“though poppies grow in Flanders fields”

In the battlefields of Belgium during World War I, poppies grew wild amid the ravages of war. The overturned soils of battle covered  the poppy seeds to,  allowing them to grow and forever serve as a reminder of the bloodshed of war.

 

In the United States,  the last Monday in May is Memorial Day, but it’s now become a  “holiday” weekend. The Friday of Memorial Day weekend is now observed as  National Poppy Day

In the early 1920s the American Legion Auxiliary adopted the poppy as the American Legion Family’s memorial flower. Still today it symbolizes the service and sacrifice of veterans of World War I as well as veterans in other eras.

ALA members distribute millions of paper poppies annually across the country in exchange for donations that go directly to assist disabled and hospitalized veterans in our communities.

armed forces emblems over a field of poppies

Why poppies?

I love the story of the poppies because it has a medical connection.

In the battlefields of Belgium during World War I, poppies grew wild amid the ravages of war. The overturned soils of battle covered  the poppy seeds to,  allowing them to grow and forever serve as a reminder of the bloodshed of war.

Out of this conflict came a poem, from which also came the association with poppies .

 

The now famous poem, In Flanders Fields, was written by a Canadian physician, Lt. Col. John McCrae.

Originally from Canada, Dr.McCrae was an English and math teacher, as well as a poet, before he attended medical school. He moved to England and was practicing there when World War I broke out, and he was called to serve as a brigade-surgeon.

I suspect that as a physician, he was deeply  pained by  treating the wounded, and the loss of those he could not save.

“In April 1915, McCrae was stationed in the trenches near Ypres, Belgium, in an area known as Flanders, during the bloody Second Battle of Ypres.

In the midst of the tragic warfare, McCrae’s friend, twenty-two-year-old Lieutenant Alexis Helmer, was killed by artillery fire and buried in a makeshift grave.

The following day, McCrae, after seeing the field of makeshift graves blooming with wild poppies, wrote his famous poem “In Flanders Field,” which would be the second to last poem he would ever write.”

(from John McCrae at poets.org)

In Flanders Fields

Dr. John McCrae, 18721918

In Flanders fields the poppies blow
Between the crosses, row on row, 
That mark our place, and in the sky, 
The larks, still bravely singing, fly, 
Scarce heard amid the guns below. 

We are the dead; short days ago
We lived, felt dawn, saw sunset glow, 
Loved and were loved, and now we lie
In Flanders fields. 

Take up our quarrel with the foe! 
To you from failing hands we throw
The torch; be yours to hold it high! 
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

This poem is in the public domain.

 

The poppy is the official state flower of California.  Read 5 more

interesting facts about poppies. 

Welcome Home Heroes- military sign
Thanks to the support of generous donors like you, The American Legion can continue to provide much-needed assistance to our veterans, service members and their families.

The American Legion 

sharing the HEART of honoring our heroes

I appreciate all of you who are following Watercress Words, and if you aren’t I invite you to join the wonderful people who are. You can meet some of them in the sidebar, where you can click on their image and visit their blogs. Use the form to get an email notification of new posts. Don’t worry, you won’t get anything else from me.

Dr Aletha

Are too many children autistic?

Like other physicians and families of people with autism, I puzzle over the increased number of children and adults diagnosed with autism. And most all of us have theories about why we now believe 1 in 68 children have autism spectrum disorders.

People point out that “when they were children” they never knew of anyone with autism.There are those who are absolutely convinced that the increased numbers of autism followed the introduction of the measles-mumps-rubella vaccine, MMR. Others implicate genetics, environmental toxins, diet, and intrauterine brain trauma.

I found an article that  offers a sound, well thought out and expressed explanation. It contains several points that I have identified and some I had not.

The article was published in Spectrum whose commitment is “to provide accurate and objective coverage of autism research.” Spectrum is funded by the Simons Foundation Autism Research Initiative. Senior News Writer Jessica Wright, Ph.D. in biological sciences from Stanford University, wrote the report. (Scientific American also published the article by permission.)

In the article, Dr.Wright concludes,

“The bulk of the increase (in autism rates) stems from a growing awareness of autism and changes to the condition’s diagnostic criteria.”

First , let’s consider some terminology. Prevalence is an estimate of how common a disease or condition is in a particular population of people at any given time.

So the prevalence of autism in children would be

the number of children identified as autistic at any given time

divided by  the total number of children alive at that time .

The currently accepted rate of autism is 1 in 68 children, or 1.4 %.

So  autism prevalence depends on children being correctly identified as autistic. At any given time, some autistic children may not be identified, and some may be  incorrectly identified.

We do not have any totally objective tests available for autism yet. There is no blood test, scan, culture, imaging study, DNA test, or  monitor to definitely conclude that autism is or is not present.

The definition of and criteria for autism have changed substantially since “infantile autism” was first identified by Leo Kanner over 70 years ago. Since 1980, the diagnosis is based on applying the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In the most recent version, DSM-5, released in 2013, autism, Asperger syndrome, and pervasive developmental disorder, formerly separate, are now a single diagnosis.

Simply explained, Autism Spectrum Disorder is characterized by

  • Persistent deficits in social communication and social interaction across multiple contexts
  • Restricted, repetitive patterns of behavior, interests, or activities
  • Symptoms must be present in the early developmental period (But may not yet be fully expressed or may be modified by learned behavior in later life)
  • Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
  • These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay.

Here is the full detailed criteria from DSM-5

Diagnostic Criteria for 299.00 Autism Spectrum Disorder

 

When the diagnostic criteria for other diseases we diagnose and manage changed, the prevalence also changed. Examples include diabetes, high cholesterol, high blood pressure, migraine, obesity, depression , even some cancers. So autism is not unique in this regard.

The currently accepted rate of autism, 1 in 68, comes from the Autism and Developmental Disabilities Monitoring Network, established by the CDC in 2000. Children are identified through reviewing health and school records of 8 year olds in selected counties. So possibly some children get missed, and some assigned incorrectly.

Another major milestone in autism awareness occurred in 1991 when the U.S. Department of Education ruled that autistic children qualify for special education services. This ruling encouraged parents of children with developmental and intellectual disabilities to secure accurate diagnosis, to qualify for services they otherwise might not  have access to.

Since 2006, the American Academy of Pediatrics recommends routine screening of all children for autism at 18 and 24 months old. Many physicians, psychologists, and therapists believe early intervention improves these children’s chances to do well intellectually and socially.

If we could go back and review records of children 10, 20, or 30 years ago, and apply current diagnostic criteria, would we find less autism than we do today? Perhaps. But such records would likely reflect the understanding of autism at the time, so might still fail to recognize autism, even when present by today’s standards.

The apparent increased number of children with autism seems alarming-some call it an epidemic. It may represent our increased awareness, recognition, and knowledge about this disorder. And while this increase should raise concern, it can lead to increased research, treatment options, and more effective care for autistic persons.

Here is a link to the original article

Autism Rates in the United States Explained

 

The story of autism isn’t just about statistics, theories, and criteria; it is about the  children and adults with autism, and their families. Here are just two of many stories of how autism plays out in real life.

We Are Autism, Too. Don’t Forget About Us.

“My boy, with his classic autism, the kind that used to be the only face of autism half a century ago, is the one who does not belong now.”

Looking Into the Future for a Child With Autism

“As my son’s limitations became clearer, I found it harder every year to write a vision statement for his I.E.P. Then he showed us how.”

 

And in this  previous post  I share my personal experience with autism.

Why I have a different way of seeing autism

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