Just the facts: Physician tells students about sexually transmitted infections

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Dr. Robert Bergamini relaxed last week in his office at the David C. Pratt Cancer Center at Mercy Medical Center.

Dr. Robert Bergamini has dedicated his medical career to helping children as a physician with a specialty in pediatric hematology and oncology. He is the director of the Cardinals Kids Cancer Center at Mercy Hospital in Creve Coeur.

He also challenges educators, parents and grandparents and assists them in bringing the facts to teenager about the devastating affects of sexual behavior on young lives.

On his own time he gives presentations to school faculties, parents and students on teen sexuality as a medical and moral crisis.

He recently was interviewed about his efforts.

Q. How did you get involved in giving these presentations?

A number of years ago I had a request from a principal who was a friend to do some presentations at their school because they were having difficulty getting someone to do it. I said I'd be happy to help.

Q. What approach did you take?

I've always been a very stick-to-the-facts person because when you deal with illnesses that are life-threatening for your vocation you can't hide things from people. That was my approach. It was a just a blunt, in-your-face presentation that several people heard and liked. So they asked about doing it at their school and it just sort of mushroomed to the point where I do many presentations over the course of a year at both public and private schools.

Q. What are some of the points you make?

Nobody starts the day expecting that they're going to come see me as an oncologist, nobody expects to be diagnosed with cancer. Similarly, if you look at what's happening with our teens, I don't think any of them start a weekend expecting that they'll catch an incurable disease or be the victim of an assault or any of the bad things we see through our emergency departments. So my focus in the presentation is to emphasize that these things are common, that it's easy to get fooled and that it's easy to make a decision that you will regret for a long time.

Universally the slides (shown at the presentations) that people say are the most memorable are the slides of the dead babies. I show three babies that died from congenital herpes. It's pretty devastating to those families and for someone to look at and understand that in a couple of those cases there were no symptoms that warned the doctors ahead of time and that this baby -- what we consider one of the ultimate gifts from God -- paid a horrible price for someone else's mistake.

At least 50 percent of today's teenagers will have at least one sexually transmitted infection by the time they're 25. I started doing these presentations nine years ago when that statistic was 25 percent. So it's clearly heading in the wrong direction.

Q. You talk about chastity, and that's something that doesn't always get presented. Is there a better reception to that than we think?

Typically in a question-and-answer period people want to see how close they can get to the line. I've had people say this is just another abstinence talk. I say no, it's not.

I tell them right up front I don't have the moral authority to talk to you about your individual behavior. God gave all of you free will and gave you parents and put other people in your lives as figures of moral authority. I'm here as a medical professional. The only agenda I have per se is to present the facts as accurately as we know them today. The facts speak for themselves.

These are the consequences of a nonchaste life. These consequences are real. The diseases are common. What makes the (news) paper are individuals who know they have HIV or some other disease and continue to have sexual relations with other individuals and infect them. Those are clearly bad people.

The reality is the vast majority of people don't know they're infected, and girls in particular pay a terrible price. Many times girls do not develop symptoms until they have sustained some significant damage which may be permanent.

Q. What do you say to parents?

I still believe the vast majority of teens are looking for parents to be parents and not friends. Parents can really influence the behavior of their children much longer than they anticipated. I gave a presentation to a very large group, probably 300 parents in the auditorium. At the end of the presentation I asked, "How many of you think that you can influence your teen's behavior?" Only seven or eight hands went up. I said this is the problem. You can't be afraid to set expectations, you can't be afraid to enforce consequences if your expectations aren't met.

We live in a world where almost everything seems negotiable. You get a DUI and people negotiate it to a parking ticket. We always talk about plea bargains. There's no negotiating with these diseases. If you get herpes, you got it and it's not going away. It doesn't matter who you know or what you can do. If you got it, you got it. If you get HIV there's no negotiating. You'll die from HIV. Maybe not as quickly as back in the '80s, but you'll still die from it.

Q. What about the emotional part?

The emotional toll is substantial. Nobody enters into a relationship expecting it will end badly. They might expect the relationship will end, but they don't expect it will end with nasty aspects to someone's behavior. Now the things you shared and thought were secrets are now public knowledge because this person no longer respects the confidence they said they would keep.

If I just say, "Listen if you have sex you're going to get depressed," they say, "Yeah, right." But I've seen it as these relationships are breaking up and after they've broken up, and I see them deal with the fallout. ... I try to present facts. The students who have given me feedback let me know they want to be able to make their own decisions, and what they want is facts. After one presentation a student came up to me and said, "This is the strongest abstinence lecture I've ever heard, and you didn't use the word abstinence once."

Kids are capable of making good decisions. But look at the information barrage with which they're faced. How difficult is it for them to really discern what's good for them or not?

Q. Elsewhere, it's presented in such a slanted, narrow view?

It attempts to undermine our authority. My counter to that is strictly on the basis of information and education. At one of the girls schools I told them being on the birth control pill raises your chances of having a blood clot fourfold. That's just one of the risks. And nothing you do will take away that risk.

Q. What else would you like to say?

A good example of needing clear parental authority is with the HPV vaccine. To me the HPV vaccine is a no-brainer. For the first time in history we can prevent cancer with a vaccine. Just as no one looks to start their day with having to come to my office and hearing that their child has cancer, no one looks to hear that their child who is doing everything right and was a victim of sexual assault is now infected with HPV which will affect him or her, usually her, potentially for a lifetime. The HPV vaccine is not a license for promiscuity. It is protection for disease, for an assault and for ignorance. The vast majority of HPV is sexually transmitted, but there's so much we don't know about the virus. Fifteen percent of children under the age of 10 are positive for HPV 16, the most carcinogenic strain, and that cannot come from maternal transmission. So we don't know how it is they're positive because we don't know about the transmission. ... The vaccine is not a license to go out and have sex. It is to protect you against other people's mistakes. You shouldn't have to pay for that. Innocent people should not have to have their lives ruined through no fault of their own. God was willing to not destroy a pretty awful city for the sake of 10. There are more than 10 people a year who have ongoing problems with HPV through no fault of their own.

(The Missouri Catholic Conference (MCC) Good News publication
recently addressed the rights of parents to be involved in a certain
vaccination. California recently enacted a law that allows parents to be
bypassed when decisions are made about whether to inject their child
with Gardasil, a vaccine that protects against the human papillomavirus
that causes cervical cancer. HPV causes changes in the cervix that can
lead to cervical cancer later in life. Children can be given Gardasil
without parental permission as early as age 12 under the California law.

(Parents, after hearing all of the information, can make the decision
as to whether their child should be given the HPV vaccine, according to
the MCC. "This is also a good time for the parents and the child to
discuss sexuality in its fullest sense, including how it is a gift from
God designed for expression within a marriage between a man and a
woman."

(There are situations, the MCC noted "where a child could be in
danger of being exposed to the HPV through no fault of their own, such
as when a child is a victim of incest. California lawmakers could have
waived parental permission in these situations, but they did not.
Instead, the state passed a law in which the parents' permission can be
waived in all cases.")