It began in college. Not knowing what career path to follow (I thought psychology was where I was headed), things changed dramatically when my first wife and I became foster parents for a child with congenital rubella. Teaching our nine-year-old foster son (with congenital heart disease and impairments of both vision and hearing) to be toilet-trained was quite the task. We eventually triumphed, but I was quickly thrust into a world I had no previous concept of. Several years and several foster children with disabilities later, we were no longer foster parents, but my path was set. I needed to go to medical school. In medical school I was tempted by most every specialty. Yet my experience as a foster parent for children needing special care was always in the back of mind. And I guess, the back of my mind won.
After medical school in Colorado, I did a pediatrics residency at Duke University Medical Center and then pursued a fellowship in medical genetics at the Greenwood Genetic Center in Greenwood SC. Medical genetics was at its infancy in 1979 so I had to convince my pediatric chair at Duke (a wonderful mentor and friend, Dr. Sam Katz) that pursuing a career as a general pediatrician and a medical geneticist was not the dead end that he anticipated.
For 24 years, I was both a general pediatrician and medical geneticist. I found that wearing one hat or the other was a challenge but at the same time quite exhilarating. Sometimes I felt like the CERTS breath mint commercial—I was two, two, two docs in one! It was this dual role that allowed me to expand my horizons. I could be a general pediatrician making newborn rounds at 7 AM, see children and families with possible genetic disorders during the day and then be on call again at night. I think it was these opportunities that hopefully made me a better doctor—that I could understand complex processes and issues faced by families with children with multiple problems and at that the same time I could engage in discussions about some of the more routine issues that all children and families face. For example, all children can get croup. I was able to recognize, treat and counsel families understanding the standard of care and understanding how a complex disorder might complicate a “routine” pediatric disease. I’d like to believe that my listening ears became hypersensitive because of this hybrid model.
Yet, after 24 years, change was afoot. Medical genetics began to occupy more of my time, and I realized that I could no longer burn the candle at both ends with 12+ hour days. I was fortunate enough to get involved in multiple projects and serve on the board of the American College of Medical Genetics and Genomics and serve in leadership roles for several genetic initiatives of the American Academy of Pediatrics. The next ten years went by quickly, but I missed the opportunity to do more teaching and practice general pediatrics.
So, at the possible retirement age of 63, I choose to work harder and became the Medical Director of General Pediatrics at a medical center (Prisma Health Upstate) and children’s hospital (Prisma Health Children’s Hospital – Upstate) in Greenville, South Carolina. I was afforded the opportunity and the privilege to work with an incredible, dedicated group of pediatricians providing care to a large underserved population and teaching the doctors of tomorrow (medical students and residents). Being an administrator certainly has its challenges but being able to actively guide policy decisions that profoundly impact others was both humbling and empowering. And I’d like to think that all of my experience as a pediatrician, medical geneticist, and educator could help guide some of those decisions.
Retirement was put off until the end of 2020. I stepped down as the Medical Director in 2019 and was able to finish my clinical career in the most delightful way possible. I was a staff physician in the Ferlauto Center for Complex Pediatric Care. I was pulling together my decades of experience as both a pediatrician and medical geneticist. For over 3 years, I had the pure pleasure of working with a team of physicians, nurses, dieticians, case managers, and front office folks that saw it as their singular purpose to provide the best holistic care to children and families dealing with various disabling conditions. Truly their passion and, by extension, mine was to leave no stone unturned providing care and support for these families. The exciting part of this was to see how much I learned from these folks. It would be an understatement to say that I also learned so much from the families. Their trials and tribulations became mine, and the resiliency that they displayed taught me so much. I still internalize to this day so many of the stories that they shared with me. I continue to be amazed at how they shared their humanity with me, making me a better doctor but, more importantly, a better person.
I retired clinically at the end of 2020. I do not miss having to wear PPE (personal protective equipment) for many patient visits. I might have retired but I certainly am not withdrawing from my role as a children’s advocate. I continue to pursue my writing (www.mychildrenschildren.com) and am currently serving as the President of the South Carolina Chapter of the American Academy of Pediatrics. In the latter role, I am very busy but find this engagement to be a continuation of my lifelong work. I might be retired but I refuse to withdraw from role as a children’s advocate.
To conclude, one might ask what I have learned in my close to 50 years since college and foster parenthood being a pediatrician, medical geneticist, educator, administrator and author. I could create a long list, but I will choose just a few—
- Trust the intuition of parents. Let that guide your evaluation and decision-making
- Listen intently. That sounds so simple but so hard to do at times.
- Leave your biases at the door. Preconceived notions based on supplied information or past experience can taint your ability to provide the best care possible.
- Smile and engage. It’s amazing how comforting a smile can be.
- Remember our shared humanity. You could just as easily be on the other end of this medical encounter.