Pediatrics

What a way to wake up. A burly shape in a Hawaiian shirt pulling on your arms, rotating your joints, pinching your soft belly. But Joseph Brandon Hubbard, age 7 hours, 28 minutes, seems not to mind. His eyes flutter open and his mouth falls into a crooked baby smile at the sight of Dr. Nick Roulakis, his first pediatrician. Joseph's face, wrinkled as a walnut, wrinkles harder as Roulakis touches the stethoscope to his tiny chest. The startled baby sneezes, hiccups, and sneezes again.

Like many parents around the nation, Cathi Thomas of Arcadia was perplexed this spring when a pediatrician recommended a new immunization--against the hepatitis B virus--for her children. "I was totally surprised," says Thomas, whose children are 5 and 2. She didn't know the disease had become so widespread, she says, and was "confused about what hepatitis B is." Thomas is hardly alone.

Reluctantly, Rory Robles dropped the toys he was playing with. A patient's bracelet still dangling from one wrist, he grumpily took his grandmother's hand and headed out of the playroom. "I wanna stay and play," wailed the 5-year-old. "Hush, we need to go home now," his grandmother said. It could have been a scene from an arcade in a mall. Instead, it was at the pediatric ward of Western Medical Center-Santa Ana.

In the world view of many young children, seeing the doctor offers one concrete payoff--a lollipop, sticker or some other material reward. But famed pediatrician and international child-rearing guru T. Berry Brazelton, 78, aims to change all that with "Going to the Doctor" (Addison-Wesley, 1996), sort of an "Our Bodies, Ourselves" for kids.

Infants born to obese mothers are a third more likely to suffer significant birth defects, including spina bifida, heart defects and at least five others, according to a study released today.

With a key vote scheduled for today, opposition is building to a proposal by Los Angeles County health officials to close pediatric and obstetric wards at Martin Luther King Jr./Drew Medical Center in an attempt to stabilize the troubled public hospital. A hospital advisory board formed by the county Board of Supervisors is lobbying against the cuts. Two of the five supervisors want to delay the vote on the plan by six weeks.

Two major advances in pediatrics may forever change the lives of newborns with transient jaundice and other children who suffer a rare but deadly condition that keeps bilirubin, the waste product that stains the skin yellow, dangerously high. Surgeons at the University of Nebraska have been the first to do an experimental transplant of billions of liver cells in lieu of a whole organ, operating on a young girl with the rare condition called Criger-Najjar syndrome.

A bitterly divided Los Angeles County Board of Supervisors took the first step Tuesday toward closing pediatric, obstetric and neonatology wards at Martin Luther King Jr./Drew Medical Center, saying it might be the last chance to save the troubled public hospital. By a 3-2 vote, the board decided to hold a state-mandated public hearing Oct. 18 to formally consider the cuts recommended by the county health department.

With television shows such as "Nurse Jackie" and "Grey's Anatomy" regularly depicting physicians and nurses with substance abuse problems, some patients might begin to wonder whether in real life anyone is monitoring the people who provide lifesaving care. Perhaps not. Or, if workers are being monitored, they're not being monitored closely enough to fit some researchers' way of thinking. A doctor survey study published online Tuesday in the Journal of the American Medical Assn.