When The Bough Breaks

"Yeah, her too. Only her I wasn't so crazy about. She was Mexican, you know, but uppity Mexican. Where I come from they did the stoop labor and the cleanup. This one had the fancy dresses and the little sports car. And her a teacher, too." It wasn't easy for Bonita Quinn, brought up to think of all Mexicans as beasts of burden, to see that in the big city, away from the lettuce fields, some of them looked just like real people. While she did the donkey work.

"She was always carryin' herself like she was too good for you. You'd say hello to her and she'd be lookin' off into the distance, like she had no time for you."

She took another drag on her cigarette and smiled slyly.

"This time I'm okay," she said.

We both looked at her.

"Neither of you gents is a Mex. I didn't put my foot in it again."

She was extremely pleased with herself and I took advantage of her lifted spirits to ask her a few more questions.

"Mrs. Quinn, is your daughter on any sort of medication for her hyperactivity?"

"Oh yeah, sure. The doc gave me pills to give her."

"Do you have the prescription slip handy?"

"I got the bottle." She got up and returned with an amber vial half full of tablets.

I took it and read the label. Ritalin. Methylphenidate hydrochloride. A super - amphetamine that speeds up adults but slows down kids, it's one of the most commonly prescribed drugs for American youngsters. Ritalin is addictive and potent and has a host of side effects, one of the most common of which is insomnia. Which might explain why Melody Quinn was sitting, staring out the window of a dark room at one in the morning.

Ritalin is a sweetheart drug when it comes to controlling children. It improves concentration and reduces the frequency of problem - behaviors in hyperactive kids - which sounds great, except that the symptoms of hyperactivity are hard to differentiate from those of anxiety, depression, acute stress reaction, or simple boredom at school. I've seen kids who were too bright for their classroom look hyper. Ditto for little ones going through the horrors of divorce or any other significant trauma.

A doctor who's doing his job correctly will require comprehensive psychological and social evaluation of a child before prescribing Ritalin or any other behavior modifying drug. And there are plenty of good doctors. But some physicians take the easy way out, using the pills as the first step. If it's not malpractice it's dangerously close.

I opened the vial and shook some pills onto my palm. They were amber, the 20 - milligram kind. I examined the label. One tablet three times daily. Sixty mg was the maximum recommended dosage. Strong stuff for a seven - year - old.

"You give her these three times a day?"

"Uh - huh. That's what it says, don't it?"

"Yes, it does. Did your doctor start off with something smaller - white or blue pills?"

"Oh yeah. We had her takin' three of the blue ones at first. Worked pretty good but I still got the complaints from the school, so he said it was okay to try these."

"And this dosage works well for Melody?"

"Works real fine for me. If it's gonna be a rough day with lots of visitors comin' over - she don't do real good with lots of people, lots of commotion - I give her an extra one."

Now we were talking overdose.

Bonita Quinn must have seen the look of surprise and disapproval that I tried unsuccessfully to conceal, for she spoke up with indignation in her voice.

"The doc says it was okay. He's an important man. You know, this place don't allow kids and I get to stay here only on account as she's a quiet kid. M and M Properties - they own the place - told me any time there's complaints about kids, that's it."

No doubt that did wonders for Melody's social life. Chances are she had never had a friend over.

There was cruel irony to the idea of a seven - year old imprisoned amidst single - swingle splendor, tucked away in a slum pocket on an aerie high above the high Pacific, and dosed up with Ritalin to appease the combined wishes of the Los Angeles school system, a dimwitted mother and M and M Properties.

I examined the label on the vial to find out the name of the prescribing physician. When I found it, things began to fall into place.

L.W. Towle. Lionel Willard Towle, M.D. One of the most established and respected pediatricians on the West Side. I had never met him but knew him by reputation. He was on the senior staff of Western Pediatric and a half dozen other Westside hospitals. A big shot in the Academy of Pediatrics. A guest speaker, highly in demand, at seminars on learning disabilities and behavior problems.