pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

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Elisabeth Kübler-Ross

Despite dealing with it—and often even causing it—the medical profession woefully neglected the slightest consideration of “dying” until 1969 when Dr. Elisabeth Kübler-Ross wrote “On Death and Dying” about her experiences with terminal patients.
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Parenting: Discipline

“Discipline,” that’s a 200-pound-gorilla-in-the-room topic if I ever heard one!

These days the so-called “do-gooders,” “haters” and “conspiracy theorists” all over the internet have made poor parents fear even the word “discipline”… let alone actually giving it to their child. But “discipline” is different than “punishment” you know.
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Watson, Crick, DNA, Nobel Prize

The “discovery” of how DNA is constructed is a complicated story best told elsewhere; but, the two men who concluded just how it is done are number 34 in our list of the 50 most influential doctors in history: Francis Crick and James Watson—except neither of them are medical doctors; so perhaps, shouldn’t be included in this particular list at all.
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Discipline: Natural Consequences The Best 

I’ve written about discipline before; but recently I’ve discovered that my colleague Gregory A. Barrett, M.D. has extensive experience with not only treating thousands of children and teens as their pediatrician but teaching pediatrics and raising a tribe of his own. All that has given him opinions about discipline—its uses, foibles and misuses. Here is a link to an extensive article he’s written about how to discipline children, its: Why, When and How—among other things.

Whenever the subject of disciplining children comes up in the office, as it does on a regular basis, parents commonly request advice regarding how to respond when their child misbehaves and which techniques are most effective. Not to dismiss the importance of “how,” because it is certainly worth asking, but that is only one of a series of questions that need to be addressed. Let’s take a look at them…

Read full article here: [ natural-consequences-are-the-best ]

Mahmut Gazi Yaşargil: Micro-Surgery, Neurologic Pioneer

We’re at number 35 in our countdown of the top 50 most influential doctors in history and have come to a physician born in a cave, at gunpoint, in Eastern Turkey where his parents were being held by revolutionary/outlaws determined to challenge the new Turkish government in Ankara.

Born “baby” Yaşargil on July 6, 1925 he went on to become Neurosurgery’s Man of the Century (1950–1999) for his revolutionary achievements and advancements in micro-surgery; but… we get ahead of ourselves.
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Refresh: 15 Back To School Diseases

I’ve written about back to school diseases and problems before but it seems that questions and issues just keep the topic alive and asking for an update.

This will be just a quick update of 15 back to school diseases your child may encounter now that school bells are ringing again.
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Medical Marijuana – What, If Anything, Is it Good For?

We’ve explained that it’s the politicians and their meddling which has so far prevented medical research from delineating the truth about medical uses of marijuana, when it was clearly used hundreds of years ago for “medical purposes”—so-called: medical marijuana.

Misguided and incompetent laws have even prevented and delayed the finding of ways to remove the “drug’s” psychotropic side effects and make it safe for use!
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Medical Marijuana

Perhaps most, if not all, of you think of gangsters, terrorists, drug dealers and low-life “users” when you think of the word marijuana. And, with all the idiocy going on by politicians over “legalization” you might also think of societal breakdown, corruption, destruction of families… loss of moral values.

Or, after being beaten into a frazzle by the constant bombardment of so-called “do-gooders” on the media, you may be starting to feel guilty for living the life you’ve always lived trying to do right, knowing what you know about human nature and thinking what you think about the good and evil you’ve seen all around you during your life.
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George Papanicolaou: Cytopathology, Cancer

If Dr. George Papanicolaou isn’t considered with our list of the top 50 influential physicians of all time; then, who is?

I must confess that I must have said the words “Pap test” thousands of times in my training without once thinking about the man whose name those words were associated with.
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Marijuana: Test What You Know

Yea, I know there have been some reports about possible “benefits” of smoking Marijuana but you have to realize that I’m from THE generation where Leary convinced millions of gullibles to indiscriminately use drugs of all kinds with the sweeping generality: “look man, it don’t hurt nobody if I do it!”

That was looooong before the goofball that told me that had absolutely ANY proof of what he was saying… one way or the other. NOW we do!
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Prenatal Marijuana (Cannabis) and Brains

To my way of thinking the very thought that medical researchers are forced to stop what they are doing on important issues beyond our control and do research to prove that marijuana is bad for you and shouldn’t be used as a “toy” is unconscionable to the extreme.

We just can’t let the scammers and dealers destroy unborn babies like they did pushing tobacco however; so, that’s just what researchers had to do.
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Children’s Fitness: The Bleep Test

Assessing Children’s Health and Fitness
The “bleep” test, the “beep” test, the “Multistage Fitness Test” (MSFT)

The test had its beginnings in Britain to quantify the fitness level of children and sports team participants. Its popularity has grown world-wide and it is now used by major league teams as a requirement of participation, not to mention military units, the FBI, schools and other venues where fitness is a job requirement. Many other “clones” of the test have been developed (such as the yo-yo test) but all of them are pretty much the same measurement of the body’s ability to utilize oxygen and get it to its cells.

For those of you who wish to have a copy of the test to use in your family, an MP3 file is downloadable below.

Setup of the bleep test

The “game” or “exercise” is easy to set up and just as easy to perform (except for the running part) but it does need some explanation to those you want to administer it to. The tape uses “beeps” to time the exercise. You start the tape and don’t stop it until the last person taking the test has dropped out. Ostensibly to the highest level it takes just over 20 minutes; but no one has been verified as completing it even though several have claimed to do so. Most fit individuals reach their maximum around 10 minutes, only professional level athletes make it above level 12 or so (there are 21).

Give the instructions, start the tape, wait for the first set of three beeps and runners begin at a pace “just fast enough” to arrive at the cone where they wait until the next beep sounds and they start back. They run back and forth at the same pace waiting at the end for the next beep until another series of three beeps indicate the “next level” and the pace picks up. So, it’s back and forth to the time of single beeps until three beeps announces the next level of faster pace.

The “players” continue until maximal effort is reached with encouragement from the onlookers. The idea is to keep going until they have been “late for the beep” two times in a row and their score becomes the last level that they reached on time. Everyone in the family will be different and playing the game will improve both the score and fitness. Here is a video of a college professor teaching students how to administer the test.


So, what to expect at the various ages for “fitness?” Barring preclusive physical impairments here are the charts for boys and girls 9 through 17. Children younger than nine can run to the beeps but really shouldn’t do so under pressure. Developing a love for how their bodies feel when they’re fit and active should be the FIRST agenda. Nine is early enough to begin the challenge of competing with one’s self for improvement as the SECOND agenda. Physical competition against others should be left for sometime AFTER 12 as the THIRD agenda.



Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/4 3/5-4/4 4/5-5/4 5/5-6/4 6/5-7/7 > 7/7
10 < 2/2 2/2-3/5 3/6-4/5 4/6-5/5 5/6-6/6 6/7-8/1 > 8/1
11 < 2/2 2/2-3/6 3/7-4/7 4/8-5/8 5/9-6/10 7/1-8/6 > 8/6
12 < 2/2 2/2-3/8 4/1-5/1 5/2-6/4 6/5-7/6 7/7-9/3 > 9/3
13 < 2/4 2/4-4/2 4/3-5/6 5/7-6/9 6/10-8/3 8/4-10/1 > 10/1
14 < 2/6 2/6-4/5 4/6-6/1 6/2-7/4 7/5-8/9 8/10-10/9 > 10/9
15 < 2/7 2/7-4/7 4/8-6/3 6/4-7/7 7/8-9/2 9/3-11/3 > 11/3
16 < 2/8 2/8-4/9 5/1-6/6 6/7-7/10 8/1-9/6 9/7-11/8 > 11/8
17 < 3/1 3/1-5/2 5/3-6/8 6/9-8/3 8/4-9/9 9/10-12/1 > 12/1


Percentile < 5 5-20 20-40 40-60 60-80 80-95 >95
Age very poor poor fair average good very good excellent
9 < 2/2 2/2-3/1 3/2-3/8 4/1-4/6 4/7-5/4 5/5- 6/6 > 6/6
10 < 1/7 1/7-3/1 3/2- 3/8 4/1-4/7 4/8-5/6 5/7- 6/8 > 6/8
11 < 1/6 1/6-2/8 3/1- 3/8 4/1-4/8 4/9-5/8 5/9-7/1 > 7/1
12 < 1/5 1/5-2/8 3/1-4/1 4/2-4/9 5/1-5/9 6/1-7/3 > 7/3
13 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/1 6/2- 7/5 > 7/5
14 < 1/5 1/5-3/1 3/2-4/1 4/2-5/1 5/2-6/2 6/3- 7/6 > 7/6
15 < 1/5 1/5-3/12 3/2-4/2 4/3-5/2 5/3-6/3 6/4-7/7 > 7/7
16 < 1/5 1/5-3/1 3/2- 4/2 4/3-5/2 5/3-6/3 6/4-7/8 > 7/8
17 < 1/5 1/5-3/1 3/2-4/2 4/3-5/3 5/4-6/4 6/5- 7/9 > 7/9

Finally, if you’re still with me, here is a summary chart of the entire test levels and shuttles on each level. It shows the relative speed the child is running (km/h) at each level as well as times and distances.


Bleep test summary information