Wednesday, September 29, 2010

Head Bonks - don't laugh

If you hang out with enough former football players, you've probably heard them talk about having gotten their "bells rung" at least once.  Fortunately, at this point, most people take head injuries more seriously, leading to the current policy on head injuries in the NFL.  Unfortunately, too few people really understand concussions.

The following short list encompasses the answers I get when I ask adults and kids "What do you think a concussion is?"

  • "It's when the brain smacks into the inside of the skull and gets bounced around and bruised."
  • "When you get knocked out."
  • "It's when you get hit in the head."
The first explanation is really what happens in a coup-contrecoup injury, and represents a more serious head injury; most head injuries don't feature this problem, fortunately.  The second and 3rd quotes are partial truths, and are part of the reason people, including doctors, miss concussions.

For definition purposes, a concussion occurs when a person sustains a significant impact, and then, essentially, feels funny.  Bonk/crunch ---> feel funny.  The impact can involve the head, or it can merely be a strong enough jolt to cause a snapping motion of the neck - back, forward, to the side, whatever.  The "feeling funny" refers to what doctors would call a change in mental status, and the following is a partial list of those symptoms:

  • loss of consciousness
  • blurry vision
  • feeling foggy
  • memory loss
  • dizziness
  • being off-balance
  • speech issues
  • discoordination
I have seen a lot of concussions, and here's (yet another) list of how they happened:
  • Kid boarded during a hockey game
  • Gymnast fell off uneven bars and landed on her backside but had her neck "bounce" hard
  • Any number of football collisions
  • Lacrosse cross-checking injury
  • Child shoved hard by another child
  • Kickball to the face
  • Teen in a rush, hit side of head against door frame of car
  • Home plate collision
  • Fastball to the (helmeted) head
  • Car accident with whiplash only.
Why are concussions so bad?  Instead of calling them concussions, let's call them "traumatic brain injuries," since that what these are - brain injuries.  I think most of us would agree that injuring your brain is bad, but how bad is it?  People with concussions and the dreaded post-concussion syndrome can suffer long-term or even permanent damage to vital brain functions like attention, judgement, balance, memory, and emotional control. 

Furthermore, some people have sleep problems, chronic headaches, and fatigue, chronic or not.  Some people even appear to suffer from ADHD/ADD-like or depression.  Google enough, and you'll see that former athletes have committed suicide after suffering from these issues.  Kids especially seem to be vulnerable to something called "second impact syndrome," which can result in either severe neurological damage or death when a person who already had a concussion suffers a similar injury before the original injury resolves.

Deep breath.

What can you do?  Read up on it; here are some good websites:
Most importantly, if your children sustain big bonks and are acting funny, take them out of the game or situation and watch them carefully.  Call your doctor if you're concerned.  Have them checked out as soon as you can, in the ER right then if you're worried.  You don't need a CT scan or MRI, but you do need a good doctor who will listen to you and your concerns.

If you're really motivated, move for your town or school system to institute concussion education programs and make sure that your coaches, from youth sports all the way to high school sports, are aware of what traumatic brain injuries are.  Push for your school to have certified athletic trainers at every game.  Hopefully, with enough awareness, I won't hear the following after I advise parents to pull their kids from sports until they're feeling better...

"Yeah, doc, I hear you...you're trying to cover your butt, and I get that, but I had my bell rung a few times when I played football, and I'm just fine..."

Tuesday, September 21, 2010

Soccer

I coach my daughter's U6 soccer team.  The kids named us Orange Juice, because we have orange shirts.  We almost called ourselves the Orange Hats, but the funnier Orange Juice voted down Orange Hats by a vote total of 7 to 4. 

To feel my role as coach, imagine herding a bunch of insane leprechauns trying either to get the same pot of gold or to throw pulled-up grass at each other.  That pretty much describes it.  True enough, there are a number of 5 year-olds that grasp the concept of "small touches" on the ball to keep the ball in front of them, and there are even some kids who understand that getting in front of someone slows that person down.  The rest of the kids just run around and behave like 5 year-olds. 

The other day, I saw a parent on the sideline.  I already knew 5 of the families from last season; this parent is not one of the veterans of Orange Juice.  I asked her how her son was enjoying the U6 experience.  She replied that he loved it, but that she was trying to get him to be on the ball more.  I told her that he was doing great, if only because he's having fun.  It also happens to be true that he might be the best soccer player on our team, but that's not really all that important.

There's a part of all of us that wants our kids to do well at everything they do.  We want our kids to try hard; we know that practice makes better, if not perfect.  For kids, though, there are no failed athletic stints or knowledge of past semi-serious efforts that might have borne athletic scholarship fruit "if only."  For many kids, especially younger kids, trying hard means doing well.  Further, the goal is to have fun - why else would one play a sport or do anything, really?  Boring sucks.

If we can remove ourselves from the equation, and just let our kids have fun, the whole experience becomes better.  There is no "parents versus child" dynamic, no struggle for control.  The kids participate at the level they're at, and as long as no one is hitting anyone else with a baseball bat, or flicking snot at anyone else, everything is fine.

Last season, a parent walked up to my wife and told her that her daughter was having a great time with soccer.  During the game, her daughter, a child with some special needs, had run very hard to where the other kids were clustered around the ball, and started jumping up and down.  We coaches yelled, "Great job, Melinda!  Nice run!"  Her mother, apparently, had been about to say, "Melinda, kick the ball!  Don't just stand there!"  However, she realized that her daughter's goal is to run hard and jump up and down.

Should high school athletes have a similar goal?  Clearly, the answer is no.  How about 10 year-olds?  8 year-olds?  I think how you address practice and game habits depends on your children's interests, but always cheer them on.  If they feel bad about what they do, it won't matter if they're PelĂ© or if they like peeling oranges.  They'll quit.

Wednesday, August 11, 2010

Media problem, part I

The days of Frogger and Peter, Paul, and Mary have past.  We live in the time of Grand Theft Auto and Lady Gaga.  Are you really sure what your kids are doing?

The American Academy of Pediatrics recommends that total screen time for children per day not exceed 2 hours - and that less is just fine.  That means less than 2 hrs of web surfing, gaming of any kid, TV, movies, texting, whatever.  Our kids don't really see the point; after all, everyone's doing it (which is, of course, a familiar line of reasoning behind lots of things kids shouldn't be doing, including smoking pot).  What is the point?

Well, it probably starts like it does with many of us.  You're at home, you have a baby, maybe 14 months old, and you're trying to get "something" done.  Baby Huey doesn't appreciate your divided attention, and protests vehemently...so you stick him in front of a "Baby Einstein" video (which, by the way, does NOT in fact make your child any smarter than he was picking his nose...but that's another post entirely).

After a while, Huey doesn't like Baby Einstein anymore, so "educational TV," then Sprout/Noggin/Nick Jr...iCarly...Hannah Montana...Spongebob Potatopants...and then who knows what.  Eventually Huey has a playdate with a friend who has Leapfrog.  Huey can't get enough of that, and the Leapfrog eventually morphs into a Nintendo DS, an XBox360, a World of Warcraft or Starcraft II account, and hours upon hours of homework not done and class A attitude problem.

If the time spent gaming or watching TV doesn't warp your kids, the material very well might.  Grand Theft Auto has scenes where sex with a prostitute is highly suggested, and its cousin Manhunt 2 allows you to slit throats with glass and beat heads in with toilet seats.  A vile game called VTech Rampage allows someone to re-enact the multiple murders from the tragic Virginia Tech  scene in 2007.  In World of Warcraft, complete strangers can strip down to their underwear and rub their "toon" against yours, all while make lewd comments and gestures.  Even Facebook games like Mafia Wars are questionable; in MW, you regularly kill and rob others to get ahead in the game, and possess the ability to harass other players day in and day out.  Further, because it's a Facebook game, MW allows bullies access (potentially) to a victim's facebook page for some real life harassing.

Mind you, I have had innumerable conversations with families about this issue, so I have heard every response.  For the most part, people are surprised by my description of media, think that it wasn't a problem for them, so why should it be a problem for their kids, or just plain don't want to deal with the hassle of having the discussion.  These discussions remind me of some families' answers to smoking pot.  "I did it, I'm fine, so is he."

For both media and smoking pot, that might even be true.  Lots of people play video games or watch TV and are just fine.  Then again, the TV-watching/video game kid might play/text/watch for a good part of the day, tank school, and develop a serious behavioral issue that makes the idea of separate schooling attractive, just like the recreational pot smoker either decides that he doesn't give a crap about school, or goes on to experiment with coke, heroin, or even everyone's favorite cooking fuel, propane.

We all impose limits on our kids, from bedtimes to mealtime behaviors to amount of treats in a week.  Electronic media is no different.  Eating until you're completely stuffed, day in and day out, leads to being overweight, and there's an electronic media equivalent.  Knowing what the game or show is before you allow it, and then discussing how much is ok, is the best way to protect your children.

Wednesday, July 28, 2010

Grateful

I have heard some parents, from time to time, scratching their heads, asking, "Now why did I spend all this time with these little ingrates, since they're now destroying my house and flinging back-talk at me?"  Knowing our kids, we all know that they'd rather play, yell, pound things, crack pots together, and generally re-enact "Lord of the Flies" rather than do anything we'd prefer.  We also know that hunger, fatigue, and lack of entertainment make for grouchy kids, but sometimes it's difficult for us to handle the grouchiness if it follows a special activity, or if the kids seem oblivious to the idea that we JUST spent a lot of energy to make sure they had a good time at the (fill in the blank).

I was surprised to learn that my family shares some strategies to control un-grateful behavior with others.  I guess parent strategies are like key concepts in different cultures of the world, like the idea of the parallel evolution of "The Trickster" or "Mother Earth," or a Supreme Being in different cultures despite lack of contact between those cultures.  Here are our parent gambits for the thankless moments:

  1. Outlawing all conjugations of bore - boring, bored, boredom, bore-fest, bored-to-death, bore-o-rama, bored-to-the-google-squared-power.  Kids should not be bored (unless they are placed in a plain white padded room with no toys).  However, we do allow for the use of the word "bore" in the sense of  "you're boring a hole in my head with that whining - could you ask me in a different way?"
  2. Creating a grateful session after dinner, and on Fridays when we light candles we say what we're thankful for.  We encourage the kids to name 3 things.  The baby is exempted.
  3. "I'm sorry, I don't think I heard that question without the nice word at the end of the sentence."
  4. "I definitely didn't hear THAT question with the tone of voice you used."
The kids were a little reluctant to do it at first; they weren't sure what to say.  Considering our kids' ages, giving them (especially Claire) some ideas to start.  We've heard some heart-warming gratefuls:

  • I'm grateful for my family.
  • I'm grateful that Charlotte is feeling better.
  • I'm grateful we got to see our family this weekend.
  • I'm grateful for my friend.
We also heard some serious "gratefuls":

  • I'm grateful that our family isn't sick.
  • I'm grateful none of us have died.
  • I'm grateful that we have food and that we're not poor.
  • I'm grateful that Daddy's knee got better.
Some flittish "gratefuls" have made the list, too:

  • I'm grateful that we had pizza today.
  • I'm grateful we got to have dessert today, not like yesterday when we didn't get dessert.
  • I'm grateful for ice cream!
It seems like the kids, at times, really think about things.  We sometimes have to cue them; Claire is, after all, only 5.  I believe that practicing anything makes one better at that thing, and good manners and humility and grateful-ness are no exception.

    Wednesday, July 7, 2010

    No fear

    For those of you following this blog, you'll recognize Claire.  She's the goofball on the right, catapulting water into the air for the love of wetness.


    Claire is the "See It, Do It" kid.  Many of you have kids like Claire.  They are frustrating for their fearlessness, and fabulous for their fearlessness.  She's the kid trying to get up from the table with an overloaded paintbrush, carrying the cup of dirty paint-water in her teeth while trying to step over Corinne...



    ...AND trying to pick up the Shiny Thing on the floor.  However, she's also the kid who marches over to the girl at Sesame Place with the same bathing suit as her, and chats up her entire family, asking them where they're from, what food they're eating, and if the girl wants to come over for a playdate, all while interjecting the Spanish she knows into the Spanish she hears them speaking.

    After observing her chatting with this family the other day, I joined her.  I joined in part because I recognized my own (?usual) reluctance to venture outside of my comfort zone, and in part because I wanted to make sure that that family didn't need rescuing, and in part because the conversation looked...fun?  Yes, as a result of Claire's mingling, we met some new people and had a warm moment in our day, and, from the smiles on their faces at the plucky Claire, probably gave them a warm moment, too.

    In a similar vein...I recently read "Born to Run," a truly excellent book about ultrarunning, running itself, "Well, you don't know me very well, now do ya?" and humanity.  I was struck at how Scott Jurek, perhaps THE premier ultrarunner of our generation, sits and waits for the last racers to cross the finish line during each of his day-long races.  Why?  Jurek relishes human connection and the need to help other to feel connected, despite having run 50-100 miles much faster than the stragglers ever could.

    Mixed in with my thoughts on Claire and Jurek are some recently discovered feelings of mine on charitable works.  Enmeshed as we are in the raising of 3 young kids, we struggle to get out as much as we'd like to participate in acts of philanthropy (the acts more so than the giving of money).  However, when we do,  I am struck by how good it feels, and how connected we feel to our world afterwards.

    I understand that we're all different, and that branching out is more challenging to some of us, yet watching Claire and Charlotte (who joined Claire in guerilla good-naturedness the other day, and was nearly as chatty as she) with that family reminded me that while we are our kids' best teachers, the sensei should also learn from the student.

    Friday, July 2, 2010

    Every Nook and Cranny

    Try hiding presents for birthdays, Christmas, whatever, in your house with kids over 4.  Unless those gifts are behind locked doors, in an attic, or guarded by the soldiers from the Tomb of the Unknown Soldier, those sharp eyes and prying hands will find what you’ve buried.  Like mice to a solitary crumb behind the sofa, they have uncanny radar for what is hidden.  

    Why is that?  There are a few reasons.  The first is that kids have nothing better to do than investigate every square inch of your house, especially if you’ve been able to teach them to amuse themselves.  If you’ve ever lost something, ask your 8-year-old:  she knows where it is.  Another reason is that because of this intimate knowledge of their den, kids recognize any change in their environment, like an expert hunter noticing a single disturbed blade of grass, a Jedi appreciating a disturbance in the Force, or akin to the way old cartoons would show a background scene with one brighter colored toon (which you could be sure was the object about to move). Finally, they can just tell when you’re not telling them the truth.

    There’s a good reason for that.  Famous neurologist Oliver Sacks, in his excellent book "The Man Who Mistook His Wife for a Hat" has a chapter on aphasia (defined as the inability to use or understand language).  In a certain institution where some of these patients lived, they were observed laughing at Ronald Reagan addressing the nation, and they were taken with how nonsensical his expressions were.  They could tell that he was lying or making no sense, unburdened as they were with the need to make sense of innuendos or subtle meanings…and could tell that he, like many politicians, had another agenda, and was somewhat full of crap because his gestures did not make sense.

    Kids might have the same reaction.  Part of socialization, part of growing up, is acclimating oneself to culture and societal expectations.  Understanding that tantrums in stores are unacceptable, that adjusting your underwear in public looks funny, that talking about your uncle getting married to his girlfriend in front of the girlfriend (especially if there are no public plans to do so...yet) creates an awkward moment, and that saying that coloring within the lines is “easy” when your little sister has just scaled Mt. Everest to do so makes your little sister feel bad....are all part of enculturation.

    Hence, children are good at seeing when your "words" are off, and when your words do not match the feeling beneath them.  We throw our words at kids every day, and they know your words like they know their house.  For example, you might not have to say that Uncle Charlie has pancreatic cancer (a miserable cancer with very low survival rate), but don't tell them he's fine.  They either know it because he looks awful or they know it because your words sound wrong to them.  Tell them he's sick and needs to see a lot of doctors, and that you're worried.  Older kids can take more - younger kids don't need to know any more than that.

    Just as you must take care hiding that special present, be careful to tell your kids the truth, or at least a version of the truth.

    Tuesday, June 29, 2010

    A village is never wrong?

    Checkup with a father present?  Automatically, a list of "things to talk to the pediatrician about" pops out.  Why? Because we Dads, if asked, "how are things going with Johnny?" will answer, "Oh, not much.  He's a good kid.  So, what...do you have to check him out or something?"

    It's not our fault - the Y chromosome is an X with a leg chopped off.  In essence, we could very well be lacking genetic material, stuff that might code for, I don't know, focusing for long enough to remember something...anything?

    Switch over to the playground.  One might see a child climbing along the outside of the playground structure, 5 feet up.  If Dad's watching (or...rather...not paying attention at all...), he might look at the child and pause for a second, but then looks around for his other child (you know, the one he hasn't seen for a few minutes?).  If Mom's watching, it's certainly possible that she runs over and grabs the child off the structure, telling him it's too high.

    I realize I'm painting with a broad stroke, and certainly, there are exceptions, but there's often a relatively laissez-faire parents and a planner, and though it often falls along the gender lines I created, it can be reversed.  Furthermore, I realize I am omitting single parents and alternate family situations.  The point is, in typical situations, parents tend to complement each other, and the child benefits from that dialogue.  One might say too high, the other says try it.  One blows things off, the other gets the rash checked out.  One says, "why can't she act her age?" while the other says, "She is acing her age."  Dad says, "Oh let him do it, what's the big deal?" and Mom says, "Once he starts, he'll think he can always do it."

    Beth and I have a rule (that, now that we've been married for almost 12 years, we seem never to need to invoke anymore).  In the Beth and Brian rulebook, it reads:

    "Whensoever a conflict between Beth and Brian shall arise, be it in the realm of child-rearing (a term that always made me snicker a bit), interior decoration, vacation planning, or ice cream flavor choice, the choice shall be determined by rational discussion, but is shifted away from a possible choice if either person really hates that choice."

    Worked like a charm.  Beth used to ask me about curtains, furniture color, whatever, and while I usually had an opinion, usually the opinion was, "I don't really care," a phrase that tattoos me XY.  However, every now and then I completely hated one choice.  Decision made.

    A famous Islamic passage states that "My community will never agree on an error."  So...make sure that you're listening to your spouse, since it's somewhat possible that the cautious mother, the doofy father, the detail-oriented father, or the absent-minded mother just might have the opinion that helps the 2 of you guide your child in exactly the right way.  Along the way, mutual spousal respect might also evolve.

    Monday, June 28, 2010

    Decorations

    1. Princesses lined up side by side on our screen door push-bar.
    2. Shed door with scrawled happy faces.
    3. 10,000 random pieces of paper with slides, monkey bars, playgrounds, and other themes-du-jour.
    My kids decorate my life.  I cannot help but collide with this evidence of their presence, in addition to the accumulated clutter of toys, crayons, and books in any room in our house.  I sometimes think ahead to a time when they direct their creative energies elsewhere, on friends, clothes, and activities, and in advance, I miss this stage of my girls.

    Fortunately, exam table paper wads, colored children's books, stickers on walls, and self-portraits trick out my patient rooms, so, on some level, I will always have pixies in my life who seek to color my world, even if that's not their intent.  However, there's something extra special about my own kids' masterpieces that I know I will miss.  I must remember to treasure the red pen on my screwdriver, or the blotted marker on my sheets (from a Sharpie Picasso with nothing behind it), because someday my things will be boring and plain, with no guerrilla artistes performing their flit-by fancifications.

    It's the whimsicality of it all that gets me.  Junk mail might sport a smiley face.  Used post-it notes (sometimes with important stuff on them) might have Horse,Version 4.023, galloping across the bottom edge.  Claire once saw Charlotte draw a playground slide, so half over her drawings have stick kids (with curly hair) on swervy lines with swervy handles, sometimes with grass and a sun.  The colors don't have to be real-world - no, whatever pink highlighter or rainbow pencil that's available will do the trick.  And both of the kids went through an R-rated stage where the centrally located, twin circular representations of the shoulders of their drawing-world-girls' dresses looked a lot like Charlotte and Claire were attempting to depict anatomically correct females.

    The cut-things-up-into-tiny-pieces phase that I know I should regard as mastery of fine motor skills instead stands out as the Vacuum Cleaner Period for me.  The experimental, load-as-much-water-colors-on-one-piece-of-paper stage?  AKA Stained Place Mat Period.  I especially love that period, since Claire also loved coloring her hands in the brown-purple waste water in which she had been dipping her paintbrush.

    So we can't have nice things - and I am ok with that.  Plastic-covered expensive sofas and fancy dining room sets might look too sterile in our house.  Our table is a relic from Beth's great aunt, and it's great for its abilities to take a beating, to fold out into double its size (though Claire bemoans her uncanny ability to be found at a table leg), and to collect oatmeal in its folded-up state.  Once there, the oatmeal hardens into a compound that is not only breakable by nothing short of the Jaws of Life but also being utilized by NASA as a panacea for all things broken outside the space shuttle.  The chairs have interesting swirly patterns where tiny fingers have picked off the finish (and then flicked the pieces on the floor, where they join the party started by oatmeal, breadcrumbs, cereal, and whatever else got the invitation).


    Now I'd like to go for a run, but not before I remove 3 princesses, a dog, a cheetah and 3 super balls from my sneakers.

    Thursday, June 24, 2010

    Bravado

    During my college days, my roommate was a huge Rush fan.  I get that liking Rush dates me in a certain way, but that's me.  Neil Peart is a machine, Geddy Lee has a tenor range through the stratosphere, and their songwriting is outstanding.  In any case, this morning I pulled out the "Roll the Bones" CD (no, I haven't converted all of my CDs to digital, I hate FM tuners, and won't spend the green to upgrade my car radio).

    Bravado came up, one of my favorites; here are the lyrics:

    If we burn our wings/Flying too close to the sun
    If the moment of glory/Is over before it's begun
    If the dream is won/Though everything is lost
    We will pay the price/But we will not count the cost

    When the dust has cleared/And victory denied
    A summit too lofty/River a little too wide
    If we keep our pride/Though paradise is lost
    We will pay the price/But we will not count the cost

    And if the music stops/ There's only the sound of the rain
    All the hope and glory/ All the sacrifice in vain
    And if love remains/ Though everything is lost
    We will pay the price/ But we will not count the cost.

    Why does this song ring relevant to me today?  What else is parenting, if not paying the price without counting the cost?  Of course, I doubt most of us look at the price, but let's examine.  You're a clueless 20-,30-,40-something with your bachelor-couple's lifestyle.  You go out when (and WHERE) you want, wake up when you want, vacation wherever, and deal with childish behavior only insofar as you or your friends and families manifest it.

    AFTER children?  Reverse everything - it's Opposite Day.  Up at 6 AM, eating at Friendly's, trekking to see the Lowell Spinners and missing the whole game so your kids can hang out in the carnival section instead of moaning about how bored they are with the game (the reason YOU'RE there?)...avoiding 5 star restaurants, no more serene weekends at a bed-and-breakfast (without imposing on the grandparents)...no more 2 AM poker games or nights with the girls, or at least fewer without the pained look on your spouse's face on your return...

    That's not to mention pregnancy - morning sickness, the disappearance of your pre-pregnancy body, the disappearance of modesty (amazing what a few pregnancy checks and a birth do to that personality trait), the pain of labor...miscarriages...clusterfeeding...no sleep...crying for ? reason...a new addiction to coffee?

    Have any of you counted the cost?  Apart from maybe wistfully recalling lazy Saturdays?  I'd bet not.

    The song's reference to Icarus recalls the hubris of the young Greek boy, but I say bring on the hubris, bring on the mammoth responsibilities of parenthood.  Does any parent say, "Man, I've got this great kid, but hooooooowwwwwwwweeeee it wasn't worth it.  My life really sucks now?"  Do we sigh and shake our heads sometimes as we watch our kids do something "their way," all while we watch, knowing that they are square-peg-round-hole-ing a task?  Sure, but we love the game!

    We reach for the sun and dare our wax to melt, for "if love remains" at the end of the day, and it always does, "we will pay the price."  Anything requiring real labor, emotional or physical, is worth the number on the price tag, not just parenting.  I remember talking to my mother after my grandfather passed away about how she was there with him at every step, during every hospitalization, through rehab, through his sad decline away from the Rock we had known in the prime of his life.  I doubt I fully grasp the price she paid, but pay it she did.  She'd do it again, and what a selfless act it was.


    Is the song about bravado, "a false show of courage?"  Some might look at the song and feel that Rush's point is that we are foolish to take on impossible tasks and Sisyphean trials, that we should pack away anything requiring vision and perseverance, and sit back with a cold one to watch the evening news?  How much easier to sit back, point at those sweating and bleeding, and say, "Wow, I guess you really blew that one?"

    I don't think Rush intended a cynical tone.  As long as love remains, the "means justifies the end", exactly the way some philosophers define the good life.  Let's not take it too far, though.  I wouldn't try to climb the "summit too lofty" of my 3 kids at the Ritz's fanciest restaurant.  But "all the sacrifice in vain?"  Surely not.  Live it, run your fingers through it, EAT it.  It's only fun if you throw yourself into it wholeheartedly.

    Monday, June 21, 2010

    Will my eyes really freeze that way?

    After a solid childhood of evil uncles and cousins, I learned the following:

    1. Your face will not freeze that way, no matter how hard you scrunch it.
    2. Santa Claus, the Tooth Fairy, the Easter Bunny, Mr. Hannukah, and leprechauns don't exist...in Massachusetts.  They have a secret hideout that cannot be known by any adult that every child knows but to which they cannot travel because, clearly, kids can't drive.  And thank God for that.
    3. You will not shoot your eye out.
    4. There's no such thing as zombies, ghosts, vampires, creatures, demons, monsters, fiends, goblins, or things.
    However...how much fun is it to say something ludicrous to a child, with your best Steven Wright


    and watch as they frown, bunch up their eyebrows, and say, "No, Daddy...really?"  No matter how ludicrous the line, there's some possibility that Daddy might be right...this time.  I like to think that this kind of teasing tests kids' logic a bit, maybe sniffs at their creativity.  Can the kids discern truth from BS, merely by comparing the truth offered to the reality they think they know?  Will their creative minds grasp at the kernel of truth within the line and run with it, following me to my Crazy Place?  True, repeating these lines too often might upset the kids, and make your wife say, "Jeez, will you cut it out already?" (not that I have any idea how that might sound).  Still seems worth it.

    Daily conversation, though, sometimes unintentionally tests kids.  Grief experts have seen kids do some pretty strange things in order to cope with our euphemisms for death.  A good example is the boy who, after his mother died, exhibited really terrible behavior for a few months until one day, tearful, he came to his father, saying that he could no longer be "bad."  Further questioning revealed that a teacher had told him that his mother's death was awful, and that "only the good die young."

    Other examples include:

    • promising something but not delivering.  (promise is a tough word to use).
    • telling them you'll let them do something "later" (that never comes).
    • "I'll break your leg" if you... - or- "Ah, jeez, Billy, I'm gonna kill you if you do that again."
    The bottom line?  Because kids are concrete, we need to watch what we say, or be prepared to translate.  Pediatric textbooks say kids are not little adults;  even so, it's hard for us to remember.  We know how to throw a ball; we've been doing it for a long time.  It's just that it's hard to teach someone what is second nature to us already.

    This post made me think about something that happened the other day.  My daughter Charlotte saw a clip from Jaws in which a swimmer grabbed her leg underwater, screaming in agony.  The clip was part of "The Today Show" that runs in the morning.  It took everyone by surprise, since Jaws doesn't usually run in the morning (though, true enough, some questionable content does run on the program, usually prompting us to turn off the TV during our search for weather in the morning).

    Charlotte: What happened to that lady?
    Me:  She had a really bad cramp in her leg. 
    Charlotte (looking doubtful and hopeful at the same time) Really?
    Me: Yeah, really.   Her leg hurt really badly.

    Good thing my poker face works well when the situation swings the other way.  The truth, the whole truth, and nothing but the truth doesn't always apply to real life.

    Wednesday, June 9, 2010

    Celebrating firsts

    "I do it mah-sef."

    "I wanna do it!"

    "Ma, let me just do it, ok?"

    (nonverbal child screeches and yanks back toy so that she can pull the handle that makes the noise)

    "These are our rules, Grammy.   Please help us enforce those rules so that Johnny will sleep/eat/behave like we've been trying to teach him."

    Kids should do things for themselves.  Not dicing tomatoes - young kids and knives do not blend well.  And while some oversight is probably a good idea, as I said in Hovering, allowing kids to experience the bumps of "haven't quite got it right yet" serves as a perfect appetizer to "Mom, I did it!"  How else can they learn how to do something,or, just as important, how not to do something?

    And just as it's important to let them crow about their successes, let them hear you celebrate.  It can be hard, though, as you swim through a sea of:

    • "Knock-knock." "Who's there?" "Chair." "Chair who?" "Chair tomato broccoli aaaaaaaaaaaaaaaaaaaaaa!" (serious giggles). "Knock-knock..."
    • "Mom. Mom.  Mom.  Mom.  Mom.  Mom.  Mom. Mom.  Mom.  Mom.  Mom.  Mom."  "What???" "I forgot."
    • "Mommy, today I went to...uh...the...uh..(inaudible)...and...uh...Michael...(inaudible)...and then he...uh...went like...(inaudible)...and I was like...(inaudible)...is that ok?"
    • "I am not going to the potty, and I don't care!" (1 minute 15 seconds later, puddle on floor)
    • "I HATE this stupid thing!" (throws thing across room, hits sister square in eye.  Commence escalated chaos).
    • "I can't (fill in the blank), I'm too scared!"
    • No, Mommy..wait...I have to tell you something. (repeat eleventy-seven times)
    Add these classic hits (all for 2 installments of $9.99) to your dishes, the lawn, their homework, your to do list (which is looking more and more like Martin Luther's Theses), the oil slick, unemployment, and your recent sleepless night because of any number of issues, and you'll miss:

    • the first whatever on the potty...and the attendant 2.73 rolls of toilet paper used to do so.
    • writing her name for the first time...or merely trying to write her name for the first time.
    • getting to the end of the maze
    • telling that overbearing friend, "No, I want to do it my way for once."
    • first time brushing teeth by himself, complete with Blob-sized splat of toothpaste clogging the sink.
    • walking down the dark hallway where the goblins live by herself.
    • the "I love you" that was supposed to come out, but you'd already had it with the 78 other things you'd been dealing with, so you said "Not now, honey, ok?"
    We miss too much; we're just not there enough to see it all.   To capture some of it, at least once a day, try the following.

    1. Stop what you're doing
    2. Kneel down with your child (being much taller and staying way up there can be intimidating)
    3. Listen.  Really listen.
    4. Give them a chance to say it themselves. 
    5. Clarify what they're trying to say without interrupting.
    6. "VERY nice name." "Horray for peepee on the potty!" "You rode your bike that far?  WOW!" (even if it's only 2 feet)  "Wow, your breath is NICE and minty."
    7. Big hug.

    Sunday, June 6, 2010

    Medical Home - the Final Frontier

    Check this medical home handout sometime.  Yes...it's very long.  Yes, you have to take the survey first...but then...check it out (I know many of you won't, but if any of you do, it will have been worth including the link).  The authors have given me (and everyone) permission to "shamelessly share and borrow" it, and so I shall.  They deserve credit for such outstanding work.

    Medical home.  It's a funny-sounding term.  For those not ready to embrace the idea of medical home...twitching, headaches, and nausea.  Why?

    Because yes, Virginia...there is such a thing.

    Medical home is a place where you/your child are known. Where they speak your language.  Where your every test is tracked, where every result is communicated to you.  Where every specialist note, ER visit, or hospital stay is tracked.  Where, if they don't know the answer, they find it for you.

    In the not-too-distant past, I'd have thought someone blurting out the above might have been caught earlier that day holding hands with the Tooth Fairy , but our practice has developed many of the processes necessary to be a medical home (thanks in large part to the guidance from the Pediatric Physicians Organization at Children's).  We're hoping to uphold the ideals of medical home; we hope to care for people in a manner that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective.

     Ask for it- you deserve it.  Who wouldn't want it?

    Thursday, June 3, 2010

    Ch-ch-changes.

    I was never a Bowie fan.  This...


    was just too weird for me as a kid.  But his song, Changes, brings up a point that I struggled with in Landslide, and Haunted by Waters - how do we cope with change?  For the point of this blog, how do kids?

    Bowie thinks this:

    "And these children that you spit on
    As they try to change their worlds
    Are immune to your consultations
    They're quite aware of what they're going through"

    For anyone trying to guide a child through something, be it mashed up broccoli, tying shoes, hitting a baseball, riding a bike (link), dating, sex, drugs, graduation, college choice, wedding planning, job choice, raising kids, planning for a bar mitzvah, planning your child's wedding...this line rings with migraine-link intensity.

    Another song from my childhood, Changes by Yes, contrasts with Bowie's self-deprecating take on change.  Darker-seeming (the song seems born of a riven relationship), it somehow stresses the self-control we have over our own destinies.  A simple statement at the start:

    "I`m moving through some changes
    I`ll never be the same"

    climaxes in the bridge of the song, rising up, full of the emotion of the song's peak:

    "For some reason you're questioning why
    I always believe it gets better
    One difference between you and I
    Your heart is inside your head"

    expressing the control we have over accepting the inevitability of change by agreeing to change, rather than allowing blind emotion to rule us.

    The song also embraces the idea that we do it better the more we do it.  Practice makes perfect in relationships and change, just like in any other arena of life.  These thoughts jive with the intro to the song, where the time signature vacillates between 7/8 and (?) 10/8, affirming the existence of unpredictable variations within the very fabric of our lives.

    What does this mean for kids?  Some kids cope with change and transition very nicely.  No warning, time to go?  No problem.  Other kids, especially young kids, need the "stop signal ahead" light that cues them of the stop signal ahead.  Most people figure this one out pretty quickly.

    I warn most parents, as they're about to have a second child, that though they might have some questions about their growing baby at each of the many appointments in the first year...inevitably, they'll pull the "yeah, yeah, the baby's fine - can we talk for a second about his big brother/sister?" out of the bag.  Can't blame the parents - their angelic firstborn has begun to channel Dennis the Menace.  Can't blame the firstborn - his universe has been chopped into 2, as his parents pay attention to something else in addition to (and often before) him.

    Another scenario, and a special topic for me, being a child of divorced parents, is dealing with kids in a divorce situation.  Most parents ache over the Dr. Jekyll/Mr. Hyde rotation through which their kids spin.  Some kids go bananas before they visit "the other" parent, some careen out of control once they return.  The kids often tilt between feeling guilty about leaving one parent to feeling guilty that they had fun with that parent.  Plus, each household often has its own set of rules; one allows cookies in bed but focuses on homework before fun, the other has no junk food whatsoever but there's a party all day long.   Throw in both parents trying to get back at each other for wrongs during the marriage, with each child now serving as a bioweapon against the other parent?  It's surprising when individual or family therapy isn't involved at all.

    I don't think I have any miracle advice for any of these situations...only these ideas.

    1. Know that change can be hard to accept;
    2. Some kids who depend on structure have an especially hard time with change.
    3. When kids act out, try to remember that "why" is as important as dealing with the situation, despite the fact that Bill Cosby was right when he said that  "parents are not interested in justice, they're interested in peace.
    4.  Blend consistency with enforcing the rules with understanding and warmth, and know that sometimes 5 parts rules zero parts understanding (or vice versa) is the right answer.
    5. You know your kids best.

    Friday, May 28, 2010

    Milk plus eggs plus water makes...lemonade?

    Parents often come in pulling out their hair, asking me how exactly does one "do the sleep thing," "do the eating thing," "do the time out thing," "not kick one's teen out of the house."  They often implore me to tell them the one thing (apologies for Curly's language...something tells me my readership, as it is, is not even close to under 21...) that makes it all easier.  They might even express frustration that the one thing I tell them tastes like chocolate ice cream, when they swear the last guy gave them vanilla.  I'm a mint chocolate chip guy, myself, but that's just me.

    The other day, my curly-haired monster


    did her curly-haired monster thing - she bulldozed her sister.


    (The big one, not the wee one).

    Why did she do it?  Because that's what she does.  Claire can impose herself on her waifish older sister because she's good at being physical; Charlotte is a speaker, not a fighter.  She is, however, far from defenseless.  Fast-forward to later in the day...

    Claire: Charlotte?
    Charlotte: (no answer)
    Claire: Charlotte?
    Charlotte: (clearly purposefully not answering her sister.  This session could be a tape-recorded version of the umpteen-thousand times.  Each iteration would pass a jeweler's examination - he'd be unable to discern the fake for the real).
    Claire: (pulls her shrieky voice out of her bag) CHARRRRR.  LOTTTTTTTTE!
    Daddy/Mommy: (now, the answer here depends on whether or not we've figured out that Charlotte is baiting her sister, and whether or not we're just toast.  Version 1 - stressed Daddy/Mommy)  Claire, for the love of G-d, cut it out!!!

    Yup.  That's the bad version.  That one never ends well.

    Daddy/Mommy: (Version 2 - bon bon popping Daddy/Mommy, Shangri-La Daddy/Mommy, just insta-downloaded developmentally friendly parenting skills Mommy/Daddy)  Charlotte, you know she gets frustrated when you ignore her.  In this house, we answer each other when spoken to, hm?  (This tag ending usually ends with Charlotte "paying attention" to Claire.  She does this by nominally listening while gazing at something wondrous off to the side.  Does she think she invented the pretend-listen?  I mastered that long ago.  Puh-lease.  Anyway, we snip that one off, too...)

    We've come to realize that, while both kids express themselves very well, Charlotte will take a pound of flesh outta Claire by frustrating her verbally.  Why?  Because both of them have different strengths. They're not clones, so why would they respond the same way?  Why should we expect them to react similarly?

    So, while time-outs and limit-setting clearly work for the two of them, their reactions are totally different.  Charlotte will often grump about having to say she's sorry, but always articulates what she has done and why, and why she is so incensed over the slings and arrows raining down on her and her alone.  Claire, on the hand, frustrates easily, and when flaming white hot, loses her considerable verbal skills.  She has trouble discussing her feelings and during time outs will often forget what she's done.  That's unfortunate for her, because until recently, a requirement for getting out of time-out is apologizing for exactly what the time-out-able offense was.  Thus, Claire has collected dust and/or gotten moldy whilst in time-out, figuring it all out.  The good news for her is that we've finally figured out that she's a different child than Charlotte, and we tell her what she's done.

    Parents have sets of rules, and they often function differently for each kid.   Whether the kids are like mine, or developmentally disabled, with medical issues, or not, it's useful to remember that each kid brings something different to the table.  The same rules, the same mindset, the same tool cannot be used the same way with each kid, for any number of reasons.

    Once upon a time, a bunch of grandparents observed as 2 young parents (Beth and me) chiseled "the rules of Charlotte" into granite slabs, hoisting them above for all to see.  I wish I could have seen these same grandparents chuckling at us in their homes a few weeks later, after our "No, no...THESE are the rules."  Even now, we continue to smash commandments, constantly editing, but as long as our kids continue to thrive, I'm happy to find some kind of eraser for stone slabs.

    Claire is Claire, Charlotte is Charlotte, Corinne (the lovely baby) is Corinne.

    Wednesday, May 26, 2010

    Well said

    Over time, it has occurred to me, more and more, how privileged I am to do what I do.  Families trust me to help them with the routine and the difficult.  Kids trust that I won't poof into a scary demon guy who will munch their toes.  Teens trust that I won't judge them for:

    • their drug use
    • their crazy family
    • their promiscuity
    • their bad grades
    • their theory that marijuana is "Mensa medicine"
    • their homosexuality
    Last night, Beth and I watched "Glee."  We're singers, so we were most likely to be hooked in, if only for the excellent vocals and  rockin' harmonies.  However, I think the best moment of the show to date came last night.  The background is that 2 characters, one straight (Finn) and one gay (Kurt) were arguing over the somewhat over-decorated style that Kurt had applied to the teens' mutual room.

    Finn: Okay, good. Well, the first thing that needs to go is the faggy lamp, and then we need to get rid of this faggy couch blanket.
    Kurt’s Dad: HEY! What did you just call him?
    Finn: Oh, no, no. I didn’t call him anything. I was just talking about the blanket.
    Kurt’s Dad: You use that word, you’re talking about him.
    Kurt: Relax, Dad. I didn’t take it that way.
    Kurt’s Dad: Yeah, that’s because you’re 16 and you still assume the best in people. You live a few years,  you start seeing the hate in people's hearts, even the best people. (To Finn)You use the N-word?
    Finn: O-Of course not.
    Kurt’s Dad: How about retard? You call that nice girl in the Cheerios with Kurt, you call her a retard?
    Finn: Becky? No, she’s my friend. She has Down syndrome. I’d never call her that. That’s cruel.
    Kurt’s Dad: But you think it’s okay to come in my house and say faggy?
    Finn: That’s not what I meant.
    Kurt’s Dad: I know what you meant! You think I didn’t use that word when I was your age? You know, some kid gets clocked in practice, we tell him to stop being such a fag, shake it off. We meant it exactly the way you meant itthat being gay is wrong.  It's some kind of punishable offense.  I really thought you were different, Finn. You know I thought that being in Glee club and being raised by your mom, meant that you were some new generation of dude who saw things differently. Who just kind of came into the world, knowing what it’s taking me years of struggling to figure out. I guess I was wrong. I’m sorry Finn you can’t stay here. I love your mom, and maybe this is going to cost me her, but my family comes first. I can’t have that kind of poison around.

    I've never heard anyone say it so well.  I might be critiqued for using something so "poppy" to make my point, or for posting on homosexuality, period, but I don't care.  If more people stood their ground and didn't stand for the BS that gets flung around on issues like homosexuality, race, religion, and gender, I'd not have to help out so many kids and families that are hurting so badly.

    Sunday, May 23, 2010

    Lovely Baby

    I don't usually do this, but I need to gush over my 9 month-old.  She is a lovely human being. 

    Here she is:


    She's a gentle, tiny little girl.  She smiles at everything.  She loves attention, but will happily chew or fiddle with anything she can get her hands only, and is surprisingly deft with those pixie hands:  I'm not sure I remember the other girls grasping things with their thumbs and index fingers as early as Corinne.  I do know that both of them had strong opinions about certain things; Corinne appears to have that kind of opinion only about her parents staying in the same room as her.

    If you pay attention long enough, she will gladly cycle through all of her tricks.  Clapping with a baby "hooray" (sort of an "aaaaaaaa" with a toothless grin), shaking her hands, and shaking her head "no" (especially if she hears the word "no") serve as her bread and butter, but she has others.  She'll cough, raz, or na-na-na at you to get your attention.  She recently seems to have picked up the "more" sign, but is unsure if she should shake her hands or clap to signify "more."

    Beth especially loves Corinne's spaghetti-sauce-covered-hands-in-the-hair trick, usually done to acknowledge that she knows the word "hair."  My personal favorite?  Her astounding typing skills. Like most babies who have sat with parents at a computer, she has become an accomplished stomp typist.  Equally impressive are her feats of legerdemain, which are part head fake (Kobe's head fake) and part excellent timing.  Her best came last month.  After trying to grab her be-cereal-ed spoon from Beth (twice), Corinne opened her mouth, and, with spoon almost in mouth (and Beth persuaded that eating was priority #1), she clapped at spoon and goo with both hands, creating a small mushroom cloud of...well, goo.

    She thinks she's a daredevil.  With her Mom or Dad holding her, she'll throw herself backwards to see what's behind her, consequences be damned. "Gravity, come and get me!"  And fearless!  In the face of elemental fury, she sits unblinkingly as water pours over her face as she bathes, and she grins when her sisters blow air in her face.  Intrepid, unaccommodated baby!  But, at the end of the day, she's a sensitive girl.  She'll lay her head on my chest and just be cuddled, and make ah, ah, baby noises.

    I am beginning to understand why people have 8 kids.  But we're done, despite the presence of this angel.  Lovely baby.

    Wednesday, May 19, 2010

    Asking the "dumb" question

    The other day, a Dad of a new baby asked me, "So what is jaundice, anyway?"

    Rewinding the conversation, there I am explaining that because the infant was only 3 days old, we'd need to watch how well he was feeding and whatnot, as his skin was a bit jaundiced.  I explained that it was not uncommon for kids to develop this yellow skin color, that we'd watch it closely, and that everything would probably be just fine.

    I pride myself on not being that guy who rips through medical terminology without explaining things, so I am glad this new father asked me about jaundice...since I never explained to him exactly what it was and why it happens in babies.  I tend to speak plainly:  for example, there's no sense in discussing the pathophysiology of asthma in great detail when I can sum it up by describing the passages of the lungs as being tight (like a doughnut instead of a hula hoop) and full of mucus and crap.

    Unfortunately, most people either blank when speaking to a medical provider, or they are afraid to ask a question that might sound "dumb."  Many of these same people then rifle through internet sites asking complete strangers what they think the physician meant.  That's NUTS.  I mean, I understand researching medical issues, and you'd have to be cursed with Shaq's free throw percentage to miss a good medical reference online on any given issue, but your doctor (hopefully) is an expert.  He/She's right there in front of you, and knows your specific issues.

    In fact, by asking your question, you might enlighten your doc about something.  Didn't consider babesiosis on the list of things that might happen after a tick bite?  Forgot to consider the effect of your birth control pill on the issue at hand?  Neglected to look at your list of drug allergies before prescribing the antibiotic?  Wasn't aware of your family's predisposition towards very early heart attacks?  Didn't know you can't swallow pills?  Truth is, medical providers need your help to help you (odd that Jerry Maguire might apply to medical care).  It's a team sport, and without your help, your doctor is flying the plane with one eye and no arms.

    Some parents abashedly ask me," I'm sorry, I have a dumb question."  If a parent has a question, chances are that a metric crapload (new unit of measure attempting to be passed in Europe.  Used to describe a large amount of a thing) of people have asked the same question.  Why?  Because the answer to "how to raise my kids well" is really non-obvious, and no one should feel bad about asking for help.  Parenting is not always natural or intuitive, even though some people make it seem like it is.

    Even if the answers were obvious, any one answer might not work for some particular kid.  There's a very good reason why 7,631 different parents might give 7,631 answers on how they disciplined their kids, how they got their kids to sleep, how they fed their kids, how they dealt with night-time belly-aches...bedwetting...school nerves...bullying...deaths in the family..."do girls pee standing up, too?"...serious illness of a parent...nose-picking...moving...siblings fighting..."I hate you"...etc.

    I love questions.  Generally, I have a list of questions that I have to ask, anyway.  Most parents ask all of my questions, and add to that list the things keeping them awake at night.  If I can subtract some anxiety from the regular amount of parental anxiety, I am doing my job.

    Ask.  If you forget to ask...call back later!

    Sunday, May 16, 2010

    Hovering

    I heard this term used the other day...

    http://en.wikipedia.org/wiki/Helicopter_parent

    I understand that this term is not a flattering one, and was created by those with some contempt for this kind of parenting, but as long as we're talking about it...

    How many schlocky 80s family sitcoms sprinkled the once-lost-now-found-parent-uttered "we're so sorry, we only wanted what's best for you?"  Typically, the scene culminated in a lost game, a busted romance, or an embarrassing stage performance, capping off a frenetic series of events in which someone ended up sprawled awkwardly on the floor, with spaghetti slopped into a ruined hair-do, topped with shocked silence or a group snicker.  And seemingly, everything could have been prevented had the parent just let the child complete her task alone.  Could the decade of child stars, bad hair, and formulaic drivel have had the right idea about letting kids do their thing?

    Like a lot of issues posted here, there's no "Eureka!" answer.  Though I favor laissez-faire parenting...here are some really bad ideas to "laissez-faire":

    • allowing your kids to play pin-the-fork-in-the-electrical outlet
    • permitting TV-watching without supervising content
    • Leaving your 3 year-old alone in the room with your infant (yes, I caught one of my kids trying to touch our infant's eyeball because she wanted to see how it felt...)
    • 3AM bedtimes!
    • lake swimming with walker-pushing great-grandma lifeguarding
    • approving their application to roll around in poison ivy "because I'm not allergic to it."
    • 5 minutes explaining the "why" of "because I said so."
    • biting your child to show that biting is wrong
    • Circus peanuts...ever.
    I read a book a while ago  - "The Blessing of a Skinned Knee" - that captures perfectly the idea of letting kids leap their own obstacles.  I'm glad Dr. Mogel didn't call her book "Blessing of a Broken Arm" or "Blessing of Some Mild Head Trauma," as I am not sure I could get behind such a book.

    What's a little blood on the knee?  Scrapes heal.  C- on an 8th grade English paper because your son gambled on snow, playing video games until 5 AM, snacking all night, having a ball, watching college basketball re-runs, only to find out early in the morning that not a flake had fallen, necessitating the worst vomit-on-paper ever produced?  Your boy won't count on snow again to rescue him from his responsibility.  Daughter cut by the high school softball team?  Disappointing, for sure, but does one have to call the coach for a tongue-lashing that leaves real welts?

    Learning experiences for kids include both book-learning and experiential learning;  no one ever learned to hit a fastball without actually staring down the barrel.  My wife Beth and I used to eat at the same restaurant once upon a time, and while there, we'd rifle through the sugar packets that spewed platitudinous remarks like "A Stitch in Time is Better than 2 in the Bush" or "What Goes Up Must Come Down Unless Aerodynamically Enhanced."  We still talk about the following one:   "experience enables you to recognize a mistake when you make it the second time."

    I suppose kids can just "figure things out" as the get older.  I guess some kids sprout resilience without ever being tested, and that some kids never get it, sheltered or not.  However, I think my daughters won't allow me to hang around 24/7 for the rest of their lives, so if I expect them to survive on their own, let's see them practice on their own.

    Training doctors work this way.  We're supervised as residents, caring for people while a more experienced physician watches.  Residents function autonomously...but have someone else not-too-far away in case PB& Fluff fever walks in, and the resident has never seen that before.  Is there a doctor who always had a more experienced doctor sitting on his shoulder after residency, watching over his every move, whispering "Ah, you SURE you want to do that?"

    Of course, stranding someone on Devil's Island doesn't teach them much, either.  Leaving a child to cook dinner for her siblings so she can experience the dinner-and-bedtime-hour would be fun like watching a can of Lysol in a bonfire is fun (so long as one observes from a healthy distance with a good fire crew nearby), but is that a useful experience?

    If your child thinks you'll pound the deus ex machina button every time her pants catch on fire from a short-sighted kid move, she'll never learn to stop, drop and roll.  As parents, we have a hard time letting go, but doing so allows them to fail so that the next time, they'll see failure coming...hopefully right before it smacks them between the eyes.

    Wednesday, May 12, 2010

    Hope

    Hope - "the feeling that what is wanted can be had or that events will turn out for the best".  http://dictionary.reference.com/browse/hope

    Optimists bank it, pessimists are bankrupt of it.  Kids usually have it, unless they don't, but some kids lack it even if their families feel like there's no reason NOT to have it, while some kids drink shining cups filled to the brim with it despite having nothing in their lives that replenishes it.  Hope is the fuel for the Porsche of Resilience.

    Why do I care?  Because though hope is a pill I can't prescribe, I know that I, as part of a child's support system, can keep myself (and help keep others) from crushing its fragile green shoots.

    Hope is that thing that keeps people going in dire circumstances.  How many kids have I seen with cystic fibrosis, Crohn's disease, cancer...kids whose parents have died, whose fathers have gone to jail, whose mothers have breast cancer...kids wandering around in the fog of Uncertain Diagnosis...who endure the hail and lightning with a grim "This too shall pass" or "Some day, it'll be better."  Are these kids clueless?  Are their families not smart enough to grasp the seriousness of the issues at hand?  Usually, no...and no.

    There are those who seek ways to "get through" to those clinging to hope in tough times.  Deal with it with eyes wide open, they say.  Gotta know what you're up against.  No sense in clinging to the dinghy of hope in a Category 5 Hurricane.  In fact, some people do  prefer to know that 95% of people with pancreatic cancer do not live 5 years; others, though, shimmy up the flagpole to reach for that 5% banner.  I can't predict which child or family fervently believes in the Promised Land, believes in those caring for them, believes in their own inner strength.  I just can't imagine crushing someone's belief that things are going to somehow turn out okay, no matter how bad the odds.

    In 1998, a movie called "Hope Floats" debuted.  It's a bit of a corny flick, but the essence of the movie, and this post, could be summed up in the following quote, said by the protagonist's daughter:

    "Childhood is what you spend the rest of your life trying to overcome. That's what momma always says. She says that beginnings are scary, endings are usually sad, but it's the middle that counts the most. Try to remember that when you find yourself at a new beginning. Just give hope a chance to float up. And it will, too..."

    Friday, May 7, 2010

    Let them crow!

    We don't allow our kids to crow.  The boasting child makes people cringe, probably because a boasting adult makes people cringe.  Class, please turn to page 1 of most pediatric testbooks.  First sentence...

    Children are not little adults.

    Pediatricians have this axiom tattooed on their foreheads in invisible ink (black lights bring it out- that's why I haven't gone clubbing in some time.  Clearly the only reason), but I hear crazy things from adults all the time that showcases misunderstanding of this point.  The list includes:

    • expecting younger kids to be able to sit for long periods of time without creating a disaster than can be visualized from outer space.
    • Telling a child once that the fill-in-the-blank behavior is expected...and actually believing that a Borg-like assimilation of said behavior happens immediately.
    • Looking at a big-for-his-age child and expecting big-for-his-age behavior.
    • Seeing a baby in pink and saying, "Isn't he cute?"  (ok, that's a different point, but it's still silly).
    • Hoping that "rub some dirt on it" will cure all aches and pains.
    Back to crowing.  Every now and then, at routine check-ups, kids will relate their accomplishments to me.  Came in 2nd at the state swimming meet.  First in the nation in an engineering competition.  Just got his helicopter pilot's license.


    I LOVE hearing about that stuff.  BRAG away.


    I  don't always get to hear about the good stuff, so hearing good news makes me smile.  Unfortunately, the child's parent often says (sounding a bit embarrassed) "Oh, Johnny, don't brag."  Why not?  There's plenty of opportunity to teach your child about the social mores of discussing one's victories.  Allow kids to feel good about themselves - the development of self-worth depends on it.

    Wednesday, May 5, 2010

    No kid gloves

    "She just won't listen to her teachers at school."

    "He's not trying hard enough in science - he really doesn't like his science teacher."

    "She says she'd study harder, but that French teacher is a real pain."

    "I just don't like the way his math teacher gives out homework."

    Before medical school, I worked as a bartender at a local restaurant.  I loved it, mostly.  In general, people loved to swap stories with me about work, friends, the Sox.  I once even got a story about a "boil" on a customer's butt, who felt I could give out medical advice, given that I had just been accepted into medical school.

    Then...there was my boss, Bill, who was about 6'2", maybe 250.  Beefy in stature, he threw his weight around figuratively, as well.  Many of the other cooks and waiters disliked Bill, who routinely dealt out useless tasks or asked people to do things outside of their job descriptions.  Bill often forgot to do parts of his own job, giving the rest of us the privilege of bailing water so the ship remained upright.

    I felt Bill targeted me, in particular.  Knowing that I'd be his bartender only until medical school called, he often made comments about my lack of immunity to the drudgery of cleaning the drink racks or swabbing the floor with a variety of dental implements.  The volume of the sucky tasks seemed to crescendo once Bill found out I would be leaving at the end of my last summer, and the choice Friday and Saturday night shifts, where the more inebriated crowd often tipped much better, started to trickle to J.D., my successor at the bar.

    My Voodoo doll of Bill seemed only to tick him off more.  I doubt fleas and his armpits met as I had hoped.

    I'm betting each of you has or has had a boss spawned from the deepest recesses of Hades, and in fact, he/she may still preside over the roasting of your poor soul.  Have any of you refused to do the tasks of you job?  It's probably a silly question, unless you're unemployed because of that behavior, in which case I guess this post might be for you, too.

    In general, schools and teachers do well in the education of their charges.  If your children say that they just can't do their work because Mr. Jones stinks, understand that, though you love your child, she of less than 2 decades is hardly in a position to judge the competence of a teacher.  A child's job is to go to school, do his work, and do as well as he/she can.  Your job is to help your children in this pursuit, to listen for something that sounds funny, and to tell them that the teacher is right, and that refusing to do work is wrong.

    Any other response giftwraps your child's license to do poorly, and sets them up to expect perfection from their surroundings:  teaching your kids to be resilient in the face of less-then-perfect circumstances might be one of the better lessons you can teach.  If your kids feel that you support them in the idea that their teachers stink, they will probably put forth less effort, and will not likely respect their teachers.

    While we, as parents, have expertise on our own children, their teachers have years of training and expertise on childhood education, and are competent observers of your children using the scholarly portion of their brains.  True, there are some situations where the teachers are wrong, or where they treat your children unfairly; sometimes, the schools get kids and IEPs (individualized education plans) wrong.  For the average child, however, no such issue exists.  I suppose that's the rub - figuring out if your child is one of the former or one of the latter.

    A few years ago, a mother and father (whom I knew well from seeing their 2 kids over 5 years) came to me to discuss the 5 year-old's behavioral issues, which included backtalk to her teachers.  After reviewing everything, I asked them if they (the parents) liked the teacher.  They said they did not.  I asked them if they vented their dislike for her in front of their daughter, but didn't need their affirmative answer as the two of them guiltily looked at each other.

    At their other daughter's check-up a month later, the parents reported that everything had improved at school, and that negative comments about the teacher waited for sneaky ears to be sleeping.


    Kids will perform up to expectations - make sure you set them high enough.

    Wednesday, April 28, 2010

    Landslide

    A few years ago, Beth and I were driving home from some family outing, and Landslide came on the radio.
     I also like this version (by the Smashing Pumpkins), but there's something soul-tugging about the gravelly original.  Not as big a fan of the Dixie Chicks, but the song's a classic no matter who sings it, right?

    In any case, I remember reading an article in the past about Stevie Nicks' thoughts on this song, and that she wrote it to help herself cope during a difficult time.  As expected,  "Landslide" is a song about inexorable change and how one copes with it.  Beth reflected on the following lines:

    Well, I've been afraid of changing
    'Cause I've built my life around you
    But time makes you bolder
    Children get older
    I'm getting older too...


    Do spouses change together?  What happens if they do not?

    Saturday, April 24, 2010

    Let them play!

    I've been on a roll here with playing, so I'll continue.

    Let them play with their food.

    Really.  Even though it kills you to watch.  No, not you, 8 year-old.  You should know better. 

    Yes, you, 8 month-old.  You too, 18 month-old.  3 year-old, no, don't be shy, stand right up.  4 year-old and 5 year-old...well, you can play a little bit.  Maybe unscrew the PB&J into 2 halves and lick one side, then the other, leaving a somewhat slimy, sodden mess for Mommy to clean up.  Yes, I said Mommy, because even if we Dads were around, we'd probably forget.  Sorry, honey.

    "But shouldn't we be teaching them manners?  I mean, kids these days...how can I ever take them to a nice restaurant?"

    First things first - please do not take your young kids to a nice restaurant.  You'll be bald like me in just a few minutes, will have wasted every sure-fire discipline trick you own in the first 15 minutes, and will be hanging on for dear life on top of the TGV with no fancy "Mission Impossible" contraption to keep you on.

    Next?  Kids, especially young kids, learn best with their senses.  They like to squash things through their fingers, listen to the sucking sound as they open their fat little fists covered in yogurt.  They enjoy the glint of wetness that their spilled milk gives to anything, and relish splashing anything splash-able all over the place.  They love both getting the spoon and bowl and flinging them both on you, on the floor, on Mars.

    What happens if you prevent them from making a time-space-continuum-rending mess?  Some kids won't care, so...if you're sure you have one of those kids, breathe a sigh of relief, and do your crossword puzzle in your regularly scheduled bedlam.  However, if you have one of the other kids (so far, 2/3 of  the DiGiovanni kids behave this way), here's a look at what might be going through their heads as your try to engineer a no-muss-no-fuss lunch.

    "What the heck?  Why is she always taking the spoon away from me.  I want that SPOON.  Here it comes again...RATS, she used that other hand.  What a big fat cheater!  Aha, the bowl...noooooooooooooo give ME the bowl!  Argh, curse my nonverbal-ness, words don't fail me now!  Oh, great, the wipe-y thing.  Wipe wipe wipe, now my hands are freezing.  Pleh, when will I ever learn not to lick that yucky washcloth that's chafing the baby out of me."

    "Well, if I can't play with that food, there must be something wrong with it.  I am NOT trying that mucky slime unless I can get these mitts on it.  ESPECIALLY, because she's been tricking me by waving that cool rattly toy in front of me and when I open my mouth, BANG, green yucky in the kisser.  So that's it.  I'm out. No green yucky stuff, no green yucky stuff that looks like green yucky stuff...let's lump yellow and orange in, because they're colors, too, and I seem to run into trouble when I eat colored stuff.  And no more spoons - yeah, if I can't get my hands on 'em, NO MORE."

    "In fact, forget sitting in this high chair.  And check this out...I was surfing the Web (awesome I can surf before I can crawl!  Wicked!) and DL'd this SWEET blood-curdling scream.  One lick of that bad boy and SHAZAAM - I get what I want.  Today, I think I'll have...chicken fingers and fries!  Tomorrow, just to be difficult, I think I'll throw the chicken on the floor."

    Like a lot of things, parenting your child centers around control (see Claire's thoughts on her tights for details).  Be careful which issues deserve your stiffest spine, or your child might be a three-food-three-year-old before you know it.

    Tuesday, April 20, 2010

    Syder Hous Roolz

    1. Kids love to play.
    2. Kids have great imaginations.
    3. Older kids will pretend that they might not like to imagine, but if you spy on them in their secret tree house, you'll see that their adventures on the seven seas fly just as high as when they were 4.
    4. If you get goofy with your kids, they will love it.
    5. If you're not sure how to do it...just do it.  If you think that's not good advice, remember all the times you wrung your hands over your child's refusal to ride her bike, hit a baseball, or climb the rockwall, despite your advice that "you'll never get better at it if you don't try.
    6. If you're still stumped, read "If You Give a Pig a Pancake," "Cloudy with a Chance of Meatballs," or, really, any kid's book.   

    Saturday, April 17, 2010

    Measure Once, Cut Twice -OR- One More Turn

    I loved my grandfather very much.  He was my role model for many reasons, but, as a kid, he was shelter, security, and warmth.  He possessed large, thick hands that enveloped me when I needed him.  When I was very young, I used to think his warmth came about because he was slightly overweight (my mother will groan over that part...right, Ma?).  At times, he did sport extra padding, but the warmth seemed to stick around even when he dropped the extra 20 lbs (anytime he chose).  I never really knew why he carried the extra 20 - must have been for storing that warmth, like a capacitor storing charge?

    Warmth in his hands, warmth in his eyes, warmth in his heart, he was brilliant with people, brilliant in general (I mean grab-your-shades brilliant), and I miss him.  So naturally, being a curious (and at times, irreverent) trickster as a kid, I looked for imperfections in this giant of a man.  After all, no one's perfect.  I remember beating him at chess for the first time:  his impenetrable armor had a crack.  I whooped around the house the first time I stumped him with my very own impossible-to-answer-by-anyone-except-me trivia question; the crack widened.  Most of all, I crowed over his, "Now, just one more turn...to make it (whatever it was) tighter..."

    Evidence of "One more turn" lay in ample evidence around my grandparents' house, which blended pictures of my ancestor magi, including one of a relative who I thought was God for a long time (actually, I still think it's a picture of God) with painted white brick, a black wrought iron ?fence, wallpaper, a giant cabinet record player and other arcane furniture and mystical flatware.  Like this - sort of:



    Honestly, I don't think I was needling him when I asked him the first few times why there were pointy bumps in the kitchen table.  At every meal, the 3 bumps greeted me at my appointed spot (they were overzealously tightened screws).  I suppose I might have been  tugging on his cape a tad when I wondered aloud why the bottom of the hassock had just a few more screws, staples, and nails than it should have, and or why some spots had really big screw holes but no screws.  He'd just grin and hug me. 

    The other day, Claire (of the Batman villain camera angle)



    stood at the bathroom sink.  The ditty she sang had no words, and seemed to repeat the same notes...over and over again.  During the period of silence that reigned PRIOR to the song (that silent tune that sends parents running to see what conflagration their kids have sparked), Claire had painted the entire bathroom sink and counter with a thin coat of water, and she now busied herself cleaning it up.

    Claire:  Daaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaddy!
    Me:  (in the other room.  big sigh) Uh, yes Claire?
    Claire: DAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAADDY!  (Claire could not hear me over her own din)
    Me: (big sigh) YES, Claire?
    Claire:  Come in here!
    Me: (loving being summoned with no clue as to why my presence is required.  Arriving...)  Yes, honey?
    Claire: (palms pressed to sides of face, squishing cute cheeks slightly.  This is Claire's self-conscious pose OR her "Look what I did" pose)  Look at what I did!
    Me: (seeing evidence of not-totally-cleaned-up-water and sopping wet towels) What did you do?
    Claire: (ascertaining that I walked into her trap, looking very pleased with herself) I CLEANED UP after myself!
    Me: Oh, great.  Thanks, kiddo! (congratulated Claire for her cleanup, asked her to wash the sink with only a slightly damp washcloth the next time the urge to clean washed over her like a tsunami.)

    Could be this incident, could be the "made bed" of sheets scrunched at the bottom of the bed with the rumpled covers, could be the clothes put in the hamper, but with socks rolled into the inside-out pants...but I find some similarities between my daughter and my grandfather.  I see the doctrine of "one more turn" and that of wet sinks, piled clothing, and messy beds as lovely imperfections.  "Only" human?  Thankfully human.

    The grandfather angle files into the endearing personality trait folder, but I think the kid angle is pretty important.  Sometimes parents will tell me that their 4 year-old just won't put away all of her toys (i.e. all 462), or that their 6 year-old can't seem to clean the kitty litter up without spilling it, or that beds and rooms are not as neat as they'd like.  Maybe the bed isn't made up to army-grade flatness, or the dusting a bit short of the white glove standard, but the kids are trying.  Is it reasonable to expect a kid to do things perfectly?  Shouldn't we expect them to do things..well...like kids would?

    Celebrate the made bed - don't always mention the messiness.  Applaud the effort at greatness - omit the "that's great...for a kid..."  I'm not saying that kids everywhere should get a trophy for participating - I loathe trinket-dusting - and I think we should grab teachable moments when we can, but I guess it's more important to acknowledge that SOME mastery itself sometimes is worth a standing "O."

    Peter Pan:  Every time a child says, 'I don't believe in fairies,' there is a fairy somewhere that falls down dead.

    Every time a child's balloon thbpthbpbpbpthbpbpbp's across the room for lack of attention to their deed, or worse, for having their triumph critiqued, some spark of magic winks out.

    How does all of this apply to my grandfather? Well, for one, I doubt that Bob Vila would have featured us in his shed-building episode, since my own cutting often eclipses my measuring.  For another, as my grandfather generated warmth, so did he generate magic.  No fairies died on his watch:  a child speaking to him had Sun and Moon rotating about them.  Lastly, not that lopsided sheds are to be celebrated, but a little recognition that perfection (including parental perfection) grows on the same tree as the Golden Apple.  Aspire for it, but unless you share genes with Greek gods or star on your own TV show with your 12 person staff behind-the-scenes, take a bite out of the Gala in your hand, and if you happen to eat a seed, heck, it's fiber.

    Or an apple tree in your belly.

    Tuesday, April 13, 2010

    Find your path. Give back. Make good choices.

    4 years ago, my friend Victoria's brother passed very suddenly.  I can't imagine losing a sibling so young:  Peter was only 32.  I never met him, but let me tell you what I learned about Peter.

    I remember wanting to leave early for his wake, and ended up arriving slightly early.  It was a cold, gray day in February.  I brought a hat (being follicular-ly challenged as I am).  It was cold.

    I had trouble parking; there were so many cars.  A line of people waited, fading somewhere far ahead.  I didn't live close, but I knew the funeral home stood somewhat nearby.  So many people, so many cars...so many teens (Peter was a singular kind of teacher).  People softly talking, steeled against the unforgiving cold and wind.  The end of the line disappeared behind me faster than the line moved forward.  No one left the line.

    Stories floated around me about Peter's goodness.  I listened:  I didn't know him.  I knew his sister; I ached for my friend.  Sometimes one might get the idea that people are connected- similar dress, similar speech, similar ages.  I had difficulty threading anyone together (except for the teens, his students) but for one thing:  the common bond for us all was Peter.

    Inside the funeral home, we waited, we hugged his family, we said...not enough, but what can one say?  I saw co-workers and staff from my office.  We lingered.  We left.

    The following day, family, students, friends told us about Peter.  The auditorium was packed with people.  Images of Peter flashed up on the screen in front of us;  seeing Peter with family, with students made me wish that I had known him.  REALLY wish I had known him.

    Next week, my friend is running the Boston Marathon, for him and for The Children's Room.  After Peter passed, The Children's Room was there for Peter's family like they are for anyone who needs them in such times.  Not enough people know about this place, but they should.

    Here's Victoria's story.

    Today, I write about Peter, not just because his sister, my friend, is running the Marathon for him and for the Children's Room.  I am writing because his message, "Find your path. Give back.  Make good choices," is a GOOD message.

    We all have our own path, even if it's a bit curvy.

    Giving back just feels damn good, improves one's section of the world, and is contagious.

    Thinking first, making good choices - what else can one say?

    On Patriot's Day, my thoughts will be with Victoria.  Good luck, Vic.  I'm fortunate to have met your brother through you.

    Tuesday, April 6, 2010

    Tangled Web

    If a child grows up in the forest, with parents that do nothing by the book (pick your book, they don't own it), and the falling tree doesn't whack the kid in the head, and he turns out just fine, does it really matter?  Does anyone care?  Would it matter if the tree did nail him into the ground a tad, and that he cried (after awakening from his concussion), but no one heard, but then he dusted himself off and whistled a happy tune on his way past Baba Yaga's hut?

    Josh Sacco said "Screewwwwwwwwwwwwwww them!" the other night.  Does THAT matter?  Would it matter if Josh's parents frequently carted him off to baseball parks and talk shows, not to playgrounds and friends' houses, or that he spends several hours a day glued to YouTube, sifting through memorable movie speeches (and hopefully not too much porn)?

    The twins on the airplane sat perched at the top of the summit of their allotted seats, drooling on the tray table of the nice man (not me- I'm not that nice :D) behind them.  Does THAT matter?  How about if drool met army-ration-grade beef teriyaki below, resulting in a whole new, tasty concoction with a certain je ne sais quoi?

    After beating/noogying his younger brother for 10 minutes, the big brother gets up, leaving the younger in a crumpled  heap (is there any other kind of heap?).  Brothers just being brothers, does THAT matter?  Would it matter if the older brother had, for years, kept his thumb strategically placed on the younger brother, keeping him down JUST enough to piss him off, not enough to attract the parent Hammer of Justice, and that the younger brother was slow-cooking a big pot of revulsion for his b-other?

    How about the teens in South Hadley?  When did "kids just being kids" morph into something else?  Was it before or after Phoebe hung herself?

    Today a wonderful mother came to see me.  With her orbited her 15 month-old Tazmanian Devil, mostly amusing himself by careening off various obstacles in my exam room.  She looked very tired:  after a bit of chatting, she admitted that she put her child in his crib asleep (rather than putting him in awake and letting him go to sleep on his own), and that he frequently awoke at 2 AM, whereupon one of the comatose parents would kidnap him off to their bed.  There, no one slept well; strangely, the parents now find themselves afloat every night in a sea of 15 month-old spiky elbows and battering ram knees.  Iceberg, right ahead, indeed.

    Whether the family is ready to take my advice of teaching him to sleep is irrelevant.  My advice might not work for them right now, and I get that...though, at some point, I didn't get it.  Thankfully, some patient families lent me crayons and some Color-By-Numbers, and, after a while, Bobo, your blog narrator-chimp, learned.

    However, my time with colorful scrawlings has not yet revealed the answer to this question to me:  when is "it," whatever it might be, a problem?  Sadly, I must have flunked something in a prior life, since I arrived with neither a crystal ball nor a Cosmic Eraser, but I have been unable to determine, with 100% accuracy, which kid will be ok with which circumstances.  That is, which kid with what kind of resiliency in which circumstances.  Er, which kid with what kind of resiliency with which kind of parents in which circumstances...with what family circumstances...in what developmental stage...in which schooling situation...with which health issues...in what economy...in what world setting...

    Man in Black: You've made your decision then?
    Vizzini: Not remotely. Because iocane comes from Australia, as everyone knows, and Australia is entirely peopled with criminals, and criminals are used to having people not trust them, as you are not trusted by me, so I can clearly not choose the wine in front of you.
    Man in Black: Truly, you have a dizzying intellect.

    Or at least a dizzying clump of interdependent variables.  Solve for Y?  I'll give it a shot.

    The lovely mother from today will likely sleep at some point.  If they choose to "Ferberize" the baby, they'll have short-term misery but long-term good sleep...but they'll likely be fine, long-term, either way.  However, if they need to upgrade to a King-sized bed in 10 years because their 11 year-old still sleeps with them, I might want to revisit the sleep thing with them.

    I think Josh Sacco could say "Screw him" (my kids wouldn't be allowed) if his parents were careful...I guess...but I think without a normal childhood he could grow up to be very different. Different might be ok if he's a resilient child, but if he's not, he's Macaulay Culkin at 5.

    I think sibling rivalry is fine, unless one of the siblings is in danger of being seriously hurt...meaning broken psyche as well as broken bones.

    As for South Hadley, bullying sucks in any capacity and kids need to be protected.  Despite the fact that some kids emerge from the shadows of mistreatment mostly spotless, some crack beyond repair - for life, or worse.

    As for the twins, if you believe in a Supreme Being (we'll call it God - that's what I believe, FWIW), permit a "God Bless" from me to parents of multiples, or parents of multiple kids.  Smile at the chaos and ignore the tumult, because managing kids in public places makes fools of us all, from time to time.  But...

    I draw the line at Beef Drooly-aki.