Pediatric Care Quotes

You can’t just do whatever you feel like.” “You can’t just do anything you want.” “You have to learn self-restraint.” “You’re only interested in gratifying your desires.” “You don’t care about anything but your own pleasure.” Can you hear the judgmentality in these admonitions? Can you see how they reproduce the mentality of domination that runs our civilization? Goodness comes through conquest. Health comes through conquering bacteria. Agriculture is improved by eliminating pests. Society is made safe by winning the war on crime. On my walk today, students accosted me, asking if I wanted to join the “fight” against pediatric cancer. There are so many fights, crusades, campaigns, so many calls to overcome the enemy by force. No wonder we apply the same strategy to ourselves. Thus it is that the inner devastation of the Western psyche matches exactly the outer devastation it has wreaked upon the planet. Wouldn’t you like to be part of a different kind of revolution?

In the great tornado of life, things sometimes seem out of control, and we can’t see where we are going. But sometimes, when the storm passes and the dust settles, things have landed into place beautifully.

The more love and support your child receives, the richer his or her life becomes, and nurses can certainly add to the circle of love surrounding your child.

Finding a good nurse is not just about checking off a list of skills the nurse can perform; it’s also about finding someone who is a good fit for your home.

Even though our journey as parents of a medically fragile child began with emotional turmoil, it has since become a purposeful odyssey that brings meaning and depth to our lives. This is the road we were born to travel.

Parents of medically fragile children find themselves becoming experts in lots of different areas, including laws and regulations, research and treatments, and the various specialists that support the health of their children.

On the flight over to Chicago, I thought of a story Mom had once told me from her days as a pediatric nurse. "There was this little boy I was taking care of," she said "and he was terminally ill,and we all knew it,but he kept hanging on and hanging on. He wouldn't die, it was so sad. And his parents were always there with him,giving him so much love and support,but he was in so much pain,and it really was,time for him to go. So finally some of us nurses took his father aside and we told him, 'You have to tell your son it's okay for him to go. You have to give him permission.' And so the father took his son in his arms and he sat with him in a chair and held on to him and told him over and over, that it was okay for him to go,and,well,after a few moments,his son died.

An exhausted parent can’t provide the best care, although occasionally, we have all had to do so.

Think of instinct as an unscientific, unquantifiable tool that can be used along with more concrete evaluations to make a well-rounded decision.

What I really don't understand is why many doctors kick patients our of their practice over this issue. What's wrong with simply disagreeing with parents but still providing medical care to their child? That's what the American Academy of Pediatrics tells us we should do. Read them the riot act once then move on and be their doctor. A family that chooses not to vaccinate still needs medical care. Sure, their child may catch a vaccine-preventable disease, and yes, their unvaccinated child decreases the local herd immunity and puts other kids at risk, but that is still their choice. Parents of patients refuse to follow my medical advice every day.

If you were spanked as a child, you may feel disgusted by your body. It may be difficult to care for yourself (including pursuing medical care, dental care, regular exercise, and healthy nutrition) because your body has been a battleground. You may find it validating to know that the American Academy of Pediatrics recommends that parents avoid spanking children for any reason,

Surgery is the most masculine of medical disciplines, taking knives and penetrating the body to find disease and destroy it. It is a war game in which cold and shiny stainless steel is pitted against the unseen, sinister but discoverable and conquerable enemy. Pediatrics is in many ways the most feminine of medical disciplines, with its focus on small children, preventive care, nurturing. In terms of gender, neonatology seems to be somewhere in between.

the new “affirmative-care” standard of mental health professionals is a different matter entirely. It surpasses sympathy and leaps straight to demanding that mental health professionals adopt their patients’ beliefs of being in the “wrong body.” Affirmative therapy compels therapists to endorse a falsehood: not that a teenage girl feels more comfortable presenting as a boy—but that she actually is a boy. This is not a subtle distinction, and it isn’t just a matter of humoring a patient. The whole course of appropriate treatment hinges on whether doctors view the patient as a biological girl suffering mental distress or a boy in a girl’s body. But the “affirmative-care” standard, which chooses between these diagnoses before the patient is even examined, has been adopted by nearly every medical accrediting organization. The American Medical Association, the American College of Physicians, the American Academy of Pediatrics, the American Psychological Association, and the Pediatric Endocrine Society have all endorsed “gender-affirming care” as the standard for treating patients who self-identify as “transgender” or self-diagnose as “gender dysphoric.

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Dr. Lydia Ciarallo in the Department of Pediatrics, Brown University School of Medicine, treated thirty-one asthma patients ages six to eighteen who were deteriorating on conventional treatments. One group was given magnesium sulfate and another group was given saline solution, both intravenously. At fifty minutes the magnesium group had a significantly greater percentage of improvement in lung function, and more magnesium patients than placebo patients were discharged from the emergency department and did not need hospitalization.4 Another study showed a correlation between intracellular magnesium levels and airway spasm. The investigators found that patients who had low cellular magnesium levels had increased bronchial spasm. This finding confirmed not only that magnesium was useful in the treatment of asthma by dilating the bronchial tubes but that lack of magnesium was probably a cause of this condition.5 A team of researchers identified magnesium deficiency as surprisingly common, finding it in 65 percent of an intensive-care population of asthmatics and in 11 percent of an outpatient asthma population. They supported the use of magnesium to help prevent asthma attacks. Magnesium has several antiasthmatic actions. As a calcium antagonist, it relaxes airways and smooth muscles and dilates the lungs. It also reduces airway inflammation, inhibits chemicals that cause spasm, and increases anti-inflammatory substances such as nitric oxide.6 The same study established that a lower dietary magnesium intake was associated with impaired lung function, bronchial hyperreactivity, and an increased risk of wheezing. The study included 2,633 randomly selected adults ages eighteen to seventy. Dietary magnesium intake was calculated by a food frequency questionnaire, and lung function and allergic tendency were evaluated. The investigators concluded that low magnesium intake may be involved in the development of both asthma and chronic obstructive airway disease.

Discipline As your baby becomes more mobile and inquisitive, she’ll naturally become more assertive, as well. This is wonderful for her self-esteem and should be encouraged as much as possible. When she wants to do something that’s dangerous or disrupts the rest of the family, however, you’ll need to take charge. For the first six months or so, the best way to deal with such conflicts is to distract her with an alternative toy or activity Standard discipline won’t work until her memory span increases around the end of her seventh month. Only then can you use a variety of techniques to discourage undesired behavior. When you finally begin to discipline your child, it should never be harsh. Remember that discipline means to teach or instruct, not necessarily to punish. Often the most successful approach is simply to reward desired behavior and withhold rewards when she does not behave as desired. For example, if she cries for no apparent reason, make sure there’s nothing wrong physically; then when she stops, reward her with extra attention, kind words, and hugs. If she starts up again, wait a little longer before turning your attention to her, and use a firm tone of voice as you talk to her. This time, don’t reward her with extra attention or hugs. The main goal of discipline is to teach limits to the child, so try to help her understand exactly what she’s doing wrong when she breaks a rule. If you notice her doing something that’s not allowed, such as pulling your hair, let her know that it’s wrong by calmly saying “no,” stopping her, and redirecting her attention to an acceptable activity. If your child is touching or trying to put something in her mouth that she shouldn’t, gently pull her hand away as you tell her this particular object is off-limits. But since you do want to encourage her to touch other things, avoid saying “Don’t touch.” More pointed phrases, such as “Don’t eat the flowers” or “No eating leaves” will convey the message without confusing her. Because it’s still relatively easy to modify her behavior at this age, this is a good time to establish your authority and a sense of consistency Be careful not to overreact, however. She’s still not old enough to misbehave intentionally and won’t understand if you punish her or raise your voice. She may be confused and even become startled when told that she shouldn’t be doing or touching something. Instead, remain calm, firm, consistent, and loving in your approach. If she learns now that you have the final word, it may make life much more comfortable for both of you later on, when she naturally becomes more headstrong.

These books, which cover many of the topics discussed in this book, may be helpful further reading. GENERAL REFERENCE American Academy of Pediatrics. Caring for Your Baby and Young Child: Birth to Age Five. New York: Bantam, 2004. Druckerman, P. Bringing Up Bébé: One American Mother Discovers the Wisdom of French Parenting. New York: Penguin, 2014. Eliot, L. What’s Going On in There?: How the Brain and Mind Develop in the First Five Years of Life. New York: Bantam, 2000. Nathanson, L. The Portable Pediatrician for Parents: A Month-by-Month Guide to Your Child’s Physical and Behavioral Development from Birth to Age Five. New York: HarperCollins, 1994. DISCIPLINE Phelan, T. W. 1-2-3 Magic: Effective Discipline for Children 2–12. Naperville, IL: ParentMagic, Inc., 2010. Webster-Stratton, C. The Incredible Years: A Trouble-Shooting Guide for Parents of Children Aged 2–8. Toronto: Umbrella Press, 1992. SLEEP Ferber, R. Solve Your Child’s Sleep Problems. Rev. ed. New York: Simon & Schuster, 2006. Karp, H. The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Newborn Baby Sleep Longer. Rev. ed. New York: Bantam, 2015. Weissbluth, M. Healthy Sleep Habits, Happy Child: A Step-by-Step Program for a Good Night’s Sleep. 4th ed. New York: Ballantine Books, 2015. POTTY TRAINING Glowacki, J. Oh Crap! Potty Training: Everything Modern Parents Need to Know to Do It Once and Do It Right. New York: Touchstone, 2015.

My fancy title is a pediatric psychologist with a specialization in neurodevelopmental disabilities, but nobody ever understands that.

When a young employee gasped at his blue language, Simons flashed a grin. “I know—that is an impressive rate!” A few times a week, Marilyn came by to visit, usually with their baby, Nicholas. Other times, Barbara checked in on her ex-husband. Other employees’ spouses and children also wandered around the office. Each afternoon, the team met for tea in the library, where Simons, Baum, and others discussed the latest news and debated the direction of the economy. Simons also hosted staffers on his yacht, The Lord Jim, docked in nearby Port Jefferson. Most days, Simons sat in his office, wearing jeans and a golf shirt, staring at his computer screen, developing new trades—reading the news and predicting where markets were going, like most everyone else. When he was especially engrossed in thought, Simons would hold a cigarette in one hand and chew on his cheek. Baum, in a smaller, nearby office, trading his own account, favored raggedy sweaters, wrinkled trousers, and worn Hush Puppies shoes. To compensate for his worsening eyesight, he hunched close to his computer, trying to ignore the smoke wafting through the office from Simons’s cigarettes. Their traditional trading approach was going so well that, when the boutique next door closed, Simons rented the space and punched through the adjoining wall. The new space was filled with offices for new hires, including an economist and others who provided expert intelligence and made their own trades, helping to boost returns. At the same time, Simons was developing a new passion: backing promising technology companies, including an electronic dictionary company called Franklin Electronic Publishers, which developed the first hand-held computer. In 1982, Simons changed Monemetrics’ name to Renaissance Technologies Corporation, reflecting his developing interest in these upstart companies. Simons came to see himself as a venture capitalist as much as a trader. He spent much of the week working in an office in New York City, where he interacted with his hedge fund’s investors while also dealing with his tech companies. Simons also took time to care for his children, one of whom needed extra attention. Paul, Simons’s second child with Barbara, had been born with a rare hereditary condition called ectodermal dysplasia. Paul’s skin, hair, and sweat glands didn’t develop properly, he was short for his age, and his teeth were few and misshapen. To cope with the resulting insecurities, Paul asked his parents to buy him stylish and popular clothing in the hopes of fitting in with his grade-school peers. Paul’s challenges weighed on Simons, who sometimes drove Paul to Trenton, New Jersey, where a pediatric dentist made cosmetic improvements to Paul’s teeth. Later, a New York dentist fitted Paul with a complete set of implants, improving his self-esteem. Baum was fine with Simons working from the New York office, dealing with his outside investments, and tending to family matters. Baum didn’t need much help. He was making so much money trading various currencies using intuition and instinct that pursuing a systematic, “quantitative” style of trading seemed a waste of

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Pediatric Chiropractic care doesn't just delve into the health of your child during times of sickness. It also looks into how your child grows and develops throughout the years.

Stigma” is a dressed-up word for ignorance and prejudice.

Pre-natal care, perinatal care, post-natal care, pediatrics, nutrition, education, orthodontics, vacations, college, postgrad, a fiancé, the whole nine yards. Her assembly line had worked just fine.

NPV

The scariest, ugliest stories about in-home nursing usually are the result of nurses demonstrating a lack of professionalism, bad morals or a disregard for the child for whom they are providing care.

Once you open your home to nursing, you essentially become the employer of a small staff, even if you aren’t signing the paychecks. As in any workplace, the staff needs to know the rules and expectations, and it is your job to set them and communicate them well. This is your new job; you’ve been promoted to Home Care CEO.

With emotions ranging from fear, grief and anger to happiness and relief, the process of bringing home a child who needs in-home care can be complicated

When it is managed effectively, in-home nursing can become a support for caregivers and families stressed with the care of a medically fragile child.

An informed parent or caregiver becomes empowered, and empowerment can lead to the best care for our children.

The partnership between nurses and families is based on mutual trust, and defining the boundaries and rules clearly will help everyone involved, especially your child.

Managing in-home nursing is not always easy. It can be terribly frustrating sometimes, and it can take a while to feel like everything is under control, but success is possible.

Being thoughtful about the comfort and needs of the people who work in your home is a characteristic of a great Home Care CEO.

If your child comes home with a stable staff of nurses that remains stable for years without interruption, you might be a family of unicorns

provided in the table below. The requirements for a Medicaid pediatric ACO are contained in Section 2706 of the Affordable Care Act. ACOs established for commercial populations by private payers may differ from these Medicare requirements.

S.P. is a 68-year-old retired painter who is experiencing right leg calf pain. The pain began approximately 2 years ago but has become significantly worse in the past 4 months. The pain is precipitated by exercise and is relieved with rest. Two years ago, S.P. could walk two city blocks before having to stop because of leg pain. Today, he can barely walk across the yard. S.P. has smoked two to three packs of cigarettes per day (PPD) for the past 45 years. He has a history of coronary artery disease (CAD), hypertension (HTN), peripheral vascular disease (PVD), and osteoarthritis. Surgical history includes quadruple coronary artery bypass graft (CABG × 4) 3 years ago. He has had no further symptoms of cardiopulmonary disease since that time, even though he has not been compliant with the exercise regimen his cardiologist prescribed, he continues to eat anything he wants, and continues to smoke two to three PPD. Other surgical history includes open reduction internal fixation of the right femoral fracture 20 years ago. S.P. is in the clinic today for a routine semiannual follow-up appointment with his primary care provider. As you take his vital signs, he tells you that, besides the calf pain, he is experiencing right hip pain that gets worse with exercise, the pain doesn't go away promptly with rest, some days are worse than others, and his condition is not affected by a resting position. � Chart View General Assessment Weight 261 lb Height 5 ft, 10 in. Blood pressure 163/91 mm Hg Pulse 82 beats/min Respiratory rate 16 breaths/min Temperature 98.4° F (36.9° C) Laboratory Testing (Fasting) Cholesterol 239 mg/dL Triglycerides 150 mg/dL HDL 28 mg/dL LDL 181 mg/dL Current Medications Lisinopril (Zestril) 20 mg/day Metoprolol (Lopressor) 25 mg twice a day Aspirin 325 mg/day Simvastatin (Zocor) 20 mg/day Case Study 4 Name Class/Group Date ____________________ Group Members INSTRUCTIONS All questions apply to this case study. Your responses should be brief and to the point. When asked to provide several

Then in March 1993, everything changed. My one-year-old son, Charlie, had his first seizure. There’s absolutely nothing funny about being the parent of a child with uncontrolled epilepsy. Nothing. After a year of daily seizures, drugs, and a brain surgery, I learned that the cure for Charlie’s epilepsy, the ketogenic diet—a high fat, no sugar, limited protein diet—had been hiding in plain sight for, by then, over seventy years. And despite the diet’s being well documented in medical texts, none of the half-dozen pediatric neurologists we had taken Charlie to see had mentioned a word about it. I found out on my own at a medical library. It was life altering—not just for Charlie and my family, but for tens of thousands like us. Turns out there are powerful forces at work within our health care system that don’t necessarily prioritize good health. For decades, physicians have barely been taught diet therapy or even nutrition in medical school. The pharmaceutical, medical device, and sugar industries make hundreds of billions every year on anti-epileptic drugs and processed foods—but not a nickel if we change what we eat. The cardiology community and American Heart Association demonize fat based on flawed science. Hospitals profit from tests and procedures, but again no money from diet therapy. There is a world epilepsy population of over sixty million people. Most of those people begin having their seizures as children, and only a minuscule percentage ever find out about ketogenic diet therapies. When I realized that 99 percent of what had happened to Charlie and my family was unnecessary, and that there were millions of families worldwide in the same situation, I needed to try to do something. Nancy and I began the Charlie Foundation (charliefoundation.org) in 1994 in order to facilitate research and get the word directly to those who would benefit. Among the high points were countless articles, a couple appearances of Charlie’s story on Dateline NBC, and a movie I produced and directed about another family whose child’s epilepsy had been cured by the ketogenic diet starring Meryl Streep titled First Do No Harm (1997). Today, of course, the diet permeates social media. When we started, there was one hospital in the world offering ketogenic diet therapy. Today, there are 250. Equally important, word about the efficacy of the ketogenic diet for epilepsy spread within the scientific community. In 1995, we hosted the first of many scientific global symposia focused on the diet. As research into its mechanisms and applications has spiked, incredibly the professional communities have found the same metabolic pathway that is triggered by the ketogenic diet to reduce seizures has also been found to benefit Alzheimer’s disease, ALS, severe psychiatric disorders, traumatic brain injury, and even some cancers. I

A comprehensive study of this foundational assertion published in 2000 in the high-gravitas journal Pediatrics by CDC and Johns Hopkins scientists concluded, after reviewing a century of medical data, that “vaccination does not account for the impressive decline in mortality from infectious diseases . . . in the 20th century.”47 As noted earlier, another widely cited study, McKinlay and McKinlay—required reading in virtually every American medical school during the 1970s—found that all medical interventions including vaccines, surgeries, and antibiotics accounted for less than about 1 percent—and no more than 3.5 percent—of the dramatic mortality declines. The McKinlays presciently warned that profiteers among the medical establishment would seek to claim credit for the mortality declines for vaccines in order to justify government mandates for those pharmaceutical products.48 Seven years earlier, the world’s foremost virologist, Harvard Medical School’s Dr. Edward H. Kass, a founding member and first president of the Infectious Diseases Society of America and founding editor of the Journal of Infectious Diseases, rebuked his virology colleagues for trying to take credit for that dramatic decline, scolding them for allowing the proliferation of “half-truths . . . that medical research had stamped out the great killers of the past—tuberculosis, diphtheria, pneumonia, puerperal sepsis, etc.—and that medical research and our superior system of medical care were major factors extending life expectancy.”49 Kass recognized that the real heroes of public health were not the medical profession, but rather the engineers who brought us sewage treatment plants, railroads, roads, and highways for transporting food, electric refrigerators, and chlorinated water.50

A must-have for any doctor you’re considering for your baby’s care: a residency in pediatrics or family medicine and board certification by either the American Board of Pediatrics (ABP) or the American Board of Family Medicine (ABFM).

Keiko Shigeno, a board-certified Family Nurse Practitioner with licenses in 22 states, has shifted her focus to telemedicine in response to the changing healthcare landscape. Collaborating with leading telehealth companies, she delivers comprehensive care across various specialties, including urgent care, pediatric care, addiction health, mental health, weight loss management, women's health, men's health, skincare, and long-term health care.

De Schipper, E. J., J. M. Riksen-Walraven, S. A. E. Geurts. 2006. Effects of child-caregiver ratio on the interactions between caregivers and children in child-care centers: An experimental study. Child Devel 77:861-74.

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The cost of not caring for the mentally ill dwarfs the cost of caring.

It’s the feeling that one is a cog in a machine that doesn’t care. Burnout makes people angry, depressed, and unable to do or enjoy doing the work of patient care. Burnout is loneliness, isolation, and an invitation to addiction, alcoholism, and other forms of self-harm.

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Honestly, I came upon massage therapy by accident. I never had the intention of becoming a massage therapist. Originally, I studied pediatric occupational therapy knowing that I wanted to work with children in a health care capacity, but I had no interest in “poking and prodding” them. While in the OT program, I soon discovered the extent of the education I would receive in integrative therapies would consist of a three-hour intro to massage/tactile therapy, movement, music and art therapies. When I inquired as to when we would learn more, I was instructed if I wanted to learn more I should seek it elsewhere. I enjoyed receiving massage, so I decided a massage school would be a good place to start. So, I searched for a massage program to simply add as an adjunct to my practice in pediatric occupational therapy.

For the best pediatric chiropractic treatment, visit us at Family Foundations Chiropractic Clinic, located in Cloverdale, Surrey, and Dr Grewal will be more than happy to assist.

Dr. David Wilson is a Utah-licensed psychiatrist whose focus on pediatric patients extends to coordinating care with diverse healthcare providers. Currently, at Salt Lake Behavioral Health, he continues his commitment to mental health.

Common Childhood Illnesses that may require PICU Care – Motherhood Chaitanya Hospital As parents, we’re no strangers to the occasional bumps, bruises, and sniffles that come with childhood. But there are times when more serious health concerns arise, requiring specialized care and attention. The Pediatric Intensive Care Unit (PICU) becomes a haven for children facing critical illnesses. With expertise from the best PICU hospital in Chandigarh like Motherhood Chaitanya Hospital, let’s delve into some common childhood illnesses that may require PICU care, understanding the challenges and the avenues of support available.

By separating fact from fiction and understanding the true benefits of pediatric chiropractic care, you can give your child a head start towards optimal health and wellness.

the hospital to tape it to the closed door of Dr. X’s office. I had signed it and on the way back to my bed I began to worry. What if I had done something really foolish? If the surgical resident didn’t care about such things, why should Dr. X? I was off call the next day and, exhausted, I spent most of the time asleep. When I returned to the hospital for the evening shift, the pediatric day resident told me that Immy was no better. For the next few hours I took care of whatever was most urgently needed on the service, but later in the evening I stopped by the Intensive Care Unit to examine Immy and speak with her family. I found her parents in the waiting room. Together we went to see Immy. She was still unconscious. Leaning over to listen to her chest, I suddenly noticed a medal pinned to her hospital gown. Turning to her parents in relief, I asked if it was another one. “No,” her mother said, “it was the same one that was lost.” Dr. X had come that afternoon and brought it to them. I told them how glad I was that it had been found. “Yes,” her father said. “We are too.” Then he smiled. “She is safe now, no matter what happens,” he told me.

to her parents in relief, I asked if it was another one. “No,” her mother said, “it was the same one that was lost.” Dr. X had come that afternoon and brought it to them. I told them how glad I was that it had been found. “Yes,” her father said. “We are too.” Then he smiled. “She is safe now, no matter what happens,” he told me. The following morning, the surgery resident told me how the medal had been found. On the previous day, Dr. X had made his patient care rounds much as usual, followed by a dozen of the young surgeons he was training. But instead of ending the rounds in the ICU, he had taken them all to the laundry department in the subbasement of the hospital. There, he explained what had happened, and then he and all his residents and fellows had gone through the pediatric laundry from the day before

Pediatric chiropractic care provides a safe and natural way to manage scoliosis symptoms without resorting to invasive treatments like surgery.

The Baby Hospital forces you to ask the big question. It forces you to ask about Death and heaven and God. “Truly I say to you, whatever you did for one of the least of these brothers and sisters of mine, you did it for Me” (Matthew 25:40).147 Some of the children at the Baby Hospital certainly qualify as the “least of these.” “Let’s not get tired of doing what is good” (Galatians 6:9).148 It’s a privilege to care for children. It’s a privilege to be called during the worst time in a family’s life. It’s a privilege to be entrusted with the life of a baby. It’s a privilege to be expected to study, to overcome the bureaucracy of medicine, and to feel capable of commanding an OR. It’s a privilege to operate on the central nervous system. I can see Death. And I can see Heaven. I wish I could understand the tapestry of the universe, of existence, of nature. But I can’t. But I can see some things. I can see that there is a Song of Creation. I can even hear it. I can hear it in a child’s laugh, my favorite sound. It’s beautiful. Yes. It’s worth it. Because of this:

One good online resource is HealthyChildren.org, the website of the American Academy of Pediatrics. You can find a lot of information about common childhood ailments there and, in particular, good guidelines on when to call the pediatrician regarding your child’s fever and other conditions.

By the century’s end, all doctors had to have a college degree, a four-year medical degree, and an additional three to seven years of residency training in an individual field of practice—pediatrics, surgery, neurology, or the like. In recent years, though, even this level of preparation has not been enough for the new complexity of medicine. After their residencies, most young doctors today are going on to do fellowships, adding one to three further years of training in, say, laparoscopic surgery, or pediatric metabolic disorders, or breast radiology, or critical care.

American parents are depressed at twice the rate of the general population—that’s approximately 7.5 million depressed parents. According to a 2006 study published in the Journal of Pediatric Health Care, over one third of women of childbearing and child-rearing years have depressive symptoms.

I also praise the cooperative efforts in our pediatric intensive care unit. In fact, this togetherness permeates every aspect of our program here, including our office staff. We're friends, we work well together, we're dedicated to alleviating pain, and we're interested in each other's problems, too. We're a team, and Ben Carson is only part of that team.

I kept thinking how grateful I felt to have been part of this magnificent team. For five months we had been one unit, all specialists and all tackling the same problem together. The staff at the pediatric ICU and the consultants in the children's center reacted spectacularly. They rallied behind us and spent countless hours without charge, working to make this operation successful. As pessimistic as I was about the eventual outcome of the surgery, I still felt a glow of pride in being able to work side by side with the best men and women in the medical field. And the end of the surgery wasn't the end of our teamwork. The postoperative care was as spectacular as the surgery. Everything in the weeks following the surgery confirmed again our togetherness. It seemed as if everyone from ward clerks to orderlies to nurses had become personally involved in this historic event. We were a team--a wonderful, marvelous team.

Angela is a pediatric nurse practitioner who specializes in caring for children and adolescents with epilepsy who also have developmental and behavioral challenges. Her desire to be a nurse was first documented in her first-grade school journal, but it wasn’t until she was enrolled in higher education that her passion for caring for children with chronic illnesses came to light. Her practice philosophy places high value on partnering with families in a team approach and viewing children holistically so that problems, rather than symptoms, are treated.

Solution #1. ELIMINATE PAYOFFS IN CLINICS TO PROMOTE VACCINATIONS. It should be illegal for doctors to accept bonuses or other incentives from insurance or pharmaceutical companies for vaccinating patients. This practice is clearly a conflict of interest. When you take your child to a doctor, you want them to focus on your child and their health, and not on a yearend bonus some other company is paying to push vaccines. These bonuses/kickbacks provide a monetary incentive to the doctor and their office not related to the patient’s health, which is clearly a conflict of interest, and should be illegal. Without this bonus/kickback in their minds, perhaps the doctors can get back in the business of simply taking care of their patients, answering their questions, and providing them with better overall healthcare. If the pediatric office has no money dangling over them in the form of bonuses/kickbacks, then there should be no incentive to bar entrance to any family who wants to receive healthcare, unless the office is so full that they cannot accommodate new patients. This taking away of the bonus/kickback money will remove prejudice and bias against those who do not want to follow the recommended vaccine schedule, or who question the safety of the vaccines. And thereby, all patients will receive equal healthcare service under the law without bias. After all, isn’t this, shouldn’t this be the goal?