Adolescent Medicine
signout | September 1, 2008You heard it here first: John McCain got Sarah Palin's daughter pregnant.
You think I'm kidding?
John McCain has repeatedly voted against legislation that would have prevented unwanted pregnancy by providing insurance coverage for birth control, programs to increase access to and awareness of emergency contraception, and biologically-based sex education.
He has repeatedly voted in support of abstinence-only sex-education programs, which don't work to prevent teen pregnancy. He also voted against laws requiring that they be vetted as medically accurate before being used.
He voted to earmark…
signout | June 18, 2007The other night, we had three trauma cases come into the pediatric emergency department, almost at the same time. The first to arrive was a boy who'd collapsed and stopped breathing after being hit in the head with a ball during his prep school's baseball practice. Then, in quick succession, came two 14-year old boys who had been shot while visiting a great-aunt. One had been hit in the arm, and one in the neck.
I was in charge of the airway of the kid who'd been shot in the arm. Trembling in his neck collar, blood oozing slowly out of the bullet wound, he eyed the IV catheter a nurse was…
signout | June 6, 2007The chief complaint listed next to her name was, "wants to know if she is pregnant." At first, it didn't seem like she wanted to know that badly--she barely looked up from her cell phone when I walked into the room for the first time. She answered questions the way fifteen-year-olds often do--briefly--and held out one skinny hand for the urine sample cup without turning her eyes away from the keypad of her phone.
I imagined the exchange:
"@ drs ofc 2 chk f nokd up"
"wnt 2 mt l8r @ mall 2 mk sum bad choicz?"
"abt fashn or sex?"
"both!!!!!"
"OK, f my boyfrnd cn come"
She looked up the second…
signout | January 3, 2007For several weeks in December, I worked with an adolescent medicine doctor who was like magic. Watching him massage our spectacularly manipulative patients into compliance was like watching someone fit a greased elephant into a cigar box. His motto was, as he told me repeatedly, "Every behavior that persists is being rewarded on some level."
We had a patient for a time, an 11-year old girl I'll call Precious. Precious had previously been diagnosed with lupus, a chronic and very real illness, but had been admitted this time for abdominal pain. Shortly after her admission (and her extensive…
signout | December 15, 2006I just started a rotation on the adolescent wards, and about half of our patients have eating disorders. They are all girls, and they range in age from 12 to 17 years old.
Every day, they have group therapy meetings in the recreation room at about noon. They file by our work area in flannel pants and pony tails, wearing shirts from cross-country teams and field hockey teams and basketball teams, slapping their slippers on the floor. They are all somewhere between 60 and 80% of their ideal body weight for height.
As they walk by, I think to myself, "Man, they are so pretty." And I am not proud…
signout | October 24, 2006These days, I snicker a little when I hear doctors say it's a privilege to take care of people. If it's a privilege to submit to this shitty schedule, that crazy attending, and those revolting bagels, I sneer, I don't want to know about the punishment. But in clinic the other day, I actually understood what they meant. All it took was a fat kid.
She was 13 years old and quiet in a sweet kind of way, and she weighed 250 pounds. "I've been fat all my life," she said, "and I just want to lose weight." On the parental questionnaire, her mother had written only, "I am concerned about my daughter's…
signout | July 20, 2006This is why people who don't know science shouldn't write about it as if they do. I don't care how much she's "mulled it over"-the author of the recent New York Times opinion piece about compulsory vaccination of girls with the vaccine against HPV makes some dangerous assertions here based on totally unscientific thinking and some seriously lame perspective.
And if this lady is SERIOUSLY going to suggest that in the face of other preventive options, we choose to rely on the often-imperfectly-used condom for prevention of STD's, especially among adolescents whose access to them is determined…