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Protecting the Child, Preserving the Family, and Honoring Life

Welcome to the Blog page of the American College of Pediatricians, which we call Scribit Veritas.  Each issue of the Blog is intended to assist parents, encourage children, and enrich the family.  Read our most recent issue below, and scroll to the bottom of this page to read earlier issues.

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For true happiness, “be fruitful and multiply”!

Group of ChildrenWhen was the last time you saw a news article encouraging couples to have 3 or more children?   This thought came to me one day in clinic when I saw a particularly smiley mom and her three children.  I recalled a chapter from the Birth Order Book and seemed to remember that 3rd born children tend to be more laid back.  They bring something extra to a family (as do subsequent children).  Factbook on my iPhone tells me that the fertility rate in the US is now at 2.06.    This is the average number of children born per woman.  We rank 121st in the world.   This number ranges from as high as 7.52 in Niger to as low as 0.78 in Singapore.    These numbers are referred to as Fertility rate.  Somehow I just cannot believe that  women from Niger are that more fertile than those in Singapore.    All of that aside,  I continued my study of smiles and consistently noted that there are more smiles the more children there are in the family.   There seems to be some tacit belief that countries that have more children are full of sad people that only wish their fertility rate was not so high and that those of us from “enlightened” countries should intervene and cause a reduction in the fertility rate.    Since almost everyone can agree that this world could use many more smiles, I would like to do the politically incorrect – and recommend that parents consider raising our fertility rate in this country to at least 3!   Ancient writings say, “Happy is the man whose quiver is full.”  This refers to having many children.  In honor of the upcoming Mother’s Day (May 11) and of the upcoming Father’s Day (June 15), I say be fruitful and multiply!

See this post from a colleague: Are you done yet?

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In Light of Ft. Hood, Some Thoughts about Guns

gunJust last month I came home to find police in our yard. They informed me that they had a fugitive in the woods who had escaped following a nearby burglary.  We were thankful for the police protection, but they can’t be everywhere at all times, and may take 20 minutes to show up where we live. I possess a gun that I will use to defend my wife and children when the police can’t make it in time. And if I was living through Hurricane Katrina in New Orleans I would want a gun to protect myself.

The United Kingdom, D.C. and Chicago have banned handguns, and yet it is still the primary weapon used to commit homicides and violent crimes perpetrated on good people in these places.  Because you or your children may encounter a gun at some point in your life, I would like to suggest some simple things you and your children can learn about gun safety.

Kids:  There was a study done in 2001 with 64 boys ranging in age from 8-12 where the pediatrician left the child alone in an exam room with video surveillance and a handgun (cleared and checked without ammunition) in a drawer in the room.  75% of the boys found the gun, 66% handled it, an amazing 33% PULLED THE TRIGGER, and only 1 boy who found it immediately left the room to get an adult and report it.  The whole experiment is a testament to the curiosity of children. Teach your kids: Talk to your children about the dangers of handling firearms and clearly instruct them to never, ever touch a gun or allow a friend to touch one without getting an adult involved.  There have been too many injuries from children playing with a gun – don’t let your child be another statistic.  After all, we tell them not to play near the street and not to smoke cigarettes, so why don’t we tell them not to touch a gun?

Gun Owners: WAKE UP and keep your firearms safely locked up 100% of the time.  Quick combination safes and biometric fingerprint safes have become extremely affordable and conveniently sized.  Even if you don’t have children, you may have friends or family that visit and wander through your house without your knowledge and cause damage with an unsecured gun – it’s happened before and there have been bad outcomes.

Know and memorize the 4 Rules of Firearm Safety.

1. Always consider a firearm to be loaded

2. Always keep a firearm pointed in a safe direction (keeping in mind that a bullet can travel several miles once it leaves the barrel).

3. Keep your finger OFF the trigger until you are ready to shoot and

4. Know exactly what your target is and what is behind it before pulling the trigger (keeping in mind the distance ammunition can travel).

Adults That Do Not Own firearms:  Be aware that your children may be playing or spending the night at a friend’s house and the friend’s parents may own firearm(s).  Many gun owners do not let others know that they own a gun for a variety of reasons. Ask about guns in the homes where your children play in a non-judgmental way.  

To Congress: On April 3rd, economist John R. Lott, Jr. commented about his son, a soldier at Ft. Hood, who recently returned from Afghanistan…”Ironically, my son is a concealed handgun permit holder. He can carry a concealed handgun whenever he is off the Fort Hood base so that he can protect himself and others. But on the base he and his fellow soldiers are defenseless.”  The same holds true for schools across our nations and college campuses where tens of thousands of people are contained in a bubble of non-protection that almost cries out for criminals to have their way without fear of reprisal. Let’s change that.

To those who would prefer guns did not exist:  I get that, I really do.  Guns are very powerful and can be very dangerous when handled improperly.  Unfortunately any laws preventing gun sales or ownership will simply keep them out of the hands of good, law-abiding citizens.  Criminals will arm themselves irrespective of the law.  Even if all gun manufacturers were shut down in the United States, firearms and ammunition would quickly make it back (illegally) into the hands of criminals. Our Founding Fathers wrote the 2nd Amendment into the Constitution to allow individuals in our nation to defend themselves and our country from attack.

To Perpetrators of Violent Crimes:  “Do Not Trespass — Survivors will be prosecuted!”


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Making Adjustments: When One Thing Doesn’t Work, Try Another

Our third child struggled with impulsivity and inattention even though we home-schooled and provided a far less restrictive academic environment than most students have.  This was interfering with his learning so we took him for an evaluation by one of my pediatric partners. A decision was made to try a medication to help his focus and decrease his impulsivity.

Our little boy was a wonderful ball of energy with a sweet disposition to match (and he is still a great kid!).  He was never down or discouraged for long and was always quick with a smile.  Shortly after starting medication, he was chided for a typical childhood infraction. Ten minutes later, his older brother found him sulking on the backyard swing. The observant teenager said, “I don’t know what medicine he’s on…but that’s child abuse.” And he was right. We stopped the medicine.

Fast forward about 5 years.  This same child is now being sent to school outside the home for the first time, without any medication.  He’s a bit nervous.  We’re a bit nervous.  After a few days of school, he walks into the house and without saying a word takes a sheet of paper out of his book bag, adds a piece of scotch tape from the kitchen drawer to it and attaches the paper to the knob of the door he just walked through.  It turns out that the sheet of paper was a form all the kids had to have signed by their parents and was due the next day.  He knew his limits and, without having to be told, he devised this strategy to avoid forgetting this important assignment.

As parents – we make the best decisions we can for our children, and we practitioners do the same for our patients and our own children.  We thought starting our son on medication was the right thing to do and we reversed course as soon as we recognized we were wrong. That may not be every parent’s  experience; but it was ours. Wise parents consider input from multiple sources and make adjustments as necessary.  Apparently…so do our kids.

Visit this link at the College website for tips on helping the inattentive child.

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It’s All Good

Long ago, in a kingdom far away, there lived a kindly king and his prime minister. Whenever news of any sort was presented to the prime minister he would always say, “It is for the best, it was meant to happen that way.” The king didn’t object to this characterization as the kingdom was doing well.

thumbOne day the king, on an accident, amputated his thumb. News of this was brought to the prime minister who responded as he always does and said, “It is for the best, it was meant to happen that way.” The king was outraged when he heard of the prime minister’s pronouncement and ordered the prime minister thrown into the dungeon. This was done promptly and the prime minister remained in the dungeon until…

Many months later, the king decided to take two of his closest advisors and go hunting. As they pursued a deer, the group inadvertently strayed into the neighboring kingdom in which lived cannibals. They were captured. The cannibals had a ritual when preparing to eat. The “food” was placed alive over a pile of wood. A medicine man would then perform a ceremony “blessing” the “food” and would then set the wood on fire. He did this for both of the king’s advisors. When he came to the king, he stopped abruptly and said, “We can’t eat this food. He is missing a thumb and it is our practice to eat only complete humans, not humans who are missing thumbs or any other body part.” The medicine man ordered the king freed and it was done.

When the king returned to his kingdom, he immediately released the prime minister. He praised him for his wisdom regarding his amputated thumb. “But tell me,” he asked, “what was so good about your time spent in the dungeon?” The prime minister responded, “It is for the best, it was meant to happen that way. If I wasn’t in the dungeon, I would have been on the hunting trip and I have both thumbs.”

It is hard to be always cheerful and is unrealistic to always think, “It is for the best, it was meant to happen that way.” On the other hand, seeing things in a positive light and making the best of bad circumstances has been shown to increase health and well-being. So be of good cheer!

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Letting Go

learning to ride bikeWhen I was a four year old lad, I became very angry with my mother. I do not remember why I was mad but I was SO mad that I announced that I was going to run away from home.  Hearing this plan of mine, my mom said in a calm and loving way, “let me help you pack.” Man oh man, I was floored. I didn’t expect that response!

My mother’s suggestion that she would help me pack helped me grasp that I had choices. I could leave if I wanted to.  She knew that I wouldn’t have gotten far, she would not have let me out of her eye sight and she would not let me know that she was watching me – a very loving response to my anger. I chose to cancel my travel plans and have never regretted that decision.

One thing we parents must do is let go of our children. Her willingness to let me go in this instance and many more helped me grow into an independent, productive adult. I fell off of my bike many times while learning to ride it (she taught me how to ride a bike) and she let me decide if I was ready to try again that day or wait to try again another day.

So, let go of your children – gently and lovingly. Be there to pick them up after they fall or fail – it is in the falling and failing that they are likely to learn valuable lessons. And cheer them on when they succeed!

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Retail [Medical] Clinics

nurseA couple of [physician] colleagues recently vented about the proliferation of retail [medical] clinics.  Not only do they fragment patient care and decrease the ability to follow growth and development, they also are more likely to decrease the number of folks willing to become physicians.  Often these retail clinics are staffed by unsupervised mid-levels (non-physician health care professionals).  These clinics “skim off” treatment of the easy stuff  leaving the much more complex, time consuming and less profitable problems to actual physicians.  The problem is that with the retail clinics getting paid for the higher volume of minor illnesses, and with decreasing financial reward for taking care of the complex problems, who will want to become a physician anymore?   I think we should all contact our respective State medical boards to address this issue.   If they do not, the future of continuity of care looks dim.

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stress meterA friend gave me a book Fearfully and Wonderfully Made which contained essays by a Dr. Brand.  Dr. Brand worked with lepers and made a good argument for the benefit of pain to help protect us.  Certainly, too much pain is not a good thing but too little pain can lead to problems and disfigurement as in his patients with leprosy.  As much as I hate it, I have to admit that much of what I am I owe to anxiety.  Anxiety over possible failing grades was essential to force me to sit and study.  Even from a very young age, anxiety has played a part in my life.  Anxiety isn’t always a bad thing.

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Marriage: an Endangered Species?

marriage proposalMarriage is getting to be an endangered species.  If Pew polls are accurate, the institution is at an all-time low; not just in numbers (only about half of U.S. adults are married) but in enthusiasm (only a third of adults feel a successful marriage is one of the most important things in life).  That’s the bad news.

Is there any good news? I get excited while making rounds in the labor & delivery suite when I see a young man in the room, presumably the father of the newborn baby.  The fact is, however, most of these men are not actually married to the mother of the baby – and married couples raising children is superior to other arrangements; even those where the parents are living together and not married. I’m glad to see men like LeBron James stepping up to the plate and fulfilling their parental responsibilities.  It’s certainly better than what most men in such situations are doing.

Children deserve better, however.  Marriage is a level of commitment far beyond attending soccer games or PTA meetings.  My own marriage, for instance, is more than the legal agreement between my wife and me that we will share assets and responsibility for our children (though it does say that).  It’s even more than the public acknowledgment of love and support for the woman I fell in love with some 25 years ago.  It’s a statement TO OUR CHILDREN, perhaps the first and most important such statement, that demonstrates how life is about personal sacrifice and commitment, not material success.  That’s why divorce, serial monogamy, cohabitation and even polygamy are often so harmful to children.  If we teach our children the importance of putting others (specifically our spouse) first, they will learn to do likewise.  And THAT is worth more than all the pick-up games and birthday parties in the world.

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A man on “Top of the World” still struggles with why his dad left him!

James LeBronLeBron James, four-time NBA MVP, has not forgotten the gift of his mother Gloria who chose life and gave birth to him as a single mom at the age of 16 and raised him to be the man he is today. LeBron also sharing his still-hurting soul in an Instagram post remembering the father he never had: The man who chose to walk away and leave his mom and him to wade life’s challenges on their own.

Kudos to LeBron James and his mother Gloria for rising above their challenges and not making excuses. LeBron today takes his parenting responsibilities to heart. He is a devoted father in spite of the man who chose to walk away and not teach his son lessons in love.

Fathers and potential fathers everywhere: take note! Your presence is important and necessary. Children need a mother and a father. The wounds left behind when one or another is absent lay raw even years into adulthood.

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Belgium mapAh Belgium, the “home” of  Hercule Poirot, famous chocolate, the Walloons and the Flemish.  I remember as a student traveling to Brussels and enjoying the diversity of cultural experiences there (although, I avoided the famous red light district).  Now it saddens me to learn that the Belgium government has voted to include euthanasia in children with disabilities.  Euthanasia has been legal there for over a decade but limited to adults only until this recent vote.  I think this issue demonstrates that once you cheapen life, the slippery slope causes things to get worse over time.  When I visited as a student, I was already horrified to learn (second-hand) how the red-light district turns women into mere objects for salacious activities.  Then it was “okay “to kill adults.  Now it is “okay “to kill children with disabilities.  I cannot imagine where it can go from here.  In my experience, many of my disabled kids are very happy.  They may be limited but in their own little worlds, they are happy.  The problem is the other people that are uncomfortable seeing wheelchair bound and/or retarded kids.  It makes me wonder.  Do people support euthanasia because they think it is in the child’s benefit?  Or do they support euthanasia because of their own discomfort in seeing and dealing with these “non-perfect” kids?

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