Where do you serve the subpoena? The Hall of Justice in Metropolis?

So here I am, trying to do some serious writing tonight, and the table of contents for this month’s Archives of Disease in Childhood shows up in my inbox. Six out of ten times I don’t even bother to read through it, even though I’m an ad hoc reviewer for it, and even though it’s brought to us by the good folks at the British Medical Journal (one of my favorites).

For some reason – maybe I just needed a break – I scanned through the e-mail and barely noticed this one word fly by as I was scrolling quickly through the message:

“Superhero”.

I did a double-talk in front of the monitor. Superhero? This has to be good. I scrolled back and sure enough, right in front of my eyes, was the title of journal article:

“Superhero-related injuries in paediatrics: a case series”

I thought, “This has to be good. Certainly worth looking up.”

A few minutes later and I have the paper up on my computer, and staring me in the face is its one and only figure:

snapshot
So, what’s this paper about, you ask? Well, here’s the scoop:

Five cases of serious injuries to children wearing superhero costumes, involving extreme risk-taking behaviour, are presented here. Although children have always displayed behaviour seemingly unwise to the adult eye, the advent of superhero role models can give unrealistic expectations to the child, which may lead to serious injury.The children we saw have all had to contemplate on their way to hospital that they do not in fact possess superpowers. The inbuilt injury protection which some costumes possess is also discussed.

The authors discuss a short case series here. The first, and most detailed, was of a 6-year-old boy who suffered an unwitnessed fall from a 1st floor indow while wearing Spiderman outfit seen above (note the “anatomically correct upper body muscle padding”). In doing so he earned a head bonk, a swollen eye and an injured foot. He had been pretending to be Spiderman and had climbed out of the window. The other four cases were also falls: three kids pretending to be Spiderman, and one pretending to be Superman. As the British authors put it (in that oh-so-British way):

“They were injured after initiating flight without having planned for landing strategies.”

Brilliant. Only the British can make something like this so amusing.

The authors indicate that while they are strong advocates of adventerous play and while they also understand that risk-taking is an integral part of childhood, they caution that parents need to be aware that children may believe that their abilities “have been given a super-boost” with an appropriate costume. They add the following warnings:

Parents whose children dress up as Bob the Builder should understand that hammers and saws are highly likely to be used in play. The parents of Spiderman afficionados should ensure that windows are correctly closed and locked. Superman’s parents may find it easier to encourage their children to wear glasses, and Wonderwoman’s parents may wish to give early fashion advice and not tell lies.

I looked in Medline to see what a search for “superhero” turned up. There are exactly five previous citations that include the word “superhero”. The authors cite what is apparently the seminal paper on the phenomena published in German in 1992 in Praxis der Kinderpsychologie und Kinderpsychiatrie. Entitled, “Dangerous comics – only a fantasy?” this paper considers whether or not the violent fantasy world of comics leads to violence in children. Their work indicates:

Comics with their regressive pull and their independent superhuman heroes represent the archaic world of narcissism unconscious, unwilling to develop and conservative. Violence serves to maintain the original state or regain a harmonious “paradise” … Thus superhero comics are only dangerous for severely disturbed children.

Apparently not.

This being America, and not Britain (which apparently has a better sense of humor about these things), leads me to wonder when we’ll be seeing tags on Spiderman costumes stating: WARNING – THIS COSTUME DOES NOT PROVIDE ACTUAL SUPERPOWERS. DO NOT ATTEMPT TO LEAP FROM BUILDINGS, TREES OR OTHER TALL STRUCTURES. Or when the first lawsuit will come up.

In any case, my point was not so much about the lawsuits, or even the phenomena of children pretending to be Superman and attempting to jump from roof of the garage while wearing a cape made of an old bedsheet. My point is more along the lines of how much fun it is to look at the world with the eyes of a physician or scientist and witness the various oddities of human behavior. Especially with children. It’s the best part of the job. My hat is off to the authors of this fun little paper – first, for taking the time to recognize the patter; second for having the initiative to write it and submit it; and third, for doing it with such style.

You can download and enjoy the paper here.