I’ve wanted to be a physician for as long as I can remember. As a teen, the choice to become a doctor seemed to perfectly meld my affinity for science, academics and helping others. Better yet, pediatrics offered the ability to work with families and children of all ages and developmental abilities.
For fifteen years, I lived, breathed, and worked toward my …
Confessions of a burnt-out physician
She was absolutely perfect. She had ten perfect fingers and ten perfect toes. Her eyes were wide and curious and drew you in fondly. She was absolutely perfect everywhere — everywhere except for her nose and mouth. She was born in 1959 with a unilateral complete cheiloschisis and palatoschisis, more commonly known as a cleft lip and palate. Where her perfect, beautiful nose should have been was an empty, gaping …
When it comes to health care, I finally understand how beautiful banality can be
Unfortunately, measles is in the news again.
Measles is a very contagious viral illness that causes a high fever, rash, cough, and a runny nose. Complications include pneumonia, brain inflammation and death. Prior to 1963 there were hundreds of thousands of measles cases in the U.S. annually, causing hundreds of deaths. In 1963 the measles vaccine was introduced, leading to an immediate decrease of measles cases in this country.
In 2000 measles was …
Those who refuse vaccines endanger all of our kids
A thought provoking article in the November, 2014 edition of Pediatrics highlights a growing problem with modern medicine: Just because we can make a diagnosis doesn’t mean we should.
The article, titled “Overdiagnosis: How our compulsion for diagnosis may be harming our children,” has been made available for free to everyone. It’s fairly dense and technical, but if you’ve been following this blog …
You’re fine: That’s the hardest diagnosis to make
Every fall I write about bronchiolitis because it is one of the most common respiratory ailments affecting infants and children under about two years of age. It is the most common reason infants end up in the hospital during the winter and early spring months. Every year we get severe cases in the PICU. Pediatricians have struggled for decades to figure out how to treat bronchiolitis but we don’t have …
Analyzing the new treatment recommendations for bronchiolitis
Postpartum depression may be a misnomer. A more accurate term might be postpartum neglect — not by mothers, but of mothers.
The human infant is uniquely helpless in the early weeks and months of life. His arms fly up over his head at random moments in a primitive “startle reflex.” His sleep patterns have no rhyme or reason. He eats and poops round the clock. Serving an evolutionary purpose, in part to achieve an upright …
Postpartum depression may be a misnomer
As a doc, I need to take care of the whole child. I do this with respect for every kiddo; and with their parent’s consent, presence, and permission. Sometimes the job includes discussing or examining a child’s genitals.
In the past, it was not thought of as appropriate to allow children to speak openly about sensitive anatomical areas (“private parts.”) Growing up as kids, we may have …
Why teaching anatomically correct words matters
Autism was first reported in the medical literature 70 years ago. In 1943 a child psychologist named Leo Kanner described a child with social difficulties and repetitive, stereotypic movements; the following year Hans Asperger described four such children. Since then we have gradually learned more about what we now call autism spectrum disorders (ASD), although we still do not know what causes it. From early on it was apparent that the …
Autism’s cause: How much genetic? How much environmental?
The fact that childhood cancer is, thankfully, a rare disease belies the fact that it is the leading cause of disease-related death in U.S. children, age 1 to 19. The fact that it is a rare disease also belies the fact the number of people with a direct stake in expanding research into pediatric cancer is quite large and extends well beyond the small number of children with cancer and …
More resources are needed for pediatric cancer research
At the national conference of the American Academy of Pediatrics (AAP), I got to hear Hillary Clinton talk about the AAP’s partnership with her Too Small to Fail campaign. It made me happy — and sad.
The partnership is a great idea. It’s all about improving early childhood literacy, which is way more crucial than most people realize. It’s not just about an income gap when we talk …
The reading gap: Too small to fail or too big to care?
While studying for my recertification exam as required by the American Board of Pediatrics, I came across this question:
A 7-year-old girl is having difficulty establishing relationships with other children despite repeated opportunities to do so. The girl prefers to stay near her mother or her teacher and will avoid other children. She sometimes cries and can be difficult to calm down after being dropped off at school, so her mother frequently remains …
Cognitive behavioral therapy: Why parents should be involved
Ebola is a scary topic; there’s no doubt about that. With the onslaught of media coverage that has no end in sight, it’s likely that older children have already heard of the Ebola outbreak or will hear about it in the near future. The question is, what can we do to help our kids work through the confusing and frightening messages they see on television?
Here are some suggestions to help …
How to talk to your kids about Ebola
A few years ago, I was doing a summer internship in which I looked at health outcomes for hospitalized patients. I sat in an office and read about patients with issues like high blood pressure and cholesterol. At a certain point, I realized that the reports on their outcomes were interesting, but the real solution to the problems I was studying was happening outside my window. My window overlooked a …
The success of health programs depends on execution
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Did you know that your digestive tract contains over 400 different types of bacteria? This complex ecosystem is called intestinal microflora. The concentration of bacteria in the gastrointestinal tract increases dramatically moving from the stomach towards the colon. In humans, the intestinal microflora is vital in many important functions including digestion of nutrients and prevention of infection. Disruption of the “normal flora” can lead to many problems including diarrhea, bloating, …
Should you give probiotics to your child?
With all the news about enterovirus 68 sending hundreds of children to hospitals, it’s easy to panic when you hear about a case in your neighborhood — or, even worse, if your child starts coughing.
But please, don’t panic.
This virus has certainly caused trouble and tragedy. But enteroviruses are incredibly common, causing 10-15 million illnesses a year — and usually, those illnesses are minor. This one, for reasons we don’t fully understand, is …
Enterovirus 68: Why you shouldn’t panic
Polypharmacy, or use of multiple psychiatric drugs, for treatment of attention deficit hyperactivity disorder (ADHD) is on the rise. A recent study compared treatment with basic therapy (stimulants plus parent training) with augmented therapy (those two plus risperidone, an atypical antipsychotic). The study concluded that treatment with risperidone was superior.
When children show dramatic improvements in behavior on risperidone, now being prescribed with increasing frequency for ADHD and a range …
Should we use antipsychotics to treat ADHD?
This weekend the kids and I had our influenza immunizations.
There is always a difficult lead up as Oliver has severe anxiety around every medical procedure. An EKG (painless heart rhythm test) and a throat swab cause extreme fear and often tears and anything with a needle, well, let’s just say that’s on a whole different level of terror and emotional pain.
I remind myself that his anxiety is a normal response …
My son depends on herd immunity, so thanks for getting your flu shot
As practicing pediatric gastroenterologists, my colleagues and I remove a fair number of esophageal and intestinal foreign bodies (i.e., things kids accidentally swallow).
A couple of years ago, several physicians across the country began noticing serious injuries in children who swallowed high-powered magnets. The issue was raised in an email forum for pediatric gastroenterologists and the response was overwhelming. There were hundreds of cases — throughout the world, as we later …
We can make a difference: Lessons from the Buckyballs recall
The Journal Psychological Science just published a complicated, long, and fascinating study about happiness. The full text is tucked behind a paywall, but it’s great reading if you can get your hands on it.
The authors arranged four separate experiments, looking at the effects of getting things versus experiencing things, and how the anticipation of waiting might affect happiness. Some of the studies involved just imagining a future purchase or vacation; …
More stuff will not make kids happy: Take them outside instead
Media deprivation: Do you think it exists? Although laughable at first glance I know I’m not the only parent who wonders if limiting screen time could change my child’s opportunity. Those of us who fiercely control screen/device time may have momentary lapses where we wonder if we’re doing things right. Even though I’m convinced there isn’t a study telling us that typically-developing children need media/apps/screen time to learn how to …
Media deprivation for children: Are parents doing the right thing?
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