Joseph Cramer, M.D.: The present is so overwhelming we need a good nap
Rip Van Winkle has nothing on me. He goes up into the woods, meets the Dutch bowlers who make thunder, tastes their ale, falls asleep and wakes up 20 years later.
I leave the academic medical center, go up into the wilds of private practice, meet kids who scream louder than thunder, taste the sweetness of parents, have troubled sleep for a while, then I return to an acclaimed modern children’s hospital after a 30-year absence.
Talk about back to the future.
There is so much different now that one has to have a tight belt and pantyhose to not have their socks blown off. There are new diseases, treatments I can’t spell and outcomes no one could have imagined just three years ago, let alone three decades.
Coming back to the advances in science and medicine, it is a combination of being a kid in a candy store and a flamethrower in a fireworks factory. There is both the thrill of learning and the panic of too much of a good thing.
It isn’t only pediatrics that has changed. Think about any profession. Construction has new materials and computers that provide a virtual fly-through of a house before one nail is driven. Law, transportation, retail or finance have all evolved so that you have to ask, is the room spinning or is it my head?
Rip didn’t have to comprehend individual genes on DNA or molecular pathways so complex that even Google Maps with GPS could not follow. He was a lazy stroll from his house when he got lost.
“In A549 cells, RSV induced expression of a complex network of CC
(I-309, Exodus-1, thymus and activation regulated chemokine
(TARC), RANTES, MCP-1, macrophage-derived chemokine
(MDC), and MIP-1a and -1b), CXC (GRO-a, b, and c, ENA-78,
IL-8, and I-TAC), and CX3C (Fractalkine) chemokines.”
What? It is astonishing to know there are real people out there who first discovered it and understand this stuff.
Thirty years ago, we weren’t thinking about childhood obesity, Type 2 diabetes or autism. We were just learning about HIV/AIDS and its unknown potential. We thought all germs were the enemy, and accidents were just accidents and not something that could be prevented
Today, preemies live 4-8 weeks earlier. Operations are performed on fetuses while they are still in the womb. Cancers are understood better, down to what genes are broken. Survival is not only dreamed about but happens more than we can hope for.
Now look at our most important job of being parents. We have new opportunities every day to improve. We know more about how infants need to be connected with their parents from not day one but from minute one. We are better informed about how our brains work to teach the infants to regulate themselves. We are wiser about nutrition and its critical importance to brain growth and development.
We are more familiar how the parents’ emotions alter the neural construction. If the mom is depressed, overwhelmed and alone, the child learns from her feelings.
Parenting is not the same. True, the babies look similar, but everything else is new. The problems, the theories, the science, the challenges, the potential successes or failures are different. Kids seem to grow up faster in more serious circumstances and the results are more critical. Like newly discovered deadly diseases, the exposure to violence is more pervasive. These challenges demand new approaches of parenting like new antibiotics.
When Rip Van Winkle awoke and stumbled back to his village, he couldn’t recognize his new world. It is the same for prisoners paroled after 30 years, grownups returning to school, parents or grandparents raising a child and older workers re-engaged in rapidly evolving fields.
Sometimes it can be so exhausting that we just need a good nap.
Joseph Cramer, M.D., is a fellow of the American Academy of Pediatrics, practicing pediatrician for 30 years and an adjunct professor of pediatrics at the University of Utah. He can be reached at firstname.lastname@example.org.
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