It's a BOY!

Ellis Moser and his Proud Parents

Of course, we knew he was going to be a boy months ago. There are few surprises in obstetrics anymore, unless of course, you are having a litter of septuplets that end up to be octuplets at the time of delivery. New parents are very excited when they spot the weenie on the ultrasound. In the old days, we had to wait until the baby was born to know what parts they wore. When I saw pregnant patient in those days, I would always guess the sex of their unborn baby. Surprisingly, I was right 50% of the time.

Since I am no longer in family practice, I really miss that aspect of medicine - informing a woman that she is pregnant. I would always ask during the exam, as I waited for the pregnancy test results, "What will be your reaction, if I tell you that you are pregnant today?" If they said they will be elated, I was happy. If they indicated that this would not be the best news, I would prepare myself. The greatest part of family practice was diagnosing a wanted pregnancy, and then having the privilege of watching that little baby grow up. The downside of family practice is that someday that baby may grow up and get pregnant and that this event was not anticipated.

Last Thursday, my daughter-in-law was induced about ten days before the due date. I was a little suspicious about this planned, early induction thinking the OB was just trying to get the delivery out of the way before Super Bowl Sunday. The delivery was uneventful and the baby was fine. I heard him screaming over the cell phone when I got the news. His name is Ellis.

We are glad our new grandson (my first biological grandchild) was healthy and glad he was just one, and not one of eight. I haven't seen him yet (just email pictures), but we are driving down in a few weeks when things quiet down a bit for the official "Ellis Meets the Grandparents" event. I desperately need to hold that little boy.

I talked to my son last night and the new father said that the baby cries from midnight to about three AM. I am quasi-sympathetic, because my son did that, too. Night shift with a new baby is a rite of passage. It helps to toughen up the new, sleep-deprived parents. Fortunately, both parents (and the new grandmother) are there to help him get through this initial transition.

I am glad that this wasn't a C-section. I always sympathize with the baby in this situation. Here you are...kicking back in your little dark room, when all of a sudden; a gloved hand reaches in, grabs you by the neck and pulls you out into a brightly-lit room full of noise and confusion. In my opinion, this is equivalent to me sitting in my reclining chair, when all of a sudden; someone rips a hole in the ceiling, reaches in and pulls me out. That would freak me out. I would much rather take my sweet ‘ol time "walking down the hall".

California, my adopted home state, is famous for alternative medical practices, like re-birthing experiences. I can't say that I would want to go through that again, although my memory of my first birth is nil. I am not really sure how they conduct that rebirthing thing, but I fear they may have some artificial vagina that you crawl through or something. Since I don't like caves, this would not be particularly appealing to me. I am here now. That's all that matters. I don't see how rebirthing is going to really help me in my life at this point. The "Curious Case of Benjamin Button", I am not.

I stared at those pictures of my new grandson and saw my son as a baby again. I was flooded with those wonderful memories. When you look at the face of a new baby for the first time, you see the future. A little boy with your same last name will be growing up, playing baseball, graduating college, and if you are fortunate enough to live two more decades or so, you may experience the eyes of another generation when he becomes a father. Babies represent newness and life, but sadly, they also remind us older folks that our clock is running down. I am not really worried about that clock; I am just going to enjoy the moment - the moment that I became a grandfather, and all of the years to come.

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When Your Kids Move Out

I have been doing college physical exams for the last several months. It is really exciting to see these young, eager kids (until they are 18!) starting their new lives. I have seen dozens of aspiring engineers, psychologists, teachers, and health care professionals getting ready for university life. Moving out to attend college is very empowering.

Their parents are proud, but they are also very anxious. For many, this is the first time they will be on their own (sort of). Some of the kids are ready. They are already independent, self-disciplined, and mature. For others, college is going to be a time to seriously par-tee! Parents worry about drugs, sex, binge drinking, and other college hazards.  Recently I had a heart-to-heart discussion with a young man about tobacco use. For some unknown reason, this young man, at the height of his physical well-being, decided it was a good idea to start chewing tobacco. Bad decision. He was given my famous anti-tobacco lecture and seemed to listen. I asked him if he used seatbelts.

"Always," he said.

"If you are going to take a chance at developing mouth or throat cancer from using tobacco, you might as well not wear seatbelts either." I think I made my point.

Privately, he also admitted to occasional marijuana use, drinking, and every parent's worst nightmare - having sex. He does not use condoms because his girlfriend is on the pill.

"Ever seen her swallow one?" I asked.

"Girls who want to become pregnant will get pregnant. You may be interested in the pleasure of sex, but secretly, she may have selected you as the future father of her baby; obviously without your expressed consent." If you must have sex, use condoms; even if she is on the pill.

My old college roommate left for the Navy at the end of our first year when his girlfriend became pregnant. They married, had a beautiful little girl. He returned to finish his medical training five years later after completing his Navy obligation. Because he had one year of medical training, the Navy decided he would be a good dental hygienist. After five years of cleaning teeth, he was ready to pick up his life where he had left off.

Becoming a responsible adult does not automatically happen on your 18th birthday. It is a gradual process of trial and error; good decisions and bad decisions. It can be an endless series of mistakes before finally achieving measurable success. Success, of course, is the progressive realization of your OWN predetermined goals and objectives.

Some parents are absolutely elated that their child is moving out. I got a kick out of the television commercial where a couple is saying their goodbyes to a son, standing beside his loaded car. As he drove off to college, they high-fived each other and headed for his old bedroom, measuring it for a pool table and spa.

I vividly remember my first day at college. I was so glad to be out of my parent's house and on my own that I could have shouted aloud. I attended school on an academic and work scholarship, so I didn't need to ask anyone else for a dime. My kids, of course, asked for that dime; lots and lots of dimes. At one time, we had four in college at the same time. Now, we have one in college with two more years to go.

My daughter has been on her own for the last ten years or so; getting financial help from time to time when she needs it. This week, she informed me that she was heading for the University of Washington. Unlike the parents who are high-fiving their kid's departure, I am sad. I will miss her dearly. E-mails and phone calls are not the same as our weekly get-togethers. I love Seattle, so I guess I will be doing some traveling.

In three more years, our oldest granddaughter will be heading off to college. I know her younger brothers will be happy about that; but we will be missing her, too.

Kids grow up. Kids leave home. Some kids come back; some only visit. Such is the life of a parent.

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Spoiled Rotten Kids - Part Two

Children that are from financially-privileged families, those that seem to have all of the best toys and the best opportunities were discussed in Part 1. I would now like to comment on the "other" spoiled rotten kids - the ones that lack discipline, respect for parents and other adults, and the one's that seem to get away with murder (hopefully, figuratively).

We all see them. They are the one's screaming in the cereal aisle at the grocery store; or the one's having a fit at the kid-height candy stand at the checkout. We see spoiled rotten kids in restaurants, school functions, and at the sports fields. Day-care and preschool providers live with them every day.

A pediatric office is a place to do an anthropological study and child-parent interactions. When children come for medical care; either when ill or for preventative services, they do not come alone. One or both parents are usually accompanying them. More often than never, a cadre of siblings will also be there - as interested observers or annoying distracters. Grandparents also tag along from time to time - a true family reunion. The smaller the examination room; the more people there are; trying to find places to sit among the automobile-sized strollers.

At least one child will be on my roller stool, spinning around or trying to stand on it. I took the liberty of posting some basic exam room etiquette "rules" such as don't play on the stool, don't take out all of the gloves from the drawers, don' t take out the pelvic exam stirrups, or play with the expensive instruments. We like to give out stickers and sugar-free lollipops to the little ones, but I have to remind parents every day not to do this until AFTER the visit. They may be sugar-free, but they are not sticky-free. And, there is nothing like seeing a child with a sore throat who has been eating a red lollipop or drinking red Hawaiian punch before I had a chance to examine him.

One day, while sitting in my office typing some notes, I heard one my rolling stools flying from one end of the exam room to the other. Clearly, some oblivious parent was allowing the child to play on it. Since I had one child that kick-launched himself into the corner of a cabinet a few weeks prior, cutting a big gash in his head (I had to put in 5 sutures), I knew I needed to intervene. When I opened the exam room door, I did not find a child on the stool, but rather a Dad happily lying on his abdomen; darting from side to side, using his legs to kick off. He was embarrassed. Good.

When you open the exam room door to enter, you are rarely surprised what you will find. It could be a mother happily talking on the cell phone ("Gotta go. Doctor just came in.") while the child has taken all the exam gloves out of the box and put them on the floor. Or, they are tearing the pages out of the children's books that I brought from home. Those books survived five of our kids, only to be destroyed by an unsupervised child.

I encourage them draw on the exam table paper to occupy their time while waiting. The older kids can play Hang Man or Tic-Tac-Toe; the younger one's can scribble or draw pictures (often very cute). Unsupervised, the younger ones go beyond the table and try to decorate the walls. I completely gave up on putting up anatomical and educational posters because they just get ripped up. My PA wife was smarter, she had hers laminated.

All of these breaches in common etiquette reflect directly on the parent's ability or inability to supervise or appropriately discipline their children. Parents who do not let their kids jump on their living room furniture will allow their children to jump on mine; even with muddy shoes. Parents who do not permit their children to eat crackers in the living room, will allow children to drop them all over the floor, only to leave without offering to clean it up. There are so many cheese goldfish on my floor some days that I could survive a famine.

It is good that parents do not hit their children anymore, but that does not mean a parent should allow a child to hit them (or me). I see toddlers punching their mothers in the face, and I have had several toddlers try to take a bit out of my leg. Granted, toddlers are not a good example, because most are inherently mean. The Terrible Twos tend to start at age 15 months with stranger anxiety, and supposed to end before age three. Some children will carry whining and tantrums well into their teen years and beyond.

Thankfully, undisciplined children are not the majority. Most of my little patients are delightful and respectful - this is why I love pediatrics. Most parents are wonderful; especially the Moms (Some Dads are clueless, I have to say). I am heartened when I find a sulking child sitting in the corner in "time out", or the peripheral entourage of kids quietly reading, listening to music (with headphones), or doing their homework. I am delighted when I see a parent reading to a child, instead of talking on the phone while their child destroys the books.

I love it when I see a parent stick to their guns. No means no. It is not negotiable. If you don't behave, you will not get a lollipop. Twenty minutes later, I will see that same child decompensating down the hall, screaming that he wants a lollipop. I told you. You wouldn't listen. Maybe next time you will get one.

I think I can handle undisciplined children (and their parents) quite well. After thirty plus years in this medical business, I don't hold my tongue anymore. I will intervene if I see a parent being abused by a toddler, or a teenager being verbally disrespectful to parent. I will also proudly comment on excellent behavior when I see it; both to the child and the excellent parent.

Positive discipline goes a long way. Children need boundaries and limits. They need to experience disappointment and logical consequences; as well as receive rewards and accolades for positive acts. They need to see examples of acceptable public behavior from their parents. The "Don't do as I do, do as I tell you" approach to parenting just doesn't work.

Lastly, children need attention and they need love. When they seek out parental approval, they should get it. When they try to please, it should be noticed and acknowledged. And, when their behavior is inappropriate, regardless of the setting, they should not get away with it.

All children are good. Good children occasionally do bad things. Bad things have consequences. Good parents have the ability to discipline with love.

Spoiled Rotten Kids - Part One

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Spoiled Rotten Kids - Part One

There is nothing like a pediatric practice to demonstrate a wide variety of parenting (or lack of) styles. I see 'em all. Can you really have children who are considered spoiled rotten?

A well-cared for and loved child may be viewed as spoiled rotten, but these are not the kids I am talking about. I am talking about the kids that have the best of toys, the finest designer clothes, and devoted parents who make sure the get the best of everything. I see kids with expensive iPods, their own, high-tech cell phones, and some pretty impressive toys. I have teenage patients who drive better cars than I drive (I actually have issues with that one). If people have the financial ability to provide their children with those things, then who are we to judge?
We helped all of our kids (all five of them) buy used cars when circumstances dictated that they needed them, such as sports practices, college, or after-school jobs. Most of our kids were grateful; some were miffed that we didn't lease them a BMW, like Kim's dad.

I said, "Why don't you call Kim's dad and see if he will get you one, too."

Some of my older patients are heading off to the universities - Stanford, UC Berkeley, Cal Poly, Yale, and Harvard. Their parents are forking out a King's Ransom in tuition. Of course, I had to work my way through school by dumping bedpans and feeding old geezers, but I am not jealous. I am not jealous because I couldn't have been ACCEPTED to those schools, let alone afford to go there. I am justifiably humbled by their accomplishments and tell them so. From a financial point of view, I am glad that my kids attended state schools. It was hard enough with four of them in college at the same time. Thank God for student loans to postpone some of those costs. We only have one more left in college, which is good since I would like to retire some day.

I have one father who built an Olympic-class pole vaulting run in his backyard so that his son could train. Parents travel the country with their kids who are in competitive soccer leagues. We have several friends who sent their kids to Europe (for fun), and one who sent their son to Japan to study the violin (he does not play the violin anymore). My heart goes out to the families that support their children in sports or other pursuits. Special kudos to Michael Phelps's mother and all those like her. I was not a promising athlete or musician, so my parents didn't have to shell out squat. My parents chose not pay a dime toward my college education, either.

A large number of my little patients attend preschool - some of the more prestigious (and expensive ones). My kids went to Montessori School - about thirty years ago now - and I was shocked by the costs then. I was amazed that it cost more for my daughter to go to Montessori for one year than it did for me to get a graduate degree at UC Davis. She even had more fun that I did. Nowadays, I have no idea how parents can afford to send their kids to private preschools and schools. I guess you can't put a price on good education. Wait! Yes, you can.



My wife did attend a snooty private school outside of Boston when she was in high school. It was the same school that her mother attended, so it was sort of expected that she would go there some day as well. She even had classmates named Muffy and Winky (I am not kidding!). In Appalachia, I had classmates named Cletus and Buck. She went to school with crowned African princes, movie star and politician's kids. Many of my classmates went to jail, or quit school in junior high to work in the coal mines. My wife and I both work in the same clinic and get the same salary. We are equal in every respect. She just has better class reunions that I do. I tease her about her private, finishing school, but I would have given my right arm to go there. Her tuition was a subsidized $6,000 a year in the mid-1960s - a lot of money in those days. It is $43,600 a year now. Even adjusted for inflation, that is still a huge tuition.

Do children appreciate things more if they have to work for them? Perhaps, but if they have a choice, they would prefer that you gave it to them Scott-free. The first car that we gave our kids was a very used Olds Vista Cruiser station wagon with faded wood grain on the sides; like the one Chevy Chase drove to Wally World - not what you would call a Babe Mobile. We found out that they parked it a few blocks from school so that the other kids would not see them in it. Very few of our kids dated seriously while in high school; perhaps, due in part to this car - our BCV (Birth Control Vehicle).

We didn't pamper (actually we did use Pampers) our children; and they seemed to turn out just fine - an attorney, two engineers, a registered nurse, and hopefully, an MBA in marketing. They don't drive fancy cars; they go to work everyday, pay their mortgages, and the ones who have children do not pamper them. Our grandchildren go to public school (those that are old enough). If anyone spoils them with toys and gifts, it is us; my wife, actually - 'Ol Giftin' Grammy.

Spoiled Rotten Kids - Part Two

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