In watching the violence at the Capital on the sixth, I wondered about the participants who joined the violent mob. I remembered two patients I had seen and knew violence and out of control behavior can begin early in life. One particular patient I thought about was a small boy who was new to me. I am not sure how his mother got him to my office or who referred him. The child was almost dragged into my examining room and immediately started pushing the music boxes that were on a low shelf on to the floor. His mother was desperate and said "Do what ever you have to, I can 't control him any more." I had read somewhere that if you have a patient like this, control can be obtained by getting the child onto the floor and literally sitting on him or her. So that is what I did. If he had been a big child, I would not been able to control him. I talked very quietly to the child and the boy soon calmed down. Thus I was able to get some history from the mother and also to ask my secretary to call an ambulance, the police, and my favorite child psychiatrist at at St. Mary's Hospital. Sadly, his special unit was closed several years ago. Now the pediatric patients have to go to UC San Francisco Medical Center. I don't remember being when told the child started becoming violent. Usually, you can pick up problems early on if you take a good history and do a good physical examination. The child's severe problems should have been addressed and treated long before I saw him. Unfortunately, the five to ten minute examinations now dictated in some HMOs do not allow a child like this to get adequate care. If any parent reading this has concerns about their child, an appointment with a good child psychologist or psychiatrist is the place to start. Any delay can make the condition worse and a child's life and the life of others may be affected.