Magazine article The Exceptional Parent

Close Enough

Magazine article The Exceptional Parent

Close Enough

Article excerpt

An 80-year-old woman bursts into the men's day-room at the retirement home. She holds her clenched fist in the air and announces, "Anyone who can guess what I have in my hand can have sex with me tonight!"

An old man in the back shouts, "An elephant?"

The woman thinks for a moment and says, "Close enough!"

While "close enough" in this instance might have made all the difference, for parents of children with special healthcare needs, "close enough" is not often close enough.

"Close enough" might be justification for payors and policy makers to alter windows of eligibility, reduce the number of days of active treatment, change the criteria of anything that is promising, and reconfigure the rates that allow Tab A to fit into Tab B, but in truth, it's truly not close enough.

"Close enough" is not a statistical term like the "intersection of events" or the "goodness-of-fit test" (two unlikely sounding statistical terms); nor is it a genuine epidemiological term like the "standard gamble" or "McNemar's test for dependent proportions" (try dropping either of those two at the next cocktail party). "Close enough" is one of those behind closed doors references that the "change artists" (not to be confused with the change agents) utter under their breaths when they've exhausted ways to make the "close enough" become closer.

If only human genetics would subscribe to the allowance of "close enough." The appearance of two X chromosomes and one Y chromosome would be considered "close enough," and folks with Klinefelter's syndrome would be put back into the totally normal gene pool. Take cystic fibrosis; there are over 700 different mutations on different genes that will cause the development of the disease to varying degrees. One would think that Mother Nature would declare "close enough" to normal on any one of these 700 culprits and just let the lungs do what they're supposed to do. With sickle cell anemia, the disorder is caused by having just one nucleotide misspelled, but it's enough to alter the red blood cells and play havoc with the cells trying to navigate their way through blood vessels. Heck, any English teacher grading a term paper would say "close enough" and give a passing grade if there was only "one" misspelled word. So "close enough" just doesn't cut it in the unforgiving, uncompromising world of gene coding.

For years pediatricians thought and exclaimed "close enough" when frantic parents questioned their children's confusing behavior. …

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