Why Paediatric Surgery?

A historically accurate, delightfully personal reflection that serves to put into words so many of the reasons I chose to be where I am today. Paediatric Surgery is much more than a list of diagnoses and procedures. It is a commitment to the total health of children – mind, body and soul.

“Why pediatric surgery?” asked my first and most illustrious mentor in surgery, Dr. Alfred Blalock (Chief of Surgery in the Johns Hopkins Hospital, 1941–1964)… He then continued, “I am not sure there is a future for a specialty of children’s surgery, and I would advise you strongly to complete your general surgery training here first to be on the safe side!”

After a few days of sober reflection on Dr. Blalock’s response, I sought the advice of my other great teacher and subsequent colleague, that self-proclaimed “surgical curmudgeon,” Dr. Mark Ravitch ….“Why not pediatric surgery?” I asked him. “Because you may not be able to make a living operating only on children. The professor’s advice is sound; become a well-trained general surgeon first, and let pediatric surgery be your hobby.” He then added, “It is a great field! But there may be no future for the specialty.”

Why Pediatric Surgery? (published in the Annals of Surgery, May 2003)

The more I learned about this rapidly developing new field of children’s surgery, the more convinced I became that this was a worthy commitment and that there were many challenges that lay ahead in the surgical care of children. The need for understanding the pathophysiology of these complicated congenital abnormalities was underlined by the fact that if they could be corrected, most of these children could have normal, productive lives.

 “I treated him and God healed him” Ambroise Paré, barber-surgeon of France, circa 1585.

So why pediatric surgery? I hope that the answer is clear: “because children are not little adults” They have some unique problems that require very special surgical management. They also do not vote, so we have another critical role—to be their advocates for the best surgical care in the world. That remains today a daunting challenge.

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