The Natasha Effect on Parents

The atddfdahik
death of Natasha Richardson is the definition of tragedy – sad, senseless, shocking. It’s just horrible and a lot of us are haunted by it. In fact, as parents, we maybe a little too haunted by it. How so?

 “It’s a wake-up call,” announced a mom friend of mine on a field trip last Friday.

“Wake-up call to what?” I asked.

“Parents now know that when their kid gets hit in the head and says they’re all right, they may not be.”

“So we should take our kids to the emergency room every time they hit their head and say they feel  fine?”

“Well, if Natasha had done that, she’d be alive today.”

Very true. That’s what the experts are saying: The actress suffered the kind of head trauma that initially doesn’t feel that serious. But then the blood starts pooling and can cause death if not drained almost immediately.

How I wish Ms Richardson had been operated on instantly! But one very unusual death preceded by an equally unusual lack of symptoms does not mean that every symptomless head bump must be assumed fatal until proven otherwise. To think that way would make it almost impossible for us to let our kids ride bikes, or play tag, or even pillow fight. Because at some point, someone is going to bump his head. (And yes, I hate it when they do.)

So I asked a doctor when a parent should worry about a head bump. These are the warning signs, said he: Nausea, dizziness, passing out, blurry vision, personality change or headache.

If any of those occur, you should probably get your child checked out, fast. But if your kid feels all right and seems all right, maybe you don’t have to immediately assume the worst.

I’m not a doctor. Just a mom who knows that whenever we hear a tragic story on the news — especially when it’s repeated a million times — my generation has a tendency to assume the same thing could easily happen to our own kids, no matter how remote the real danger. (Think: Kidnapping, or school shootings.) “Just to be safe” we do everything we can to prevent it – sometimes smothering normal childhood in the process.

I’m sure the next time one of my sons hits his head, I’ll be more worried than before. (And believe it or not, I’m a worrier!) But I also hope I can summon the courage to let them rough-house and play and even snowboard (ugh), despite this newfound fear of a bump that doesn’t seem too bad.  — Lenore


30 Responses to The Natasha Effect on Parents

  1. Jen March 23, 2009 at 11:07 am #

    The only difference I can see now is more parents will be making their kids wear a helmet for snowboarding and down hill skiing. I remember when I was really really small I had to wear a helmet for tobogganing but I outgrew it.

  2. KateNonymous March 23, 2009 at 11:30 am #

    I’m not entirely sure about how much a helmet would have helped in a case like Natasha Richardson’s, though. I read an article that talked about the fairly narrow speed window in which they make a difference (New York Times, I think?), and Mr. Nonymous has seen statistics that show that the rate of head injuries in snow sports is largely unaffected by helmet use.

    That doesn’t mean helmets do no good at all, but people should be aware of when they are and are not helpful.

  3. school tools March 23, 2009 at 12:54 pm #

    I don’t think parents should start acting hysteric. We all just need to keep in mind that some head hits can be dangerous and thus should be examined.
    We want our kids to be healyhy – physically and mentally . 🙂

  4. ebohlman March 23, 2009 at 1:10 pm #

    It’s worth pointing out that there’s actually a safety downside to treating every head-bump as cause for a trip to the ER. Namely, the vast majority of kids or adults who are asymptomatic after a simple head bump (one that did not result in loss of consciousness, as it didn’t in Richardson’s case) will actually have no injuries, and they’ll be such a majority as to exceed the specificity of the tests they’d be subjected to at an ER. What that means is that the majority of positive test results at the ER will actually be false positives, and following up on a false positive potentially involves risky procedures (a repeat CT scan involves quite a bit of radiation, an MRA involves injection of contrast material to which some people have reactions, an overnight stay for observation involves exposure to hospital-borne infections). If you just do an initial CT scan, you still have to accept that while that may save a certain number of kids from a fate like Richardson’s, it will also mean (due to the radiation) that a certain number of extra kids will eventually develop brain cancer. The numbers in both cases are probably pretty small, but it just goes to show you that while you can minimize particular risks, you can’t simultaneously minimize all risks.

  5. Anne Ohny Maus March 23, 2009 at 1:33 pm #

    Things that are news worthy, almost by definition, are things we need not be that worried about … as they become newsworthy by being rare.

  6. John March 23, 2009 at 2:52 pm #

    My child experienced a minor concussion in a very minor skiing tumble just two weeks ago. (First in the family to get a ski patrol lift off the mountain). When she still had a headache two days later, a trip to the doctor was made. Turns out – it was just simply a minor concussion. She was wearing a helmet. She was negative on all other symptoms…

    Seeing this news was a little freaky, and I have to say – it is really really hard to be a parent some times. 🙂

    Kids WILL fall down.

  7. ebohlman March 23, 2009 at 3:23 pm #

    My child experienced a minor concussion in a very minor skiing tumble just two weeks ago.

    Just to clarify some terms (note that I am not a medical professional, just someone who knows a little bit about sports medicine): A true concussion implies at least one of the following:

    1) Kid passed out after being hit.
    2) Kid can’t remember what happened right before being hit.
    3) Kid can’t remember what happened in the few minutes after being hit.

    If any of those things are true, then you’re perfectly justified in taking your kid to the ER (in fact you should do it). If none of those apply, but your kid

    1)Develops a headache
    2)Develops nausea or vomiting (vomiting that comes on suddenly without nausea is especially worrisome)
    3)Experiences alteration of consciousness (“doesn’t seem like him/herself” counts here)

    then you should also go to the ER. If none of the above apply, then you just need to watch your kid to make sure nothing strange happens.

    This won’t catch really low-probability brain damage, but then again going to the ER in the absence of such symptoms probably won’t catch it either (most radiological studies like CT scans would be negative at this stage). There’s only so much modern medicine can do; as I mentioned before, in the absence of such symptoms you’ve got too much of a chance of getting a false positive that will require possibly risky followup measures.

    Note that the presence or absence of bleeding says very little about the severity of a head injury. The face and scalp are full of tiny blood vessels, and any injurty to them can produce horrible-looking results even if it’s really superficial.

    I’m speaking as someone who smacked his head two weeks or so ago as I was carrying some stuff down the stairs in the process of moving. It turned out to be inconsequential (I was expecting a goose egg on my forehead, but nothing happened; no swelling or scarring).

  8. Andromeda March 23, 2009 at 7:57 pm #

    IIRC one of the exacerbating factors was that they transferred her to a hospital near her home in NYC, rather than keeping her in Montreal.

    I think a fine lesson to take away is “if you’re going to the hospital *anyway* for a head injury, don’t waste time heading for one far away”.

    I know someone who had a pretty terrifying head injury (like, should have died, months of rehab), so I’m already on board with understanding the seriousness of head injuries. (And yeah, I still bike to work. But you better believe I wear my helmet.)

  9. george.w March 23, 2009 at 8:12 pm #

    Just be aware, concussions are cumulative. This is something retired football players know, and retired boxers know, and now I know it too.

  10. cagey March 23, 2009 at 9:23 pm #

    Another thing to consider that has not been mentioned here is that Richardson was 45. 45! We have no idea what sort of lifestyle she was leading or what her health was. The media loves to make a story out of tragedies like this. Yes, head injuries are terrifying, but I question whether we have all the pertinent details related to this. And considering how difficult it is get information from a doctor about a family member, because of HIPAA, surely the media is not being granted all the particulars, either.

    I love that you mentioned that you are a worrier. I think it is important to teach folks that yes, worry away, but still let your children live and explore their world. I worry about injuries all the the time, but what I fear most is an arrested development for my kids.

  11. Lori March 23, 2009 at 10:51 pm #

    I have been through head injury trauma with my youngest child. She was dropped from an adult standing up when she was 2 days old. A CT scan was done and it indicated a brain bleed, so she was put in ICU overnight for observation. Basically, all they did was watch her for unusual behavior. They kept asking me if she was behaving differently – she was 2 days old – how do I know? Fortunately, a second CT in the morning showed that there had been no increased bleeding. We took her home and she is fine.

    But, I’ve also had the experience of taking a child into the emergency room from a fall and been told that almost all cases of falls like she had are not serious. In this case, though, my child was again less than 6 months old and she had rolled off the bed.

    We can all learn more about what symptoms to take seriously and which ones are most likely nothing to worry about. That’s most frequently my question to my doctor’s office before I come in – does this sound serious enough to check out?

  12. Anna March 23, 2009 at 11:20 pm #

    We’re getting ready to hit the slopes today – for the first time in two years. I knew about Richardson’s accident and didn’t even think of it until reminded by this post. It doesn’t change anything – we have helmets and we’ll wear them and we’ll enjoy the skiing just like we always do (ok, I’m a bit nervous about skiing alone with my son – I’m not an expert skier and my son is still is a novice – my husband is in meetings all day. So I’ll just take it easy and stick to my comfort zone – even if my son is urging me to take him down a double black diamond ;-).

  13. Elisa March 24, 2009 at 1:38 am #

    Thank you, Lenore. As usual, you are the voice of reason.

    I feel horrible for what happened to Natasha Richardson and her family. However, I hate to see a new frenzy of fear. Children will get hurt. Yes, get your child medical attention when necessary. Be safe when engaging in potentially dangerous activities. Other than putting my 2 year old in a bubble, I’m going to let her live life . . . and make some mistakes. (And if I went to the bubble method, the oxygen in her bubble would be at the wrong concentration, or the bubble would contain BPA which will cause her future reproductive problems, or. . . .)

  14. BMS March 24, 2009 at 2:01 am #

    This story is only news because a famous person is involved. This sort of thing probably isn’t as common as diaper rash, but also isn’t completely unheard of. Accidents happen. We can’t prevent them all – that’s why they are called accidents! Being a movie star, or having hovering parents, will not guarantee that you will sail through life to the age of 100 with nary a scratch.

    I guess I’m a bad mommy – it would never occur to me in a million years to think: “One celebrity died after a skiing accident. I must therefore prevent my kids from ever skiing and make them wear a helmet on the school bus just in case…”

  15. Jane March 24, 2009 at 2:22 am #

    It’s amazing how news clips can sause such fear! My son bumped his head on the table shortly before going to bed last night. He had a little bump. I kept checking on him while he was asleep as I was filled with fear that something bad would happen. Before the Natasha Richardson incident I would have been much, much calmer. I had to keep reminding myself that a bump on the head can just be a bump on the head and just relax!

  16. SheWhoPicksUpToys March 24, 2009 at 3:32 am #

    You know, I think it’s probably healthy that we as moms get a little surge of fear over events like this. We shouldn’t change anything major, or overreact at every little accident, but having this little extra bit of information about the danger of head injuries rattling around in the back of our minds (plus the very helpful information about what to look for that some commenters have contributed above) is probably all to the good. A little occasional “panic” of this sort probably keeps us on our toes in ways that could pay off later, provided we don’t overreact.

  17. Lola March 24, 2009 at 5:30 am #

    I have four children under the age of six. No twins. They are all really active, agile children, incapable of climbing a staicase properly. If I am expected to take them to ER every time they hit their heads, I might as well start living there.
    BTW, last time my eldest bumped her head while jumping on her bed, she actually cracked the wall, said “ouch” and kept on jumping. In fact, I have given up on making them behave and only tell them off when they break my furniture, my doors, my walls… You know, “watch out for cars, children, don´t run them over”

  18. DJ March 24, 2009 at 10:20 am #

    My father-in-law tripped over the bottom of the basement stairs in the dark and fell a few days ago. He was sore, but no biggy. A day or two later, the pain hadn’t abated, so he ended up the ER. They just gave him pain meds, and a BIG lecture on seeing a doctor within 24 hours of a fall. Seems the Richardson accident is causing overreaction for adults as well (even though she was seen by a doctor within 24 hours).

    Also, there’s a big hoohah about the lack of emergency helicopters in the region — based on one accident. (Without stats on cost, number of people it could help, balancing with number of accidents involving emergency helicopters and overworked pilots, etc.)

    I’m worried that we are going to need a free-range adults movement soon. Yes, I’m a fan of helmets on tricky stuff, but the article I read said she was on the beginner slope. If I’m on the bunny slope and they require me to wear a helmet, I’m going to have a BIG problem.

    Side note, my husband’s extended family, parents, and sister have skiied at Mont Tremblant every January for years and have had a wonderful time and no major injuries. We are hoping to join them in the future, as our kids are now big enough for ski school.

  19. MY March 24, 2009 at 8:30 pm #

    It’s funny, my daughter fell off the top of the sliding board a couple of weeks ago and bonked her head. While I wasn’t so concerned about her head, she was complaining about her stomach so I took her to the doctor. I didn’t see her fall, so other than where there were scrapes, I didn’t know what hit.

    BUT, the first thing I thought of when I learned about Natasha Richardson was my daughter’s fall. I’m glad I had her checked out. But I agree, that there will probably increased trips to the emergency room as a result of this.

  20. Douglas John Bowen March 24, 2009 at 9:26 pm #

    The weekend following the Richardson incident, my son, age 8, fell and hit his head (hard!) on the sidewalk; one could hear the “smack.” A tough kid, he got up, shook it off, and said he was all right. We believed him, up to a point, but throughout the day we kept an eye on him for dizziness, blurred vision, and so forth, just as a precaution.

    I’d be lying if I said the Richardson incident wasn’t fresh in our minds. But as parents, my wife and I were determined NOT to overreact based on a recent, unusual tragedy headlined to all. We made “testing” for vision a game–a rapid repetition of “how many fingers am I holding up?”–for my son, who understood why we were doing it but wasn’t stampeded into a panic over it. In fact, that evening he volunteered for the test (and passed).

    When he went to bed early–very unusual for him to willingly do so–we again were tempted to yield to overreaction. As a compromise measure, we kept an eye on his early sleeping (breathing patterns, bed tossing, etc.), but otherwise let things be, reminding ourselves that we couldn’t monitor every move, every minute. Of course, the next morning our son was up early (as nearly always) and raring to go.

  21. Christopher Byrne March 24, 2009 at 10:15 pm #

    Natasha Richardson’s death is a tragedy, and as someone earlier pointed out it’s newsworthy because much of the media I read considered it a “freak accident.”

    Tragic as it is, it started me thinking–Do you ever see kids with injuries any more? Helmet laws have significantly reduced head trauma on bikes. As popular as skiing is, it’s still a tiny proportion of the population that participates.

    No, I’m talking about your basic scrapes, broken collar bones, a broken arm. Now, of course we don’t wish these on any of our kids, but these are also the sometimes inevitable consequences of being kids. I broke an arm falling out of a tree, a hand in a bicycle accident, an ankle jumping off a garage roof. You would think I had no business doing any of these risky things, and you’d be right. Not to mention numerous scrapes, cuts bruises, bites from snakes (non poisonous), sprains, etc. But my parents scolded me for all of that, so I don’t need to hear more. Moreover, I wasn’t alone. We were constantly getting banged up, and, we succeeded at things more often than not. I climbed the steeple of our church with nary a scratch, being one of the more extreme and, to my adult mind, crazy things that we did. I remember in fifth grade, there were four of us out of a class of 48 in casts at one time.

    And I heard, “What on earth were you thinking?” more often than not from my parents. But we had lots of fun. And we learned two things: How to take calculated risks, even if what was “calculated” to us would seem insane to an adult mind, and when to know what our limitations were. (I drew the line at jumping off a 30-foot waterfall, though a couple of my friends did it and were just fine.) And we learned how to take care of each other. My friends knew I didn’t like heights, so they didn’t push on the waterfall thing, though they said it was great. Goody. I still don’t regret passing up that experience.

    These are important skills that kids need to learn. Do we wish they could never get a bump or a bruise? Of course, but that’s not real life, and kids who are overly protected and watched every second have a hard time separating from their parents and become fearful. What do they do when they are asked to gamble on a dream–from pursuing a career to starting a business? Risk tolerance is a critical skill for healthy development, and it starts with kids pushing their limits physically. It’s also a natural human characteristic–that curiosity about what happens if…

    I have a young friend who at 7 is an avid skateboarder. He’s been in casts and bandages from time to time, but mostly he’s a confident, together young man who has a great sense of himself, and while small for his age, has a sense of self that’s truly impressive. I think it’s partially because he’s taken these risks. His parents do the calculating, too, trying to ensure that he has a safe environment to play in. When I got to go off the training ski jump in Park City last summer for a TV shoot, my young friend was incredibly jealous. You have to be 8 to do it. You can bet he’ll be there this year.

    If there has been one phrase that has driven my career more than any other, it’s, “Sure, I’ll try that.” It’s an attitude toward life that I believe was engendered and reinforced by doing crazy things and ending up okay. (A broken arm is okay, particularly since the dawn of modern medicine.)

    So, yes, Richardson’s death is terrible, and I ache for her boys deprived of their mother. I’m not advocating recklessness at all. But we all know that kids will come up with things that adults would never imagine. The best we can do is provide context, attention (without being obsessive), freedom and the safest environment possible. And if we hide out from life and try to protect ourselves from every tragedy, can we really say we’re living?

  22. Lianne March 25, 2009 at 8:19 am #

    According to local news sources, Richardson refused to be seen by paramedics on-site, insisting she was fine. Nobody was close enough to know if she lost consciousness after the fall. It wasn’t until later, when she complained of feeling unwell, that she was taken to the hospital. One medical professional raised a good point – somebody with a head injury is probably not the best judge of their own health. Paramedics may have detected the bleeding, may have gotten her to a hospital sooner, and may have saved her life. A tragedy regardless.

    Meanwhile it’s raised a flurry of activity around regulations for helmets, mandatory helmets, etc. As usual none of us can be trusted to be responsible for our own safety…”if it saves one life”.

    My daughter and I both wear helmets when biking. She wears a helmet when skating, but I debated that one (I don’t wear one myself). Meanwhile our neighbour’s child hit his head playing at school, knocked himself out, and ended up with a concussion. Go figure!

  23. Mike Chlanda March 25, 2009 at 11:07 am #

    i have to disagree with the helmet only useful in a narrow window. i was hit a van going 60 miles an hour , landed on my head (helmet) and that helmet saved my life.

    i’m not saying helmets will save you in all/most instances – but I’m still walking and talking. I am very lucky to be alive. Two years later i am still going thru rehab and surgeries to fix the rest of my body.

    Even if a helmet could only give you a 10 or 20 percent chance more at surviving an accident, or coming thru it without a serious brain injury, wouldn’t that be worth the 20 or 30 bux a new helmet costs?

    and i never have to worry about my son wearing his helmet now! (but i don’t recommend this course of action)


  24. MikeOnBike March 26, 2009 at 6:00 am #

    Lianne said: “My daughter and I both wear helmets when biking. She wears a helmet when skating, but I debated that one (I don’t wear one myself). Meanwhile our neighbour’s child hit his head playing at school, knocked himself out, and ended up with a concussion. Go figure!”

    Mike said: “Even if a helmet could only give you a 10 or 20 percent chance more at surviving an accident,”

    If we wore helmets based on risk of head injury, we’d all be wearing car helmets and pedestrian helmets. And probably shower/bath helmets.

  25. decrepitoldfool March 26, 2009 at 6:19 am #

    “If we wore helmets based on risk of head injury, we’d all be wearing car helmets and pedestrian helmets. And probably shower/bath helmets.”

    Yes. My lifetime concussion record includes a horse, a shot-put ball, a dune buggy, an overhanging pipe, a punch, a slip on the ice, and a bicycle. And a neurologist after the last one who explained that increasingly severe symptoms are a result of a cumulative effect.

    Now I wear a helmet when I ride a bicycle but my experience suggests that if it happens again, it will probably be something other than my bike.

  26. Mammamsterdam March 27, 2009 at 7:34 am #

    my 4-ys old managed in one and the same week to fall behind in a very complicated way at nursery school (thanks god our family MD’s practice is across the street, so when they called me and I was a good 1 hour drive from there I wasn’t too hysterical) and to get a bad cut near his eye with a hockey stick thrown by his brother.

    He just turned five, and has the tiniest of scars near his eye, which proves the good quality of the ‘glue’they use these days instead of stitches. The head scar is lots bigger, but I am having his hair grow on it.

    I am sure he can tell wild stories to the girls in a few years, because all evidente is plausible.

  27. Carla March 28, 2009 at 2:50 am #

    I think you all said something like this would happen. (Media using Natasha’s accident to further report stories).

  28. Jessica April 1, 2009 at 5:04 am #

    I think in the case of Natasha Richardson, the fall actually looked really bad. Her instructor thought she should go to the hospital, and the resort made her sign a waiver when she refused. Parents need to remember that this didn’t seem like any old head bump to anybody except the unfortunate victim. When you see something scary happen to your child, you will probably know the difference.

  29. Suzie April 3, 2009 at 9:47 pm #

    can you imagine a mother with three or more children and a fulltime job actually GOING TO THE EMERGENCY ROOM EVERY TIME SOMEONE FELL DOWN? The last time I took a child to an ER for an ear infection on a holiday weekend we waited ELEVEN HOURS. The one seriously overprotective mother I know is the full time stay at home mom of a sixth grader. I honestly think she makes a lot of these projects up just so she can seem busy and justify staying home. If I were to exercise the kind of vigilance that she suggests, I’d get fired. (She’s been known to show up at school to rebrush her daughter’s hair at lunchtime — if her daughter wears a ponytail to school. Who knew that wearing a ponytail was a project that required a mom of a school aged child to visit school during the day to fix it? Can you even imagine?)


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