Saturday, January 16, 2010

A paediatrician who needs to be spanked. Do it for the children.

I have often blogged about the fact of my incidental motherhood. Recently one of my skeptic-spawn has come down with what I am convinced is a bout of giardiasis, sans diarrhea. We just spent christmas in my childhood home in the tropics where the little blobby parasites in question are endemic, and it has been going around the local paediatric population. The only problem is, my dear little infected sproglet doesn't have diarrhea, just all the upper abdominal symptoms, and the local general practice population here in more temperate climes seem pig-ignorant of what a protozoan hoe-down actually looks like clinically. I tried to explain to them that giardiasis often present without diarrhea. Then in desperation I even explained that many other children my kid had been playing with have presented with the tell-tale diarrhea (actually, the way it was relayed to me was that a certain child "vomited mayonnaise out of his arse".)

The fact that some people only get upper abdominal symptoms with giardia infection isn't exactly new, I have a prehistoric parisitology textbook from the 1950s that even makes note of it, and that matches my own clinical and personal experience. After doing a rather puzzled internet search, I uncovered an amazing thing: There is something like 30 giardia fact sheets from around the world that have exactly, and I mean verbatim, the same true, but clinically misleading information on them. The CDC and the New South Wales health department among them. Whereas my ancient parisitology textbook was written by a boffin who based his information purely on what he saw himself down a microscope and in the people who he presumably chased for stool samples.

We are becoming a profession of gullible rubes. Its so easy to go and google something that nobody stops to think about what they actually see in front of them. Or what that crotchety old GP spent fifty years seeing in front of him, and then told you about. I'll admit tropical medicine is my schtick, I wouldn't know a chillblain if I found one on my arse, but I found it disturbing that if you got all of the GPs together that I have had to see in the last week, you would probably get one knowledgable doctor in the aggregate.

So I'm sitting here nursing a good head of hate for other peoples' willfull ignorance, when all of a sudden I come across a JAMA article called "Cimate Change Puts Children In Jeopardy" by Rebecca Voelker. Yawn. Whatever. Heard it all before. I must have been feeling masochistic, though, 'cause I kept reading. Mostly it was all the same tired old crap about how children are going to be hurt most by climate because they are the future. Or the future was going to hurt them because of the climate. Something like that. Then I see this:
When pediatrician Aaron Bernstein, MD, sees young patients with Lyme disease at Children’s Hospital Boston, in Massachusetts, his advice to parents often goes beyond the obvious of protecting their children against infectious ticks with insect repellant, long pants, and long sleeves on trips to the woods.
I think I knew where this was going, and I didn't like it. I had to read all the way to the end of the article, past the bit where they recommend saving the children by replacing wholesome incandescent bulbs with toxic mercury bombs, to get the second bit of the Lyme disease story.
Back in Boston, Bernstein makes an effort to give his patients’ parents a quick rundown on how such vectorborne illnesses as Lyme disease that make their children sick are linked with climate change and its influence on ecosystems.

Oh. Sweet. Lord. Of. Crap. Fire this man immediately. IMMEDIATELY!!!!! At the very least make him do some remedial undergraduate pre-med biology classes. Or medical ethics. Or maybe we could explain to HIM, with his kids present, how his children are all doomed and its all his fault.

How does he even vaguely think this is going to help the parents of a child who has FRICKIN' LYME DISEASE?!!! This man obviously cares about his patients above and beyond the call of duty, does he also espouse paediatric bubble-wrapping? Microchipping? (Actually, I have considered microchipping my children, but thats different.)

OK. Breathe, Paua. Breathe. Think of a happy place. You're on a beach somewhere. A polynesian David Thewlis has just shown up with a jug of mojitos...

Its going to be alright...

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