Save the Children

Mashtots Poghotz Walking the streets of Yerevan, Charlie Chaplin often turns up on T shirts and storefront posters. Maybe it’s because Charlie’s side-kick, Jackie Coogan, helped to raise millions of dollars for starving Armenian orphans in a 1920s media blitz organized by Near East Relief. The campaign was so effective that you probably heard their meme relayed via your parents’ parents: clear your plate, remember the starving Armenians.

Near East Relief, ancestor to the Peace Corps, retained artists, actors, singers, even made a film, to make their pitch. The campaign proved how well photos and films that depict sad, beautiful faces can compel a critical bit of behavior change: donation. The millions that were raised in this un-precedented effort helped thousands of survivors of “death marches,” like Dana’s grandma. They came south and east, from Western Turkey into Syria, through the mountains.

Lecture Hall, Yerevan State Medical University The largest congregation of pediatric professionals I’ve seen is convened on a Friday to hear New York child psychologists, talking heads beamed over to a large screen in the hall. The discussion is about losing our children to media–to computers in particular. The Americans (ironically enough) are emphasizing what these clinicians already know: the animations and interactives that pour out of the US, among other sites, are endangering family relationships.

As in the US, a high percentage of Armenian children and adolescents continually focus on those pocket computers that we label innocuously as “cell phones.” Toddlers aren’t exempt: television stunts their language development in dose-dependent fashion. I doubt there is a pediatrician practicing in the US today who hasn’t been out-competed by such a machine in her attempt to have a discussion, to build a relationship, with a young one. I know the seated maestros of “World of Warcraft” and its like possess an extraordinary suite of skills, but I don’t want to play, so I can’t relate.

Questions from the audience: “Can you tell us in what ways social media have been studied or used to improve children’s health?” “We now label cigarettes for their negative effects on health; what do you think about doing the same for video games?” “We hear your advice to guide parents to restrict kids’ video game hours, and TV, but how should we do this? We are trying to guide parents and it doesn’t seem to work. What really works?” Stunning, insightful questions that set the experts to spin: “Clearly, we need more studies … No studies have been done … ”

One happy picture of parenting shows us simply admiring the old-fashioned child’s play, the kind that doesn’t rivet their attention through micro-chips, from a distance. A nice way to convey the principles of self-determination–competence, autonomy, relatedness–all at once to ones we love. Interventions for parents of kids with behavior problems like ADHD borrow this approach, and have parents narrating, extolling, though never influencing the play itself. “Avoiding boredom is one of our most important purposes.” (Saul Steinberg) A milestone! You’ve rescued yourself from your own boredom! thinks the watching parent. Meanwhile, these machines fit into the lonely caves of our boredom like a key in a lock.

In Dana’s book (Like Water on Stone), set a few years before Near East Relief flew into action, there’s a moment when a three year old is alone at home, waiting for her brother, fighting off boredom by swinging her feet. In 1915, she lives far from the electronic media networks that will soon help rescue her.

Song: feet up, feet down


Future Selves


Clinic, Yerevan This 7 month old was fine until the last 3 months: decreased visual interaction, increased flexor tone, keeping hands fisted. MRI shows leukodystrophy, and my colleague’s first thought is metachromatic. Or Krabbe–how is the head growth? The interview takes place standing, in one corner of a colorful, windowed playroom. The parents smile at how his gaze reaches for me as I say his name. Repeatedly, during the interview, he seems to grow sleepy, then he revives, as though it’s important to stay present.

Another family watches from the other side of the room. Perhaps they are related?  But they keep their distance, 15 feet. As I come to realize that they are in fact the next consultees, my mind scrambles to reconcile the dissonance of the confidentiality breach. Aha!– they are like family. It’s in the gravity of their gaze. If there is curiosity there, it isn’t morbid; if there is empathy there, it minds its fences. Though the two families have never met, I wonder if they know what I know: after this meeting, they are like family.

The confidentiality practices in Armenia stir a bit of anxiety in me, but I’ve been keeping that to myself (until now). As an ethical principle, confidentiality doesn’t just protect us from social hurts in the here and now (e.g., stigma, gossip). It also protects our future selves from pigeon-holing, from financial disadvantage, from getting nudged into a ditch somewhere down the road. Of course we may be our future selves’ worst enemy, under-estimating and abusing them with static expectations (“I always … I never …”).

We move over to the family across the room; now they are lit with the first family’s gaze. Their articulate, economical responses to my colleague’s questions are no more ruffled by their neighbors’ attention. Hemiparetic, she reaches her right hand across the front of the doll’s house to open its side door, playing seriously while her parents talk. Her seizures have significantly reduced on Depakene. She is 4, and just now starting to relate to peers. Her condition– infantile hemiparesis—was first described by Freud before he turned to other brain problems.

Later, the first parents come un-announced to my colleague’s office. Their faces look beautiful together as they gaze at the translucent MRI film: grandfather, rough and stubbled; tidy, composed grandmother; laconic, equanimitous mother; her infant child, eyes also searching. Their joint attention transcends the image of disaster they behold.

I have a strong impulse to photograph them … if I ask, they might feel they have to assent … they have enough to worry about … will others see their beauty in a photo, ricocheting around the planet? … it’s not like I’m family.

I leave that office turning over my inhibitions, with a new ambivalence about confidentiality rules. “Treat people as if they were what they ought to be, and you help them to become what they are capable of being” (Goethe). And what if we ought not to defend our future selves so carefully? I still think of that family, looking through an MRI towards a window they can’t see; maybe they are like family.


“OK, you take my picture”

Comforts of Home

“All right, I’ll bite, what’s the gooseneck in the bag?” asks the customs lady. I explain. “You brought your oud all the way to Armenia and not your wife?” She’s coming a little later. She admits me, an oud-toting pediatrics professor from Vermont looking for a donut.


Even donuts have family back in the old country. It is cousin to the ponchig, which you can eat under an umbrella at a window-front bakery back in Yerevan. Ponchigs can be had–and have them you will if you can–at just 150 dram, sweet fried things with custard under-bellies passed to you through a window marked with strange letters by a woman with dark eyes and clear plastic gloves. As you eat the deltoid pastry, breath through your nose, not to inhale it, and watch the fine sugar drift away in sweet convections, melting on the  sidewalk under you in the 90 degree heat. This jet fuel can get you through the morning and then some. My translator warns me not to eat such things, as the frying oil may intoxicate me with free radicals. They have those here? But I can see her sadness as she conveys this teaching. She misses eating ponchigs.

“You never know when you leave the house, you might come home by a different route,”  (James McMurtry); I think he means the traveller has changed, more than the route. After a fretless 15 hour trip across the stratosphere to Boston, I am at Braintree’s midwestern-quaint bus depot. Little evidence of trees, but the brains are neighborly. A brown lady with a welcoming smile sells me some coffee and a donut.  The donut line-up has changed, as these things must always change, lest we hordes of donut-eaters grow bored. Our attention, battered by fluorescent lights, diesel fumes, and faux-vinyl seating, wanders easily. I scan the steel-rack slopes for a donut whose olfactory character may take me all the way home, like a salmon, swimming up the tributaries, deciding which way to turn. There’s a right answer, and many wrong answers.

I choose a donut dressed up as a piece of lemon cake. Wrong. Outlandishly yellow (# 43?), with a bullet-proof jacket of sugar and a belligerent dash of yellow flavoring that I suppose must be called “Natural” (like Plutonium!), its Armenian clansman would scarcely recognize it. Still, it shall be my ponchig, for the while. I am what I eat, and I am loyal, if no longer fully natural. Some day, Dunkin’ Donuts will recall its ancestry and serve ponchigs. Meanwhile, I’m trying to make better choices.

Sitting high in the Megabus, I stare out the picture window, eyes drinking, as we enter the White, and then the Green mountains. A geographic birth canal–shaggy, fog-smoked foldings of earth–weaves past and around me, until I am abruptly delivered into my academic ecosystem, there to re-join a circle of patients, families, colleagues, administrators, directors, friends from Africa who keep the place organized. My oud-pegs are a little tight from the change in humidity, but–even part ponchig–I love home. I know it’s comforts.

Guitar: Comforts of Home