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Standing Up To Bullies: A Father Shows His Son How It’s Done

Brad 1975009Brad asked how I think I influenced his development as a child. I think I taught him about leadership, perseverance, patience, problem solving, pattern recognition, innovative thinking, and compassion for others. The irony is I believe he taught me more than I taught him.

Mutual trust and respect must go hand and hand with the love for a child. Kids are people too. They have the same emotional responses to perceived events as we do as adults.

One of many incidents of mutual respect comes to mind. Brad was 11 years old in the 6th grade.

My accountant, at that time, was an avid stamp collector. I thought learning about the sub culture of stamp collecting would be a terrific intellectual experience for both of us. My accountant took us to several stamp shows and taught us how to value stamps. We started collecting. We accumulated a nice stamp collection. The collection had great potential to increase in value. We both learned a lot and grew together in the stamp collecting business.

Brad was very proud of his stamp collection. One night at dinner, Brad asked if he could bring a couple of sleeves of stamps to his 6th grade to explain the joys of stamp collecting. I said “sure.”

At dinner the next evening he told us someone had stolen his stamps. He left them in his school desk pocket during recess. They were gone when he got back to his desk. He explained that he was certain he knew who stole the stamps.

I asked him how he knew who stole the stamps. He told me about a wise guy kid who was always intimidating his classmates. This kid bullied other kids and constantly took things from them.

I remember a kid like that in my 6th grade class. He was always hitting us up for pennies.

I asked Brad what he wanted to do. He said he wanted to figure out how to get his stamps back. He had already spoken to the teacher. She said she would talk to the boy.

I thought that was a great first step. I said I would call the teacher in the morning. I spoke to the teacher. It was obvious to me she did not want to get involved.

I then asked to speak to the Principal. When I explained the situation to the Principal, she volunteered to speak to the teacher. She then set up a meeting with both boys and their fathers.

I cancelled my scheduled patients from 10.30 am to 2pm on the day of the meeting and came to the school. Brad told me he was more convinced than ever that the boy took the stamps. Other kids told him he had taken things from them but they did not have the courage to complain.

The meeting started at 11 a.m. There were two fathers, two boys and the Principal present. After I explained the situation the boy’s father became indignant. I said,” hold it.” We have evidence that your son has been a bully to other kids in the class. He has intimidated them and taken things from them. He is the most likely person in the class to have taken Brad’s stamps.

The father wanted the proof. I told him we would be happy to produce the proof. The pressure on the boy was too much. He admitted taking the stamps. He promised to return them in the morning. The boy’s father was enraged and embarrassed. There would be no attempt by the father to understand the boy’s behavior.

Both the father and son apologized to us. Brad and I accepted the apology. I could just feel how proud Brad was of me. I expressed how proud I was of him for sticking up for his rights.

This bonding experience is one of many. It lasts to this very day. The proof of this bonding between us can be seen in Brad’s introductory blog to this series.

Our goal is to explore why our relationship works and help others if we can improve their relationship with their kids.

*This blog post was originally published at Repairing the Healthcare System*

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One Response to “Standing Up To Bullies: A Father Shows His Son How It’s Done”

  1. Adam says:

    Well played. Seems like you did everything right; kept your cool, found out the facts, spoke to the teacher, instantly went to her boss when nothing was done, re-arranged everything else and made the meeting about his son the number one priority, remained civil but refused to be pushed around.

    I give you an A+.

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Richmond, VA – In an effort to simplify inpatient medical billing, one area hospitalist group has determined that “altered mental status” (ICD-9 780.97) is the most efficient code for use in any patient work up.

“When you enter a hospital, you’re bound to have some kind of mental status change,” said Dr. Fishbinder, co-partner of Area Hospitalists, PLLC. “Whether it’s confusion about where your room is located in relationship to the visitor’s parking structure, frustration with being woken up every hour or two to check your vital signs, or just plain old fatigue from being sick, you are not thinking as clearly as before you were admitted. And that’s all the justification we need to order anything from drug and toxin screens, to blood cultures, brain MRIs, tagged red blood cell nuclear scans, or cardiac Holter monitoring. There really is no limit to what we can pursue with our tests.”

Common causes of mental status changes in the elderly include medicine-induced cognitive side effects, disorientation due to disruption in daily routines, age-related memory impairment, and urinary tract infections.

“The urinalysis is not a very exciting medical test,” stated Dr. Fishbinder. “It doesn’t matter that it’s cheap, fast, and most likely to provide an explanation for strange behavior in hospitalized patients. It’s really not as elegant as the testing involved in a chronic anemia or metabolic encephalopathy work up. I keep it in my back pocket in case all other tests are negative, including brain MRIs and PET scans.”

Nursing staff at Richmond Medical Hospital report that efforts to inform hospitalists about foul smelling urine have generally fallen on deaf ears. “I have tried to tell the hospitalists about cloudy or bloody urine that I see in patients who are undergoing extensive work ups for mental status changes,” reports nurse Sandy Anderson. “But they insist that ‘all urine smells bad’ and it’s really more of a red herring.”

Another nurse reports that delay in diagnosing urinary tract infections (while patients are scheduled for brain MRIs, nuclear scans, and biopsies) can lead to worsening symptoms which accelerate and expand testing. “Some of my patients are transferred to the ICU during the altered mental status work up,” states nurse Anita Misra. “The doctors seem to be very excited about the additional technology available to them in the intensive care setting. Between the central line placement, arterial blood gasses, and vast array of IV fluid and medication options, urosepsis is really an excellent entré into a whole new level of care.”

“As far as medicine-induced mental status changes are concerned,” added Dr. Fishbinder, “We’ve never seen a single case in the past 10 years. Today’s patients are incredibly resilient and can tolerate mixes of opioids, anti-depressants, anti-histamines, and benzodiazepines without any difficulty. We know this because most patients have been prescribed these cocktails and have been taking them for years.”

Patient family members have expressed gratitude for Dr. Fishbinder’s diagnostic process, and report that they are very pleased that he is doing everything in his power to “get to the bottom” of why their loved one isn’t as sharp as they used to be.

“I thought my mom was acting strange ever since she started taking stronger pain medicine for her arthritis,” says Nelly Hurtong, the daughter of one of Dr. Fishbinder’s inpatients. “But now I see that there are deeper reasons for her ‘altered mental status’ thanks to the brain MRI that showed some mild generalized atrophy.”

Hospital administrators praise Dr. Fishbinder as one of their top physicians. “He will do whatever it takes to figure out the true cause of patients’ cognitive impairments.” Says CEO, Daniel Griffiths. “And not only is that good medicine, it is great for our Press Ganey scores and our bottom line.”

As for the nursing staff, Griffiths offered a less glowing review. “It’s unfortunate that our nurses seem preoccupied with urine testing and medication reconciliation. I think it might be time for us to mandate further training to help them appreciate more of the medical nuances inherent in quality patient care.”

Dr. Fishbinder is in the process of creating a half-day seminar on ‘altered mental status in the inpatient setting,’ offering CME credits to physicians who enroll. Richmond Medical Hospital intends to sponsor Dr. Fishbinder’s course, and franchise it to other hospitals in the state, and ultimately nationally.


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