Sixteen and Out of Control (Pedcast)

It’s DocSmo time again, so if you have a tween or a teen in your house, this pedcast is for you. I am your host, Dr. Paul Smolen, both the Doc and the Smo in I started this blog for the benefit of parents and children 3 years ago, and I must say, I am having fun creating these pedcasts. Nothing is off the table here, and we talk about anything “I” am interested in. Topics are everything child here, anything from the crib to college, from the stroller to the sports car. Today, I am going to talk about something that a lot of families experience when their children are about 15-16 years old… destructive behavior. You remember being 16, preoccupied by social stuff, hormones raging with all those thoughts, and probably major league insecure, desperate to be accepted by your peers. Many of the families that I have known in my 32 years of pediatric practice have struggled with their children when they were this age.

I often have a front row seat to what goes on in families. Many of these parents and children I have cared for and have known since the day they came home from the hospital. That’s a very intimate view, wouldn’t you say? Well, here is what I have observed. Even the nicest families with the smartest, nicest children can have struggles when their children are mid teens.  Psychologists say that these years are dominated by a need for independence, a sense of autonomy, and a rejection of our parents’ authority. I would agree with this evaluation. These struggles often come out as drug and alcohol experimentation, poor school performance, self-destructive sexual experimentation, an intense rejection of parental authority, and lots of oppositional behavior. This is a very difficult time for everyone in the family, but here is what I have learned from my years of experience… families where there is stability around a spinning-out-of-control child usually end up with a happy ending. If the teen is loved, has a stable home setting, and does not have major mental illness or drug addiction, usually the child does just fine.

The teen may be 17, 18, or even 25 before things improve, but eventually, if there is stability around them, they will start to focus on positive life goals, assuming major substance abuse or mental illness hasn’t taken over. So, here is my advice to families in the thick of teen angst…be patient, concentrate on the positive, don’t dwell on failure, set reasonable expectations, create as much stability and routine in your family as you can, and trust that your teen will grow up and be someone you can be proud of…someday. If you need the help of a psychologist, get it; if your teen has serious drug or alcohol problems, don’t be afraid to get the help of a drug program, or if you, the parents have unresolved psychological problems like marital problems, substance abuse, or depression, get help yourself. Create that stability around your children… they need that in order to do all the other difficult tasks of growing up.

Thank you for spending a little time with me today.  I hope you found this pedcast informative and useful.  Portable, practical, pediatrics is always our goal.  Take a moment to write a comment or send this podcast to a friend or relative. It’s easy.  This is Doc Smo, asking you to create some positive family energy to help your child achieve life synergy.  Until next time.

Book Review: “Wonder” (Book review Pedcast)

 Help support by buying this reviewed book using this affiliate link. You get Amazon’s best price and earns a small affiliate marketing fee.  Thank you.


By RJ Palacio

Publisher- Alfred Knopf, NY


I was biking with friends recently, one of who is an excellent forth grade teacher named Mindy Passe.  We were talking blog as we whizzed through the streets of Charlotte, and Mindy mentioned a book that readers of my blog may find interesting.  The book is called Wonder, written by R. J. Palacio.  Mindy’s class read the book and discussed its themes, which both the children and the teachers found instructive.  I gave the book a read and in today’s pedcast, I am going to give you my opinion and insights about the book called Wonder, by RJ Palacio.


Here is the basic story of the book:  A child named Auggie is born with major facial deformities that have a genetic basis.  Auggie undergoes numerous surgeries and is still left with a face that others find shockingly ugly.  His mother homeschools him, but, when he is ten, his parents think it is time for him to attend school.  They coax him into trying his first year with other kids at Beecher Academy, a local prep school.  The book chronicles his first year at school as told through the eyes of Auggie, his family, his classmates, and teachers.  Highlights of Auggie’s fifth grade year include enduring the shock of his classmates getting used to his major physical deformities, dealing with social isolation and the outright hostility of his classmates, the death of his beloved dog who was at his side during all his recoveries from surgeries, and finally gaining acceptance, respect, and even the admiration of his classmates.  His classmates’ almost complete rejection at the beginning of the school year is ultimately replaced by their acceptance of his deformity and their admiration of his strength of character.


The author masterfully describes these experiences through the eyes of the children, their parents, and teachers. The story is engaging.  Watching these events unfold in the book provokes the reader to ponder the following questions:


a.  Why does a birth defect elicit such fear, anger and hostility in others?

b.  How does Auggie have the strength of character to endure all the negative experiences he encounters?

c.  How does one define character?

d.  How do we make sense of the death of those we love?

e.  Why do the characters change their view of Auggie from someone to be feared and reviled to someone they admire and respect?



Both young and older readers will grow from thinking about these questions. I’ve got to say that I really enjoyed this book.  It was fun to read and well written.  I wish I had read it with my kids when they were young. I recommend this book highly.  It is written on a level that even young readers can master.  That’s not to say that adult readers won’t relate to the story; I think they will.  In my view, the power of this book is that it broaches subjects that we usually don’t talk about, such as how we treat those with handicaps, and how people with handicaps affect us, and visa versa. In my view, reading this book with your child can only be a positive experience.  I highly recommend that you buy it, download it, or check it out of the library.  You will be glad you did.  I give it a 4.5 out of 5 Doc Smo stars



I didn’t know that a book review could have so much relevance to current events, but I think this one does. In the book’s case we are examining how a child and society interact when the child has a severe physical deformity.  In the case of Newtown Connecticut, substitute autism/Asperger syndrome for the deformity and it seems to me many of the themes are the same.  Something to think about.  Thanks   for joining me today. I hope you can listen to other DocSmo topics you will find at my blog,  As always, your comments are welcome.  This is your host, Dr. Paul Smolen, helping you fill the need for a darn good read.  Until next time.


A doctor’s advice: harsh or life changing? (Pedcast)


-Welcome to another edition of  I am your host, Dr. Paul Smolen, the hardest working pediatrician east of the Mississippi, bringing you pedcasts… short, informative, entertaining mp3’s discussing everything kid:  subjects ranging from the crib to the country club , from the play pen to the prom….from diapers to the dorm.   Well, you get the idea. With his permission, I am going to tell you a story about one of my patients who we call Drew that I think you might find interesting.  I did.  So sit back and listen to how a visit to the pediatrician changed Drew’s life for the better.

-Drew’s story starts at a party at the University of North Carolina a few years back…when my daughter was an undergraduate there.  Sarah, my daughter and …the web master of this blog, was introduced to Drew at this party. When introduced, he asked Sarah was she related to a  Dr. Smolen, and of course Sarah answered yes. Smolen is an unusual name and I happened to have been Derek’s doctor growing up in Charlotte.  Derek then spontaneously goes into the story of how I changed his life…  you heard me right…changed his life.  As he tells it, he was in for his routine physical where, of course,  we discuss all the routine subjects… height, weight, BP, BMI, exercise, diet etc.  It turns out that Derek was overweight at the time of this physical and his diet was very poor… lots of sweet drinks and processed food.

–His recollection of our conversation was that I was rather blunt about his weight problem and his poor diet.  I told him he had to change his diet or he might well go into the adult world being overweight and in poor health I told him that men generally reach their peak physical capacity at age 17 years and if he wasn’t healthy then, when would he be?  I strongly encouraged him to stop drinking soda, sports drinks, sweet tea, and processed foods so that his weight would normalize.  He informed me that “he was a football player and that he burned plenty of calories.”  “Everyone drank these drinks”, he explained.   At that point we had a short discussion about calorie balance I explained to him that unless one runs marathons, keeping a normal healthy weight with excess calorie intake is almost impossible. “Our weight is much more about what we eat than how much we burn. “  I explained.

-You need to understand, I have these conversations all the time with teens.  I see about 5-8 teens everyday and diet is a big part of a checkup.  I don’t remember him getting upset or angry during the visit but apparently I struck a cord.  As he tells it, “ he was very angry when I left that day.  He felt that I had been overly critical of him and he resented it.”…buuuut , the message got through.  He said the other doctors just danced around his weight but I was direct and he heard it.  Maybe he was just ready to hear it or maybe he understood that I cared about him and really wanted him to change… but for whatever reason, he decided to take action.

– After that visit, he stopped drinking soda and processed foods and his weight quickly normalized.  Activity was not his problem since he was quite athletic… it was his diet.  The short conversation we had at his checkup had truly changed his life.

-So here is what I learned from Derek’s experience:

People hear messages when they are ready to hear them…Derek was ready the day I saw him

Showing concern for someone’s well being, even if what you tell them is painful, is worth the effort.

Direct communication is the most effective way to connect with young people. My rule is, listen first, then speak.

And finally, people in positions of authority need not be afraid to use their influence in a positive way.  Children respond to honesty and direct communication.  We owe it to our kids to help them with direction and guidance when we can.  Remember, someone did it for us.

-Thanks for joining me today for this edition of  If you enjoyed this podcast, fell free to check out the myriad of other topics discussed in this blog.  And if you really get excited, write a comment about this story or any others you find interesting.  Don’t forget to “like” DocSmo on Facebook, or to subscribe on either my website, or on iTunes. This is Dr. Paul Smolen, hoping you won’t find it too strange, to adjust to inevitable life change.

Until next time


From the desk of Doc Smo: Life is a group activity! (article)

No wonder we are becoming an extremely polarized society: people, especially young adults, are walking around with mp3 players, cell phones, and earphones everywhere they go. They may be physically in one place, but they are interacting with an entirely separate virtual world. When I walk around the streets, what I see are people walking around not hearing birds, not talking to people they encounter, not hearing bikers or cars approaching, and generally being in another mental place. I see little conversation between people on the street. No meeting new people or interacting with strangers. I think this is a shame. I think this kind of isolating behavior is not good for the individual immersed in portable media, but I think it is also bad for our society as a whole. It’s easier to succumb to the danger of becoming rigid and dogmatic in your thoughts if you are not forced to encounter opinions other than your own. Portable media creates isolation.

The world needs more tolerance and understanding, not less. That’s why travel, both local and distant, is so great. You meet new people from other cultures and backgrounds. You are forced to see the world from their perspective. You are forced out of your own comfort zone and see the world through a different lens. In my opinion, parents need to understand the isolating effect of cell phones, portable media, and video games and actively counter their effects. Set a good example by greeting people on the street, seeking out friendship with people with different backgrounds from your own, and showing a curiosity about people and things that are unfamiliar to you.

My daughter and I love to wander and take pictures. It’s our hobby that we have shared for years. I always tell her that no matter how many pictures we take on an outing, if we get one great picture the whole day seems worthwhile. I think the same is true of encounters outside your normal sphere of comfort. In your travels, if you make one new friend, learn something about the world you didn’t know before, or see life in a broader context, the whole experience becomes worthwhile. If you and your children do use the new portable media, make sure you strive to spend an equal amount of time showing a curiosity about what is around you.

Can You Shape Your Child’s Attitude? (Announcement)

Tune in to next week’s podcast to hear Dr. Smolen’s take on shaping attitude in your children. Dr. Smolen believes that a child’s ultimate attitude toward family, work, school, and society are shaped by messages and experiences they have when they are young and impressionable. Parents have more power in this regard than they may realize. Listen to what Dr. Smolen feels are key personality traits that parents can influence and what you can do today to raise healthy balanced children.