Just Break It

Hammer_Tools_clip_art_mediumI know some kids who are building a fort. This is startling news. I have been a pediatrician for some time now, and no one has ever told me they were building a fort. Going swimming, sure, camping, naturally, visiting amusement parks, you bet. But a fort?

This fort, I learned, involves hammers and nails and wood. And it’s being build by kids. There are no parents or uncles or contractors involved. While marveling, I mentally ran through my list of pediatrician safety topics: sun block, helmets for bikes and scooters, seat belts. There are no admonitions against fort building except perhaps measure twice, cut once. I am glad.

During my pediatric residency, warm weather brought trauma: minutes after the city schools let out the fire rescue radio in the emergency department crackled to life: bicycle versus motor vehicle, ETA five minutes. The kids would arrive taped to backboards. Most weren’t wearing helmets. They’d get imaging, I’d clear their cervical spines and remove their collars. I’d clean out wound, stitch and splint.

While some of these traffic injuries were the terrible intersection of children and their urban environment, the ones that didn’t involve the paramedics were part of a normal childhood. The kids banged up running around in the park, playing basketball, and honing their jump rope skills stood in stark contrast to some of the city kids who lived where it wasn’t safe enough to play outside. Some of those kids had weight problems, and I always had high hopes that a long, active summer would trim them down. It hardly ever happened; indeed most of the kids gained weight faster once school was out. The reason: their working parents, out of necessity, kept them safe inside where there was access to TV, video, and food.

Nationwide, too many children are regularly attached to the electronic teat so their parents can keep track of them. This sedentary, passive behavior is not the work of childhood, although sometimes the alternatives are almost as bad. Summers can be filled with adult led, top down activities where children line up and move through stations of swimming, crafts or sports at prescribed intervals. Parents struggle with the current status quo because the child who isn’t enrolled in these activities will spend her summer alone because everyone else has been packed off to an adventure day camp leaving no one to play with.

A child’s work is play. And that play should be age-appropriate and child-driven. Kids can get past boredom and pre-programmed tie-in “toys.” I prescribe a nice refrigerator box, old clothes and some paint. It’s a fort, it’s a pirate ship, it’s an airplane. The sky’s the limit. Children thrive in an environment that’s safe enough to be healthy and open-ended enough to be fun and engaging.

When I treat an injured child, I ask how the injury occurred so I can best diagnose and treat. There’s usually no harm, no foul when parents bring in their child who’s fallen off the monkey bars or split their chin dancing on the hard wood floor. I usually give extra credit. There are injuries and there are injuries. And there is childhood. Kudos go to parents who don’t their kids sit around in front of a screen.

I wished my fort builders a great spring and an even better summer. But I must confess that before I let the kids out of the office I checked one more little thing: that their tetanus boosters were all up to date.  They were, and I am glad.

About Lisa M. Asta, MD

Lisa M. Asta, M.D. is board-certified by the American Board of Pediatrics and is a Fellow of the American Academy of Pediatrics, for which she is also a Media Representative (she has been interviewed for “Kids Health” on Health Radio, and quoted in Parenting Magazine, USA Today, and the New York Times, among other publications). She is a Clinical Professor of Pediatrics at the University of California at San Francisco and past pediatric chair at John Muir Medical Center in Walnut Creek. She graduated from Temple University School of Medicine and the Johns Hopkins University. Dr. Asta is also a writer whose fiction has appeared in Inkwell, Philadelphia Stories, Schuylkill, and Zeniada. Her essays have appeared in the Journal of the American Medical Association, Hippocrates, the San Jose Mercury News, and The New Physician Magazine. She is an occasional contributor to KQED public radio’s Perspectives series, and has written articles for Bay Area Parent, Valley Parent, Parents’ Press, and Parents Express, as well as online at WebMD.com, Rx.com, and MyLifePath.com. She wrote a chapter in The Field Guide to the Normal Newborn, ed. Gary Emmet, M.D. BabyCenter.com currently has two how-to videos for parents in production which feature Dr. Asta. For more on Dr. Asta’s writing, visit www.LMAsta.com
This entry was posted in 101, Children, Pediatric Bits, Phenology, Play, Simply Safe and tagged , , . Bookmark the permalink.

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