Thursday, September 30, 2010

SPEAK out



Today's New York Times has a full page ad from Penguin books that promotes the book Speak, by Laurie Halse Anderson.   This powerful story about a teenage rape and the depression, loneliness and ostracism that ensue was given to me by a patient a few years ago.  It was eye-opening then and remains a powerful read for people of any age still to this day.

However, in Missouri, some people think differently. In particular, a Missouri State University professor supposedly has called for a ban on this book in schools.  Bizarrely enough, he equates the rape  with "soft pornography" and has invoked Christian values to support his idea.  The blogoshpere is active with writing about book banning and the attempt to silence the conversation about adolescent rape.

On their website, Speakloudly.org, Penguin books promotes not only Speak but freedom of speech and of the press in general.  According to the blogs, this book has been instrumental in helping many women--some well past their teens-- come forward with their stories of rape and silence.  Having a conversation about this story in class, at home and in doctors' offices can go a long way to bringing sex crimes out of  the darkness and  increasing understanding and compassion for its victims.

Tuesday, September 28, 2010

Preparing for Haiti

Today's article "Weighing the Lives of Babies in Haiti" which describes the heroic survival of a premature infant in the desperate and stark tent hospitals of Port au Prince served as a timely reminder that I leave for Port au Prince in just 12 days.  Donated boxes have piled up on my front porch and I am starting my prayers to the American Airlines gods. Hopefully they will still be compassionate enough to not charge me for my extra bags of supplies-(notably Purell and rubber gloves--the most urgent thing the last pediatrician to visit told me was in short supply) as they were when I visited in January.

The article describes the "Macgyver-like" ingenuity of the pediatricians who crafted an incubator out of a box, blankets, and a bare light bulb to ensure the survival of the tiny, but otherwise healthy infant.  It also paints a picture of the triage mentality among the Haitian clinicians who doubted this childs'  viability as well as the ingenuity and persistence of the American doctors.   Far be it for us to criticize their system for providing care and having to choose whom to treat and whom to give up on.  In addition to the realities of their situation which includes a lack of basics like water, Purell, or clean gloves, they undoubtedly suffer from a collective depression that has surely taken its toll after eight months of on-going post-traumatic stress. 

Which is probably why the director of the residency program asked me to prepare a talk on stress management to accompany the ones on menstrual disorders, pubertal development, diarrheal disease and cerebral palsy.  It is my hope that I will be able to teach these physicians some skills that have less to do with their current medical school curriculum but everything to do with survival.

Sunday, September 26, 2010

Helicopter Parenting à la Chinoise

Wuhan University (image courtesy of home.olemiss.edu)

Apparently a Chinese university is catering to parents in a BIG way. They are finally getting their own dormitory.    This is according to the ever-amusing column, "It must be true...I read it in the tabloids" from the wonderful magazine, The Week.  Allegedly, Chinese parents hover even more than their occidental counterparts because of the national "one-child policy".  Some one and only children are accompanied to university by their parents who heretofore have slept in their child's dorm with them. A university spokesman was quoted as saying that the new digs will allow them to wash and eat! Guess they don't have a meal plan.


Friday, September 17, 2010

Concussions in the news again, thankfully!


This week has seen not one, not two , but three major news stories about concussions in young athletes. In case someone still thinks this is not relevant for our children, let’s just start by acknowledging how common concussions are. In Mamaroneck school district there have already been 4 concussed football players reported this year. It is estimated that nationwide there may be as many as 3.8 million recreation and sports-related concussions every year.

Then comes the shocking story of the University of Pennsylvania football player who committed suicide at the age of 21 and whose brain at autopsy showed signs of chronic traumatic encephalopathy or CTE. CTE is the pathological finding that is coming to light in the brains of middle aged NFL players who suffer from dementia. It is their devastating demise that has the NFL looking to more conservative policies on the field.

But this professed policy does not seem to have helped the Philadelphia Eagles’ Stewart Bradley who is seen on video here to be stumbling down the field following a serious hit. Only after he was allowed to go back into the game and come out at half time was a concussion diagnosed. Just watch this video and you will see that something isn’t right:



Also prominent in the news this week are pediatricians who thankfully have more concern for the long term welfare of our children than does the NFL. They have given us the extraordinary report in the American Academy of Pediatrics journal Pediatrics titled “Clinical Report-Sport-Related Concussion in Children and Adolescents.” This is the most current, cogent and comprehensive report I have ever seen on this subject. It is truly worthwhile reading (find it here) and needs to be disseminated to coaches, athletes, parents, trainers, superintendents, teachers and physicians.

They make many important points but I will list the four most important ones here:
  • Concussions can be difficult to diagnose at the time of injury and sometimes are only apparent as the symptoms evolve over the days following the impact.
  • Most symptoms resolve in 7-10 days but some athletes may take months to recover completely. Premature return to play can significantly prolong recovery and risks complications.
  • Athletes with concussion should rest, both physically and cognitively (sometimes staying home from school) until their symptoms have resolved both at rest and with exertion.
  • “Education about sport-related concussion is integral to helping improve awareness, recognition, and management.”

At Mamaroneck High School we have developed and implemented a policy designed to address these state of the art concerns and protect our students. I am available to talk with any members of the community to help educate and promote understanding of this complex subject which demands a cultural shift in our thinking.

Monday, September 13, 2010

New Driving Laws Affect You!

As if the New York state graduated driving rules weren't confusing enough, they have just added a new rule that has been quietly introduced but with very little fanfare. And it promises to have some serious consequences.

As of September 1, 2010, the new law requires that drivers under 18 may not have more than one non-family member under 21 as a passenger. period. Read it again.


 State authorities are responding to the facts at hand.  Drivers 16 and 17 years old are more than three times as likely to be involved in a car crash than others.  Limiting distractions while driving is one method of ensuring safer driving.  However, my recent conversations with teens has brought up three quick points worth thinking about and discussing: 
  • The designated driver after parties will no longer be able to take a couple of friends home if they have been drinking.  Of course, New York State cannot officially recognize that underage drinking happens and therefore doesn't take this side effect of their remedy into account.  But to hear one seventeen year old describe it: "That means that half the people at a party need to be designated drivers."  Maybe that's not such a bad thing.
  • SafeRides programs which provide confidential and supervised taxi services for kids in communities may have to re-think whom they allow to drive.  Seniors under age 18, who usually travel in pairs,  can no longer drive fellow students even if they have senior drivers licenses and good records.
  • The fact that there are fewer friends in the car makes the urge/need to send text messges and stay in touch that much greater.  And we all know it's just not OK to text and drive. 
Nonethess, it's the law. 

Other good news in the announcement from the DMV: it is in the process of forming a new group called the Driver Education Research and Innovation Center (DERIC) which will look at reforming driver's education for young drivers.  In my experience, driver's ed is largely an inefficient misuse of precious time for juniors in high school who have better things to do than sweat through their friends' twenty minutes behind the wheel. Let's hope they will come up with a better plan.

Friday, September 10, 2010

A Facebook Fast?

With the Jewish high holy days upon us and the annual Yom Kippur fast just a week away, Harrisburg University of Science and Technology has declared a different and decidedly secular way to enforce deprivation on its students.  The Chronicle of Higher Education reports on the Harrisburg administration's announcement to remove Facebook and other social media from its network for a week.   They say they hope the lack of access will help students to understand what pre-social media life was like and maybe come up with innovative ways to use it. 

Hmmm.  Even I, middle aged and technologically challenged that I am, recognize the futility of this exercise.  I am pretty sure that students will be able to take their laptops (which all Harrisburg students apparently have-no class distinctions or objections on those grounds) over to the nearest coffee shop and get online to anywhere.  Or that those who have smart phones will be able to power-up and connect anywhere on campus.  And the notion that deprivation will inspire new uses for the technology seems backwards.  I know that it's in the use of the technology that new ideas and clever uses come to light. 

As for the idea that depriving students of Facebook will help them understand what life was like pre social media, well, it reminds me of when I try explaining to my kids what carbon paper was, or what a telex was, or how I wrote on an aerogram to my parents once a week while in college.  They smile and indulge my reminiscences, leaving me thinking that only a curious history student somewhere, sometime will care at all about these ancient technologies.