This article was originally published on May 12, 2014 in MedPage Today’s Ivan Today.
My brother would have turned 37 today.
But he didn’t. On January 9, 1995, he died in a car accident, at the age of 17.
That was the day he became a statistic.
I don’t usually need any reminders this time of year. If I somehow forget, May 12 is …
The day my brother became a statistic
Some skills are best learned in childhood, like playing a musical instrument or speaking another language. Sure, you can learn these things later in life, but you’ll have to work harder and you may never play music or converse with the ease of someone who learned young.
The same is true about learning how to talk openly with your doctor. Kids develop their habits and attitudes about health care with every …
Raising kids who can talk with their doctors
“Motherhood is the hardest job you’ll ever love.”
I’m not sure who first coined that phrase, but its truth becomes clearer to me every day. And nowhere is that truth more evident than in mothers of children with a serious illness.
Throughout my years of working at this hospital, I’ve had the privilege of knowing dozens of moms who find themselves within these walls …
Remember the mothers of sick children
Physicians today are challenged with the unique task of navigating the fundamental incompatibility between patient autonomy and the goals of public health. A few months ago, I faced that challenge when my elderly patient declined to receive the recommended influenza vaccine.
“I respect my patients’ right to choose, but sometimes I’m concerned that they make choices based on fiction rather fact,” I reflected in a recent post. “It’s been quite a challenge …
Vaccines and public health: Can we have our cake and eat it too?
My family’s world changed instantly upon receiving Annie’s diagnosis of apraxia and autism spectrum disorder (ASD) a day before her second birthday. Hearing three words, “she has autism,” we suddenly faced a lifetime of uncertainty. I knew that I had to embrace my role as a mother of a child with autism, and as an autism champion — and more critically, find a physician that I could form a trusted …
Autism treatment requires a collaborative patient-doctor relationship
Shakespeare said that brevity is the soul of wit. I say brevity is the soul of a good note.
As a resident back in the early 90s I would look at office notes written by older, near-retiring physicians. I’d read these one or two lines written on 3 1/2-inch note cards, turn to my fellow residents and ask, “How can someone possibly document this way?” Years later, I realize the genius, …
Brevity is the soul of a good EMR note
I get asked a lot about essential oils. I answer very little. Why?
The answer is simply that we don’t know much about how or if they work. Except from stories about how they have helped certain people in certain situations, no one has done a large studies to truly evaluate their effectiveness or safety.
The main explanation for why they are used is that people (parents) are simply looking for something that’s an alternative to …
A few thought-provoking questions about essential oils
As I look back, I remember teachers. One taught to be compulsive and complete. Another, calm and humor in the face of chaos. Another believed in me and thereby taught me to believe in myself. One made me write and rewrite. Above all, there was a mentor who opened my heart and eyes to the need for compassion. That special teacher was Dr. Black.
Tuesday afternoon, 8:30am, July 12, 1966: Dr. …
A mentor who opened my heart and eyes to the need for compassion
It’s coming up on that time of year again. Spring break is here, next comes school assemblies leading up to the end of the school year.
It’s that inevitable time of year where I see news story after news story where children are rewarded Oprah-style for their awesome record of perfect attendance:
“You get a bike and you get a bike and you get a bike.”
Yeah! It’s pretty heart-warming and exciting, right?
There …
Is perfect attendance what we really want in school?
Stephanie wrote in about a very common problem:
My daughter is 4 years old. She isn’t the tallest cat in town (she is about the 15th-25th percentile for height), and her BMI always ends up being in the high range (like over 85%). I worry about it. I am very health conscious for myself and my family. We live by all of the “rules.” And yet.
The family doctor doesn’t worry — …
Should BMI be used to measure obesity in children?
Something is in the air right now. There’s a strange mix of vaccine-preventable illness sweeping the country (measles) and a strange bump in media coverage for celebrities and vocal opponents to tested and recommended vaccine schedules. Part of me thought we might be done with that but pageviews, clicks, and views all sell.
My hope is the coincidence of coverage and outbreaks is just that, a coincidence. But as a mom, …
Measles and the media: Are parents are being duped?
News broke recently that Daniel Murphy, second baseman for the New York Mets, recently took two days off for paternity leave, causing him to miss Major League Baseball’s opening day and the season’s second game to be with his wife and child.
Mike Francesa, a popular New York sports radio personality, devoted about 20 minutes of his Wednesday broadcast on WFAN to a rant against paternity leave. According to him, a …
Real men don’t leave their wives right after birth
Michelle Obama refers to childhood obesity as the tobacco of the 21st century. I agree. Obesity is quickly overtaking smoking as the nation’s No. 1 killer.
As a pediatrician who sees firsthand the impact of overweight and obese children, we need to have conversations with our patient families that focus on obesity as a clinical issue.
Right now, this isn’t happening. The rate of missed diagnosis for childhood obesity is over 95 percent, …
Clinical obesity, not morbid: A plea to change the diagnosis
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Lying in a hospital bed, my seriously obese patient can barely see her swollen and odorous right foot over her abdominal fat. The foot is soon to be amputated, the result of an untreatable infection exacerbated by diabetes and kidney failure, which developed in part because of obesity.
Her two children, ages 6 and 12, hover from the hospital bed to the couch. In between, the bedside table is strewed with …
Doctors struggle to treat childhood obesity
I’ve been involved in several boisterous Twitter debates about vaccines, at least to the extent that one can debate using snippets of 140 characters or less. I’ve also been a “super moderator” at a very large Internet message board for many years and have seen my share of passionate vaccine debates there. I’ve been a pediatrician for over 30 years and trained in the subspecialty of pediatric infectious diseases before I went …
Why do vaccines in particular give parents concern?
The statistics tell us that our children are getting sicker and sicker. Attention deficit hyperactivity disorder (ADHD) has more than tripled in just 20 years: It is now diagnosed in 11 percent of all kids, and in an astounding 20 percent of teenage boys. Autism is also on a rapid rise. The latest reported rate suggests that it occurs in one in every 68 kids — 20 years ago it …
We are turning childhood into an illness
You know those little packets of paper, folded over eight times, written in type that can’t possibly be seen? You’ve seen them glommed onto the side of stock bottles of medications, or shoved into the paper box alongside a tube of prescription ointment. That unreadable thing is the official “product information,” often called the “label,” required for every FDA-approved medication. It contains all sorts of information, including lists of Read more…
When pediatricians write prescriptions for off-label use
Headlines soared recently with the CDC report that the number of children with autism diagnoses had increased by 30% in the past 2 years.
“Reality is there are many children who are having serious struggles because they can’t communicate well and have a hard time being with people,” Dr. Chuck Cowan clearly stated to me this morning. Like a bell on a quiet night, I feel parents need to hear this most: …
Is autism diagnosed more frequently? Making sense of a recent study.
A large number of pediatric practices these days use after-hours call centers for parents who have questions about a sick child. I’ve been looking around to find some data about how common this is, but my sense is that the majority of pediatricians use them. There is no question these call centers make live easier for the doctor; having somebody screen the calls, answer easy questions, and only call you …
Do call centers send too many children to the emergency department?
There is nothing more disheartening for a physician than watching a patient die from a preventable cause. And, of course, the loss for the family involved is unimaginable.
But it’s important, especially for parents, to understand the potential consequences of preventable, infectious diseases.
Here’s a scenario doctors across the country are witnessing first-hand: A 2-year-old girl develops what seems like a cold. Over the next several days, her breathing rate increases. At …
Understand the consequences of preventable infectious diseases
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