All shelters but one of the children died before the age of two years

As scientists discovered the phenomenon of “emotional deprivation,” the more dangerous it is, what are we to do now – and whether you want to pursue the most modern medical technologies. The publishing house “Alpina” published the collection of articles of Professor of neurobiology Robert Zapolskogo “Who are we? Genes our body, society.” “Pravmir” publishes an excerpt from it.

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Robert Sapolsky

But most, in my opinion, instructive disease with a reverse gradient is not an illusion, and it has a logical explanation. It’s a disease called hospitalism. It was almost a thing of the past, but its very existence is amazing and disturbing Chapter in the history of medicine.

To get a General idea of hospitalism, you need to keep in mind that in many traditional societies, newborns are not given names until the child will not grow up to several months or even several years. This is due to the very high infant mortality: wait until the child will survive before to give it a personal name.

Similar cultural adaptation could exist in the early twentieth century in American orphanages — institutions for orphans and refuseniks: there the infant mortality rate was also extremely high. In 1915, the physician, Henry Chapin’s interviewed ten such institutions in the United States and cited figures that do not require a statistician: in all institutions, except one, each child died before the age of two years. Every child. We are at a loss looking at these tragic data, reading smug expression Chapina ninety years later.

The situation of children in hospitals at that time was not much better. Usually the child is hospitalized for more than two weeks, began to show signs of hospitalism: to gradually waste away despite adequate food. Weakened muscles, lost reflexes, increased risk of gastrointestinal and pulmonary infections. But all together increased the mortality rate almost ten times.

Scientists had their suspicions. In hospitals at that time was dominated not very healthy, and it was assumed that children in their wards apply some sort of infection. In the era Chapina the focus was gastrointestinal diseases. Ten years later of pulmonary disease, particularly pneumonia. Appeared all kinds of fancy titles to describe the “malnourished” children, but they were all missing the point of hospitalism.

Now we know. Hospitalism lies at the intersection of two notions of time: the cult sterile, sanitized conditions at any cost and confidence of the pediatric community (overwhelmingly men) that you can touch, hold and rock babies — mother’s sentimental nonsense.

Children should be seen and not heard. Spare the rod — spoil the child. Such then were the sayings. America began the twentieth century left behind the dark world of child labor in sweatshop factories, but most of the recommendations of experts on parenting today would have seemed cold and harsh.

Dr. Luther Holt of Columbia University, the counterpart to Dr. Spock of the century, wrote a bestseller for parents of the time “the Care and feeding of children” (The Care and Feeding of Children). He warned parents about the dangers of “bad practice” to swing in the cradle or take the baby when he cries and don’t advise too often to keep it on hand.

If such advised parents, imagine how few were interested in the interaction with the baby nurses and nurses, which were entire departments of these children in shelters or hospitals. One pediatrician at Chicago’s children’s memorial hospital told its employees to take babies on his hands and “entertain” them several times a day. Years later it is still considered weak-willed eccentric, so he was ahead of his time. Usually even the parents were allowed to visit only a few hours a week.

By 1942, had accumulated enough research on the psychology of development, to find the correct explanation of the causes of hospitalism. It gave an internist at new York University Harry Bakwin: “emotional deprivation”. Or “loneliness” as he defined the problem in the title of one of the publications on the hospitalism.

When the mother licks and courting a rat, it excretes growth hormone that triggers cell division: mother’s touch is necessary for normal growth. In a series of outstanding research Michael Mini with colleagues from McGill University has shown that lucky pups whose mothers work very hard on grooming, resulting in many changes in brain development with consequences for life — in adulthood produces less stress hormones, they learn better under duress, perhaps, their brain ages later.

Similar stories surfaced in studies of primates, starting with the classic work of Harry Harlow, who showed that young monkeys understand in the development of more average pediatrician, fighting hospitalism: if given the choice, monkeys prefer feeding mother’s touch. And not just tactile stimulation. Speaking about what is necessary for the normal development of primates, Harlow dared to enter in the modern scientific literature the word “love”. A severe, sometimes fatal, developmental disorder due to emotional deprivation in humans are described in any textbook of endocrinology growth: it’s called psychosocial dwarfism.

Infants in hospitals, despite proper nutrition, a sufficient number of blankets and protection from all sorts of infection, others from emotional deprivation. And when they are made sluggish and depressed, weakened immune system (as shown in young human primates subjected to a similar deprivation). Soon they became victims of the gastrointestinal or respiratory infections, ubiquitous in hospitals of the time, and then the case enters the feverish desire of physicians to sterile isolation.

Pediatricians believed the infection is the cause, not the consequence of hospitalism, they send their children to a private chamber, inhibiting any touch of human hands. And the death rate soared to the heavens.

Now we are clear on that, but our current explanation would be gibberish for caring and competent physician of those times, whose battle with the disease began and ended the microbial theory.

And why hospitalism was reversed social gradient in health? Part of the clues scattered here and there, hidden in the crumpled papers. Seen as were baffled the experts who periodically thought about the strange statistical regularity: children are less likely to have sick hospitalism in hospitals is poorer who could not afford insulated boxes with the latest technology.

From here you can take a few lessons. The lesson of hospitalism is still relevant. Modern medicine has developed the unique ability to save premature babies, even those born in the months later and weighs less than a kilogram. But such feats must the neonatal intensive care unit, where in the name of sterility sacrifice stimulation.

Photo: Getty Images

In the classic work of the early 1980s, Tiffany field with colleagues from the Medical school of the University of Miami went into the branch for newborns and began to touch the children three times a day for 15 minutes stroking their body, move their limbs. And it gave miraculous results. Children grow and develop 50% faster, were more active and more cheerful, and was discharged from hospital almost a week earlier than premature babies who were not touched. Months later, things are still was better than pristine premature.

It seems to me that this important conclusion still calls for the widest possible application. And no need to go to neonatal intensive care unit or to dig in the ancient medical records, to detect similarity hospitalism. Hold a crying baby, enjoy the rest, comforting him, even though you’ll think the world is fair and safe — and then imagine children, stacks piled in the Romanian orphanages: the embodiment of hospitalism, you will be impressed.

But this morality is not exhausted. Quoting Sholem Aleichem, the poor be ashamed, but not honorable. Try not to be poor. Try to help those who are poor. Health care is not only the destruction of microbes. Normal development — not just proper nutrition. And even if you are filthy rich, you still need to use sunscreen.

And the last conclusion, which should sound more as a warning than as unscientific ranting. When someone gets sick loved ones or ourselves, when above us hangs the sudden horror of death, the most far-sighted of us rushing into battle.

We review medical journals, magazines about health, use any connections, calling a former neighbor of the second cousin, who occupies a high position at the medical center — all to learn about the best, newest methods of treatment.

And the moral among those that sometimes do not just jump. Not the fact that the last achievement of medicine — always the best offer.

It’s not very practical lesson, because medical error is not immediately detected. Just remember that somewhere many years ago the most advanced a doctor could tell a favorite patient on the newest tool, such as leeches or bloodletting to release from the body of evil spirits, or to give a free sample of the new drugs — thalidomide (sleep aid sold in the United States, Germany and other countries in the years 1956-1962; women who took it during pregnancy, had babies with congenital malformations (according to various estimates, has suffered 8000-12, 000 children). Or maybe it was the assurances from concerned parents that their sick child will put in the chamber equipped with the latest technology.

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