Magazine article The Exceptional Parent

Tissues in the Pockets of White Coats. (Editor's Desk)

Magazine article The Exceptional Parent

Tissues in the Pockets of White Coats. (Editor's Desk)

Article excerpt

There are five glands in the human body that parents of children with special healthcare needs are intimately familiar with. The "Big Five" aren't the ones you would normally think are palpated, scanned, biopsied, poked or transplanted. There are no support groups that emanate from the chronic malfunctioning of any of these organs, nor can you find a lab dedicated to theft research at the National Institutes of Health. No one has ever listed them specifically on an organ donor card, nor have you ever received an envelope with gummed address labels and a request to donate money for their research. They are never a focus on ward rounds at Harvard or Stanford.

From time to time we all call upon them to kick in and do their thing. Except that for the most part we don't have a thing to do with their instigation, except for living a full life or involving ourselves with the care of a child with special needs (not that they are mutually exclusive). The glands of Krause, Wolfring, Manz, Zeis, and Moll get very little attention in medical school or other professional allied-health training.

As I recall, there was one question in my pathology course that referenced the gland of Moll (indeed it was one of the wrong multiple choice answers provided in a question about renal clearance). It's sad that more of these glands, which readers of EP report to me they use sometimes daily, hardly get any exposure in basic anatomy or the introductory clinical rotations in pediatrics, surgery, internal medicine, ob-gyn, or psychiatry (there is a place for familiarity with these glands in all those specialties).

While it's sad that medical school curriculums are overlooking their structure and physiology it's almost unfathomable that they don't address their role, their contribution, their meaning, their symbolism, and their life-sustaining purposefulness. You would think that glands that enable humans to perform an activity, an activity that is solely unique to humans, would at least get a thirty-minute drug-company-sponsored lunch lecture on a Friday afternoon the day before Easter vacation (where attendance has sometimes reached an incredible three percent of the class). Not being exposed to the workings of these glands doesn't give the would-be clinician a comfort level being around people who are actively using them. In fact the insights of the poets, playwrights, mythologists, and theologians are much more resourceful than the pages of Harrison's, Guyton, Cecils, and Merck's (the titles most familiar to medical students). While the medical school bookstores are resplendent with guides to the rapid interpretations of EKGs, neuro-trauma, clinical pearls, or frequently asked questions on dermatology rounds, there's not one guide that helps the new, white-coated student assist a patient with their Wofring, Manz, and Krause glands going at full tilt.

Parents of children with special needs often cry. I do not have any eyebrow raising statistics to tell you how much, how often, for how long, or even how they feel after. It's enough to know you do--and with good reason, or with none at all. People, for the most part, are uncomfortable with people who cry. Clinicians, teachers, family members, and friends come to the weeping environment with their own reference points. Our culture sends out mixed signals about crying: sometimes we encourage it, often we try to curtail it. It depends on our perceptions of the role we play standing by while someone is decimated, overcome, or annointed with emotions accompanied by tears. The "Big Five" glands mediate our tears, all three kinds of them. …

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