Dr. Bex
speaker
498 appearances
7 recordings
1 series
first heard Nov 2024
last heard Jun 2025
Dr. Bex’s voice in public audio — every appearance, attributed to the second.
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And it's interesting because when they returned to Kaiser Permanente San Diego is the first report to HHSA, which is Health and Human Services Agency in California, but that's the overlying agency that manages all the child abuse claims or abuse claims. And the reason for that first report was some kind of tampering with an IV line by the mother.
Although it's not clear what that was, that's what the statement in the initial report is. And this is where, again, Shaylin Nino comes into the picture because she is the child abuse pediatrician or one of them in the San Diego area. And so when these cases do get referred, then even though she was not at Rady's at that point, she was in a hospital in San Diego County.
So Dr. Nino gets involved as the child abuse pediatrician. Um, I just want to take one little sidebar. Cause again, we're going to do this about a couple of the other physicians in the case, but Dr. Nino. Um, and so she actually was a nurse before she was a doctor, which is interesting. I was a teacher before.
I think, um, people who had a career before kind of come into medicine a little bit different. I think we've had a little more life or living. And the fact that she was a nurse before, I think puts a different perspective on what she sees. I'm sure. And then she decided to go back. She got her MD in Virginia, did her pediatric residency.
And I want to point out that she is actually fellowship trained in child abuse pediatrics. So we met Sally Smith during the Kowalski case, and she was what we call grandfathered in to the specialty because there were not fellowships when she came out of residency. Same as me, although I'm not that old. Pediatric hospital medicine is a relatively new specialty.
And so I actually was grandfathered in, which makes me feel extremely old. where there were not as many fellowships offered when I came out of training. And so just because of my years of experience, I was able to sit for the board and I'm board certified in hospital medicine. But Shaylin actually did the training and the actual fellowship in child abuse pediatrics and is also board certified.
The time she's called a so-called child abuse expert makes me want to, my head pop off because there is no so-called about it. Like, I mean, and this is not just because I know her. I would say the same about, I said the same about Sally Smith, but like, you cannot, if there's anything you can say about a human, like, She is a child abuse expert. I mean, I don't know what else to say.
And if anyone is this specialty, it is Shaylin. She has done her time, she has done her work, she has taken courses and classes and continued her continuing medical education to stay up to date in the field. That's just my sidebar because her name is going to keep coming up.
Child abuse pediatricians are not the ones going out and hanging a shingle, you know, in the grocery store strip mall and saying, look, I'm a child abuse pediatrician. Come see me. People don't want to see the child abuse pediatrician.
It's not something lucrative. It's not something you go into for, you know, the honestly like the reward like, oh, yes, I'm sorry. You do go into it for the rewards because you are really so important in these children's lives. But you are not going in for the financial gains. You are not going into it for the reputational gains. Speaking to what has happened to some of them.
I don't know, honestly, how we're going to get new fellows in the specialty because I'm really worried that. that with everything that's going on, we just, who would choose this, right? And that, for me, I respect them more for still doing it right now.
Having the youngest daughter with her always sometimes in a wheelchair walking around, sometimes with leg braces on walking around.
A clinical diagnosis is a diagnosis that relies on the story and the symptoms that are being described more than anything I can do a specific test for or a physician can do a specific test for. So often there is no lab diagnosis, MRI diagnosis. It is ruling out other things sometimes and then being left with the story and the symptoms fitting the condition.
The problem is in medicine, there are a lot of diagnoses that we don't have that one perfect test for. And I think I was just talking to my friend this week about how in pediatrics, I think it's even a little bit different because we're not relying on what the patient is telling us. In some cases, we're relying on what the parent is telling us.
And pediatricians in general are trustworthy people who is taught and is trained to listen to the parent or listen to the story and try to come up with a diagnosis.
The question is if they're eating and they're doing okay is the difference because there are kids who are not supposed to be taking oral or whatever and they'll get in trouble, right? But if you're having a kid who's eating, I'm just hypothetically, you have a kid who's eating pizza and doing fine or eating all this stuff and doing fine, you have to beg the question of why you have a G-tube.
Most parents don't want a G-tube. And in fact, I've been involved with lots of ex-preemies where they needed a G-tube for growth and development and the parents so wanted them to eat from a bottle. you know, and they were begging, can we do anything but the G-tube? I want my kid to be normal and well. So that's, that's my experience. And so, no, it doesn't make, it doesn't make any sense.
And I mean, there's going to be conditions where you're, like I said, you're going to be doing some oral, some G-tube, but there's usually, it's transitional usually, unless like I said, this, someone had a horrible esophageal cancer and they had to do some reconstruction. And it's like, you can take some from up or you had cancer in your neck and
You can take some from up, but you'll choke a little bit, but we have to make sure you get enough by G tube, but that's not the case. No, no. If you're eating pizza and pepperoni and all this stuff, it's probably not.
In medicine, we rely on the honesty, integrity of the parents trying to help their child. And unfortunately, in child abuse and medical child abuse, the motivations, I'm not a psychiatrist, but it's not what we're, we don't have a shared mission of getting this child better.
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