Before getting to how I became a pediatrician, some family background: This summer my wife and I had the pleasure of spending a lot of quality time with our five grandchildren. As any grandparent can tell you, there is a special bond with grandchildren that is absent or muted in the relationship with their parents when the latter were children. We have an excellent relationship with our three daughters and their husbands. We vacation together and often have meals together, which we all look forward to. But our relationship with the grandkids is qualitatively different.
When this topic comes up with friends, they also comment on this wonderful connection to grandchildren. They raise several possibilities to explain this effect. A common factor mentioned is that raising one's own kids takes a great deal of one's time, with regular periods of stress, worry, befuddlement, and confusion in the process. Grandparents may worry about their grandchildren, but it is not the same. The problems are more distant and sporadic.
Others say that there is usually a much stronger sense of personal responsibility for one's own children—their behavior, attitude, values, and the rest. Grandparents do not ordinarily feel such intense personal responsibility. “I can enjoy them and spoil them and then just send them back to their parents,” is a statement that always brings a knowing laugh from the group, including me.
But, at least in my case, I sense that there is something deeper at work. And I believe it began long before my grandchildren were born:
I started my internship in 1960, one month after my marriage. I chose a rotating internship, which was still the dominant choice. I consider myself lucky to have rotated through the GU service, cardiovascular and general surgery, various medical services, and pediatrics; it was a wonderful compressed and advanced medical education that you couldn't buy. I enjoyed at least parts of all of them and learned a lot about myself. I found that I didn't want to be a surgeon and that I was especially attracted to pediatrics. During my internal medicine residency we could choose two one-month electives. I chose hematology and pediatrics.
I loved my pediatric rotation. I enjoyed seeing the babies and joking with the toddlers in the Well-Baby clinic. By then I had two children of my own and had recently been through a lot of the same issues faced by the families I cared for. Most of the kids were normal so there was a happy atmosphere in the clinic.
On the impatient service I was smitten by Homer, a chubby African-American infant with a wonderful disposition. He was admitted because of a gastrointestinal anomaly and was scheduled for surgery. He easily got through the surgery and was soon discharged. Babies seemed so much easier to care for than old folks; of course, my experience was very narrow at that point.
When I was a pediatric hematologist-oncologist in the 1960s, our therapy was often ineffective and the mortality was very high. Despite those dark days, I never lost my enthusiasm for taking care of children, which only increased despite the difficulties.
People often ask how I could work with dying children. My response was that I was doing research to find better therapy; that made it possible for me to press on.
My interest in hematology had grown partly because as a medical student I had moonlighted for three years, taking night call for the clinical labs in a community hospital. Unlike today, the labs were not very busy at night, so I could look at stained blood samples without sharing the microscope and I became proficient at drawing blood from patients. I developed a particular interest in blood clotting, which led me to look for a fellowship in hematology that was strong in clotting.
My mentors recommended that I apply to a program in Cleveland and another one that was one city block away at the University of Illinois Medical School. I did my residency at what is now Rush Presbyterian St. Luke Medical Center. My wife and I were born and raised in Chicago and never lived anywhere else. Both sets of parents were alive and were enormously helpful to our young family with meals, baby-sitting, and gifts. I was making $100 a month plus another $100 to help cover the cost of living in a hospital apartment.
So I made an appointment to interview with Dr. Irving Schulman, the chair of pediatrics at the University of Illinois. I told him I trained in internal medicine, not pediatrics, and he said that was OK and that I could have the job. (I am sure he had checked up on me before the interview.)
I was given a lab project and carried out the normal clinical duties of a pediatric fellow. I saw patients at the hematology-oncology clinic and made rounds on the inpatients. I took my turn in the Well-Baby clinic, a noisy but satisfying duty. I became quite comfortable caring for the children with the backup of my senior colleagues. Several of my medical school colleagues told me they hated their pediatric rotations because the parents were a pain and they preferred not having to deal with them. But I enjoyed dealing with the families as well as the kids.
After a year, Dr. Schulman said if I was going to do pediatrics, I needed some residency training. By then, I had decided that pediatrics suited me. So I was both a pediatric resident and a pediatric hematology-oncology fellow simultaneously throughout the following year. (I became board certified in pediatrics and internal medicine, though I always thought my limited pediatric training made my qualifications inadequate.)
I became more enchanted with children, especially babies and toddlers, including my own. The more I saw them and watched their magical development, their sponge-like learning, how joyful they could be, and how they could pass that mood on to the people around them, the more I knew that pediatrics was for me.
I was especially mesmerized by the wisdom they acquired (I don't know how) that would take one aback in wonder. And I began to understand the cause of meltdowns and, with my wife's unerring instincts, how to overcome them. In fact, my wife Pat is the best mother I have ever seen in action. As I have noted before, she has the amazing skill of knowing precisely when to get tough or give a hug, when to put her foot down or coach them along. She taught me a lot of what I know about kids.
And to this day, I cannot go into a supermarket or to a beach, or on my daily walks without engaging a little one in a short conversation when we pass each other. My family is used to this and I sometimes embarrass them when I talk to a 10 month-old stranger at Publix. But I don't care, I love those little guys and they give me much more than I give to them when I (we?) chat briefly.