Archive | December, 2012

3 Simple Questions to ask about Bullying

25 Dec
Anti Bully


I punched a boy in the face when I was in the 5th grade. The principle made me sit in his office for the rest of the afternoon.   This was my punishment for trying to stop bullying at my elementary school.  I remember the principle teaching me adult concepts–concepts, that my little eyes totally glazed over.

All I knew was the following: Some punk-ass kid just called my friend fat and smelly.

Yeah, she was fat. And smelly, too.  But, NO ONE says that aloud in an attempt to hurt her feelings.   That was the only concept I really cared about.

Then came high school, repeated lesions of “conflict resolution” were recited to us ad nauseum.   Like a little good girl, I listened.   But have always rolled my eyes at such things.  Then came medical residency training: a young attending called me “A bad physician,” and said that I was “careless” in front of the entire 2nd floor.    My senior resident, told me to just be quiet and nod my head in agreement.   But, my instinct was to say,  “I do not want to be a bad doctor, so teach me how to be a better resident.”  I said this with my most  honest and sincere desire to improve my clinical skills.

I was looking for an honest critique and tools to improve myself.  But, as my senior resident said—the norm, in situations such as this is just  to “be quiet” &  let the person in authority rant, and you move on.   This was the status-quo, my senior resident taught me.  Just don’t take it personally, he guided me.    This is the norm, I thought to myself,  if ones wants to be among the status-quo.   Is this the adult version of “conflict resolution?”  Do we just now let bullies in positions of authority just rant?

I thought back to the little guy I punched back in the day.   From childhood to adulthood we are given tools by our authority figures that help us  navigate “Conflict Resolution.”      But, why are we not provided with tools  for conflict prevention?    As a family medicine physician, prevention is an essential part of my profession.    Yet, even my training as a family medicine physician has not always  been rooted in that concept.  I am a very analytical person, but somewhere in the bottom of “my gut” this pedagogy just does not seem correct.

I was reading the Journal of Pediatrics, from which, two leading studies regarding bullying and food allergies stand out in my mind.  In one, Dr. Shemesh from the Mount Sinai Medical Center in New York and his colleagues surveyed 251 kids who were seen at an allergy clinic with their parents. The children were all between age 8 and 17 and with a diagnosed food allergy.

“Just over 45 percent of them said they’d been bullied or harassed for any reason, and 32 percent reported being bullied because of their allergy in particular.”

Studies suggest between one in ten and one in three of all kids and teens are bullied.  The kids in the study were mostly white and well-off, this group is less likely to experience bullying.  So, then bullying, in general,  may be more common in poorer and minority children. 

We cannot encourage our young children to master their punching skills and become more like Mike Tyson.  Nor can we ask our children to “just be quite and look the other way.”  We must not only focus on conflict resolution, the conversation needs to switch to conflict prevention.  The lead authors of this study and the many pediatricians that I work with collectively stress that “we need to get the dialogue started with our children.”

Similar to Yael Cohen’s non-profit  Fuck Cancer which is a platform that  urges teenagers to ask their parents about cancer screening, we need to embrace that same message—Fuck Bullying!  We just need to get the conversation started with our children.    Some of us will be shy to use the F word, yes.  And I am not requesting that you use the F word with your children.  Pay attention, it’s a beautiful concept 🙂

A tool that I have used very consistently in my clinical experience is made up of three simple questions that I ask my adolescent patients.   Our children need their parents to be their allies in their lives.


So, Ask your kids these questions on a biweekly basis: 

1.  Do you feel down, depressed, or hopeless?

2.  Do you have little interest in doing things you like?

3.   Is someone bullying you in school right now?

As parents you can help your kids feel strong, without punching like Tyson or having them feel like they need to turn the other cheek.


Some Facts about Obesity

25 Dec

Here are some random facts about Obesity:

– Similar to how our muscles strengthen after lifting weights-

– Our bones respond to external forces such as our body’s weight, by strengthening our bones.

-Mechanical loading is a fancy way of saying the previous.

-Obese children tend to have mostly upper extremity fractures because their upper extremities (arm &hands)  aren’t  being loaded to the same degree, as their chubby little legs.  And thus, are more prone to fractures.

-Autoimmune antibodies in Celiac disease attack ones’ bone matrix.  This action is considered to be the mechanism behind bone destruction seen in celiac disease.

-50% of cats in the US are overweight. And, as another random FYI:  I am not a cat person.

chubby baby

Fries with that?

-Obese people are more likely to have chronic hair-loss, erectile dysfunction (ED), and infertility issues.

-Five percent of people surveyed said  they would rather lose a limb.   But, there are more obese Americans than Americans without limbs.

-Losing a limb is not a cure for obesity.  Rather,  it can occur with poorly controlled diabetes and obesity.

-Obesity ranks second among  preventable causes of death. Tobacco use is number one. Fuck Obesity.

-Cellulite is NOT the only skin condition you need to fear as a result of obesity.   Keep in mind: it’s harder to air-brush cellulitis, lymphedema and candida interigo than cellulite.

-Cellulitis is not Cellulite.  Candida Interigo is a yeast infection of your skin folds.   Please google image search these.

-The three main orthopedic diseases in children due to obesity are: slipped capital femoral epiphysis (SCFE), upper limb fractures, and perhaps Blount’s disease.

– Not all patients will benefit from bariatric surgery–as some are too overweight to get this procedure!

-Bariatric surgery has shown to reverse Type II diabetes.

– Chubby is not the new black.

-“With my sunglasses on I’m Jack Nicholson; without them, I am fat and 60.”  -Mr. J. Nicholson

-Sunglasses are not a cure for obesity.


Santa’s choice of drink

25 Dec


Happy Holidays

25 Dec


Happy Holidays

So, I pulled up to the Starbucks drive through on Christmas Eve and Nick asked, “What would you like for Christmas?” I said “a medium black coffee, double cupped.” For those of you that don’t personally know Nick, you are missing out. Though, most of you probably know him from one of my first entries on my blog.

Nick for the last 16 months has asked me on an almost daily basis as to why I choose to have my cofee black. No, he’s never said “Once you go black, you dont…” Pay attention!

I explain the details of my AM coffee to him, Everyday. In the drive-through lane. Our latest conversation has been about non celiac gluten sensitivity and why a young man chooses to wear skinny jeans. I teach him about the former, he the latter.

“So, you just want a black cup of coffee for Christmas?” I smile at him, and say: “Yes, just that.”

This time, he simply smiled at me and said “Happy Holidays.” This was my first interaction with Nick in which I did not need to bust out my “super celiac educator cape” for the 1 in 133 people out there. There indeed was a lot of smiling going on.

I consider it to be my responsibility as a physician to educate people about Celiac disease, on a daily basis. I smile alot, nod my head to show that I am actively engaged in conversation, and BHAAMMM!! They end up learning something.

This time, I smiled back at Nick, and just needed to say “Happy Holidays.” No teaching, no educating needed today. For the first time, I felt like all the other people in the line: I simply felt like an anonymous overpaying Starbucks’ customer. I felt normal. And then Nick, in his deep Tom Brokaw– voice said, “The driver in front of you paid for your coffee.” I was touched by their random act of kindness, especially since I was guilty of tailgating them too closely and totally violated their personal space in the drive-through lane.

And then, I became even happier when I heard what Nick said next: “ They asked why you wanted a black coffee, and I told them “it’s because are you are allergic to soy, gluten, and dairy.”


To learn more about Nick:


11 Dec

I’ve been quite busy for the past two weeks. I attended a major preceptorship on Celiac Disease & I’ve been working for some cool things for the blog.

I will continue very shortly!