Belina Yi, OMS III
Belina Young-Joo Yi
There are some matters in the field of medicine not often brought up for discussion. Sometimes it is because some subjects are too “emotional” or “uncomfortable.” Child abuse is one of those topics.
I attended a lecture about child abuse at the UCSF Interpersonal Violence Conference on November 14, 2015. It was heartbreaking to hear about different ways people abuse their children. I learned the importance of screening all children, not just relying on noticeable physical signs of abuse. According to the lecture, only 12 to 15% of pediatricians regularly screen for abuse. I have to say that I felt embarrassed, because I do not remember asking abuse-screening questions when I was on my pediatric rotation. Some might say, “Well, if you do your physical exam thoroughly, there is nothing to worry about.” However, abuse does not only include physical or sexual abuse. At the conference, there was a panel of community members who had experienced child abuse. They said verbal abuse and neglect are just as hurtful, and they affect you for the rest of your life. They also stated none of their doctors ever asked them about how they were doing at home.
So, how do we screen? What I found odd during my pediatric rotation was every time I asked patients if they would want their parents to step out for some “sensitive” questions, they all said it was fine for their parents to be present. They would answer questions about sexual history and illegal drug/alcohol use in front of their parents. However, it is important to ask questions about possible abuse away from parents or care providers. When I expressed this concern to a speaker at the conference who was a pediatrician, he recommended talking to the parents when I walk into the exam room and ask them if it would be okay for them to step out at a certain point of the interview.
Another subject brought up during the lecture was the cultural difference in disciplining children. I was brought up in Asia where it is common for parents to believe that spanking their children makes them behave. Maybe some people think calling their children stupid and worthless would give them motivation to work hard, which would eventually lead them to become successful. Some countries, like Sweden, have distinct laws against corporal punishment. Establishing the line between discipline and abuse is complicated and this is something that the pediatric community should keep discussing. Our children’s physical and mental health depends on it.
I am not a parent, so I cannot imagine how difficult parenthood is. However, I do know I want all children to be healthy both physically and psychologically. I hope I will never have to face a child who has been abused. Nevertheless, it happens and as a future pediatrician, I want to be the healthcare provider who is able to recognize the abuse and provide the necessary support. I want to be the doctor who advocated for my patients wholeheartedly.