Diagnosing our Doctors

Television has ruined us.  Oh, I don’t mean it has affected our brain, our weight, or our response to violence.  That’s all terrible, but there is a worse effect.  We expect every law enforcement officer to be The Mentalist, every music teacher to be Will Schuester from Glee, and every doctor to be House.  Television has warped our ideas about what it means to be human.  It has made us less grateful for the rare brilliance that does exist around us, and impatient when our cops, teachers and doctors turn out to be fallible.

These are my reflections after a recent “well” visit to my own doctor.  She’s a rather humorless but bright woman who probably sees about 30 patients each day at a busy practice.  In the now common fashion practiced by doctors everywhere she presented my test numbers and then asked me what I wanted to do.  Huh? Didn’t I just drop off a co-pay to ask you that? 

“So,” I responded,  “Really?” (OK, not my most articulate moment.) Don’t get me wrong. I am grateful for being empowered.  Most women report that they are not taken seriously at the doctor’s office.  Studies show that doctors respond very differently to men and women who visit them with the same symptoms. Men receive more talk and care, while women are dismissed as “imagining” symptoms.*  One of the reasons I chose a women as my doctor is because I thought that a fellow woman would give me more respect.   But this was too much respect.  I needed her to at least take a good guess before involving me.  I have no medical training. How would I know if I had a rare disorder that manifested in cravings for chocolate and Big Love reruns?

Help. Me.
Photo: Color-coded.net

Assuming that your current doctor has the potential to get it right, here’s how a little planning can help you and I get the most out of our next visit:

After noon all the good magazines will likely be taken.
Photo: NYTimes.com

Make a morning appointment if possible.  Your doctor will be less rushed, less fatigued and your wait might be shorter before patients stack up.

Be organized.  Doctor’s are too busy to listen to your rambling complaints because they have lots of other complaints to not listen to before the end of their day.

Don’t be brushed off after some chit chat about your doctor’s most recent vacation.  Ask actual medically relevant questions, like:

What do those test numbers mean?

What should my goals be?

How can I best achieve those goals?

What resources does this practice have to help me?

When should I come back?

Take your time.  If your doctor suggests expensive tests, an excess of medications or a diagnosis that doesn’t make sense to you take the time to do some research before you acquiesce.

This might be a good time for a second opinion.
Photo: Sodahead.com

If you don’t get good answers you might want to let the doctor know of your dissatisfaction, in a way that will improve your communication in the future.  I suggest something along the line of “How can we communicate better next time?” over the always popular “Did you really even go to medical school?”

If you do need to look for another doctor, don’t make the same mistakes.  Think about factors like location, hours, testing facilities, hospital affiliations, staff attitude, how doctor’s absences are covered and how the doctor works with specialists.  Pony up for an interview appointment if your insurance won’t cover it (do I hear you laughing?) to ask about approaches towards holistic medicine, alternative treatments and whether they warm their speculums.  (Men can skip that last one.)

Is he checking your records or is he really watching House for ideas?
Photo: Fotosa.com

Remember that your doctor is human.  They may try to conceal this fact under layers of jargon and shiny surfaces, but if you look closely you will see dead people.  It is your doctor’s willingness to work with you over time that is important.  Of course, you can always forgo the check-up and watch a House marathon instead.  He slways seems to get it right.

The only magic in medicine.

* Resources regarding doctor attitudes towards women can be found at Classical & Contemporary Sociological Practices by Scott Appelrouth & Laura Destor Edles, Harvard Guide to Women’s Health, and the Encyclopedia of Gender and Society

Sext Now, Pay Later

Your teenager cannot help having a cluttered and chaotic brain.  According to brain research* at about age 11 or so the brain starts to specialize. It prunes connections that aren’t used (like good manners and neatness) and begins to strengthen remaining pathways (vampire movies and Starbucks.) During this rewiring project, which goes on until about age 18, there is a good bit of construction going on in the prefrontal cortex area of the brain.  That’s the area responsible for rational behavior, and forseeing the consequences of one's actions.  Unfortunately, the prefrontal cortex is mostly closed  for business during this messy undertaking-- live wires sticking out everywhere--and the hard work of making decisions is left to the more primal, emotional part of their brain, like the limbic system.

Actual diagram of teen brain.
Photo: Uphaa.com

OK, clearly I am not a neurologist.  I am a parent, and so while I may have fudged the anatomical details a little, the point is that teenagers (much like congressmen and professional athletes) think with their fully functional pleasure center, without worrying about what happens next. And that’s why they sext.

Sexting is the practice of texting sexually explicit pictures using the iPhone you just bought them.  It is most prevalent with young teens, and it is generally illegal. 

About 80% of American teens age 12-17 own a cell phone.  You probably allow it for safety, and for social reasons.   But your teen may be much more social than you think.  About a third of cell phone-toting  teens are sending over 100 text messages each day.  Some of those messages may be inappropriate.

A survey by TRU** reveals that nearly two out of every five teens using a cell phone will send and/or post sexually suggestive messages to each other.  One in every five teens will send and/or post nude or semi-nude pictures or video.

She lost her phone, but it was found.
Photo: GooGaGe.com

Of course they have excellent reasons (by teen limbic brain standards.)  About 75% of teens who have sent or posted sexual content say it is for their boyfriend or girlfriend.  They are quite sure when they send it that it is for private use.  Perhaps if their prefrontal cortex were in better working order they might foresee that break-up was a possibility, and that the photos might ultimately be used for sport, for revenge or worse.  The sad fact is that almost 40% of teens have viewed sexually explicit texts or emails that were meant for someone else.

After the break up
Photo: Singlemindedwoman.com

These sexts (and subsequent posts) can be very embarrassing, but they can also be damaging in more serious ways.  In Cincinnati a girl named Jessica Logan killed herself after the humiliation and bullying she was subjected to when her boyfriend forwarded a nude photo to hundreds of teenagers (Cincinnati.com.)  Frighteningly, TRU tells us that 15% of nude sexts and posts by teens are actually meant for  complete strangers who were known only through their online identities and who could have any number of motives.  

DA Risa Vetri Ferman of Montgomery County confirms that teens have been harassed, stalked and blackmailed after sexting photos, and that law enforcement agencies are becoming progressively more involved. It is illegal to take, send or post a picture of a nude underage person, regardless of the age of the person taking the picture. These acts constitute child pornography and your teen can be prosecuted for engaging in the practice.

Hard to text in cuffs.
Photo: Eurweb.com

If your kid stays out of jail, there may be other consequences.  Kaplan finds that 10% of colleges routinely check for online posts when making decisions for admissions, scholarships and campus jobs.  And electronic transmissions are forever.  Career Builder tells us that 22% of hiring managers will check your kid’s posts, and Computerworld found that one third of those who checked for inappropriate content found something that caused them to eliminate the job candidate from consideration.

Um, could I just check my emails real quick?
Photo: Screened.com

Before you try locking your kid in a small closet with a bucket and a slit for food, or taking their cell phones away (equally punitive measures in a teen’s world) know that help is on the horizon.  Apple was recently granted a patent that blocks sexting, though it is not yet available.  In the meantime, make sure your kids understand: 

Anything you text and/or post is in the public domain. Forever.  Assume someone you don’t like, or don’t want will eventually view what you send.

You can’t take it back. “Send” takes away all of your options.

Don’t cave to pressure. (About half of girls say their boyfriends pressured them to sext.)

Delete pictures that are sent to you. You can be arrested for having or forwarding them, and you can’t keep them once you are in jail anyway.

Understand the consequences. Loss of self-respect, crazy strangers, public humiliation, blown college admissions or scholarships, job loss or even jail. Yah, you look hot, but is it really worth it?

  Maybe you don't look that hot after all.
Photo of Miley: Hipsterrunoff.com

Ultimately, as parents it is helpful to recognize that the messy bundle that is your kid’s frontal lobe is not fully functional at this time.  Your kid’s brain is under serious construction, and while you wait for all of the wiring to be connected properly you may need to step in and remind them to glance at the blueprints before they act.

Photo: Guardian.co.uk

* More information on teen brain development can be found in the book Primal Teen by B. Strauch, pbs.org, and scholastic.com.

**The survey was conducted by TRU (tru-insight.com)to a total of 653 teens (ages 13-19) between September 25, 2008 and October 3, 2008.

The Self-Esteem Epidemic

After ten seasons on the air most of us have seen the American Idol auditions at least once.  I’m not really interested in the undiscovered divas who are about to be launched into a life of fame and fortune.  I’m much more fascinated with the eager, proud and ever-so-sincere singers who are confused and dazed when their efforts are met with eye rolls and laughter.  Why do these people think they can sing?

Narcissist? Ya think?
Photo: NYMag.com

We all know a narcissist.  Aunt Millie believes she has a glorious voice though you think she croaks like a frog.  Your husband’s friend Bruno surreptitiously looks in the mirror while speaking to you to make sure he is still great looking (in his own eyes.)  Or how about cousin Al, who feels that he is chosen for something special, though he’s not quite sure yet what that is (though it’s definitely not a day job.)

Ok, maybe Bruno does look good...
Photo: Viamedic.com

Narcissism at its worst is a mental illness.  In fact, the U.S. National Library of Medicine defines Narcissistic Personality Disorder as “a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves.” People with this disorder have a tough time seeing themselves as others do, partly because they have been trained to view themselves as deserving of love and praise for no particular reason.

I'll be needing a bigger litter box...
Photo: Seminareventreview.com

I’m not saying Aunt Millie or Bruno are mentally ill.  Mild narcissism can be healthy; we call it self-esteem.  But with the self-esteem parenting movement in the 1980’s, narcissism has become rampant.  Ann Le Suer-Collins writes about the relationship between environmental narcissism and the sense of entitlement in our young people.  She estimates that 1 in 10 young adults have already experienced a level of narcissism that qualifies as a personality disorder.  Doctors Jean Twenge and Keith Campbell actually consider narcissism in children an epidemic, and write about the fallout of the self-esteem movement in our society.  The bottom line is that many of our children have been the victims of too much love from us, their parents.

No, you are a hot dog.
Artwork:  Billboardmama.com

I know.  Your kids are definitely the most brilliant, most athletic, best looking children with which mankind has ever been graced.  But maybe we shouldn’t let the kids know that.  Maybe we shouldn’t sing them self-love songs like I am Terrific or  Look at Me. Maybe we should think twice before reading books like Bowser’s Learning to Love Me or Adams’ Happy to be Me.  Maybe we should stop awarding every little athlete a trophy for just for trying. 

Look Ma!  I showed up!
Photo: Flickr.com

These songs, books and practices are part of a long list of parenting resources focused on building self-esteem in our kids.  Well, typical for boomers: we overachieved.  About ten percent of our kids not only believe in themselves, they are in love with themselves. Maybe we should have been reading books like Maureen Stout’s “The feel-good curriculum: The dumbing-down of America's kids in the name of self-esteem.”  As a teacher trainer with lot’s of experience with different populations, Stout observes that giving an “A for effort” often leads to less effort and more feelings of entitlement.  It’s not too late to learn from the mistakes we parents made in the 80s and 90s. You can raise kids with real, earned, healthy self-esteem by treating them, well, a little less nicely. 

Photo: Amapaforkids.com

Parents and educators, it is right and proper to reward children for their achievements.  It is a loving act to help children embrace all of their strengths, and yes, weaknesses.  But trying isn’t winning, and winning might come only after losing a few times.  So instead of teaching our kids that they are glorious just the way they are, and that they are entitled to admiration simply by the act of being, why aren’t we teaching our kids how to try their best, win humbly, lose with grace, try again, persist and continue to improve themselves all of their life?

Here are some ways for you to encourage your kids to feel great not only about who they are but who they can become.

Encourage your children to work.  Don’t reward them unless they do the job well.  Lowering your standard will lower theirs.

Encourage your children to fail.  It’s how we learn.

Encourage your children to give to others.  Because really, they aren’t the center of anyone’s universe except yours.

Be honest with your children. Help them know what they do great, and what skills they need to build.  It will save them the shock of finding out for themselves.

Be a good example. Tiring but true. 

Self-esteem is great.  But self-delusion, narcissism and a sense of entitlement lurk just behind it.  Respect your kids enough to help them assess their strengths and weaknesses, and build to their goals.  The judges and viewing public thank you.

Photo: Funnyfidos.com

Photo: Moti.com