I have spent the overwhelming part of my post-high school lifetime studying about science. Biology, physics, chemistry, biochemistry and more in college; anatomy, physiology, pharmacology, psychology, microbiology, immunology and more in medical school; pathophysiology, infectious disease, development, radiology, psychiatry, genetics and more in pediatric and medical genetics training programs. And then ongoing continuing medical education, journal reading and conference attendance for my over 40-year clinical career.
Such activities are not unique to me but shared by those in the medical professions and others in the other sciences. Science drives our lives and for good reason. A straightforward definition for science reads – the pursuit and application of knowledge and an understanding of the natural and social world following a systematic methodology based on evidence. Science is a unique vocation and worthy of being followed with integrity.
At first blush, it might be easy to say that science really doesn’t matter for children, that they are so resilient that they can handle whatever comes their way, and that science matters more for adults. After all, children tend to be less affected by COVID-19, cancer is less likely, and heart attacks are rare. Such a cavalier approach, however, totally ignores the importance of children. It ignores that the adults of tomorrow are the children of today. It ignores the millions of parents that want the best for their children. It ignores the unique nature of the children. Pediatricians take pride in being annoying about the promoting the well-being of children and families and using science in such activities.
Why? Because pediatricians are staunch advocates for children and oftentimes, we can be downright annoying in our persistence to make a positive difference for children and families.
A recent article by Stephen Hall in the New York Magazine (February 2019; The Lost Generation: Trump’s environmental policies are putting the health of American children at risk) makes a dramatic point by stating that “It’s a cliché to say children are the most vulnerable members of society, but over the past three decades, scientists have established this as a physiological fact. Children eat more food and drink more water per unit of body weight than adults. They breathe more rapidly (and tend to breathe that air close to the ground). Those facts alone make children particularly susceptible when they are exposed to chemicals and pollutants. But that is especially true in the prenatal period and during early childhood, when the brain undergoes tremendous development.”
Pediatricians are physicians…and scientists. We take Mr. Hall’s words seriously.
So medical decisions are made with science in mind because science matters. And science matters more than ever now. Science is under assault these days, but it shouldn’t be. Science instructs care and advances how we improve the lives of our most vulnerable citizens and their families. Let’s discuss some examples.
- Vaccines—one of the absolute joys in my medical career is the progress in the eradication of lethal infectious diseases. Fortunately, I have never seen a case of polio, and now some forms of meningitis where I signed death certificates have been eliminated thanks to vaccines. A recent outbreak of preventable measles is a real shame, and HPV vaccine can prevent cancer yet too few children get the vaccine. COVID-19 vaccine was developed with amazing alacrity and shows similar effectiveness as the other vaccines. And let’s emphasize that vaccines do not cause autism.
- Antibiotics—in the middle of the last century, antibiotics started to be used. Their use has made an incredible difference in the treatment of so many diseases. But in the spirit of advancing care and using science, the discovery was made that antibiotics can be overused. Antibiotic overuse can be detrimental to patients and equally important, it can be detrimental to mankind. These discoveries demonstrate that the constant surveillance of science and the changes that occur are crucial to medical care.
- Cancer therapy—Childhood cancer has gone from incurable to often very treatable during my medical career. Why? Because clinical trials using scientific investigations were able to try different drugs and determine which ones helped and what went right. Scientists in the labs learned about how cancer cells function, suggested what medicines might be beneficial, and then worked with pediatric cancer doctors to see how they work in patients. Not everything was successful, so constant monitoring of the results was necessary. Therapies then needed to be checked years later to make sure the effects were sustained or not detrimental.
- Early childhood development—the science involved with understanding how adverse events (from abuse, neglect and even household dysfunction) affect children’s brain development has led to remarkable discoveries. These discoveries help explain child behavior, adolescent behavior and even adult-manifest diseases like hypertension, diabetes, and heart disease. The wiring of early brains and the genes that will be expressed are molded by the early experiences. We now know that changes in early brain development can be corrected with a variety of interventions that are exquisitely simple yet socially difficult. Therein lies the rub—how to use this science to help children, families and communities.
- Environment—The problems (pollen, pollution, smoking exposure, lead, you name it) that children are exposed to are critical to their development and health as noted in the quote above from Stephen Hall. Science has shown us that these exposures adversely affect children and mandate how we should correct problems in the environment. There is now good evidence to suggest an association between pesticides in the environment and the rise of autism and ADHD.
For those that argue that science runs counter to religion and the will of God, I would argue that science and its benefits are the will of God. Faith and science are not opposites. They are logical, integrated partners. The power of the human mind and its mysteries as acknowledged by those of faith celebrate the great discoveries that have changed lives forever, and thank God, we are better for it.
Medical decisions are made with science in mind. I contend that social decisions should be made with science in mind. Science cannot be ignored. Every morning when people wake up and take their prescriptions or start their cars, they are living science. One cannot selectively accept science for an advantage and ignore it at other times. Science matters—it improves lives, it tells us when we need to make changes and it provides a blueprint how to help children and their families. To make a difference, we should embrace science and use it to our benefit and avoid the pitfalls of ignoring it. And it is a big deal for children.