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Out of the mouths of babes and sucklings
In June 2001, our cover contained an image of an artwork now hanging in the Royal College of Paediatrics and Child Health's council chamber, showing children rollerskating (fig 1). Dr Anthony Cohn, a Watford (UK) paediatrician, told us that his son had remarked how dangerous it was that no child in the painting was wearing a helmet. Eager to subscribe to the current passion for hearing the patient's voice, we politely asked Dr Cohn if his son would like to write us a short note of his views. With our usual close attention to detail, we had failed to note that Gavriel Cohn was aged 4. Dr Cohn responded that, consequently, a short note would be somewhat overambitious; his co-drawing skills, he told us, were subjectively meaningful but objectively abstract (fig 2). However, Dr Cohn kindly passed on his son's opinion that the reasons for helmet use were: in case you break your head and;
then the doctor will have to come
you can't see anymore
you will have to go to hospital for a long time
you will be died (sic)
We are grateful to Cohn and Cohn for their contribution and are impressed by the second author's belief in the reliability of his general practitioner's probable response to a request for a home visit. Our referee expressed concern about the perceived prolonged length of stay in Watford General Hospital. The editorial board were alarmed about the stated likely outcomes so wondered whether our ethical position demanded that we advise the hospital's medical director to mount an audit of such patients. However, Cohn and Cohn also pointed out that a US report in 1996 identified 76 000 injuries and 36 deaths from the activity illustrated1 so we withdrew our suggestion on the grounds that the second author (and probably his senior colleague) were at least as safe in Watford as in California.