host of other less serious maladies. A week ago, I discovered the best reason I …
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Physicians have a duty to respond to emergencies if they can
I love being an academic pediatrician. I didn’t start out to do that; I thought I would be writing novels and working part-time in an inner-city clinic. I wrote with Robert Penn Warren in college and my first (and only) novel was published when I was a senior in medical school. But things don’t always turn out the way you expect them to. In my case, I didn’t expect to be …
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The loneliness of a long-distance academic
When, aged thirteen, my best friend died of complications from sickle cell disease, her parents could not attend her funeral or find out where she was buried. My mom explained to me that in the Yoruba culture because parents are not expected to survive their children, it is considered an abomination for a parent to know where their child is buried. So, the young adults in the extended family attended …
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The death of a child is an abomination
The American medical establishment has systematically clogged his arteries with paperwork, lined his lungs with rules, and filled his intestines with, that’s right you guessed it, shit. There he lay, in a comatose state, awaiting to be pronounced. Only one thing is sustaining his overworked body.
Idealism.
Four months into my intern year and I’m just realizing how crucial maintaining my idealism — as unrealistic as it may be — is to …
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The idealized doctor is dead. Or at least on death’s door.
I remember a warm September day at the playground 22 years ago. I was there with my 19-month-old daughter and newborn son. Zack was hungry, so I sat down on a bench to nurse him — but every time I got him settled, Michaela ran away from me. Far away, out-of-view away (she was a quick little thing). The playground was fenced in, but there were lots of ways for …
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Sometimes, talking to strangers is necessary
Physicians today are not held in the same high esteem as they used to be. We are often portrayed as callous, intolerant, clutch-fisted, know-it-alls who schedule patients around our daily golf game. (For the record, I do not play golf.) Physicians are accomplished in the application of science, but we are not experts in public relations.
We are human beings: mothers and fathers, sisters and brothers, sons and daughters. Like everyone …
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The public needs to see physicians as human
As many who are pediatricians or know pediatricians are aware, the quest to end gun violence is a passion for our profession and an advocacy issue of utmost importance for our professional organization, the American Academy of Pediatrics (AAP). Having practiced in areas with a high incidence of gun violence for most of my career until recently moving to California, I have seen first-hand how this tragic issue affects the …
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It’s time for physicians to raise their voices and end gun violence
A couple of years ago, “epic fail” was the phrase my teenage son used as I unsuccessfully attempted to beat him in a game we were playing. At the time, I thought to myself it was a harsh but accurate assessment of my performance. And I was certainly motivated to practice on my own so that the next time, things would be different.
That same phrase came to mind as I …
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The collective failure of the HPV vaccine is ours
In the dark lecture room, I watched the neurologist’s shadow flicker across the only source of light — a projection of the New York City subway map. He pointed at Times Square station. If the subway system were a brainstem, then Times Square would be the pons, transporting vital signals like breathing, speaking, and swallowing.
He likened the station’s abrupt destruction to a stroke producing locked-in syndrome. Writer Jean-Dominique Bauby describes …
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Would you choose heaven over hospital?
