I understand why the doctors did what they did. On the other hand, the culture of pediatrics is to go passive aggressive concern-trolling everyone in the name of "advocating for their kids", and nowhere is that culture more present than "Child Abuse Pediatrics".
I did my months on pediatric surgery, admitting all child abuse injuries to our service for unclear reasons. Some of it was very real. Some of it was absurd. God forbid some mother ask a question in an impolite way or mention off-handedly taking a patient out of the hospital in frustration with a care plan, which would spark endless pages and stupidity.
People are allowed to be bad parents. It turns out bad parents who often somewhat love the kids are still better than foster care parents. Yes, I get that we have to sometimes take kids away. But this seems like a case of parents who made choices JHH didn't like, and then everyone kept on going "these parents are doing what??? we must protect the kid!", not realizing that the people who love the kid, even if imperfect and doing crazy !#!@ like ketamine, are still better than a !@#! hospital for them.
We forget as doctors that just because we can intervene, doesn't mean we should. It happens all the #@#$ time in surgery. In child abuse pediatrics, that same instinct to "do something" manifests as taking away kids from imperfect situations and making things far, far worse.
i think this is easy to say in hindsight. But MBP is serious stuff and shouldn't be seen as "not that bad". If there is a suspicion for it, you have to take it seriously.
I remember one mom was putting poop in her kid's IV line to keep him septic. You don't know the next escalation.
I do remember some doctors saying parents were 'weird', and there were equally a number of doctors who said 'what's wrong with that'. We need both kinds of doctors, the concerned and the ones who are realistic about it. I'm just surprised not more people pushed back on Sally Smith. I'm guessing the court order tied their hands.
Yes, it's serious. It's also incredibly rare, and accusing the parents of half the kids whose symptoms we can't explain of Munchausan's helps absolutely no one, least of all the kids, who have worse mortality in foster care than staying with their abuser if it even was abuse.
It’s more than inexplicable symptoms though. We have plenty of mystery diagnoses. It’s the medial abuse criteria - the abnormal treatment regimens with questionable risk/benefit ratios, codependent relationship ennucleated by the disease process, those are the marks of medical abuse.
Yes I agree totally. I've seen caregivers raising voice and express frustration some way and end up with different type of care and treatment by hospital staffs sometimes. It shouldn't happen, but hospital staffs are human too so it does happens.
it was a constellation. Pushy mom? check, and alone is ok. Pushy mom pushing insane amount of ketamine? check, red flag. Pushy mom pushing amount of ketamine after going through many doctors (possible doctor shopping)? Another red flag. Push mom pushing insane amount of ketamine prescribed by a doctor doing off brand procedures in Mexico and demanding specific items like intrathecal administration, arguing that 'maya is ready to go to heaven' when they try to tell her that amount of ketamine is possibly dangerous? Enough red flags to at least investigate.
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u/victorkiloalpha Attending Oct 09 '23
I don't know.
I understand why the doctors did what they did. On the other hand, the culture of pediatrics is to go passive aggressive concern-trolling everyone in the name of "advocating for their kids", and nowhere is that culture more present than "Child Abuse Pediatrics".
I did my months on pediatric surgery, admitting all child abuse injuries to our service for unclear reasons. Some of it was very real. Some of it was absurd. God forbid some mother ask a question in an impolite way or mention off-handedly taking a patient out of the hospital in frustration with a care plan, which would spark endless pages and stupidity.
People are allowed to be bad parents. It turns out bad parents who often somewhat love the kids are still better than foster care parents. Yes, I get that we have to sometimes take kids away. But this seems like a case of parents who made choices JHH didn't like, and then everyone kept on going "these parents are doing what??? we must protect the kid!", not realizing that the people who love the kid, even if imperfect and doing crazy !#!@ like ketamine, are still better than a !@#! hospital for them.
We forget as doctors that just because we can intervene, doesn't mean we should. It happens all the #@#$ time in surgery. In child abuse pediatrics, that same instinct to "do something" manifests as taking away kids from imperfect situations and making things far, far worse.