Dr. Claire McCarthy is a primary care physician and the Medical Communications Editor at Boston Children’s Hospital. Along with her blogs here on Thriving, you can find her at the Huffington Post and Boston.com. Follow her on Twitter @drClaire.
Medicine can do amazing things these days. Whether it’s face transplants or new treatments for diabetes or curing many kinds of cancer, it can seem like medicine can do everything.
But medicine can’t—and shouldn’t—do everything.
There were a couple of news stories this week that got me thinking about this. First, there was a study published in Pediatrics showing that when a fussy, spitty baby was given the diagnosis of gastroesophageal reflux disease (GERD), parents were more interested in getting medication for their baby than they were if the fussiness and spitting were simply referred to as “a problem.” And here’s the crazy part: they still wanted the medicine even when they were told it likely wouldn’t work.
The thing is, lots of babies are fussy and spitty. The vast majority of those babies are, well, just fussy and spitty babies that get better with time. There is nothing actually wrong with them. It’s a problem, sure, but it doesn’t warrant a diagnosis, let alone a medication—but that doesn’t stop lots of doctors from giving both. Mostly, doctors do it in an attempt to be helpful—and we do it because it’s easier for us to give a diagnosis and a medication than teach parents to deal with a really stressful baby.
But when we do that, not only do we risk side effects from the medication, we risk giving parents false hope. And more importantly, if they think it’s a disease, it gets in the way of helping parents actively find ways to soothe both their baby and themselves. It gets in the way of helping them learn problem-solving, perseverance and patience, which are three lessons all parents need to learn.
And the news about the rise in diagnoses of attention deficit hyperactivity disorder (ADHD) is even more worrisome. Apparently data from the Centers for Disease Control and Prevention (CDC) shows that nearly one in five high-school boys, and 11 percent of school-age children overall, now carry this diagnosis. This means that compared to a decade ago, the number of kids ages 4 to 17 who have ever been diagnosed with ADHD has gone up 41 percent. That is astounding and scary—especially when two thirds of the people with this diagnosis get a medication for it.
Now, some of this increase is clearly real. Whether it’s the effects of too much fast-paced media, or that overscheduled kids don’t get a chance to learn the self-organization and social skills they need, or whether it’s something in the environment or food, or something else entirely, we are seeing more ADHD. But some of the kids in that 41 percent are essentially normal kids who happen to be a bit active, impulsive or distractible. And some of them are perfectly normal kids who are caught up in our achievement culture and want to get better grades.
Treating those kids with medication may calm them down. It might even give them better grades. But there are other ways to do that, ways that don’t involve medicines with possibly dangerous side effects. There are techniques their parents and teachers can use, and skills the children can learn, that would not only be safe and effective—but would work for the rest of their lives. Like problem-solving, perseverance and patience.
There are lots of times when medicines and other treatments are really necessary and make all the difference. But all of us, doctors and patients alike, should ask questions before we take or prescribe medicines and treatments. We should always ask if there’s another option—and whether, perhaps, that option might be better.
Sometimes, the best thing to do as a doctor, or a parent, has absolutely nothing to do with a medicine or treatment. Sometimes the very best thing we can do is support and be at someone’s side, help them learn how to make it through the next hour, the next day, or maybe even the rest of their life.
Which, I think, is every bit as amazing as curing cancer.
I remember the first time I saw my son’s name on his gravestone. I felt like I’d been punched in the stomach.
