It is hard to believe that it was 50 years ago. The summer of 1975, I headed to Fitzsimmons Army Medical Center in Aurora CO at the beginning of my fourth year of medical school for a month-long rotation in pediatrics. It was then called a sub-internship – an immersive experience to see if pediatrics would be my chosen medical path, an immersive experience with an increased level of interaction with patients but still without the responsibility of direct patient care. I could see more and do more but still have appropriate supervision for the care rendered.
Proud Mom and son, 1972
It is quite ironic that the first patient I remember from that experience was an adolescent male with measles. Ironic because of our current measles epidemic given that this disease was eradicated in between then and now. He was sick enough to be in the hospital and needed an IV for fluids. I also remember that I was unable to start the IV, requiring help from the senior resident. I still had a lot to learn!
Over the course of the following 50 years, I served in multiple roles as a medical professional –
- Pediatrician
- Medical geneticist
- Clinical researcher
- Administrator
- Leader of SC pediatric society
- Medical training program director
- Teacher for medical students
- Teacher for medical trainees – pediatrics and medical genetics
- Medical education coordinator
- Medical research coordinator
- Author – books for the lay public and medical professionals; website blog
- Complex medical care physician
- Consultant for trauma-informed care
- Outspoken child and family advocate
I say all of the above not to praise my efforts but rather to give some context to my comments and my angst about issues related to children and families. Even though I retired from active practice 5 years ago, pediatricians never lose their zealous advocacy for children and families. Not just for my children and my family but for all children and families, especially those historically underserved and vulnerable.
So, what worries me? Lots, and for good reason.
- Preventable infectious diseases – there will be an increase in preventable diseases with decreased vaccination rates and decreased emphasis on the necessity and safety of vaccines
- Mental health – we are not really concerned currently with appropriate attention to the mental health of our children based on lack of services and funding; children suffering from trauma (physical or emotional abuse, neglect, violence) are too often underserved and further victimized with our inattention to their plight.
- Environmental exposures – children are at greater risk for environmental toxins because they have an increased surface area per exposures and are generally closer to the ground where numerous toxins reside.
- Cancer – childhood cancer has dramatically benefitted from the dedicated efforts of scientists and physicians and any decrease in support will only harm the efforts going forward.
- Rare diseases – advances in genetics and related fields have provided incredible promise to families with children with rare diseases but those advances are being threatened with funding cutbacks.
- Weather disasters – climate change is leading to more devastating weather events that disproportionately affect children when their lives are upended.
- Systemic racism – yes, racism does exist in our society and to deny such only serves to perpetuate the toxic effects of such. And being anti-DEI is just refusing to acknowledge such and avoiding efforts to improve the lives of all citizens, not just folks like us.
- Incivility – a lack of civility in our society (demeaning and belittling others, overt expressions of hate too freely expressed) only serves to provide the wrong examples for children and erode our social fabric.
- Diverse lifestyles – it is all too easy to damn others that are not like us instead of understanding that they are also children of God.
- Lawlessness – the inability to abide by the rule of law (and condemning those faithfully adhering to the rule of law) exhibits a wanton disregard for the glue of our society; democracy is only viable when the rule of law is adhered to.
- Health care – the inability of vast swaths of our society to receive fair and equal health care is a sad commentary on a “caring society” that professes in large part to be Christian.
- Book censorship – book banning is not a feature of a free society and has a frightening effect.
- Illegal deportation – sending people out of our country without proper due process only serves to allow for a further degradation of social justice and continues to erode our social fabric.
The current philosophy of the US government is to cut services, personnel and programs that disrupt all sectors. The list above of current issues (a short list) is not new but accentuated greatly in our current environment. It is hard to keep children’s programs and services intact when chaos reigns. People advocating for children are fighting for the children on so many fronts that their efforts are often diluted and ineffective. Chaos only breeds inefficiency that poorly serves all children. The chaos appears to be purposeful and even more contemptuous in the context of hurting our children.
My fifty years and counting as a medical provider and related roles do provide me with the opportunity to speak with some degree of authority on issues child and family related. In fact, to not use this experience for the betterment of others would be counter to my responsibility as a concerned citizen. Citizens care for and about others. As a physician, I have the privilege and obligation to speak out and do whatever I can. And I will not relent. I cannot relent for my remaining years.