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Collateral Damage

pdnews@elsevier.com

“Oops” is probably my most frequently used subject when creating e-mails. The recipient is immediately alerted that in the text they are going to find an extensive mea culpa. Often I am apologizing for forgetting to attend a meeting. Although “forgetting” may not be the most accurate word when it comes to group exercises destined to go nowhere slowly.

Warriors have their own versions of “oops.” Both conjure up horrible and tragic images of death and destruction. One is “friendly fire.” The other is “collateral damage,” a term that refers to devastation outside the expected target area.

A few months ago I opened the Sunday morning paper and encountered an explosive event on page 4. You have probably read or heard other versions of the story of a 56-year-old pediatrician from Lewes, Del., who is in jail awaiting prosecution for a 471-count indictment for sexually molesting some of his patients over at least 11 years in practice.

The details of the case that have come to light so far are complex and terribly disturbing. The ground zero for this horrible explosion is predictably the children who were molested, particularly those who have some memory of the events. Sharing the epicenter are their parents whose anger is directed outward to the alleged perpetrator. And inward at themselves for not acting on the occasional uneasy feeling that the physician whom they had trusted with their children seemed a little too weird.

We can only hope that with time both parents and children will find a physician with whom they can feel comfortable. For some I am sure it will take many years to repair the damage. But, because we live in an age of instant and global communication, this horrible bomb of mistrust is radiating and will continue to radiate damage far beyond the borders of that tiny town on the Delaware Coast.

Parents from Portland, Maine, to San Diego will be looking at their pediatricians with a new and suspicious eye. “Does he seem overly interested in my daughter's private parts?” “Does she spend too much time trying to find my 8-month-old son's testicle?” “Doesn't that beard make him seem just a little too weird?” Those of us who wear oversized polka dot bow ties or occasionally don red clown noses to put our patients at ease may be in for special scrutiny.

Although some of us may feel we need to traditionalize our attire, sartorial alterations are relatively easy to make. Behavioral adjustments will present more of a problem. Doctoring can and at times must be hands on. In some circumstances private places must be carefully inspected. Complicating matters is the fact that even on our most hectic days we don't just tolerate our patients. We like them.

There are times when this genuine affection emerges in a big hug for the 4-year-old who has weathered his preschool shots with only a glint of a tear in his eyes. Or a pat on the head for a 3-year-old who has finally mastered the skill of holding still for an ear exam. Two-month-old infants can be too cute not to cradle in one's arms.

But because of the alleged and horribly inappropriate behavior of one of our number, some things will have to change. We will always have to explain what and why we are doing the sensitive portions of our exams. We can no longer assume that because we are pediatricians, our behavior will be interpreted as appropriate.

But what won't and mustn't change is our affection for our patients. However, we may have to begin asking permission for some things that once came so naturally. Unfortunately, the spontaneous hug may have become a casualty of collateral damage.

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pdnews@elsevier.com

“Oops” is probably my most frequently used subject when creating e-mails. The recipient is immediately alerted that in the text they are going to find an extensive mea culpa. Often I am apologizing for forgetting to attend a meeting. Although “forgetting” may not be the most accurate word when it comes to group exercises destined to go nowhere slowly.

Warriors have their own versions of “oops.” Both conjure up horrible and tragic images of death and destruction. One is “friendly fire.” The other is “collateral damage,” a term that refers to devastation outside the expected target area.

A few months ago I opened the Sunday morning paper and encountered an explosive event on page 4. You have probably read or heard other versions of the story of a 56-year-old pediatrician from Lewes, Del., who is in jail awaiting prosecution for a 471-count indictment for sexually molesting some of his patients over at least 11 years in practice.

The details of the case that have come to light so far are complex and terribly disturbing. The ground zero for this horrible explosion is predictably the children who were molested, particularly those who have some memory of the events. Sharing the epicenter are their parents whose anger is directed outward to the alleged perpetrator. And inward at themselves for not acting on the occasional uneasy feeling that the physician whom they had trusted with their children seemed a little too weird.

We can only hope that with time both parents and children will find a physician with whom they can feel comfortable. For some I am sure it will take many years to repair the damage. But, because we live in an age of instant and global communication, this horrible bomb of mistrust is radiating and will continue to radiate damage far beyond the borders of that tiny town on the Delaware Coast.

Parents from Portland, Maine, to San Diego will be looking at their pediatricians with a new and suspicious eye. “Does he seem overly interested in my daughter's private parts?” “Does she spend too much time trying to find my 8-month-old son's testicle?” “Doesn't that beard make him seem just a little too weird?” Those of us who wear oversized polka dot bow ties or occasionally don red clown noses to put our patients at ease may be in for special scrutiny.

Although some of us may feel we need to traditionalize our attire, sartorial alterations are relatively easy to make. Behavioral adjustments will present more of a problem. Doctoring can and at times must be hands on. In some circumstances private places must be carefully inspected. Complicating matters is the fact that even on our most hectic days we don't just tolerate our patients. We like them.

There are times when this genuine affection emerges in a big hug for the 4-year-old who has weathered his preschool shots with only a glint of a tear in his eyes. Or a pat on the head for a 3-year-old who has finally mastered the skill of holding still for an ear exam. Two-month-old infants can be too cute not to cradle in one's arms.

But because of the alleged and horribly inappropriate behavior of one of our number, some things will have to change. We will always have to explain what and why we are doing the sensitive portions of our exams. We can no longer assume that because we are pediatricians, our behavior will be interpreted as appropriate.

But what won't and mustn't change is our affection for our patients. However, we may have to begin asking permission for some things that once came so naturally. Unfortunately, the spontaneous hug may have become a casualty of collateral damage.

pdnews@elsevier.com

“Oops” is probably my most frequently used subject when creating e-mails. The recipient is immediately alerted that in the text they are going to find an extensive mea culpa. Often I am apologizing for forgetting to attend a meeting. Although “forgetting” may not be the most accurate word when it comes to group exercises destined to go nowhere slowly.

Warriors have their own versions of “oops.” Both conjure up horrible and tragic images of death and destruction. One is “friendly fire.” The other is “collateral damage,” a term that refers to devastation outside the expected target area.

A few months ago I opened the Sunday morning paper and encountered an explosive event on page 4. You have probably read or heard other versions of the story of a 56-year-old pediatrician from Lewes, Del., who is in jail awaiting prosecution for a 471-count indictment for sexually molesting some of his patients over at least 11 years in practice.

The details of the case that have come to light so far are complex and terribly disturbing. The ground zero for this horrible explosion is predictably the children who were molested, particularly those who have some memory of the events. Sharing the epicenter are their parents whose anger is directed outward to the alleged perpetrator. And inward at themselves for not acting on the occasional uneasy feeling that the physician whom they had trusted with their children seemed a little too weird.

We can only hope that with time both parents and children will find a physician with whom they can feel comfortable. For some I am sure it will take many years to repair the damage. But, because we live in an age of instant and global communication, this horrible bomb of mistrust is radiating and will continue to radiate damage far beyond the borders of that tiny town on the Delaware Coast.

Parents from Portland, Maine, to San Diego will be looking at their pediatricians with a new and suspicious eye. “Does he seem overly interested in my daughter's private parts?” “Does she spend too much time trying to find my 8-month-old son's testicle?” “Doesn't that beard make him seem just a little too weird?” Those of us who wear oversized polka dot bow ties or occasionally don red clown noses to put our patients at ease may be in for special scrutiny.

Although some of us may feel we need to traditionalize our attire, sartorial alterations are relatively easy to make. Behavioral adjustments will present more of a problem. Doctoring can and at times must be hands on. In some circumstances private places must be carefully inspected. Complicating matters is the fact that even on our most hectic days we don't just tolerate our patients. We like them.

There are times when this genuine affection emerges in a big hug for the 4-year-old who has weathered his preschool shots with only a glint of a tear in his eyes. Or a pat on the head for a 3-year-old who has finally mastered the skill of holding still for an ear exam. Two-month-old infants can be too cute not to cradle in one's arms.

But because of the alleged and horribly inappropriate behavior of one of our number, some things will have to change. We will always have to explain what and why we are doing the sensitive portions of our exams. We can no longer assume that because we are pediatricians, our behavior will be interpreted as appropriate.

But what won't and mustn't change is our affection for our patients. However, we may have to begin asking permission for some things that once came so naturally. Unfortunately, the spontaneous hug may have become a casualty of collateral damage.

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