It is important to note that this applies to children all over the world: in rich and poor countries, in socialist and capitalist societies, on every continent, in the East and the West, in the Northern Hemisphere and the Southern Hemisphere. The importance of these observations for health care is clear: if we could understand the causes of health disparities in this minority of children, we could eliminate half of the physical illnesses and mental disorders in the population and significantly reduce medical costs. In other words, more sustainable societies could be created, with happier and healthier people. There would also be stronger families, with fewer physical and mental illnesses, parents and children with prospects for a better future, full of hope and optimism.
Poor health in children and subsequent morbidity in adults are therefore not accidental. Diseases do not occur “equally and fairly” across the entire child population, but only affect some of them, like my sister. Therefore, there are systematic and significant percentage differences in disease incidence between subgroups of children, and these do not result solely from nature (i.e. genetics) or nurture (i.e. experience and contact with the environment), but from the ongoing and systematic interaction between nature and nurture, i.e. gene-environment interactions. Understanding these interactions will, in time, lead us to the latest discoveries in the emerging field of epigenetics, and even further.
Health status: what does it tell us?
But first we need to go back to the beginning and figure out why the health of individual children varies so much depending on which group they belong to and who are the unfortunate people who are disproportionately sick.
Although I am skeptical of overly simplistic typologies and categorizations, in an extensive program of research, my colleagues and I have found that children have very different internal and biological ways of responding to their environments. To summarize briefly what the science has shown, we can say, for convenience, that these responses fall into two distinct categories. Some babies, like dandelions, have an extraordinary ability to cope with almost any environment they encounter. Dandelions grow and flourish wherever they sprout—from fertile mountain meadows to cracks in city sidewalks. Others, like orchids, are extremely sensitive to their environment; their counterparts, children, are particularly weak in difficult conditions but also extremely vital in favorable conditions, and then they succeed.
These metaphors—the baby orchid and the baby dandelion—come from my brief acquaintance, nearly twenty years ago, with an elderly Swede who came to hear a lecture I gave at Stanford University. After I had said what I had to say, a wrinkled, bushy-browed, Yoda-like old man, leaning on a crooked stick like a root, stepped out from between the desks at the front of the classroom and pointed it at me. He said, “You’re talking about a mascrobarn!” I had no idea about that, nor did I know what a maskbrobarn was. As he explained, it is an idiomatic Swedish term meaning “baby milkweed.” The Swedes call these children who, like dandelions, grow wherever they are planted—having an unlimited capacity to grow anywhere. Because this charming, picturesque word appealed to our imagination, we coined a Swedish neologism: orkidebarn, or children’s orchid – to describe children who, like these flowers, are exceptionally sensitive to their surroundings: they can only flourish if they are carefully cared for, and they can wither and wither when they are neglected or harmed.
From this point on, we can make increasingly useful distinctions between lion children, who flourish regardless of their environment, school, or family conditions, and orchid children, who can develop into beautiful, capable beings or into fragile, threatened versions of themselves, depending on their environment. The orchid children, more sensitive and biologically less resistant to external influences, both in the laboratory and in natural conditions, arouse our collective concern, anxiety, and fear as parents, teachers, and health professionals. Both they and their adult counterparts—the friends and peers we often worry about—can become the cause of great suffering, sadness, and disappointment in their families, schools, and communities when they are not understood or supported.
W. Thomas Boyce — pediatrician and distinguished professor emeritus in the departments of pediatrics and psychiatry at the University of California, San Francisco. He co-directs the Child and Brain Development Program at the Canadian Institutes for Advanced Research and serves on the Council on Children, Youth, and Families of the National Academies of Sciences.
Excerpt from the book “Orchid or Dandelion Child. How to Support Sensitive Children” by Dr. W. Thomas Boyce, translated by Magdalena Słysz published by Czarna Owca Publishing House.