This Is Your Child on Drugs
The latest edition of PBS's documentary series, "Frontline," arrives under the title "The Medicated Child," but the film, which airs tonight at 9 p.m., could just as easily have been called "The Foolish Adult."
As is so often the case with this documentary series, its subject — the over-prescription of psychiatric medicine to children as young as 3 — is worthy and honorable and of more than passing interest. Yet the overall tone is so tediously neutral that it's enough, to quote Raymond Chandler, to make a bishop kick a hole in a stained glass window.
A few requests: When doctors and psychiatrists are under discussion, could some brave soul on PBS or anywhere else please use the word "quack" or "shrink" once in a while? (Does anyone at PBS — or anyone they interview — have a sense of humor?) Or give us a quick rundown on the Hippocratic Oath, i.e., "First do no harm," along with its approximate antonym, "iatrogenesis," meaning "illness caused by doctors." And if you're going to talk about children being diagnosed with attention deficit hyperactivity disorder (ADHD), bipolar disorder, or just general disorder (the state of being formerly known as "childhood"), how about introducing a little history by referring to the fact that, once upon a time, parents used to beat some sense into their kids rather than rushing off to the nearest charlatan with a medical license and the power to "cure" their problems by hooking them on as many as eight different drugs?
More context is what's needed. By failing to refer to the possible effects of the contemporary environment (hyperactive video games, cell phones for tots, the speeded-up rhythms of television, etc.) on ADHD, and by not comparing the problems of American children with those in other countries, or even to those of American children in the past, "Frontline" essentially deposits us in a dark tunnel of psychiatric guesswork and then asks a variety of shrinks and others if they can see a faint glow at the end of it.
It's not that the makers of this documentary aren't skeptical about the prescription of drugs to children. It's the timidity with which they go about expressing it that's at the heart of the problem, and indeed much of public broadcasting.
A good example would be Tom Wolfe, author of the marvelous essay, "Sorry, But Your Soul Just Died," written in 1996, which balances an appreciation of the developing science of neurochemistry with what's lacking here, namely a consideration of how we regarded children in the past, of how "high-spirited" becomes "hyperactive," and of what a completely science-driven view of human nature is likely to entail in the future. ("Science is a court from which there is no appeal.") One of the more interesting facts to emerge (between the lines) from this documentary is the malign role played by teachers, many of whom seem to double as social workers. The first child we're introduced to is Jacob Solomon, whose parents, Iris and Ron, live in Los Angeles, where Ron works as a screenwriter. In preschool, one of Jacob's teachers recommended that Jacob — at age 2 — be treated for hyperactivity and lack of "impulse control."
According to Jacob's mother, one teacher suggested that "there was a chemical situation going on with this child" that medication might be able to help. One's heart, or rather one's "chemical situation," aches to hear such language out of the mouths of mothers. What with all those chemicals, the child sounds less like a child than an unruly gas station attendant. But parents are generally not the villains here — at least not compared to the institutional busybodies pushing their offspring toward the drug pushers.
"The Road to Ritalin is of course a prosperous road," wrote George Trow, who thought that ADHD was an understandable, if unfortunate, response by children to their hyperactive environment. "Your classroom is of a kind that can be disrupted; your family life is of a kind where 'acting out' is noticed; where a 'solution' is called for — and implemented."
But that was in 1997. As "The Medicated Child" notes, there are more and more people on hand who are ready to do the implementing across a wider social spectrum. Influential child psychiatrists such as Joseph Biederman, Kiki Chang, and others have pushed for early diagnosis of bipolar disorder, arguing that "rapid mood swings, tantrums and … 'explosive irritability' are the key symptoms of childhood bipolar," though it's unclear as to whether anyone knows if childhood bipolar even exists. The forbiddingly thick tome on diagnosing mental illness in children, which apparently enjoys biblical status in the profession, is given a close-up worthy of a Hollywood star. It looks like the computer manual from hell.
In one of the more entertaining scenes, we are introduced to Jessica, a "clear-cut" bipolar young lady of 5 years old who likes to talk about busting people's heads open, and so forth. This reminded me that I rather like talking about busting people's heads open myself — it's better than doing it, after all — and that my favorite witticism as a 6-year-old was "Put your head in a drawer and slam it." Unfortunately, I was living in the backwater of Portugal at the time, ruled by the dictator Antonio Salazar and, tragically, the pills that might have "cured" me were unavailable.
"The Medicated Child" isn't a bad program, or an uninformative one; it's just a bit small-minded, ahistorical, and unimaginative. There are good moments, however. "This is 10-year-old Matthew Detrick," the narrator states at one point. "His parents are concerned about his moodiness."
And then we see men in white coats sticking the poor child inside some giant MRI-style brain-scanning machine.
In other words, "Put your head in a drawer and slam it. Then we'll give you the results and drug you up to your eyeballs."
bbernhard@earthlink.net
