THE GREEN SHEET 37 - Balt. Sun: 11-29-82 _. _..--- .~ Doctor Koop's - Bad Idea T HE surgeon gellad of tha United States, Dr C. Eramtt KOOQ, MX,nti,' llHd% l%W'S at. a meeting of pedintriciaez by main- uining that violence was a treat- able public health problem. The idea is strategically UII- sound and clinically ~reQosterous. Doctors have never wanted any- thing to do with violence and still By John R. Lion don't. Few pediatricians wish to ses violent chiklren snd even psych& trists woid violent aduits. The Amerfan PaychiaJric Ae- rsof t$;oie:: Indzt~ . . n cam. out in 1374 and is now out of Qfitlint; ViOhCO t UOt H QOQukr SS the study `bf &Qmesion or schiw- Qb?%Ili.S. child. .SbUH WH QNtiCd,,' ig- nomd by the medical profession untiIsuchtimeashwscameinto existance rquiring doctors to re- port incidenm of child abuse; doc- tars wdd much have preferred tc look the other way. Even now. oncz o caaaofcbildabueeiarecognized, tImmalu@xme?ltofthecaseb~ suad by social welfare and crimi- nal justice institutions. Dutaide of training hospiteis or aprddized facilities. it is an en- caediqly ram. practitioner who ekte to dhgnone and treat violent Quieotd and their famSee. A ~trician facad with a via- Ient yamgster wiU shncst inevita- bly shunt that patient somewhere elsa?b hasn't the skiUs or the time to spand with the patient and bin family. That's the kind of thing Mucus Weiby night be able to spaad a hdful day doing. &e&kg of televisioion, the sur- gwn general also SUggHted that doctors watih tbe entertlinment ?nenu~" of their pation@. He wan referring to telavision vioirnce. Dr. KOOQ ought to be aware of other public heahh aspects of mie- vision, not just violence. For exam- ple. studiea hm shown that heavy alcohol drinking is depict.4 in 40 percent of prime-time programs, yet only 1 percent of the characters 011 tk! Q-W m ShOWn to bW* a d&king probbm or to be eico- holiH. Nor dw anyone ever seem to get seriousiy hurt driving, despite the perverse frequency of car S,Q.,,hUQ8 on these shorn. Ardya%~ of adult QrognunS indi- cate that a mere 7 percent of major &aractem have injuries or illnesses requiring treatment. Victims of in- juriee are hardly even shown. AlI in dl, television's effect far transcenda the simple display of aggression. The TV menu Dr. KOOQ spanks of is hardly to be changed by the medical profcrrion. If the surgeon general wants to do battle with the industry, that's quite an- other matter with a potentidly ef- fective outcome. The most distressing thing about Dr. KOOQ'S commenta is thair epidcmiologic~ fussiness. His ra- marks indicata that clini~iaru should focus on signs and symp- tmns of cbildlmod violence such M pychomotor epilepsy. Psychomotor epilepsy has baan -linked with violence, but the link is tenuous. The disem~ is very ram anyway. About 15 percent of alI epilepir are of the psychomotor type and the coexistence of vio- lence cpile~~y Is even rarer. `Ww to diagnose a violent child on the bs*s of brain dysfunction is CN- cial. but it contributea aa much to the reduction of crime and violence in &nor& aa the swntting of a sin- gle mcaquito contributes to the controlof malelm. If the surgeon general realty wmt~ to tuw an effect on heaitb and violenca as thay relate to one another; he ought to go to work on Jcohol-related highway deaths. That's where the numbem are. The othar day we memoriali the nearly 5WOO peo~lr killed in the Vietnam War. An quai num- ber of Q%OQIO are killed every single year in this country in highway ac- cidenta and over half of them are alcohol-dated. They are pnwnt- able. Physiciam play the tinieat role in such prewntion. Politician% legiskan and judges are responsi- ble. The surgeon general's office hu influence. It battled the tobacco in- dustry nnd won major victories In: stead of doctom. Dr. Koop should start working with the Mothers Agdnst Drunk Drivers UMDD). That would mduca a lot of camaga. Dr. Lion is pmfesror a/ psychia- try at the Unioersity of 54aryhnd Medical School. :