Staying Healthy: A Conversation with Deerfield’s Medical Director
Dr. Thomas Hagamen has been Deerfield’s physician since 1989. A graduate of Dartmouth Medical School and trained as a family physician, Tom leads the Dewey Health Center’s team of professionals who tend to our students’ physical and emotional well-being. He lives with his wife in a house on Main Street just a stone’s throw from the Health Center. Their daughters graduated from Deerfield in 2001 and 2003.
Q. Based on your 23 years of experience here, what is the key to staying healthy at Deerfield?
A. Sleep deprivation is the number one health problem and risk factor for a multitude of physical and mental health issues. This has not changed in 23 years. Lack of sleep is a difficult problem to solve because of who we are, in other words, the kind of students and families that we attract. Our students are highly motivated and push themselves hard. Our younger students seem to learn from our older students that staying up late to work is an acceptable strategy for getting through Deerfield. We have made some progress in the last five years, most notably by changing the schedule so that the school day starts later. Our students demand a lot of themselves, and it is always challenging to convince them that sleep is a significant factor in success.
Q. Does the school community get sicker during the winter months?
A. Winter term is more stressful. It is longer–13 weeks versus 10 in the fall and spring. And the local environment is more miserable, colder and darker and just drearier in general. We do see a modest increase in colds and other viruses. The intensity of our services does go up a little bit with more overnight stays, but not dramatically.
Q. So the Health Center is slightly busier during winter term. How often do you see our children?
A. We get 8,000-10,000 student visits per year which averages out to 15-20 visits per student. Some students use the Health Center regularly, others not very often. In the winter months students are more likely to stay in the Health Center and miss class.
Q. Would you describe the spectrum of services that you provide?
A. Our mandate is to deliver comprehensive health care to Deerfield students. We treat a wide variety of physical ailments from minor injuries and illnesses to more significant medical maladies such as concussions and post-operative care for injuries like ACL tears. We also handle a wide variety of mental health issues that are often stress related. We refer most of those cases to our two in-house psychologists, Dr. Stuart Bicknell and Dr. Sheila Fritz, who work in this building. Their close proximity is very important because our philosophy is to integrate mental and physical health care. And our school psychiatrist comes to the Health Center a half day per week.
Q. Is the Dewey Health Center used equally by boys and girls, or do you see more of one than the other?
A. The level of usage for illnesses and injuries is comparable. But for stress-related ailments, we see more girls. Girls are more willing to seek help than boys, although thankfully that is changing. Our counselors used to see twice the number of girls as boys but in the last 20 years it has become more socially acceptable for boys to seek professional help. So we are trending towards parity between girls and boys in treating anxiety and depression. With respect to eating disorders, the national trend remains 10 to 1, girls to boys, and our experience here reflects that.
Q. In your opinion, what is the root cause of stress for Deerfield students?
A. The Health Survey that we conduct every two years shows that our students are driven to be successful. They are motivated first and foremost by their own internal drive, then second by their teachers’ expectations, and third by their desire to please their parents. So even though our students are incredibly talented, they are so strongly motivated to achieve that, not surprisingly, they are vulnerable to getting overextended by their academic workload and their co-curricular commitments as well as their social obligations. Something has to give.
Q. What does the Health Center do in the short term and longer term to alleviate a student’s sense of being overwhelmed?
A. Sometimes a student is overloaded and needs a time out. We can help him or her email a teacher or coach to take a break from his or her responsibilities. In other words, we can help get a child out of a test or sport for a brief period of time. We like to think of it as providing a respite from the busy world of Deerfield. In the longer term, we can help students weigh the tradeoffs that they have made in their academic, co-curricular and social schedules and then modify them.
Occasionally we see a highly stressed student who presents symptoms that may be the tip of the iceberg for a more serious illness such as depression, an anxiety disorder, obsessive-compulsive disorder or an eating disorder. In those cases we intervene immediately and get the parents involved if they are not already.
Q. What is the role of the parent in all of this? Let’s say that my child sounds overwhelmed. I do not know if it is a little deal or a big deal, but my sense is that she needs help. What do I do?
A. Talking to your child’s advisor is usually the first place to start. Advisors are the most likely adult to know your child well and to see him or her often. They are the one most likely to have their finger on the pulse of how your child is doing. Sometimes that person is a teacher or a coach, but parents should reach out to an adult at Deerfield for help. That adult may in turn refer a parent to the Health Center if it appears warranted. But as often as not, parents call us directly. When we get a call from a parent with concerns about stress or fatigue or possible symptoms of depression, we usually strategize on the phone and then come up with a plan about how to proceed. Often that plan involves in some way both the counselors and the medical staff.
Q. Are there a few simple guidelines that my child can follow to keep from getting overwhelmed?
A. Absolutely! First and foremost she should get plenty of sleep. I do not want to sound like a broken record, but your child should go to bed when she is tired. Eight hours of sleep per night would be a wonderful goal although the average Deerfield student I believe should sleep nine hours per night. Second, eat well and stay well hydrated. Third, learn to prioritize what is important and what’s not. Then set time limits on projects based on those priorities. Successful Deerfield students acquire the skill of being able to manage the tradeoffs in their academic, co-curricular and social lives. Last but not least, do make time for a healthy social life. I do not advocate over-socializing, but time with friends is important.
Q. How can we parents help our children stay physically and emotionally healthy?
A. Stay in touch, be a sounding board and be supportive. But do not micro-manage your child’s Deerfield life. Parents naturally want to keep their children from making mistakes. But mistakes are important! We learn so much more from our mistakes than from our successes. Don’t buy in to the distorted perspective that your child may have about the ramifications of a bad outcome. For instance, your child may believe that a bad test grade will ruin his life. Well, it won’t! Your job is to help him understand that. Dealing with a bad test grade or any of a myriad of other small, medium or sometimes significant setbacks that students experience during their Deerfield careers is important in developing the resilience and durability that are necessary traits for success at Deerfield and beyond.
Q.Thank you, Tom, for taking the time to talk with us.
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