Bullying: children hurting children.

Mark’s parents were worried. Their 14-year-old son, who recently had entered a new school, was a small, clumsy child who was poor at games and had odd mannerisms. He was unable to enunciate his words clearly or quickly and became flustered when provoked. He had problems making friends. After a few months in his new school, he became known as Mark the Martian because of his mannerisms. He was unable to ignore the taunting, which included being kicked, punched, and tripped by classmates. The problem was especially pronounced on the playground. He became so tense that he reacted volatilely and dramatically, earning him the reputation among staff of being aggressive. His reactions encouraged the bullies to continue. No single incident was severe, but the cumulative effect was devastating. Mark did not approach school staff, and they never saw any of the bullies’ attacks. They did see Mark’s aggressive reactions and did not have a sympathetic attitude toward him. The bullying finally came to light when it was discovered that Mark was walking around town all day in winter weather rather than facing school. At the same time, the mother of one of his classmates phoned his parents and the school to say that her son was becoming distressed at the extent of the bullying Mark was having to endure. Many of the children were disturbed by the events, but no teacher had been aware of what had been taking place. If he were your patient, what would you say to the child? What would you say to the parents? What would you do if no action was taken by school personnel to remedy this problem despite parental efforts? Bullying, largely a covert entity, is a problem that physicians should understand because it affects far more children than most people realize and can be devastating for those involved.