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Testing The Limits

He watched as one after another of his friends played the game. At the end of the game, they each wobbled about unsteadily and stared about glassy eyed. But after a moment they recovered, and in a macho explosion of pride at having successfully crossed some unknown boundary, they laughed. And now it was his turn. He panted at first, then he held his breath and held his breath. Then came the sudden squeeze across his chest, and the solid ground beneath his feet seemed to disappear in an instant. He fell forward, his head slamming hard against the wall.

He was thirteen, in junior high, and his mother had brought him to the emergency room after receiving a call from the school nurse that her son had fainted after playing this bizarre breath-holding, chest squeezing game.

"I thought they would catch me," the teenager told me, holding an ice pack to his swollen cheek, obviously disappointed that his friends had let him down.

"Why do you play those games?" his mother asked, bewilderedly.

"You feel a little high, a little spacey for a minute," he innocently answered. "That's all."

This was not unusual behavior for a teenager. In fact, in an age of drugs and alcohol, it falls into the more bland of risk behaviors. We all have our individual temperaments. Some of us are more risk-takers, others assiduously avoid taking risks. Some of us are more daring, others more cautious. But growing - in youth or adulthood - requires taking some risk, pushing ourselves, if not to the brink, at least towards it. The danger lies when our risk-taking is motivated by non-productive competition, as in my teenage patient's breath-holding challenge; by trying to alter one's consciousness using drugs without considering the consequences; or by the vacuous thrill of a game, such as an adult's excessive gambling.

We ought to expect that children will take risks. Indeed, the heroes of television, film, and real life are risk-takers. We have to expect that children will emulate them. The job of parents, teachers, and mature peers is to channel risk-taking behavior toward socially desirable goals. The thrill of competitive sports instead of the thrill of drugs. Mastering a difficult academic challenge instead of mastering how to cut school.

While we must set limits and help define goals for those children who are impulsive and dangerous risk-takers, just as much effort ought to be made to encourage a shy, withdrawn child to take a risk.

I think the embarrassment of being brought to the hospital by his mother, and perhaps perceiving that he had failed at his schoolyard game, pained my young patient more than the small gash on his face that was easily sutured. He'd have a little scar on his cheek forever. Perhaps it would be his "dueling scar," small evidence of youthful foolishness and risk-taking. I think it was a small price to pay for a valuable lesson. Experimenting with losing control, he realized, was not only dangerous but some consequences were permanent.