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Here’s a good rule for life: No matter how important you are, never, ever ask an authority figure, “Do you know who I am?” That’s what actress Reese Witherspoon inquired of the Atlanta police officer arresting her husband Jim Toth last week for (very) drunk driving. Worse was the officer’s response, left out of the police report for the sake of brevity: “Lindsay Lohan? Wait, no! Britney Spears? No, then, uh, Matthew Perry? Look, I give up! Just get in the squad car!” The bottom line is that if you ask a cop, “Do you know my name?” chances are good the answer will be, “Yes. The Defendant.”
Gripe water
The cause of colic is totally the Higgs boson of pediatrics. We can all describe colic, but what is it really? Intestinal gas? The angst of the “fourth trimester”? A complex electro-neutral doublet of the weak isospin SU(2) symmetry with a mass between 125 and 127 GeV/c having + parity and zero spin? Wait, that last one actually was the Higgs, but who’s to say the Higgs boson, in addition to providing strong support to the Standard Model of particle physics, is not also the cause of infantile colic?
Dr. Luigi Titomanlio from Paris Diderot University and his colleagues, that’s who. They published a study in JAMA suggesting a strong link between infantile colic and childhood migraines. Dr. Titomanlio's group surveyed parents of children who presented to French and Italian emergency departments in 2012 with either minor trauma, migraines, or non-migraine headaches. The kids with migraines were nearly seven times more likely to have had colicky crying during infancy than were those with minor trauma or non-migraine headaches. All patients were reassured that, since they lived in France and Italy, nothing could be all that bad.
This study makes the fourth one to link colic to migraines, building on a model of pain sensitivity that is starting to explain a lot of syndromes that were classified when I was in medical school as “hogwash,” or, for our vegan classmates, “potato wash.” Maybe colicky infants cry because they don’t yet have the words to say, “For Pete’s sake, would someone turn off those lights and get me some ear plugs, two ibuprofen, and a Diet Coke?!” I’d like to see future studies that correlate colic to fibromyalgia and chronic fatigue syndrome. In the babies. There is already a well-established link to chronic fatigue in the parents.
All in the family
In some ways, we had it easy when I was a medical student. Sure, we worked hours that the World Court eventually classified as war crimes, and no one cared if our preceptors browbeat us until we slunk into a linen closet weeping and wondering why the universe had allowed us to be conceived. But at least we didn’t have to present in front of patients and their families. A review in this month’s Pediatrics makes the case that, for the several minutes each day medical students and residents are in the hospital, those not spent in self-empowerment support groups should be passed right in patients’ rooms. Has author Suresh Nagappan, M.D., M.S.P.H., from the University of North Carolina in Greensboro ever actually been in a patient room?
I mean it’s hard enough to spout arcane facts, subtly imply that your team members are intellectually deficient, and flatter your attending in a sterile conference room at the end of the hall. With Dr. Nagappan’s “Family-Centered Care,” you have to do all that in front of actual parents, surrounded by discarded fast food wrappers and talking over a Total Gym infomercial. Do parents really want to hear medical students diagnose every child on the ward with acute intermittent porphyria?
Apparently they do, by a margin of 85%. Predictably, family-centered rounds take 20% longer than traditional rounds do, as the attending has to explain that no, no one actually has acute intermittent porphyria, it’s just a disease medical students made up to give the appearance of having generated a differential diagnosis. On the other hand, families and nurses were less likely to call team members back to the room after rounds, presumably because by the time rounds were over, the patients had been discharged. Half of medical students remain suspicious of family-centered care, fearing both that they might look foolish in front of patients and that they might actually purchase the Total Gym.
Fatal attraction?
I have to wonder what this country is coming to when retailers are afraid to sell a toy -- a really, really fun toy -- just because it might kill small children. Overstock.com and Toys “R” Us are among the latest outlets to stop selling Buckyballs and Buckycubes, sets of tiny, super-powerful neodymium magnets, because when a child swallows two or more of the magnets, they tend to stick together in the intestines, which is where the fun stops. The Centers for Disease Control and Prevention can find only 33 cases requiring emergency surgery and only one death from what the manufacturers keep pointing out is a seriously entertaining toy.
This trend must be stopped, or we risk living in a world where infants are forced to ride in approved car seats, medication bottles have nearly impossible-to-open caps, and there are some modest restrictions on the sale of military-grade assault weapons to people with mental illness and criminal records. Ah, who am I kidding? If that last one ever happens, you can arrest me and call me “Charlie Sheen.”
David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).
Here’s a good rule for life: No matter how important you are, never, ever ask an authority figure, “Do you know who I am?” That’s what actress Reese Witherspoon inquired of the Atlanta police officer arresting her husband Jim Toth last week for (very) drunk driving. Worse was the officer’s response, left out of the police report for the sake of brevity: “Lindsay Lohan? Wait, no! Britney Spears? No, then, uh, Matthew Perry? Look, I give up! Just get in the squad car!” The bottom line is that if you ask a cop, “Do you know my name?” chances are good the answer will be, “Yes. The Defendant.”
Gripe water
The cause of colic is totally the Higgs boson of pediatrics. We can all describe colic, but what is it really? Intestinal gas? The angst of the “fourth trimester”? A complex electro-neutral doublet of the weak isospin SU(2) symmetry with a mass between 125 and 127 GeV/c having + parity and zero spin? Wait, that last one actually was the Higgs, but who’s to say the Higgs boson, in addition to providing strong support to the Standard Model of particle physics, is not also the cause of infantile colic?
Dr. Luigi Titomanlio from Paris Diderot University and his colleagues, that’s who. They published a study in JAMA suggesting a strong link between infantile colic and childhood migraines. Dr. Titomanlio's group surveyed parents of children who presented to French and Italian emergency departments in 2012 with either minor trauma, migraines, or non-migraine headaches. The kids with migraines were nearly seven times more likely to have had colicky crying during infancy than were those with minor trauma or non-migraine headaches. All patients were reassured that, since they lived in France and Italy, nothing could be all that bad.
This study makes the fourth one to link colic to migraines, building on a model of pain sensitivity that is starting to explain a lot of syndromes that were classified when I was in medical school as “hogwash,” or, for our vegan classmates, “potato wash.” Maybe colicky infants cry because they don’t yet have the words to say, “For Pete’s sake, would someone turn off those lights and get me some ear plugs, two ibuprofen, and a Diet Coke?!” I’d like to see future studies that correlate colic to fibromyalgia and chronic fatigue syndrome. In the babies. There is already a well-established link to chronic fatigue in the parents.
All in the family
In some ways, we had it easy when I was a medical student. Sure, we worked hours that the World Court eventually classified as war crimes, and no one cared if our preceptors browbeat us until we slunk into a linen closet weeping and wondering why the universe had allowed us to be conceived. But at least we didn’t have to present in front of patients and their families. A review in this month’s Pediatrics makes the case that, for the several minutes each day medical students and residents are in the hospital, those not spent in self-empowerment support groups should be passed right in patients’ rooms. Has author Suresh Nagappan, M.D., M.S.P.H., from the University of North Carolina in Greensboro ever actually been in a patient room?
I mean it’s hard enough to spout arcane facts, subtly imply that your team members are intellectually deficient, and flatter your attending in a sterile conference room at the end of the hall. With Dr. Nagappan’s “Family-Centered Care,” you have to do all that in front of actual parents, surrounded by discarded fast food wrappers and talking over a Total Gym infomercial. Do parents really want to hear medical students diagnose every child on the ward with acute intermittent porphyria?
Apparently they do, by a margin of 85%. Predictably, family-centered rounds take 20% longer than traditional rounds do, as the attending has to explain that no, no one actually has acute intermittent porphyria, it’s just a disease medical students made up to give the appearance of having generated a differential diagnosis. On the other hand, families and nurses were less likely to call team members back to the room after rounds, presumably because by the time rounds were over, the patients had been discharged. Half of medical students remain suspicious of family-centered care, fearing both that they might look foolish in front of patients and that they might actually purchase the Total Gym.
Fatal attraction?
I have to wonder what this country is coming to when retailers are afraid to sell a toy -- a really, really fun toy -- just because it might kill small children. Overstock.com and Toys “R” Us are among the latest outlets to stop selling Buckyballs and Buckycubes, sets of tiny, super-powerful neodymium magnets, because when a child swallows two or more of the magnets, they tend to stick together in the intestines, which is where the fun stops. The Centers for Disease Control and Prevention can find only 33 cases requiring emergency surgery and only one death from what the manufacturers keep pointing out is a seriously entertaining toy.
This trend must be stopped, or we risk living in a world where infants are forced to ride in approved car seats, medication bottles have nearly impossible-to-open caps, and there are some modest restrictions on the sale of military-grade assault weapons to people with mental illness and criminal records. Ah, who am I kidding? If that last one ever happens, you can arrest me and call me “Charlie Sheen.”
David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).
Here’s a good rule for life: No matter how important you are, never, ever ask an authority figure, “Do you know who I am?” That’s what actress Reese Witherspoon inquired of the Atlanta police officer arresting her husband Jim Toth last week for (very) drunk driving. Worse was the officer’s response, left out of the police report for the sake of brevity: “Lindsay Lohan? Wait, no! Britney Spears? No, then, uh, Matthew Perry? Look, I give up! Just get in the squad car!” The bottom line is that if you ask a cop, “Do you know my name?” chances are good the answer will be, “Yes. The Defendant.”
Gripe water
The cause of colic is totally the Higgs boson of pediatrics. We can all describe colic, but what is it really? Intestinal gas? The angst of the “fourth trimester”? A complex electro-neutral doublet of the weak isospin SU(2) symmetry with a mass between 125 and 127 GeV/c having + parity and zero spin? Wait, that last one actually was the Higgs, but who’s to say the Higgs boson, in addition to providing strong support to the Standard Model of particle physics, is not also the cause of infantile colic?
Dr. Luigi Titomanlio from Paris Diderot University and his colleagues, that’s who. They published a study in JAMA suggesting a strong link between infantile colic and childhood migraines. Dr. Titomanlio's group surveyed parents of children who presented to French and Italian emergency departments in 2012 with either minor trauma, migraines, or non-migraine headaches. The kids with migraines were nearly seven times more likely to have had colicky crying during infancy than were those with minor trauma or non-migraine headaches. All patients were reassured that, since they lived in France and Italy, nothing could be all that bad.
This study makes the fourth one to link colic to migraines, building on a model of pain sensitivity that is starting to explain a lot of syndromes that were classified when I was in medical school as “hogwash,” or, for our vegan classmates, “potato wash.” Maybe colicky infants cry because they don’t yet have the words to say, “For Pete’s sake, would someone turn off those lights and get me some ear plugs, two ibuprofen, and a Diet Coke?!” I’d like to see future studies that correlate colic to fibromyalgia and chronic fatigue syndrome. In the babies. There is already a well-established link to chronic fatigue in the parents.
All in the family
In some ways, we had it easy when I was a medical student. Sure, we worked hours that the World Court eventually classified as war crimes, and no one cared if our preceptors browbeat us until we slunk into a linen closet weeping and wondering why the universe had allowed us to be conceived. But at least we didn’t have to present in front of patients and their families. A review in this month’s Pediatrics makes the case that, for the several minutes each day medical students and residents are in the hospital, those not spent in self-empowerment support groups should be passed right in patients’ rooms. Has author Suresh Nagappan, M.D., M.S.P.H., from the University of North Carolina in Greensboro ever actually been in a patient room?
I mean it’s hard enough to spout arcane facts, subtly imply that your team members are intellectually deficient, and flatter your attending in a sterile conference room at the end of the hall. With Dr. Nagappan’s “Family-Centered Care,” you have to do all that in front of actual parents, surrounded by discarded fast food wrappers and talking over a Total Gym infomercial. Do parents really want to hear medical students diagnose every child on the ward with acute intermittent porphyria?
Apparently they do, by a margin of 85%. Predictably, family-centered rounds take 20% longer than traditional rounds do, as the attending has to explain that no, no one actually has acute intermittent porphyria, it’s just a disease medical students made up to give the appearance of having generated a differential diagnosis. On the other hand, families and nurses were less likely to call team members back to the room after rounds, presumably because by the time rounds were over, the patients had been discharged. Half of medical students remain suspicious of family-centered care, fearing both that they might look foolish in front of patients and that they might actually purchase the Total Gym.
Fatal attraction?
I have to wonder what this country is coming to when retailers are afraid to sell a toy -- a really, really fun toy -- just because it might kill small children. Overstock.com and Toys “R” Us are among the latest outlets to stop selling Buckyballs and Buckycubes, sets of tiny, super-powerful neodymium magnets, because when a child swallows two or more of the magnets, they tend to stick together in the intestines, which is where the fun stops. The Centers for Disease Control and Prevention can find only 33 cases requiring emergency surgery and only one death from what the manufacturers keep pointing out is a seriously entertaining toy.
This trend must be stopped, or we risk living in a world where infants are forced to ride in approved car seats, medication bottles have nearly impossible-to-open caps, and there are some modest restrictions on the sale of military-grade assault weapons to people with mental illness and criminal records. Ah, who am I kidding? If that last one ever happens, you can arrest me and call me “Charlie Sheen.”
David L. Hill, M.D., FAAP, is vice president of Cape Fear Pediatrics in Wilmington, NC, and is an adjunct assistant professor of pediatrics at the University of North Carolina at Chapel Hill. He is Program Director for the AAP Council on Communications and Media and an executive committee member of the North Carolina Pediatric Society. He has recorded commentaries for NPR's All Things Considered and provided content for various print, television and Internet outlets. Dr. Hill is the author of Dad to Dad: Parenting Like A Pro (AAP Publishing 2012).