This generation of teens communicates differently from any others as smartphone technology has outpaced the normal evolution of day-and-age vernacular. As a result, adolescents use short phrases, hashtags, abbreviations and emojis to convey their thoughts while parents and society scramble to catch up.
However, within these bite-size “codes” or phrases could be volumes of meaning, some delineating at risk behavior, some foreboding suicide.
While many parents are on the lookout for terms used such as “depressed”, “sad”, “wasting my life”, and “I’m a nobody”, Daily Mail reports Tik Tok users have been using cryptic phrases, such as those below, as “cries for help”. These include:
I had pasta tonight
I want to tell my mom my favorite pasta recipe
I’m living in Spain right now but the “s” is silent
My shampoo and conditioner are almost empty
I finished my shampoo and conditioner at the same time
The pandemic, and isolation from which, has left many adolescents feeling alone, sad, and despondent about the future. Many teens, as a result, will isolate further and not reach out to others. However, some might, as a last resort, look to social media for acceptance and love.
Some may use hashtags such as:
Although some of these terms such as “love” appear harmless, they may indicate that the child may need help from a counselor, physician, or National Suicide Prevention Hotline.
Breaking the code
Generation Y’s (Millennials) and Z’s (those born after 1995) have learned to be concise, descriptive, and to the point as technology and social media encourage less characters/keys being used to get one’s point across.
Teens and young adults, therefore, may use codes that often come from the letters that correspond to the key pad on a phone.
So here’s a guide to some of the unfamiliar terminology the young ‘uns are using:
NIFOC – nude in front of computer
CU46 – see you for sex
8 – “ate” used in discussions on oral sex
831 – I love you – “eight letters, three words, one you/meaning”
143 – I love you (denotes letters on keypads, or #’s of letters in each word (love has 4 letters)
2N8, 2NTE – tonight
4AO – four adults only
2B@ – to be at
4EAE – for ever and ever
53X – sex
775 – kiss me
?^ – hook up?
BAE – before anyone else
IWSN – I want sex now
ITX – intense text sex
NP4NP – naked pic for naked pic
1174 – strip club
< 3 – broken heart or heart
182 – I hate you (1 stands for “I”, 8 stands for “hate”, 2 stands for “you”)
2G2BT – Too good to be true
2M2H – Too much to handle
Blarg, Blargh – similar to “darn” but deeper
Butthurt – receiving a personal insult
Salty – being bitter about something or someone
Watered – feeling sad, hurt
Wrecked – messed up
4FS – For F***’s Sake
Poof – disappearing
::poof:: – I’m gone
Ghost – disappear
555555 – sobbing, crying one’s eyes out
ADIH – another day in Hell
KMN – kill me now
VSF – very sad face
KMS – kill myself
KYS – kill yourself
187 – homicide
420 – marijuana
420 – let’s get high
A/S/L/P – age/sex/location/picture
A3 – anytime, anyplace, anywhere
LMIRL – lets meet in real life
WYRN – what is your real name?
Chrismas tree – marijuana
Catnip – marijuana
Gold – drugs
Gummy Bears – drugs
Blues/Bananas – narcotics
Bars – benzodiazepines
Smarties/Skittles – Adderall/Ritalin
Ski Equipment/Yayo– cocaine
Cola – cocaine
Candy/Chocolate Chips/Sweets/Smarties/E – ecstasy
Crystal Skull/Wizard – synthetic marijuana
Hazel – heroin
Gat – gun/firearm
Lit – getting high/drunk
Smash(ed) – getting drunk, stoned, or having sex
9 – parent is watching
99 – parent is not watching anymore
P911 – parent alert (parent 911)
PAL – parents are listening
PAW – parents are watching
POS – parents over shoulder
AITR – adult in the room
CD9 – code 9 – parents in the room
KPC – keep parents clueless
RU/18 – are you over 18
And the above is just a small sample of some of the terms used these days. This list continues to grow by the day so parents need to always be aware. Kids want to KPC and avoid POS so be ready for the next group of codes being created as we speak……
The AAP (American Academy of Pediatrics) released a statement urging kids to be allowed this Fall to be “physically present” in school.
On their website they state that schools are fundamental to child and adolescent development and well-being and provide our children and adolescents with academic instruction, social and emotional skills, safety, reliable nutrition, physical/speech and mental health therapy, and opportunities for physical activity, among other benefits.
Schools were closed this Spring when data reflected children being able to carry the virus and expose adults, even if they were not symptomatic.
Most parents initially supported the idea of school closures and having online teaching to avoid spread of the virus to parents and grandparents.
But online learning did not appear to be as productive, and many parents feel their children learn better in a classroom environment.
The AAP agrees but only if the following benchmarks are met:
School policies must be flexible and nimble in responding to new information, and administrators must be willing to refine approaches when specific policies are not working.
It is critically important to develop strategies that can be revised and adapted depending on the level of viral transmission in the school and throughout the community and done with close communication with state and/or local public health authorities and recognizing the differences between school districts, including urban, suburban, and rural districts.
Policies should be practical, feasible, and appropriate for child and adolescent’s developmental stage.
Special considerations and accommodations to account for the diversity of youth should be made, especially for our vulnerable populations, including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school.
No child or adolescent should be excluded from school unless required in order to adhere to local public health mandates or because of unique medical needs. Pediatricians, families, and schools should partner together to collaboratively identify and develop accommodations, when needed.
School policies should be guided by supporting the overall health and well-being of all children, adolescents, their families, and their communities. These policies should be consistently communicated in languages other than English, if needed, based on the languages spoken in the community, to avoid marginalization of parents/guardians who are of limited English proficiency or do not speak English at all.
Children were one of the smallest groups affected by COVID, but some did suffer from Multisystem Inflammatory Syndrome (MIS-C), with fever, rash, and multiple organ involvement.
The AAP cites evidence that school closures are harmful to children. They state:
Lengthy time away from school and associated interruption of supportive services often results in social isolation, making it difficult for schools to identify and address important learning deficits as well as child and adolescent physical or sexual abuse, substance use, depression, and suicidal ideation. This, in turn, places children and adolescents at considerable risk of morbidity and, in some cases, mortality.
School’s however grapple with the notion that if COVID or flu cases surge this next Fall they may be forced to re-close down, again subjecting the students to abrupt, changes in learning. Some have suggested “hybrid” learning formats that include both in classroom and online learning for student safety by limiting group sizes, thus additionally easing the transition if a lockdown happens again.
During the pandemic, many medical clinics closed, or stayed open only for emergencies to minimize risk of spread of COVID-19.
So unfortunately many parents and caregivers struggled to get answers to simple questions when a child they were caring for sustained an injury or became ill.
Terms such as “COVID rash”, fever, shortness of breath prompted parents to seek resources on what symptoms were serious vs mild.
So physicians and students teamed up to create an easy to read guide, The Art of the Boo Boo, on how to address common ailments that affect children.
Advice on ailments include:
If mild, such a small burn on an arm or leg, run some cold water on the area, but avoid ice as ice can damage the already sensitive skin. Larger area burns or those that blister should prompt a medical professional’s evaluation.
Many illnesses are accompanied by fever, as the body tries to fight off the infection by raising surrounding temperature. A fever is generally defined as a temperature greater than 100.4. However, some fevers could spike so quickly that they may induce a febrile seizure. Fever onset should be documented as well as other accompanying symptoms, and if not resolving with acetaminophen or other fever reducers, should be evaluated by a medical professional.
“Upset stomachs” may range anywhere from having a meal that didn’t sit right with them to an appendicitis attack. Rare vomiting and diarrhea might be managed with sips of fluids and diet alterations such as BRAT (Bananas, Rice, Applesauce and Toast). However, frequent vomiting, diarrhea, abdominal pain, rash or fever needs urgent medical attention.
Boo Boos could be external but also internal, and kids sustain frequent bullying by others throughout their education. Good communication with your child and school officials can help fend off the depression and isolation that could ensue with frequent bullying by other children.
Resources such as The Art of the Boo Boo, although not meant to replace an evaluation by a medical professional, can surely answer some questions that we parents, caregivers and teachers face.
Educating oneself before the emergency or illness is a powerful tool in helping to quickly address our little one’s boo boos.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and is a Board Certified Family Physician
“Match Week” in March of every year is like a medical/osteopathic school lottery. Thousands of students hope to get accepted into a residency and if they don’t, they use this week to apply again or “scramble” into open spots that might not have been filled.
Many of these applicants have fantastic CV’s or resumes, but might not have matched because they applied to programs who were highly competitive, or chose a specialty that did not have enough spots (too much demand and not enough supply).
So many other students may find themselves in the Spring without an internship or residency, feeling lost and scared about what the future may bring. If you’re one of them, realize you have options. Here are your next steps….
Keep searching for new and open spots!!!
Sites such as the NRMP and Resident Swap post the latest spots that open. Residency spots can be open post-match for any of the following reasons:
Some programs still have spots that did not fill
Some students may have extenuating circumstances that caused them to abandon a position they received during match
Some are new programs who just received accreditation
Check for openings daily!!!!
Boost your resume
While you are searching and waiting for new spots to become available you can spend the time you have doing the following:
Edit and improve your personal statement, MSPE characteristics, CV, etc.
Do research – many projects can be accomplished in a short amount of time and very meaningful
Do community service – again there are multiple meaningful projects that can be done that don’t require huge time commitments
If you had low board scores, consider retaking one of them
Consider taking Step III or Level III of your boards
Many residencies might not have chosen you because they thought you would score low on the boards. If you need to reapply next year and already have a “Pass” for your third set of boards, that issue becomes a non-issue and you become a highly competitive applicant. This may not be an option for all students, but is worth looking into.
In short, you are not alone. Hundreds of students don’t match and multiple programs fail to fill each year. And as new residencies are born each year, their timeline on accreditation or opening may differ from the rest allowing you the opportunity to apply and secure a spot in April, May and June. Don’t give up hope! You graduated medical/osteopathic school. Now let’s get you a job!!!
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.
Speaking at a Ford plant in Ypsilanti, Michigan, President Donald Trump vowed he would not allow the country to shut down again if a second wave of COVID plagues us this Fall.
He stated, “We are going to put out the fires. We’re not going to close the country. We can put out the fires.”
Although his optimism was applauded by many who have found the economic downturn from months of business closures to be irreparable, many wonder if he actually has control of stopping a second country shutdown.
In early March the Trump administration tried to contain the panic, and keep businesses open, however other powers were at play.
Schools closed down first. With school closures, many employees could not leave their children unattended and needed to stay home.
Then traffic to many businesses slowed, as many chose to “shelter in place” for fear of being exposed to COVID-19. Employees of businesses chose to stay home as well in fear of exposing vulnerable family members to the virus.
Then as death tolls were reported, Governors began to institute stay at home orders and business closures.
As businesses reopen and schools ready for the new school year, many teachers and parents are preparing for a bumpy road ahead.
Even if a COVID second wave spares us, influenza is notorious for causing death, and each year takes its toll on the pediatric population.
Concerned parents may easily call for school closure and online learning because of flu, COVID, school shootings, or any other issues that could tragically affect children.
If schools close this Fall for any reason, employees will be forced to stay home and the cycle can occur all over.
Many businesses are transitioning to work from home models, however many businesses still require traffic and in person customer service such as restaurants, salons, movie theaters, shops, etc.
I believe our healthcare system will, as Pres. Trump suggests, be able to address new COVID cases, however, whether the administration will have the ability to mitigate the panic or calls for business shutdown is entirely another issue.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.
New Title IX regulations have been created and their implementation begins on college campuses throughout the US on August 14, 2020.
Title IX was born out of the Civil Right’s Act of 1964 which prohibited discrimination in employment based on race, color, sex, national origin, or religion. Then the Education Amendments of 1972 prohibited discrimination based on a person’s sex by any educational institution who received federal funds.
No person in the United States shall, on the basis of sex, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any education program or activity receiving Federal financial assistance.
Then Title IX evolved over the next few decades including rules against sexual harassment.
By 2001, Title IX had specified the consequences of sexual harassment, creating a “hostile environment” that may be caused by a repetitive series of harassing conduct.
In 2011, Title IX through a “Dear Colleague” letter (DCL) included specific guidelines for sexual assault and violence.
In order to assist recipients, which include school districts, colleges, and universities (hereinafter “schools” or “recipients”) in meeting these obligations, this letter1 explains that the requirements of Title IX pertaining to sexual harassment also cover sexual violence, and lays out the specific Title IX requirements applicable to sexual violence.2
In 2014 another DCL, urged universities to not racially discriminate in terms of discipline and sanctions.
….in our investigations we have found cases where African-American students were disciplined more harshly and more frequently because of their race than similarly situated white students. In short, racial discrimination in school discipline is a real problem.
In 2018, President Trump announced the formation of the Federal Commission on School Safety and rescinded parts of previous DCL’s with plans of providing new guidelines. These were released this week.
Harassment includes sexual assault, dating violence, domestic assault, and stalking as well as unwelcome conduct that is “so severe, pervasive and objectively offensive” as to deny a person equal educational access.
School must take action on those grievances that occurred during an education program or activity provided by the school. But the scope of the school’s jurisdiction will continue to be reviewed as it pertains to a building owned or controlled by a student organization (i.e. fraternity house.)
Schools must continue to guarantee the rights protected by the US Constitution including freedom of speech, but if an allegation does not meet the definition of “sexual harassment” the school may address the allegations as deemed appropriate through their “code of conduct.”
Parents and legal guardians can submit formal complaints and act on behalf of parties in Title IX matters.
School response to an allegation must be performed “promptly” with supportive measures provided to the victim.
“Burden of proof” lies with the schools and not the parties
“Live hearing with Cross Examination” is mandatory in post secondary school Title IX cases. Victim and accused do not need to be in the same room, and virtual hearings can be done with audio or audiovideo footage recorded. Affected parties can have an “advisor” present and if they cannot bring one, the school must provide one free of charge if requested. If one chooses not to engage in the live hearing or answer certain questions, it should not be used against them in the final determination.
This is a developing story….
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.
This year many of you have lost a moment you have spent years fighting for. Your graduation was a rite of passage, a ceremony in which those who saw you sacrifice, toil and triumph could witness and share. The coronavirus epidemic and resulting closures robbed you and your loved ones of this opportunity, but it couldn’t rob you of this….
Your mark in this world.
You have succeeded honorably despite multiple obstacles and reached your goal during a time when life was very uncertain.
Those of Generation Y and Z have witnessed some of the most tumultuous times, and this pandemic adds to the rocky start to many of your careers.
We older individuals might have had difficult paths as well but we had a much clearer picture of our future, of that finish line which helped guide our path.
You all had to, in the fog, reach this point and the fact that you chose to keep fighting and working at it defines the new generation of Americans.
Our future may seem uncertain during this time of pandemic and economic hardship, but one thing that is certain is you all give us hope.
Our country will be rebuilt and thrive because the next generation of hardworking Americans is YOU. You who wouldn’t falter after 9/11 or the Great Recession, or social media invading every part of your life. You defied odds and proved that a job, or money or career did not need to be dangled in front of you to complete your studies and finish your schooling.
You got the job done! And I, who have been through multiple graduations – high school, college, and medical school, am saddened that you can’t be on that stage, applauded for your perseverance, ambition and passion. But realize, no ceremony can begin to describe the pride your friends, families, teachers, mentors and fellow Americans have for you.
You are loved, revered, and honored, and we are so excited and grateful that our future will be driven and strengthened by you and your classmates!
Congratulations Class of 2020!!!
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and Board Certified Family Physician
Welcome to the 2020’s!! Whereas the 1920’s were roaring with music, fashion, cars, speak-easy’s, and prohibition, the 2020’s will be no less dramatic. Expect a high speed roller coaster with exponential changes across the board in all industries, jobs, housing, schooling, technology and relationships. Whether we like it or not, this is where I believe we’re heading……
Education – most schools will be online, similar to Ready Player One in which a student logs in from home and enters a “virtual classroom” each morning. Afternoons will be designated for sports, exercise and team projects.
Teacher glut – As schools move more towards online, one teacher can teach to multiple virtual classrooms at the same time. Chat rooms will be staffed by educators who will answer student’s questions individually. But teacher to student ratio can be widened, allowing school districts to hire less staff.
Half of all US employees will be working from home.
Commercial real estate glut – as more businesses use online platforms, and employees work from home, less office space will be needed, trimming bottom lines for corporations who don’t want to spend extra for rent, cleaning, utilities and security.
Recession will begin mid-decade
Trump will be reelected in 2020 but Pence will fail to win the Presidency in 2024 resulting in the White House turning Democrat mid decade.
A female President or Vice President will elected
Men’s and Women’s restrooms will be renamed as “Restrooms” allowing any gender to use the facilities
Medicine will become socialized as a Democratic executive branch will implement a public option or buy-in to Medicare/Medicaid, with tight rules to curb healthcare spending.
Telemedicine will be your primary care provider with allowances to see a doctor in person if certain criteria are met.
Drones will be delivering medicine, packages, mail to your door
Anorexia and other eating disorders will rise as “intermittent fasting” becomes more popular
New superbugs, viruses and fungi will be resistant to the best of our medications and non antibiotic/viral/fungal treatments will be perfected.
Less than 1/4 of Generation Z’ers (those born after 2000) will choose to get married
Less than 1/4 of Generation Z’ers will have a car
Apartment and condo living will surpass single family residence homes as there is less upkeep and commitment during a trying economy.
The 4-year college degree will be offered for free, but online and useless due to its ubiquity
Virtual TV show watching, where you can engage within the scene, will surpass current streaming of shows in popularity
Currency will be obsolete as cards and finger prints will be used for money exchange
Kiosks will replace most salespeople in retail industry
A younger “teen” porn industry will arise as kids outsmart parental controls and demand footage devoid of middle-aged actors but casting those in their young twenties….with companies marketing directly to young adults.
Some seniors may live to 125-130 years old
Marijuana use will become epidemic with people becoming tolerant to common strains resulting in needing more potent leaves.
Vegetarian and Vegan diets will surpass meat and potato saturated meals
“Farting rooms” will be created in buildings to allow those who are eating more vegetables to release their gas.
Smart toilets and do it yourself testing will be in every household
The Supreme Court will weigh in on mandatory vaccines
Baby Yoda will have a Star Wars Movie Series
Radio will be stronger than ever as people want to hear real opinions
TV News programs will begin to fall as demand for non-opinionated factual news rises
The Dallas Cowboys will make it to the Superbowl at least once; the Kansas City Chiefs…multiple times.
I know some of these sound crazy but this is where society is heading. The 2020’s will be fast paced, and blow right by you, so hold on to your hats….which by the way will also be making a comeback.
This is Part II in a series in which we put your mind at ease after you learn you failed one of the most important tests in your training. We know it’s not easy and lots of emotions are stirring, but since you will need to retake the exam, let’s dissect the most common questions so we can get you ready for the next one.
Why did I fail?
It’s the first question you’ll ask yourself and understandably so because you will want to improve on what you missed. However, for many students they clearly can’t understand why…..they performed the correct OMT modality, they completed their SOAP notes on time, they made the SP smile….so what happened? We may never know exactly why one fails their PE but it could include some of the following:
Failure to greet the patient and thank them for waiting
Failure to make them feel more comfortable if they are in distress
Failure to respect their privacy when it comes to gowning and draping
Failure to maintain good eye contact and reflectively listen
Failure to allow the patient adequate speaking time to answer your questions, (i.e. interrupting or rapid fire questioning)
Not “intervening” when they admitted to having a daily habit that could contribute to a health condition (i.e. smoking, alcohol use, poor diet)
Not ensuring the patient understood the assessment or reasons for questioning
Not appearing confident when one explains the assessment and plan
Not suggesting to address the pain or distress in the plan
Rattling on and not closing the encounter strongly.
Failure to suggest modifications that can help them at work or home
Failure to address other body systems by only concentrating on the chief complaint (i.e. a left shoulder pain complaint may also need questioning regarding chest pain in addition to musculoskeletal symptoms)
Failure to ask associated symptoms or pertinent positives/negatives (i.e. in a patient presenting with back pain, inquiring about lower extremity numbness and tingling, incontinence, hematuria, etc.)
Failure to address medical symptoms that may stem from a habit they have (i.e. urethral discharge if they partake in unprotected sex)
Failure to address medical symptoms from a medication they may excessively take (i.e. abdominal pain or blood in the stool of a patient who takes NSAIDS often)
Failure to examine the appropriate body parts that could be contributing to the illness, (i.e. thyroid and carotids in a patient presenting with dizziness)
Asking “why” when they take excessive medication – they may be self treating another medical condition
Asking “why” they came in for a physical (family member may have been worried about their memory)
Failure to complete all four sections (S O A P) consistently in each case
Failure to address the chief complaint in all four sections (i.e. if one presents with back pain, did the note address the subjective complaints, an exam of the back, differentials of what the back pain could be, and testing/OMM in the plan that addressed the back pain?)
Failure to include associated symptoms (i.e. in a patient presenting with a headache, were they negative or photophobia and neck stiffness)
Failure to document appropriate history and physical
Failure to list the differentials that the presenting complaint could be (i.e. a patient presenting with fatigue may have depression, anemia, sleep apnea, hypothyroidism, antihistamine overuse)
Failure to include OMM, testing, medications, work modifications, follow up in the plan.
Failure to ask permission prior to performing the OMM
Failure to explain what OMM is and why one is choosing to perform it
Appearing “rough” in technique
After performing the OMM, failure to ask how the patient felt and its effect on symptomatology
How soon can I retake the PE?
Although most students can go online and register for their retake, most academic institutions will have guidelines on when one should sign up for the retake and prove eligibility to remediating professors. We suggest you follow your school’s recommendations as retaking the test too soon could lead to an additional failure.
According the NBOME website, students are allowed 4 attempts in a single year and 6 total. However, many academic institutions may have different guidelines, so review your school’s handbook to determine how many attempts they will allow before dismissal.
Is it better to take my retake in a different city than the first one?
We have not seen any data on switching test sites and its effect on passing one’s retake. For some students the familiarity of the testing city and neighborhood makes the retake easier. For others a fresh city with fresh SP’s offer the placebo needed to pass. Since the average SP doesn’t remember one student specifically or their score, the effect of seeing a repeating SP is negligible.
Will I not match into residency due to my PE fail?
Most students who retake their PE and pass, go on to match into a residency. Of course this could be more challenging if one picks a specialty that is highly competitive such as surgery. However, overcoming a test fail is often times looked upon positively by program directors. If the question comes up during the interview be honest and humble without blaming anyone or anything for the failure.
Will a PE failure prevent me for applying to residency this year?
Most schools have a timeline on what needs to be completed before entering the match and better yet, some have a fail-safe built into the curriculum to allow some time off for board remediation if needed. Most schools however, want all board scores passed before entering the match, and since test scores may take 6-8 weeks to comeback after taking the exam, discuss with your school on your time needed to remediate and when to schedule your retake.
Should I take a leave of absence (LOA) to study for the PE?
If you feel you need to concentrate your efforts on passing the exam, an LOA may be of huge benefit. However, other students use their clinical rotations to help them hone in on their PE skills and prefer to keep learning while preparing for their retake. This decision will be based on your school’s recommendations and the degree of your PE failure (i.e. one section vs multiple sections.)
Will I still be able to get letters of recommendation (LOR) from faculty if I failed my PE?
Yes….but make wise choices in choosing the faculty. Those with whom you closely worked during clinical rotations, research, or community service are good choices, especially if they liked you and you performed well around them.
Again, hang in there. We know you just received devastating news with your first failure, but remember most students who study, retake their PE and pass, go on to residency. It’s a bump in your long academic road but a small one and one that can be easily overcome. You got this!!