Hovannes Melidonian, M.D.

Diplomate American Board of Pediatrics

Compiled by Dér Stépanos Dingilian, Ph.D. © 1999

Q. When a child is brought to your office for an illness, how do you try to treat that child?

A. Of course, the first order of responsibility is to treat the illness, that which is causing suffering to the youngster. Generally that is the easier part of what I do. However, if I merely stopped there and sent the young person and the family home, then I wouldn’t feel comfortable. The reason is because I feel that any sickness or even an accident happens because of a reason. It does not just happen. Unless I help that family understand the reason and learn how to prevent that illness, I really don’t feel I have done enough. In all my work, I often find lack of self-esteem on the part of the child as the reason for an illness or an accident. So I take the time with the youngster and the family not only explaining what they need to do medically, but also how they may change their behavior or outlook in life in order to avoid that illness or accident. Self-esteem is not just feeling good about oneself, but appreciating oneself, own family, friends and community. Self-esteem has to do with being a person with a well rounded personality and habits, which in turn affects one’s appreciation of health and its maintenance.

Q. Could you give us an example that illustrates this point?

A. Sure, I’ll give you two examples. First, I find very often that children get sick very quickly because their bodies are too susceptible to bacteria, virus, and other factors that cause illnesses. One of the main reasons for this is that children do not get enough exercise where their body builds up strong function so it can resist and overcome illnesses. When you send the child to school, you cannot prevent him or her from coming in contact with children who may be ill. It’s impossible. So I encourage parents to provide the youngster with sufficient physical exercise and strength where he or she will overcome any illness when exposed to it. Of course having the children in a sport program would be nice. But in order to build up physical strength and immunity all a child needs is consistent exercise as opposed to being part of a soccer, basketball or football team which can be very costly and time consuming.

Q. Doctor, you also mentioned about accidents.

A. Yes, and that is the second most common reason why children are brought to me. We often speak of accident prevention, but I believe we don’t go far enough in explaining the reason and the thought process that causes an accident. For example, the other day a 13 year old was brought to my office with his eye and nose bleeding. To cut a long story short, he made what he thought was a humorous comment to a classmate, who didn’t take it as humorous and punched him immediately. This young man was ready to go and avenge his humiliation. After we had a conversation he agreed that he had no business making humorous comments to a person whom he did not know closely nor met his family. He also agreed that trying to avenge by beating him will not solve the problem either. So, from this experience at a young age, this youngster learned a few lessons about making humorous comments to strangers. Again, understanding the personal side will hopefully help this youngster stay out of fights and in turn physically healthier.

Q. Doctor, it sounds like you spend a great deal of time with your patients and their families?

A. In fact I do. Those who come to my office often wait a long time. But, they are glad when they leave because they better understand the whole situation around the illness – what it is, how it came about and what they can do to prevent it. The parents also appreciate my conversations with the youngsters. Often a parent repeatedly tells a youngster to do something but he doesn’t. When it comes from "The Doctor," generally it carries more weight. Children also like to be explained to as an adult; that is part of the process of growing up. Of course I have to explain it at their level, which is a consequence of my personal effort as opposed to strictly my professional training. Youngsters are very ‘busy’ today and because their attention span has become so short, it is hard to get their attention. However, when they are sick or not feeling well, you have their attention. That is the time to explain to them in a firm and friendly way with some common sense.

Q. And what advice do you give to the parents?

A. I am glad you asked that. Actually, during the visitation, half of what I say is for the child and the other half for the parent. I explain to the child, but the parent needs to be educated as well in order to assure that what I advise regarding the child’s health is carried out. For example, I mentioned earlier the importance of self-esteem. But the family needs to instill this self-esteem, not the child. Before the school does it, the child must already go to school with this self-esteem. So I convey this message to the parents in very clear, direct and in no uncertain terms. If the idea is new for the parents or they seem inexperienced, I repeat my instructions over and over until I feel comfortable that they understood what I said.

Q. Since you come in contact with so many Armenian families, what do you see as the strengths and weaknesses in the way Armenian parents treat their children?

A. Fortunately the strengths are many and the weaknesses are very few. I am glad to say that the child has a very high priority if not the highest, within the Armenian family. In the case of illness, need for medication or special medical attention Armenian adults take better care of their children than they often do of themselves. This gives me a great deal of satisfaction because I know that the advice I give them is appreciated. And I think this is why parents bring their children to me even though they know that they have to wait for some time. In terms of a weakness of the Armenian family, I wouldn’t exactly call it a ‘weakness’ but say that it is a situation that is the consequence of the community structure. Often families live with extended family members, and likely either the wife’s or the husband’s parents. So when a child becomes ill, everyone comes rushing to help with numerous suggestions on how to deal with the illness. Typically, the mother brings the child to my office and accompanying them is the grandmother. When I begin asking questions about what happened, the grandmother begins answering. Generally I politely inform the grandmother that I would like to hear from the mother and not her. The mother needs to be educated about the child’s health not the grandmother; the grandmother already knows. Most understand my point, but some become frustrated and end up sitting in the lobby. What the extended family members do is all in good intention and often necessary. However, I believe that if a child will grow physically, mentally and spiritually in good health, then he or she must recognize the importance of the family unit and the relationships and responsibilities within that unit. More than anything else, I believe that a child needs a loving, compassionate and understanding family in which he or she can grow in health and peace.

Q. How does spirituality, the relationship with God, affect the child’s health, if any, from your perspective?

A. Let me start off by saying that I am a person who attends Church and we have raised our family in the Church. I know all the sharagans (hymns) and feasts and so forth. However, what I find often is that I have to emphasize the need for the parents to think on their own when it comes to the child’s health. Sure God blesses us, but we have to do something with those blessings. So I may come across as agnostic, but I really emphasize that the family unit must take the initiative for the child’s health and well being rather than just leaving it up to God. In turn, what I try to do is bring hope that all will be well if the child is well nurtured. Often parents come in a panic during an illness; I try to calm them down as opposed to cause further panic or fear. This is how I try to help them spiritually.

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