Category: Uncategorized

March 4, 2018

Dear Colleague,

Yesterday, the Florida Senate rejected a ban on assault weapons as well as an amendment to allow police to seize weapons from someone under domestic violence injunction. Two weeks ago, as the Parkland students were marching to their state legislature to plead for safer gun control measures, their politicians were in session voting to disallow any conversation or debate on the ban of assault weapons. The Governor of Florida had created incentives for gun manufacturers to move to Florida. Senator Rubio and the majority of his Republican colleagues in the Florida legislature have voted against any meaningful firearm safety legislation.

In November 2018, the AAP is scheduled to hold its annual conference in Orlando. This is occurring as Florida students, themselves, are asking for people and businesses to boycott events and activities in Florida. Major corporations, businesses and investment firms have changed or are considering a change to their policies on supporting the NRA and/or banning the sale of assault weapons.

I ASK YOU NOW TO DO SOMETHING THAT   WILL TAKE ONLY A MOMENT OF YOUR TIME. CALL, EMAIL, OR TWEET THE NATIONAL AAP OFFICE AND THE MASSACHUSETTS CHAPTER OF THE AAP EXPRESSING THE CRITICAL IMPORTANCE OF MOVING THE 2018 NATIONAL AAP CONFERENCE OUT OF FLORIDA TO A CITY THAT IS LEGITIMATELY AND DELIBERATELY ADDRESSING THE ISSUES RELATED TO THE USE OF FIREARMS.

We must be more than an advocate for these students. We must now be an ally, walking and protesting beside these courageous teens and their families. It will take only a moment of your time to offer the clear message to politicians that pediatricians and our pediatric provider colleagues will be direct, firm and active in this effort. Letters and lobbying efforts certainly need to continue but we can do more. Saying “MOVE THE AAP CONFERENCE” will deliver that message. Thank you. PLEASE SEND THAT “MOVE THE AAP CONFERENCE” MESSAGE NOW. THE TIMING IS CRITICAL.

For our Children,

Matt Masiello, M.D., MPH, FAAP

“MOVE THE AAP CONFERENCE” message to:

The Massachusetts Chapter of the American Academy of Pediatrics

781-895-9852

chaggerty@mcaap.org

@MassChapAAP

 

American Academy of Pediatrics

202-347-8600

dmiller@aap.org

@AmerAcadPeds

“The victimization of children is nowhere forbidden; what is forbidden is to write about it.”

― Alice Miller, Thou Shalt Not Be Aware: Society’s Betrayal of the Child

In 1998, a large study commented on the health and social effects of adverse childhood experiences (ACE) over the course of a lifetime. It is an extremely significant report in that for the first-time researchers demonstrated the relationship between adverse conditions and experiences of childhood and how they would later affect the health and wellbeing of these children as adults. Three categories of adverse experiences were identified: childhood abuse, neglect and household challenges. Specific to the events taking place in Alabama, the abuse categories identified those adults studied later in life, who as children, were abused emotionally, physically and sexually.

The population was mostly white, college prepared, and approximately 50 years of age. The interviews indicated that these predatory incidents are well concealed by “time, shame, secrecy and social taboo.” The adverse experiences were predictors of how these victims went on to experience more disease, more alcoholism, more drug use, higher incidence of suicide attempts and early death.

As ACE increases so does the number of marriages, and unwanted pregnancies leading to abortion. Domestic violence increases by over 500 % and the likelihood of being raped by 900%. Adverse childhood experiences are responsible for half of all depression leading to suicide attempts, two thirds of rape cases, and 50% of domestic violence

With an ACE score going from 0 to 5, alcoholism increases 5-fold, intravenous drug use 9-fold and suicide attempts 17-fold. A rising ACE score is responsible for 2/3 of alcoholism, and half of all drug use. These risk factors associated with ACE underlie the 10 most common cause of death in the U.S.

It is no surprise then that these women are coming out now to reveal their terrible experiences. Physicians and public health professionals need to step up and give testimony to this fact of why women are revealing these negative experiences of their youth and doing so later in life. The reason for the timing of these revelations is based on multiple scientific studies since 1998. As the initial researchers at Kaiser Permanente and the CDC stated, individuals hide these feelings and this anger because of ‘time, secrecy, and social taboos.” These prominent figures that now have their political bully pulpit strike a nerve of courage in these women. The resiliency these women have developed to overcome these adverse conditions now allows them to speak up and be heard. We need to support them not only because of the credibility and corroboration of their stories but support them based on the science of what we now know about these experiences and how it affects their lives.  We cannot assume for one moment that the sexual abuse inflicted upon a 14 year old by one political figure has been the only negative and harmful childhood experience. We are living in America, the land where not all benefit from a safe home, adequate education and housing ,  optimal health care and an adequate wage. Adverse Childhood Experiences are the most basic causes of health risk behaviors, morbidity, mortality, disability and health care costs in America. Yes, these experiences are very different from those experienced by an adult. The sooner we realize this the sooner we can make appropriate decisions about the Moore’s of the world, and hopefully someday, about health care in America.

Matt Masiello, M.D., MPH, FAAP

 

“The truth about our childhood is stored up in our body and lives in the depths of our souls, and although we can repress it, we can never alter it. Our intellect can be deceived, our feelings manipulated, and conceptions confused, and our body tricked with medication. But someday our body will present its bill, for it is as incorruptible as a child, who, still whole in spirit, will accept no compromises or excuses, and it will not stop tormenting us until we stop

evading the truth.”

― Alice Miller

 

Reference:         Vincent J. Felitti, et al. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death: The Adverse Childhood Experiences (ACE) Study. Amer J Prev Med 1998; 14(4).

“In the counsels of Government, we must guard against the acquisition of unwarranted influence, whether sought or unsought, by the Military Industrial Complex. The potential for the disastrous rise of misplaced power exists, and will persist. We must never let the weight of this combination endanger our liberties or democratic processes.” – Dwight D. Eisenhower, 1961

 “It’s a growth industry and we will get what we want.” – General David Petrius.

(When recently asked about the need for the deployment of more troops to Afghanistan.)

 “The question in my mind is how many additional American casualties is Saddam worth? And the answer is not very damned many.” ~Dick Cheney (Speaking to the Discovery Institute after the first Gulf War, on 8/14/1992, when Secretary of Defense.)

 

As we came to the end of our walking-wheel chair trek from the Jefferson Memorial, Korean and Vietnam War Memorials and finally to the World War II site my 82 year old mother offered a most surprising comment. And this was from the wife of a WWII veteran who was awarded the Silver Star and a Purple Heart for his heroism. “We Americans sure like our wars”, she sadly stated from her wheel chair. It was that simple comment that made me pause and reflect on where we were as a society, a country. I am also the sibling of a two tour Vietnam War veteran. Thousands of our young died depriving us of a social force that may have brought us to a more peaceful, a more academically enlightened and possibly a more environmentally friendly time decades later. Dwight Eisenhower said it best when he commented on the need for war to “prevent” communism, terrorism, or world domination. “When people speak to you about a preventive war, you tell them to go and fight it. After my experience, I have come to hate war.”

As thousands of our young soldiers have died in this war many more thousands have returned with a multitude of war related illnesses. And as we were under prepared to properly equip and protect our soldiers on the battlefield so are we now so ill prepared to care for these young Americans, their children and their wives upon their return to our communities. And, again, another generation lost and a country missing out on what could have been,  if these thousands of young men and women were here today, healthy and alive. The compromised physical and mental health of these thousands of young soldiers will have an immeasurable toll on their families, our health care system and our country for years to come. “The time not to become a father is eighteen years before a war”, so says E.B. White.

 A conservative number of 100,000 thousand innocent Iraq and Afghan men, women and children have died in this war. An apology and a few thousand dollars is offered as a payment of loss of home and life.  For generations, the families of these innocent victims will hold us accountable for their sadness, misery and loss – A breeding ground for sustainable acts of terrorism.

 “And one of the things we should learn is you can’t fight and win a civil war with outside troops, and particularly not when the political structure in a country is dissolved. So it wasn’t the press that was the problem. The problem was that we were in the wrong place with the wrong tactics.” –

Robert S. McNamara, (Former Secretary of Defense for two presidents who acknowledged that he and his colleagues were “wrong, terribly wrong” in the prosecution of the war in Vietnam)

One in eight Americans and one in four children now rely on food stamps and the number is growing. Sixteen million people are out of work and this number is also is growing. We have more families and children living in poverty now then we did during the Lyndon Johnson war on poverty era. In the U.S., a child is born into poverty every 33 seconds (Children’s Defense Fund, CDF). As we continue to experience the numbing greed of Wall Street, we have more children going to bed hungry than ever before. The economist Jeffrey Sachs, tells us that “Wall Street takes more bonuses each year then the U.S. gives in all official development assistance.” In this United States many of our community food pantries were finding it difficult to keep their shelves well stocked for this past Thanksgiving Day and quite possibly for the upcoming holidays and holydays. “Food-stamp beneficiaries aren’t them; they’re us,” states James Weill, President of the Food research and Action Center, on an analysis of 30 years of data that found nearly half of U.S. children and 90% of black youths will have to depend on food stamps at some point in their childhoods (Time magazine, Nov, 16, 2009). Since 2001 more then $950 billion has been spent on the war. According to Marian Wright Edelman, President of the CDF, it will take $105 billion over ten years to provide maximum health care reform for children. What is the child worth? Who are we?”

             As our health system is fragmented and failing, our educational system is also suffering. The U.S. high school dropout rate is unacceptable by anyone’s standards. Our science and math scores are noncompetitive at the international level and the ability of our students to obtain a degree once they enter college is surprisingly and sadly low. Our children still do not have the right to an education and health as is the case in other modern, industrialized countries where health outcomes are significantly better than that of the U.S. Our young adults leave their educational environment thousands of dollars in debt before they have their first job offer. This is not the case in the great majority of other modern societies. We still abuse children by the hundreds of thousands, with one in ten suffering some form of maltreatment.  More than 10,000 children died from abuse and neglect in the U.S. from 2001 through 2007. “It is an alarming statistic, and the real number could be twice as large because many deaths from abuse or neglect are attributed to other causes,” states David Finkelhor, University of New Hampshire. Thousands of children go to school every day in this country and feel unsafe and feel that they have not one friend. On our city streets, playgrounds, and in our schools, children are victims of what the world sees as our strange approach to firearm ownership. According to U.S. Attorney General Eric Holder, sixty percent of our children are exposed to violence in their lifetime. “It is a ‘toxic’ stress to them. Children are exposed to a level of violence that we would not ‘tolerate’ as adults.”

This month nations are staging special events to mark the 20th anniversary of the Convention on the Rights of the Child, which came to be on November 20, 1989. It is the most widely ratified international human rights treaty. Every country in the world, with the exception of the United States and Somalia, has ratified it.

Poverty breeds social unrest and violence. Though we need to be intelligently and morally responsive, militarily, to terrorism, the real war to win is that on poverty. Our military experts are now negotiating with the Taliban, realizing that they fight for food and money, regardless of who pays. According to Sachs’, it will take one tenth of one percent of the world’s gross national product to provide basic financial support to the worlds’ poor; and $35 billion, total, as compared to the hundreds of billions being spent on the war effort, to significantly and positively alter the course of world poverty.

This has been a war where some of our most esteemed politicians, like Colin Powell, stated that misleading and false statements were used to encourage entrance into this conflict. Even those endorsing on-going support for the war admit that it may take five or more years of military involvement. In other words, another generation of youth subject to the decisions we will make today. When General David Petrius, the overall commander of U.S military forces in Iraq and Afghanistan, was recently asked about the need for more troops his response was the following: “It’s a growth industry and we will get what we want.”

Many Americans are now approaching that Viet Nam mindset of war weariness, and at a time when we are in a deep economic depression. There is discussion of a ‘war tax” just as we are realizing the cost to overhauling of our health care system; upgrading our educational system and moving to cleaner, more efficient energy sources. It is also the poverty, the hunger and the declining spirit of the masses. “The most successful war seldom pays for its losses,” so states one of our Founding Fathers, Thomas Jefferson.

“Peace is not absence of conflict; it is the ability to handle conflict by peaceful means”. -Ronald Reagan

 This country has a “machine” as strong and powerful as our military machine of generals and war strategists. “Give peace a chance” should no longer be a cliché of the past. Today, we are much better prepared to call upon and muster nations, experts in international economists and community planning; sociologists, educators, medical and public health professionals, and known political peace makers who can strategically infiltrate a society in conflict, or a country experiencing massive poverty and reap significant gains, with significantly less loss to life. And, yes, there is actually a United States Institute of Peace, located in Washington D.C. The challenge is being proactive in inserting new and different voices into the national conversations of conflict and war. It is time for a new world order.

Whether it be with the advice of  John Kennedy, “Mankind must put an end to war, or war will put an end to mankind,” or  General Douglas MacArthur when he courageously stated: “I believe that the entire effort of modern society should be concentrated on the endeavor to outlaw war as a method of the solution of problems between nations,” it is now that moment in the history of our country, at this place in time, to speak out, peacefully protest, write and stir the spirit of this country.

 May we never confuse honest dissent with disloyal subversion. ~Dwight D. Eisenhower

 

War will exist until that distant day when the conscientious objector enjoys the same reputation and prestige that the warrior does today. – John F. Kennedy

War should be the politics of last resort. And when we go to war, we should have a purpose that our people understand and support.  – Colin Powell

http://money.cnn.com/2013/04/25/smallbusiness/doctor-quit-healthcare/index.html