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How Are Pediatricians Saving Lives Today? (Pedcast)




Child death from an infectious disease like pneumonia was all too common in America just a hundred years ago. If you read descriptions of life in the 19th century, you quickly realize that children suffering from infectious diseases was common and often devastating.  Thank goodness those days are gone. Good riddance.  To demonstrate that point, just take a look at the most common causes of death in older infants and children during the turn of the century era.  Study of childhood deaths year 1900

#1 Pneumonia secondary to influenza

#2 Tuberculosis

#3 Acute Gastroenteritis

Notice, all of the big three causes of child death have one thing in common; they are all infectious diseases. Have you ever known any children who have succumbed to any of these diseases? Probably not because these infections that lead to death in 1900, are very rare in today’s children. Just forty years ago, at the onset of my pediatric career, pediatricians regularly saved children by treating them for meningitis, sepsis, pneumonia, and dehydration secondary to acute gastroenteritis; but not today. Those days of infectious disease deaths, relative to the past, are mostly gone. But pediatricians still regularly saves by using tools other than traditional medical therapies.  What are those tools you ask? Well stay tuned to find out and explore this interesting topic further in this edition of Portable Practical Pediatrics.

Musical intro

Accidents are the leading cause of death in children today

You are probably asking yourself, if deaths from infections are becoming rare in America, what are children suffering from today?  Take a look at the 2015 statistics of the leading ten causes of death in children by age from the CDC, and you will quickly see the answer to that question. CDC statistics child deaths 2015



Today, death from unintentional accidents is by far, the leading cause of death in children. Unintentional accidental death from motor vehicle accidents, drowning, fires, burns, choking/ suffocations, and pedestrian accidents lead the list of tragedies.  Causes of childhood deaths 2015. Note, that deaths from pneumonia, the grim reaper of 1900 barely made the list in today’s list child deaths. You can see that while it is great news that children are not dying of pneumonia, parents, pediatricians, and society at large, still have a long way to go if we are to eliminate the tragedy of child deaths from injuries. Injury prevention is the next great frontier in pediatrics.

How do Pediatricians Save Lives Today?

But how are pediatricians saving lives today?  When I started practicing pediatrics, a week didn’t go by when I didn’t save a life of a child by treating them for meningitis or pneumonia. That fact was one of the main reasons that I decided to spend my life treating sick children. It is incredibly thrilling and rewarding to take a child with a life threatening infection and bring them back to health with the tools pediatricians have today. Fortunately, another incredibly powerful tool at a pediatrician’s disposal has almost ended the era infectious disease deaths in children–vaccines. So how are pediatricians saving lives today?  Rather than by using antibiotics,  my life saving is done in a more subtle fashion, using the tools of persuasion, education, reminders, nagging, storytelling, praising, and what I like to call authoritative convincing. By using these tools , I know I am saving lives even though I am not there to see it happen.  I save lives by preventing tragedies from ever happening, by using words and thoughts to convince parents and children to hedge against taking risks. Yes, I save children today by convincing parents that their children need to be properly restrained while riding in a car, by convincing parents that every child needs enough swim lessons to be safe around water, by convincing parents not to let their children play unsupervised on a trampoline, by reminding families how dangerous head first diving into water is, by educating parents how effective helmets are at reducing brain injuries, by making sure that guns locked and are out of reach of children, by reminding parents to have functional smoke  and carbon monoxide alarms, and encouraging parents to feed their young children in high chairs and avoid feeding their children foods that pose a high risk choking; all simple straight forward advice but life saving.


How Do I Know My Tools are Working?

You may be wondering if I am just full of myself, deluding myself into believing that I am actually saving children’s lives with some words at checkups and during visits for injuries. It is true, I have not been collecting statistics or data to prove that my life saving tools of persuasion, education, reminders, nagging, storytelling, and authoritative convincing  are effective… but I know they are. I know because families tell me they are. I can’t tell you how many times I have heard children and parents tell me that they got rid of the trampoline because I convinced them it was too dangerous, let the dirt bike “break” making it no longer available for Johnny to use, or put their child back into a booster when they realized that an adult seatbelt was not safe for their school aged children. I’ve even had children tell me that they heard my voice in their heads, warning them not to dive,  just before they were about to go head first into the lake on a hot day.  I know from 35 years of experiences like these that my words have changed behavior and avoided countless tragedies. I also know because I sense the gratitude that parents of my patients express to me when I help them set limits for their children; in front of their children. No longer is it just mom and dad saying no, it’s someone with some street credibility and real world experience who is saying the exact same thing.


Fortunately, today’s pediatricians are using far less antibiotics, IV fluids, and clever pharmacology than they did a generation ago, mainly due to the incredible effectiveness of vaccines. Today’s pediatricians are improving the health of children by using their influence to convince parents and children to properly buckle up in the care, to put on their helmet whenever they are playing on rolling toys, to forego the toys with powerful motors, to not play with guns fire or explosives, and to ensure that all children have strong swimming skills. After a health visit where I am directing the conversation, my goal is to put my voice in each child’s head that will quietly whisper to them, “Would Doc Smo and my parents want me doing this?”  By using some very simple but powerful tools: persuasion, education, reminders, nagging, storytelling, praising, and authoritative convincing, I hope that my voice will keep them all safe.


Thank you for joining me today and making Portable Practical Pediatrics one of the 10 best pediatric blogs in the world as judged by! Top 100 Best Pediatric Blogs

My audience continues to grow thanks in large part to you. If you enjoy learning about pediatrics and child health with pedcasts, consider taking a moment to like and share an episode on my blog, the Facebook page, or on iTunes. This is Doc Smo, broadcasting from studio 1E, that’s my first child’s bedroom on the east side of my house, hoping you children can always skirt, situations where they can get hurt. Until next time.

Gentle Skin Care of Babies Saves Lives (Pedcast)



Thanks for joining me today. I am your host, Dr. Paul Smolen, a board certified pediatrician with 35 years of practice under my belt and a whole lot to say. From diapers to the diploma, if it involves kids, we discuss it here. Ever wonder why a baby’s skin feels better than the skin of older children and adults. Well, the reason is really rather simple. Baby skin is thinner and more supple than that of an older person. Baby versus adult skin. To get a sense of the difference thickness makes to skin, take a moment and feel the skin on your own palm, and then compare that with the skin on the back of your hand. Most of the difference that your feel, is due to the difference in the skin thickness. More specifically, we are talking about the thickness of the surface layer that is also known as the epidermis. Do you remember the names of the two layers to your skin? The deeper layer, where the nerves, blood vessels, sweat and oil glands are located is called the dermis. The dermis in turn is covered by multi-layers of cells called the epidermis; similar to the way shingles on the roof protect your house. The thing is, babies don’t have nearly as many shingles in their epidermis as do older people.  Their skin therefore tears easier, is more porous, loses water more easily, cracks easier, and tends to dry out faster.  Consequently, if a baby’s skin becomes damaged more easily, things that they touch the surface can penetrate right into their dermis provoking bad things to happen. More on that a few minutes and many other exciting things you need to know about your baby’s skin so don’t you dare miss this episode of Portable Practical Pediatrics. Continue reading

Best Docs Listen, Observe, and Test (Pedcast)



Welcome to another edition of Portable Practical Pediatrics! I’m your host Dr. Paul Smolen, also known as Doc Smo. From gestation all the way to graduation, if it involves children, we discuss it here. Today we are going to take on the question of what trait or traits make a great physician? How do you know if you have a just an average pediatrician or you’ve got one that is a cut above? Are the best doctors the ones that got the highest scores on exams in med school or the ones who have seen the most patients? Or are the best doctors the ones that are the friendliest, best looking, and have the best bedside manner? Since I have been practicing and teaching pediatrics now going on 36 years, the question of good doctoring traits is one that I have pondered for some time. Certainly, excellence involves a lot of factors but here is what I have concluded after a my long career in medicine; the doctors who are the best observers, take sufficient time and attention to get a thorough understanding of the child’s symptoms, and then judiciously do testing to either confirm or deny their conclusions–those are the best physicians. In short, the best physicians are the ones that are the best listeners. The famous physician of the 19th century, William Osler who help found the Johns Hopkins Medical Center, said it best when he remarked, “Listen to your patient, he is telling you the diagnosis.” In medicine, this is called getting a good history.  Today we are going to explore the art of diagnosis from a doctor’s perspective. I am going to pull the curtain back on the diagnostic process behind your child’s visit to the pediatrician and explore things you can do to maximize the value of your child’s next visit to their health care provider. Continue reading

What if Grandma Had Refused Vaccines? (Pedcast)

Banner Photograph, courtesy of Rare historical Photographs-Link in Smo Notes



It’s the summer of 1952 (the year I was born) and America is at the peak of the polio epidemic and America is paying a heavy price. More than 21,000 people, contracted paralytic polio in 1952 alone. 3000 of them died and many were children. Every mom knew that polio was a summer disease. As the swimming pools opened and the temperature got hotter, parents were terrified that their children would be afflicted. Thank goodness that 1952 also happened to be the year that Jonas Salk perfected an effective polio vaccine that put a halt to the trauma America had experienced at the mercy of this horrible viral disease. Most of you probably knew all that, but in today’s pedcast, I want you to give some thought about what would have unfolded for subsequent generations, had our grandmothers  been vaccine refusers. What would have happened if they had hesitated to vaccinate  their children like so many parents are tempted to do today in the growing anti-vaccine climate that exists in America now? So, don’t you dare move onto another podcast in your queue and miss this important edition of Portable Practical Pediatrics. Continue reading

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