In such a terrible disease as cancer our pessimism is not always justified. A friend of mine operated on a patient with severe abdominal pain and found a cancer at the stage where surgery could not help. He merely sewed up the wound and for at least a year after the patient was free from pain and apparently doing well. Operations never dreamed of a few years ago are now being done routinely on the lungs, heart, and blood vessels. For long, we have said that we assume more responsibility in refusing operation than in doing one. We hardly have to argue that now.

Leukemia, a disease of the white corpuscles, is considered deadly and yet a few years ago a near neighbor of mine lived on for well over a quarter century after her diagnosis had been proved. Childhood diabetes was quickly fatal until insulin was discovered in the early nineteen-twenties. Some of the earliest children to get insulin are now nearly middle aged and still doing well. Some of us doctors, who have been attending our tumor clinic since its beginning, are greatly cheered when a patient whom I will call Mary makes her yearly visit. She is now an attractive woman of forty-two. When she first came to us as a lovely girl of seventeen an operation showed that she had a bad type of tumor at the back of the neck and close to the spine. Another operation and two radium treatments, followed by skin grafts, were necessary and then a growth in the chest appeared, which was treated by X-ray. Yet for a dozen years now Mary has been in good health with no symptoms of trouble.

And so it goes. New methods of hygiene, new drugs, new types of operation, and what I think fully as important, new knowledge of physiology, are accomplishing great things, as you can see from all the health statistics. Thus you have a concrete basis for being optimistic, and it is easier now to approach health problems in this way.

Yet even before all these new developments had come to our aid, the will to believe had been a strong factor in our favor. We are beginning to understand, although not too clearly, that the brain, working in conjunction with the pituitary and adrenal secretions and probably more indirectly with other bodily forces, has made cheerful determination a strong factor in combating our internal enemies as we have always believed it did in physical strife.

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For children who have been starved for praise, words alone may not work, so tangible rewards are given. Some teachers give out points for good behavior, and children trade the points later for prizes. Such a scheme is called a contract. And parents can adapt it to reward a child for any desired behavior – washing dishes, taking out the trash, studying, using good table manners. Parents and child agree on what kind of behavior wins points, how many points get the prize and what the prize is. Parents must never fail to honor a commitment.

Once the behavior is learned, set up a new contract for a new behavior. Phase out the rewards for learned behavior, so that it becomes important for its own sake. Also, to keep the contract intact, if a child fails to win points for some days, ignore this failure.

Many teachers and parents argue that children should not be rewarded for things they ought to do anyway. They call that bribery. Professors Sulzer-Azaroff and Mayer point out that bribery induces illegal or immoral acts. By rewarding good behavior, they note, you are not inducing something illegal or immoral. The reward is to the child’s advantage, not to the advantage of the reward giver.

While most psychologists agree that praise works better than punishment as do tangible rewards, teachers and parents must be wary of killing a child’s curiosity and innate eagerness to learn. If a child learns to work only for rewards, they soon lose interest in studying or practicing for their own sakes. However, praise and tangible rewards can jump-start a change of miscreant behavior.

Dr. Mayer adds that most adults are paid for their work and says there is nothing wrong with paying children for their “work.” So give children their “paycheck”: smile!

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GENERAL HEALTH