News-Record.com

I've lost two posts in the last two days with this type-key system - I've logged in, typed in my comment, and then tried to post - but the post falls out and the system tells me I've not logged in. So I'm trying this again:

Elaine, first let me say that I am profoundly sorry about the ordeal your friend's grandson has suffered. I am glad the problem was diagnosed and he could be treated. I understand your reaction to the letter.

From Nelson's Textbook of Pediatrics (often referred to as the "Pediatric bible" - the edition I have immediately available at this particular clinic is the 16th), retinoblastoma occurs in 1/18,000 live births in the United States - with no racial or gender predilection. Overall, about 60 percent of cases are unilateral and nonhereditary, 15 percent are are unilateral and hereditary, and 25 percent are bilateral and herediatary. The retinoblastoma gene is located on the long arm of chromosome 13.

Nelson's (written by a bunch of people a whole lot smarter than me) goes on to say that Retinoblastoma is detected in a variety of ways: (1) Routine neonatal opthalmologic screening in the context of a positive family history. (2) Classically, with a white pupillary reflex (leukocoria) - either picked up on routine physical exam (all well-child check-ups include a physician checking for the "red reflex"), or noted in flash photographs of the child's face. (3) Strabismus (deviation of the eye) is another common presenting sign/symptom. Advanced disease can present with other signs and symptoms.

In other words, retinoblastoma is usually "caught" by the child's regular physician or family. The moral of the story is to make sure your child gets regular check-ups (especially after the age of five) - and to listen to your child's teachers about any problems they may be having - be it with seeing the board, hearing, concentrating or behavior. If you want to get the full eye exam as a precaution, by all means get it. Should it be a public healthcare mandate? No.

The health and welfare of children is a very emotional issue - and where public policy is concerned, to some degree it should be. We should care . . . very much. And we all speak from personal experience, good and bad . . . as well as with deep emotion when it comes to medical care. But public policy must be grounded in facts.

There is a weath of information on the circumstances surrounding this eye exam mandate already posted on Jodi Hyler's original Letter to the Editor (January 31, "Eye Examination will waste Time and Money"). I am not going to reiterate it here. But the FACT, Elaine, is that this "law" was pushed through the legislature WITHOUT ANY "informed opinion" or debate being offered by medical or educational professionals. Many medical organizations have, after the fact, publicly stated that the law was not properly vetted and is (to quote several stories in the N&O), "irrelevent".

The debate should have happened BEFORE this mandate became law . . . not after.

Ms. Hyler, being an "informed" teacher and voter, noted that Speaker Black is an optometrist. Ruth Sheehan, a News & Observer reporter, this week related a story in which the flustered Speaker (confronted that opthalmologists opposed the mandatory exam) said, "I cannot believe that opthalmologists would say they do not support this. After all, the eye docs got their cut."

This is the most damning evidence yet that this mandatory eye exam for kindergarteners was born of something other than Speaker Black's concern for children.

Doctors need to find their voice - both collectively and individually - in politics and public policy. Somewhere along the way, we lost it.

I don't know the guy and don't claim to, but isn't it possible that Black became an optometrist because he cares about the eyes of children (and adults) and that same passion is behind his opinion on eye exams for kindergartners? That doesn't seem illogical to me.

I don't agree that people can't have a genuine concern about an issue that they could also benefit from. Many people enter into a line of work because it's their passion, but then it pays their bills, too. You haven't proved that Black is abusing his position, nor have you shown proof that his motivation is sinister. You may be right, but where's your evidence?

And for those who object to eye exams, be glad you don't live in Florida. A friend who moved here from there said that state requires that children receive a full physical exam before enrolling in school, and in her case, her children had to miss two weeks of school before her family could borrow the money to pay for the doctor visits. (They had no insurance and earned too much to get assistance, but too little to afford the visits after paying their monthly bills.)

From the Speaker's own lips, Missy: "The eye docs got their cut." Sinister? No. Unethical? Yes.

http://www.newsobserver.com/114/story/395483.html

"The cut" is of our tax dollars - yours and mine . . . at a time when the folks in Raleigh have already been busted for letting millions, if not billions, be poured down the drain. There is a right way and a wrong way to do "the people's business" in Raleigh. Public policy regarding healthcare should be good policy - and arrived at by debate and consensus. Speaker Black took some big shortcuts here - even as he talked out of the other side of his mouth about ethics reform.

And you're right. Most people go into medicine for idealistic and altruistic reasons. That brings us to the "up" side of this story. In this day & age when everyone assumes that doctors are just in it for the money, doctors have come out in force to prove them wrong. As Ruth Sheehan pointed out in her OpEd, the eye docs in our state didn't ask for "the cut". Their silence regarding this initiative could not be bought for a little income security.

As one of those folks who did go into medicine to "make a difference", I've been on the wrong end of so-called public servants abu$ing their power by lying and cheating to get what they want, so I don't have any use at all for this garbage. It's time for those who represent us - and work FOR us - to CLEAN UP THE ACT.

As for "proving" anything, (as Ms. Sheehan also pointed out) the Board of Elections can sort it all out.