I loved “Welcome back, Kotter.” It was a show about Brooklyn public school kids that ran when I was a Brooklyn public school kid, it was populated with what I later realized were Jungian archetypes of Brooklyn high school kids (and teachers), and some of its best characters were people you never saw onscreen.
Like Epstein’s mother.
That was her name, Epstein’s mother. Epstein could always be counted on to produce a note from his mother excusing any outrageous behavior or justifying any outrageous request. Mr Kotter would read it in class, including the last line, which was always, “Signed, Epstein’s mother.”
It’s school year again, and I’m looking for Epstein’s mother. I need to hire her. Once again we are deluged with families who were told that anything they want from the school system they can have if they bring — you guessed it — a doctor’s note.
A perennial favorite is a lunch-is-too-late note. Well, for a child who had breakfast (if any) was at 6AM, 2PM is far too late for lunch. Or 10AM too early, for that matter. Why have a lunch period that late anyway? Can I just write one note for the entire Board of Ed? 2PM is too late for anybody, not just those who faint from hypoglycemia.
Transportation issues are a daily problem. Show me one kid who will not get motion sick from a crosstown bus ride. Closer school, door-to-door bus service — where do you draw the line? Do you only grant door-to-door to the wheelchair bound? What about asthmatic children — mild intermittent? Moderate persistent? Is there an FEV1 cutoff for door-to-door? Is there a body mass index cutoff for the obese children, or do you tell them that the farther they have to walk, the better for their health?
Gym. “No gym x 2 weeks” is a standard standby for an acute illness. What about a slow kid who gets picked last for dodgeball? Do you excuse him from gym permanently to avoid damage to his self-esteem? How is he going to get any stronger if he spends his gym period in study hall?
Since we are on the self-esteem subject, how about a doctor’s note to transfer away from bullies? What about bully teachers? I knew several; none were fired, at least one promoted to a supervisory position. Aren’t unions great? There was a principal once who said that he did not accept notes signed by Russian-speaking pediatricians. That did not get him fired; embezzlement and inappropriate behavior with students’ mothers did. Rather a good thing that bigots are generally stupid in other ways as well.
There does not appear to be any means for quality control for school nurses. Asking for a HiB shot for a seven-year-old is common. HiB vaccine is only approved under six years of age. Sending a child home with mosquito bites on suspicion of chickenpox is a perennial favorite. Referrals to Child Protective Services for anterior tibial bruises (soccer) and cupping marks (folk remedy) — even though both are specifically mentioned as NOT abuse-related in every child abuse investigation guide. Good nurses are in many schools, but if yours does not have one, you are out of luck.
And, finally, a theory of mine: the reason schools are asking for a doctor’s note is so they can avoid something they really dread: a note from a lawyer. Apparently there are all kinds of provisions in educational law students’ (and families’) rights and entitlements; a letter on a law firm letterhead sends school officials scurrying for a compromise before a court orders them to grant every reasonable request and a bunch of unreasonable ones as well. Ajello & Ajello (http://pview.findlaw.com/view/1279439_1) is a firm that is highly spoken of in educational law, one of its partners being a former teacher.
So let me be done, for now, with scribbling (of notes and blogs) and get back to work in real medicine. Don’t be surprised if you find notes from my office that are signed,