Rx For Parenting Today

Mental Illness and Guns

I do not understand why a rich nation like the United States cannot do something about the terrible, ongoing violence that we have been and are having.  One of my worst memories as a Stanford medical student was having to care for a boy in the  ER at the big county hospital. He  had been shot by a playmate. The resident and two of us who were medical students did everything we could to save the child's life, but he died. I will never forget that day. Why any parent would buy a gun for an 18 year old, as just happened, is beyond my understanding. I think we must hold parents like that responsible. The  Buffalo shooter also had 2 other guns. It was reported that the school recognized the youth has major  problems and did some kind of an examination. In my experience with school administrators they do not like to spend the money to have  full  examinations done  by a qualified  psychologist. I have fought with several of these individuals and usually had to find  the money to pay for an examination with grant money.

One teacher told me  her principal said she could just refer three troubled students a year, for examinations. That is hard to believe.

Sandy Hook, Parkland and other School Shootings

There was an excellent article by the attorney Joyce Vance in the New York Times on 2/13/22 about school shootings. It is particularly relevant today when we  heard  the news that the Sandy Hook families of the murdered 20 children won their law suit against Remington gun makers.

Joyce Vance's article stated that parents need to be held accountable for school shootings by a child of theirs.  Adam Lanza used one of the guns in his home to kill the Sandy Hook children and six teachers. His mother knew that he was  very disturbed and yet would take him target shooting. He was said to be also autistic but I have never seen any evidence that  Adam received help for his mental problems. I am glad that Remington had  to pay for pushing  the selling of the AR15s, but what about Adam's' mother?  The parents of Ethan  Crumbley, who killed four classmates in Michigan, knew he had mental problems but also did not get help for him.  Neither did  the school authorities insist he receive help. So not only are the gun makers responsible for these killings. but  so too are  the school personnel and the parents.

Several teachers have told  they were instructed to  report only 3 or 4 problem children a year with problems. Some teachers defy this but are at risk of losing their jobs. So as parents, doctors, and concerned individuals we all must speak up about all the guns in circulation and  fight hard against  gun makers and the gun groups.

Parenting and the Virus

It is amazing and painful to me that many parents will not get the vaccination  against the virus for their children when they are eligible. 700 plus children have already died and more sadly will. Religious scholars say there is nothing in any religion that prevents vaccination. If you have had to see children die as I  have from awful genetic diseases you would be first in line with your child as a parent.

I was certainly glad that Drs. Salk and Sabin had perfected the polio vaccine when my children were born. I was an interne when there was the polio epidemic and watching  children become paralyzed or die was terrible. Not only do children now end up in the hospital with the virus but they also infect others. It makes no sense not to get the vaccine.  If I had a parent when I was in practice that would not get a vaccine I would send a registered letter and ask them to find another pediatrician. Fortunately, that never happened. So please ALL parents get the vaccine when your children are eligible.

 

Pediatric Care in the U.S.

I am often amazed at what parents tell me about the  pediatric care their children are receiving or not receiving in the U.S. One mother told me  her daughter's pediatrician had never looked below the child's waist. I was appalled. I have found many abnormal things by doing a complete physical exam once a year on kids. 

When I ask parents if yearly urinalysis are done, the answer is usually "no".  Every child, even little ones, should have a yearly urinalysis done. I have been amazed at the many problems I  have found by doing this. One teenager was not feeling well when I examined her, but I was unable to find anything wrong. I did check a urine, but it was O.K. I asked the girl's mother to bring her daughter back the next day.  Once again, there was nothing specific I could find wrong. I asked for another urine and the mother said, "but you did one yesterday." I told  her I would not charge for doing it, but did want another urine. The girl brought back a urine specimen that was brown. I knew immediately she had pyelonephritis. This can be extremely dangerous and I started her on antibiotics. The mother was very grateful and subsequently referred many other kids to me.  I saw the teenager many years later in San Francisco when I was doing a book signing and was delighted that she looked so happy and healthy. So parents please insist  a yearly urinalysis be checked on your children. A lot of problems could be found and helped.

Teenagers and Social Media

It is hard to watch the news and hear statistics about teens, who because they are active on social media,  may do harm to themselves. It  got me to thinking about what I would do if I was the parent of a teenager. I would certainly find a lot of fun activities the kids could become involved in, jobs they could do, or ways they could volunteer to help others. What are parents thinking if they allow a teen to spend hours on a computer being involved on social media sites? Don't parents have any  control of what their kids are doing these days? What about chores, helping around the house? Do teens these days learn to cook, sew, knit, iron, have music or art lessons, or have homework to do? I started working when I was 12 and later on worked as a waitress after school and on weekends. Money was tight for us as a family, even though my father was a college professor. 

Both of my children had sports activities and music lessons, and my son became very involved in theater.  My daughter volunteered at a school for children of  low income parents.  Then  later, after college she started a  program in San Francisco to help kids with disabilities find jobs and my son became a physician. If you are going to  be a parent, it is a hard job, but very rewarding if you take the job seriously. Are parents too involved with their social life, their jobs, shopping, or themselves? Something is very wrong if a child thinks suicide or hurting himself or herself is the answer. One of the reason I sold my much loved pediatric practice was  either I was going to  have to adopt some of the children who were in such pain or  open an orphanage.  

Raising Children with Manners and Morals

It must be hard to raise a child today with both good manners and good morals. With all the anger, division, and craziness in the world today, what can parents do? I think the answer is to go back to the basics of good  parenting. Children want and need to know their parents are in charge. Parents are also role models for their children. If you cheat, are unkind to people, and think money is the more important than anything else, how do your children know what is right?

I have seen all kinds of parents as a pediatrician. Some were wonderful parents, some were terrible parents, and some were essentially absent parents. When a child is raised by a nanny, a grandparent, or someone else, how do they know how to parent when they have children of their own? Some parents today just want to be friends with their children and are afraid if they ever say "No" that their child or children will not love them. I do not know where that concept came from or when it started, but it is just plain wrong. Children have much more respect for a parent who is in charge and from whom they can learn both good morals and good manners. It is a lucky child who has this kind of parent.

Children and the Pandemic

Children are becoming ill and far too many (450) are dying from the virus. Are they being exposed by family members, friends or teachers? Now 29% of the Covid cases are children. I do not understand how any adult could be so SELFISH as to say they will not get the vaccine. Tucker Carlson and his counterparts are certainly responsible for much misinformation. It is hard to believe that Tucker Carlson grew up in the same  small community where I now live and went to Country Day where my children went. Does he just care about the money he makes and the power he has? That is selfish and completely wrong. Of course, he and his family have had the vaccine. 

I am so very glad that I don't have school-age children. No, I would not send a child to school unless I could be assured that every adult and all the children age 12 and up had been vaccinated. If I were a school board member or a Principal or in charge of several schools I would mandate that everyone be vaccinated. That should not be a choice. I wish pediatricians and family doctors would be more out-spoken about the need for everyone to be vaccinated. I have not seen that. Nor have I seen anything from the AMA or other large medical groups about the importance of vaccinations.  

 

Hospitalizations for Children

As more and more children are being admitted to hospitals for the Covid 19 virus, parents and relatives need to be very sure  a child is getting the best possible care. This is a difficult time with doctors and nurses and other personnel tired and being pushed hard to care for all the patients. I do not understand why any adult would not have the vaccine. That is selfish and can cause a relative, friend or child to die. 

If I had a child admitted to a hospital I would want a parent or relative to be by the child's bed at all times. There is a lot that can go wrong and a child will be frightened and lonely. I am not sure a special, much loved stuffed animal will be allowed, but I would ask. There may be restrictions about parents not being allowed to be near a child, but if they have been vaccinated and wear a mask they should be allowed to be by their child's bedside. Parents and relatives can take shifts, so there is always a familiar face for a child to see. It is also important that parents take care of themselves during these difficult times, particularly if  a child is hospitalized.

In general you would want the child's doctor to talk to you each day, but these are difficult times, so I am not sure that will always be possible. It is important to get to know the nursing staff and call them by name. They work hard and a good nurse is worth his or her weight in gold. 

Checking that your insurance covers the hospitalization is important and after a child is hopefully discharged, you need to check the bill very carefully. Lots of mistakes can be made.

 

Choosing Health Care

I am always amazed at how even people with advanced degrees don't seem to be able to find good health care and settle for care that is not only bad, but could be dangerous. When children are involved that is even a greater concern. The man who was instrumental in starting the concept of HMOs finally admitted  it was a very bad idea when he himself had care from an HMO.

A friend asked me to check on a doctor she was to see for severe back pain. Not only had he gone to a poor medical school, but he was not even an orthopedist with training in back problems. Before I would see any doctor whether it is for yourself, a family member, or a child, I would look on the Internet and check his or her training, how long the doctor had been in practice, comments about the doctor and if he or she has been in practice for more than a few years.  You also want to be sure the doctor is board-certified in his or her particular specialty.  I am sure there are good young doctors, but I would only go to a doctor who has been practicing for a while and also has had good training. 

If you decide to use an HMO, be aware that there are many restrictions, Also, they use many nurse practitioners who do not have MDs supervising them. They may also have restrictions on what specialists can be seen, conditions that are excluded and  out of state emergencies not covered.

Before you sign anything, read the fine print very carefully. It could save your life or that of a family member. 

 

Do Your Kids Have Chores?

I am finding that more and more kids these days have no chores or allowances and use their parents as ATM machines. I always asked about chores when I did a complete physical examination and was usually pleased at what I was told. Now  kids tell me they are not given chores or an allowance, but just get money as they request it. How are children going to learn about doing various jobs or the value of money if they expect to always be given what they ask for? Something has changed, as so many parents want to be friends and not parents. I think both boys and girls need learn how to cook, iron, clean, do jobs around the house and be able to take care of themselves. 

I do not support wiping out all student debts, because how many of the students in debt did anything to earn money for college? I know a former medical school professor who came from a very poor family and worked 40 hours a week all through medical school. I have always wondered how he did that. I worked summers and waited tables during my years at Stanford. That was hard because the affluent girls looked down on those of us who were waiting table. However the group of hashers, as we were called, turned out well unlike many of the students we had to wait on. 

If a child has a disability, there are usually jobs they can do. One teenager with cerebral palsy was severely disabled but he was a  great source for dates, telephone numbers and other information. It gave him an important role in the family. One favorite youth with Duchenne muscular dystrophy was required by his mother to do the same chores his brother did. He was a remarkable boy and never felt sorry for himself. He had many friends and always looked out for others.

I give lists of possible chores by age in each of my parenting books. I always kept a chore chart on the kitchen bulletin board where my two children checked off the chores they had completed, so they could be eligible for their allowances.