It’s not bad enough that we’re living through huge political instability, isolation and under socialization - I have to bring this possibility up. Sorry.
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I have speculated that a part of the cause for the epidemic of psychiatric and psychological maladies we are dealing with are not just the social isolation and uncertainties due to the pandemic, but from direct effects of the virus on our neurological functioning. There is ample evidence of the virus causing objective and serious effects on the brain.
Not sure what to expect next, but it ain’t good.
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I’m sure you know this already, but speaking from (long ago) experience:
Do not ask questions about sexual activity in front of the parents. Find a way to get the patient into a safe space before asking.
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We use a questionnaire filled out confidentially for this. I will boot the parents for any further discussion. I have has a few parents who won’t allow the kids to fill it out and do it themselves, and then refuse to leave the room. We don’t really have an answer for that. Had one mom leave the practice after her daughter asked to speak to me alone and I backed her. In the end, they always have that option.
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Those are the parents to most worry about, on behalf of the children. But you know that!
I used to consult with a pediatrician who developed a clinic for international adoptees. He takes all the information, but then navigates how and when to openly support the adoptee’s needs to the parents because so many of them are doing it for the wrong reasons and if they feel judged or called out (or simply reminded that these children have needs and are not simply going to be grateful and perfect idealized children) then they’ll walk and the kid will probably never again have a pediatrician who has actually researched their needs.
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I remember way back in the early 80s our family physician needed to ask me personal questions because I was developing hemorrhoids from eating too much meat and not enough veggies. Mom was asked to leave, but was cool about it
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That happens way too often, especially with LGBTQ youth. And we are pretty helpless. It’s not “abusive” in terms CPS would deal with, so we have to be very careful in addressing issues like this. I have used a lot of approaches in different settings, there is no one ideal for all parent-child dyads. Mostly good judgement, which comes from experience, which comes from bad judgement. 
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My BFFs brother is a neuropathologist, and is often asked to sit in on autopsies. He’s said that brains of covid-19 victims often look strange. I think he was writing on this topic, but have no idea if his work on that has been published yet?
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Funny thread. I have told Ms. Pane that since I had Covid in July, I’ve felt like my brain “doesn’t work right/the same” but I cannot really describe it. So while I’ve mostly chalked it up to general fatigue of work and raising kids, it does seem different. 
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Sounds like you might have a low level case of long-covid! That sucks! I’m sorry… But if these are all true, that the brain is a major target area of covid, than things like that would make sense…
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That is very scary. Covid is just the curse that keeps on giving
@anon33932455 take this with a lot of salt- but extra b vitamins helped me with some lingering COVID-brain. It was something my bro suggested and while I couldn’t find any great evidence, there were some suggestions it might help and b vitamins are water soluble. My doc said it would be fine to try. I took the smallest supplement I could find* and upped my leafy green and egg intake. Might be worth a try?
- WTF is it with mega-supplements? Vitamins and minerals are not usually a more of the merrier type of thing.
I can’t find what I did before but:
https://www.sciencedirect.com/science/article/pii/S030698772100061X
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I have “treated” 2 kids for vit B6 toxicity. Causes a pretty scary peripheral neuropathy. As you pointed out, it is water soluble, so to get toxic levels these guys had to be pounding some really serious megadosing. Treatment was just “Stop doing stupid things,” and it went away. But yeah, more is not necessarily better.
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I’ve been doing a b-supplement and a magnesium supplement for a couple months. No change. Cut back on booze. Esh. But it’s also allergy season. It’s frustrating.
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Selma Alabama, as of a few minutes ago.
And another one nearby.
ETA: the big one in the picture was 10 miles from my house, and moving away so we’re safe. Thanks for the good thoughts!
E2TA:
Amazing picture. Not far from my house, and thankfully on its merry way to somewhere the fuck else.
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Holy shit! Stay safe, my friend! That’s a god damn monster…
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Whoa - that’s huge! Please stay alert and safe!
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That’s what was in the person’s text. “It’s a monster!”
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I hope they’re okay! So scary… And Selma looks awful. I hope that everyone there is okay.
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