Teen-Agers' Doctor

The slim, blonde, pregnant 16-year-old stubbornly clung to her story. Sally insisted that she was still a virgin. Many a doctor might have exploded. But Dr. Arthur Roth, 37, knows and likes adolescents too well for that. As founder of the five-year-old Teen-Age Clinic at Kaiser Foundation Medical Center in Oakland, Calif., Roth is an expert in a new medical specialty -- "ephebiatrics" -- that closes the gap between specialized treatment for children and for adults. Last week, having discovered the family causes of Sally's mental block-building, he persuaded her to go to the obstetrician.

Sally's case is extreme, but her need for friendly persuasion by an understanding doctor is shared by almost every adolescent. Usually, just when he becomes most conscious of mysterious aches and pains, the teen-ager finds himself medically a displaced person. His parents often brush off his vague complaints as "growing pains." Many doctors view adolescents, who have the lowest mortality rate from illness of any group, as uninteresting cases. When adolescents fall ill because danger signals have been ignored, says Ephebiatrician Roth, "they feel too old for the pediatrician and too young for the internist."

The Right Place. Dr. Roth entered his new field years ago when he tangled with a 15-year-old boy who refused all medical aid after getting a chicken bone caught in his throat. Just the mention of a doctor scared Denny out of his wits. After finally wooing Denny into the hospital and extracting the bone, Pediatrician Roth decided to focus on adolescents. He got help from his old training school, Children's Hospital in Boston, where Dr. James Roswell Gallagher set up the country's first teen-age clinic in 1952, now has four hospital floors serving 600 patients a month. With Gallagher's advice. Roth set up the second such clinic at the Kaiser Medical Center, where the case load has leaped from 25 patients a month to 300. Other clinics have since been started in Philadelphia, Denver and Washington.

At the nine-man Kaiser clinic, the aim is to give patients "what every teen-ager wants from everybody--respect and honesty." The waiting room, filled with teenagers' fashion and hobby magazines, is designed to make patients feel they are "in the right place." Visits by parents are discouraged; the patient is on his own, alone with his own doctor.

Biggest single age group in the clinic's range from eleven to 21 is made up of baffled, questioning 14-year-olds, who seem hardest hit by adolescence. Nearly a third of their complaints have no medical basis. But not all are so simply psychosomatic as those of the boy whose serious headaches began when his father remarried shortly after the death of his mother --who had similar headaches. Many surface complaints turn up real trouble: vague pains sometimes signal diabetes, tumors, infections, heart disease.

Rewards. Yet what Dr. Roth's patients usually need most is reassurance about the vast, puzzling range of normal adolescent development. "Anxieties or problems that seem trivial to others," he says, "are very meaningful to teen-agers." The adolescent constantly fears that his or her body is not following the lines of the "ideal" movie star. A girl worries about small breasts; a boy fears that his are overdeveloped. Most frequent complaints: acne, obesity, menstrual "disorders," lack of beard, the skin striations common to fast growth. Not every doctor cares to worry about such normal minutiae. Dr. Roth disagrees.

"Teenagers are interesting, cooperative and grateful," he says. "It's a pleasure to work with them." His satisfactions come from such cases as that of the 15-year-old girl who fell into despair when her twelve-year-old sister began menstruating before she did. Her turn would come. Roth gently reassured her. Recently, her face beaming, she collared him at the clinic. "Dr. Roth," she yelled. "I've had it!" That, says he, was as rewarding as delivering a new baby.

This file is automatically generated by a robot program, so reader's discretion is required.