Commentary on medical news by a practicing physician.

  • Epocrates MedSearch Drug Lookup


    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov

    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.

    "Opinions are like sphincters, everyone has one." - Chris Rangel

    email: medpundit-at-ameritech.net

    or if that doesn't work try:


    Medpundit RSS

    Quirky Museums and Fun Stuff

    Who is medpundit?

    Tech Central Station Columns

    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews


    Medical Blogs


    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc




    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It


    SOAP Notes


    Cut-to -Cure

    Black Triangle



    Kevin, M.D

    The Lingual Nerve

    Galen's Log



    Doctor Mental



    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House



    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day


    The Business Word Inc.

    Point of Law

    In the Pipeline


    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station





    The Skeptic's Dictionary

    Recommended Reading

    The Doctor Stories by William Carlos Williams

    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn

    Intoxicated by My Illness by Anatole Broyard

    Raising the Dead by Richard Selzer

    Autobiography of a Face by Lucy Grealy

    The Man Who Mistook His Wife for a Hat by Oliver Sacks

    The Sea and Poison by Shusaku Endo

    A Midwife's Tale by Laurel Thatcher Ulrich



    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info



    Tuesday, June 08, 2004

    Professional Stupidity: School officials in New Mexico reported a father to the state's child protective services because he stopped the kid's Ritalin:

    In February, 12-year-old Daniel began displaying some symptoms that his father suspected were related to the use of Ritalin.

    'He was losing weight, wasn't sleeping, wasn't eating,' Taylor told ABC News affiliate KOAT-TV in New Mexico. '[He] just wasn't Daniel.'

    So Taylor took Daniel off Ritalin, against his doctor's wishes. And though Taylor noticed Daniel was sleeping better and his appetite had returned, his teachers complained about the return of his disruptive behavior. Daniel seemed unable to sit still and was inattentive. His teachers ultimately learned that he was no longer taking Ritalin.

    School officials reported Daniel's parents to New Mexico's Department of Children, Youth and Families.Then a detective and social worker made a home visit.

    'The detective told me if I did not medicate my son, I would be arrested for child abuse and neglect,' Taylor said.

    The symptoms that the father noticed - poor sleep, loss of appetie, and weight loss, are all, indeed, side effects of Ritalin. Evidently for both the doctor and the teachers, it's far better to have a subdued child than a healthy one. And reporting the father to the state for discontinuing Ritalin is ridiculous. It isn't as if the kid were taking it for a serious, suicidal depression or to control schizophrenia. He's taking it so he'll be quiet in the classroom and not overtax his teachers. The father is right, and he knows it:

    Taylor told KOAT-TV he is not putting Daniel back on Ritalin, no matter what the consequences for himself may be. "Yeah, I'll go to jail for it," he said. "I'll go as long as I have to go."

    UPDATE: A reader takes me to task:

    Your statement " It isn't as if the kid were taking it for a serious, suicidal depression or to control schizophrenia. He's taking it so he'll be quiet in the classroom and not overtax his teachers. The father is right, and he knows it."

    Sydney, way to fast of a rush to judgement: a possible disservice to the child, an unnecessary indictment of educators, not clinically accurate and it reinforces a stereotype about the serious of some ADHD diagnoses. The agency I run sees the most problematic of the problematic--youths who are seriously suicidal, psychotic, depressed, profoundly encumbered with advanced substance abuse and I can tell you that some of the most ill, symptomatic and challenging are kids where ADHD is the most appropriate diagnosis. And you know, regardless of popular press, many kids with ADHD have a biologically based disorder that can respond beautifully to appropriate medication. Is medication misused, of course. Is it important and critical to appropriate functioning for some kids, of course.

    Who knows about this particular case? What I do know is that you are not in position to rush so quickly to judgement. I do not know what lead to the schools decision--on the surface it appears quirky and perhaps unsupportable--but so did the story last year about the Sheriff who reported a parent for child abuse because her child was getting sunburned at the county fair. The Sheriff slept well and a few months later, after being a laughing stock, the parent was charged with homicide and child neglect of that same child.

    That's true. We don't know all the particulars of this case - only the father's point of view. However, dealing with the worst of the worst has a tendency to skew one's viewpoint. This child may be one of the truly bad cases in need of the medication, or he may be like the many children who pass through my office who aren't such great students and who fidget a lot, and who bring letters from their teachers asking that they be treated for ADHD. What's most disturbing about these letters is that they often describe my own daughter to a tee. And yet, none of my daughter's teachers have ever asked that we have her evaluated for ADHD. The reason? She learns quickly, so she doesn't tax her teachers that much. In my daughter's case they shrug off her behavior as boredom. (It isn't. She's always in a fidget.) But another kid who requires more effort to learn, and more effort to teach, gets labelled as ADHD. That's just not right.

    And there's another disturbing thing I've noticed about this quickness to diagnose ADHD on the part of school systems. It's much more prevalent in the poorer ones, where teachers don't have as many resources and where many of the kids have a lot of other underlying social problems. Here on the frontlines of community medicine, it's apparent that for many teachers Ritalin is a quick and easy fix. Actually, it often isn't the fix they need, but it makes the teacher feel like he's doing something to help. And it's a lot easier than finding a way to teach a problem kid.


    posted by Sydney on 6/08/2004 08:23:00 AM 0 comments


    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page


    Home   |   Archives

    Copyright 2006