adolescent medicine

I managed to avoid the gastro and general grumpiness on the pediatric ward by having a month of adolescent medicine. I figured that teenagers and their problems would be a nice challenge after years of working with school-age kids with ADHD.

Adolesence is a time of such power. Between 14 and 20, people still have many years of good health to expect, their parents are usually still healthy, and often even their grandparents. Abstract thinking opens up a whole new way of looking at the world. And not having stuff or money to protect means that people are free to take risks and make choices based on their values, not on what rising interest rates might do to their ability to make car payments in the coming year.

Too bad we spend so much time and effort "waiting out" these years instead of helping youth to really live them.
I have a deeper dislike now for:
* worksheets and other time-fillers
* ridiculous arguments about hem lengths on uniforms
* teachers who confiscate books
* school hours that prevent community involvement
* advertising that encourages girls to disappear
* eating disorders that make girls disappear
* Alcohol, cutting and whatever else youth use to evade the pressure to disappear
* Sexual abuse that reminds youth that they aren't even in charge of their own bodies so they may as well give up trying to make an impact on the rest of the planet.

I know that working with teenagers always brings up one's own adolescence. I was worried about working with teens when i started. . . What could i possibly have to offer to the kids who had "typical" teenage problems with sex or drugs/alcohol/smoking or whatever?? I was such a teenaged geek! I didn't even have enough social wherewithal to find people who knew people who could get me any illegal substances. Which was probably good in retrospect. I was also such a wannabe badass that i would have gotten myself into some stupid messes that i avoided by having a strange but remarkably healthy peer group. Although, to that end, i was and remain earnest, gullible and more than a bit dense. There were probably people in my peer group who, unbeknownst to me, lived with eating disorders, addictions, STD's, and all the other ailments that are as common in this age group as diabetes and chest pain in old men.

Overall, a good month:

* days that start at 9 am.
* lunch
* teaching, supervision, and other luxuries not available to most of quebec medical students at the time
* I can do a gyne exam.
* I can do an eating disorder assessment in french
* I'm not great with eating disorders in any language.
* I still find boys with conduct disorder charming and interesting.
* Little kids fear, loathe and puke on doctors. Teenagers have parents and teachers to hate: the doctor provides contraception, and doesn't tell teachers or parents.
* A disturbing number of moms will side with their boyfriend/husband when their kid accuses him of sexual abuse
* Lichen sclerosis atropica - and other reasons doctors should include the genitalia of little girls in routine exams. If nobody ever looks, how can we know what is normal and what is a problem?

I start two weeks of neonatology in the morning, and a whole new set of anxieties (some of which aren't even attached to people who exist yet!)