Teens get a chair of their own
Experts hope the creation of Australia’s first academic chair in adolescent health will spur interest in a neglected area of medicine. Health editor Adam Cresswell reports
KYLIE Polglase knows only too well the extra pressures illness places on teenagers. Born with cystic fibrosis, by the age of 13 she was desperately ill and needed a double lung transplant to survive. At a time when other youngsters were busy socialising, studying and finding out about themselves, others and the world, Polglase was hiding in her room.
She felt isolated and was deeply depressed, reluctant to speak to friends or family.
‘‘ I was always in the dark and I didn’t like sunlight or anything like that any more,’’ she says. ‘‘ I just didn’t have any emotion, I was kind of like a zombie.’’
By the age of 13 she had watched five friends die from cystic fibrosis, a figure that climbed to nine over the next two years. Before she got her own lung transplant in 2005, at the age of 18, she spent almost a year in hospital, much of the time dosed up on morphine to kill the pain of her lungs collapsing.
But even when she was at home, life wasn’t great. ‘‘ Friends my age didn’t really understand, and I felt like there was no point talking to anyone about it because no one was going through what I was,’’ she says. ‘‘ I started to withdraw from people and lock myself away in my room practically every day.’’
In fact, Polglase was one of the luckier ones. She was treated by one of the relatively few doctors who specialise in adolescent health, and a nurse on her ward was setting up a peer support program for teenagers with chronic illnesses. It became Polglase’s lifeline.
‘‘ It used to be the only thing I would get out of bed for,’’ she recalls. ‘‘ In hospital I was on morphine 24/7, and I would drag my I/V pole with me when I went to the group. We never spoke about what medical problems we had, but if someone said ‘ I had the worst blood test today’, everyone could relate to it. At school if I said ‘ one of my friends just passed away’, everyone would freeze, because they didn’t know how to react.’’
After her operation, Polglase returned to the group as a peer leader, and describes herself as ‘‘ passionate’’ in the cause of improving health services for adolescents.
But if this makes it sound like a simple question of helping teenagers feel less lonely while they are treated, and not talking to them as though they are young children, think again.
The University of Sydney has just announced the creation of the country’s first fully academic chair in adolescent medicine, which its backers hope will attract more research talent to this neglected area.
A fundraising appeal to endow the chair in perpetuity has already raised $3 million towards the target of $4.5 million. But rather than wait to raise the full amount, the position will be advertised and the search for candidates will begin while the appeal continues.
Although not the first chair in the subject — the Centre for Adolescent Health in Melbourne is headed by a professor — the Sydney post is said to be the first that is fully academic, and the successful applicant will not share their time with a clinical role.
The statistics do appear to suggest the new post is needed. Up to 20 per cent of Australian adolescents have some form of chronic disease. Over 75 per cent of deaths in this age group are preventable, and one-third of young people are experiencing personal troubles such as depression, relationship difficulties and engaging in risky behaviour.
Young people are also disproportionately at risk in the areas of accidents, drugs, alcohol, smoking, eating disorders and sexually transmitted infections.
Many are also overweight or obese: up to 31 per cent of males and 23 per cent of females aged 12 to 24 are carrying too much weight, and from 1985 to 1997 the proportion of young Australians who are above the healthy range for body-mass index shot up — almost doubling in the overweight category, and more than tripling the rate of obesity.
Susan Towns, head of the department of adolescent medicine at The Children’s Hospital at Westmead, says the new chair will provide ‘‘ clinical leadership’’ that will help start the ball rolling on research, which will in turn create more evidence for the best ways to treat adolescents.
‘‘ It’s very hard to find specific evidence (for best treatments) relating to adolescence,’’ says Towns. ‘‘ It’s such a time of change, not only physically, but emotionally, cognitively and psychologically, that impacts on their healthcare needs in quite a profound way.’’
Managing chronic illness in the context of the developmental changes that occur in adolescence is complicated, she says, by the pressures teenagers feel under in the natural process of growing up. Illness interferes with this process.
‘‘ Young people, as they are going through
Youth focus: Susan Towns, centre, with arts co-ordinator Natalie Anderson and patient Samantha Hobourn (15), left, in the activity centre at Westmead Hospital