Ignoring Is Bliss
This week in the world of pediatrics there seems to be a distinct theme: ignoring problems is the best way to make them to go away. I learned this as a child, when the piles of dirty clothes I left on my floor eventually simply disappeared, only to rematerialize later in my drawers clean and folded, as if by some miracle. As a medical student I found that something similar would happen to scraps of food I left around the house, except I could see when they would reappear because they were crawling.
As a parent and a pediatrician I have to stand in awe of anyone who would dedicate an academic career to the study of temper tantrums. I don’t know what you get paid to do that job, but I can guarantee it’s not enough! As it turns out, however, there are at least three authors willing to spend time in the exhaustive analysis of the sonic characteristics of tantrums. According to their findings, pediatricians are generally correct when we advise parents to ignore them. Tantrums, apparently, share a relatively predictable and consistent progression, beginning with the child expressing uncontrollable anger and ending with the parents demonstrating uncontrollable drinking. In the meantime come a series of stages that may only be prolonged by attempts to appease the child. In an interview for NPR, the author remarks that far from being annoyed by tantrums, he instead analyzes them for their common properties. While I suspect this strategy may help you stay calm with your own toddler, I’m not sure you should pull this same move on your spouse.
In a story that should either disappoint or embarrass pediatricians, Dr. Eliana Perrin and colleagues from UNC Medical School found that fewer than a quarter of parents of overweight children recall ever having been told by a doctor about their child’s condition. These results beg the obvious question: are pediatricians going blah-blah-blah about body mass index, diet, and exercise, and parents aren’t listening, or is it that doctors don’t have time for the whole blah-blah-blah thing so they conveniently “forget” to mention the part about little Johnny being, well, not so little. Sadly, the answer to this question has actually been studied, and it seems to be pretty evenly divided. Personally, I’m planning to jazz up my discussions of childhood overweight and obesity with parents using visual aids, compelling stories, and frequent random mentions of Lindsay Lohan. See, now you’re paying attention!
The biggest news of the week had to be when Kathleen Sibelius, Secretary of Health and Human Services, announced the administration had chosen to overrule the Food and Drug Administration’s recommendation to make Plan B contraceptives available to teens under age 17 over the counter. Since HHS has never before taken such an action, and since there appeared to be no sound medical rationale for the decision, some people are conjecturing this election-year decision was made for political reasons! The American Academy of Pediatrics went so far as to join the American College of Obstetricians and Gynecologists and the Society For Adolescent Health And Medicine in issuing a press release condemning the decision, although in this day of texting and tweeting a simple “Say wha?!” would probably have sufficed. But despite having no medical training, Secretary Sibelius has common sense, and she knows that teen pregnancy, like most problems, will go away if we just ignore it long enough.
David L. Hill, M.D, FAAP is vice president of Cape Fear Pediatrics in Wilmington, NC and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill's first book, Dad to Dad: Parenting Like A Pro will be available starting in April 2012 from AAP Publishing.