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Commentary: A Pediatrican Reflects on Her Career

By Deborah Raiken

Buffalo, NY – I'm often asked if I always wanted to be a pediatrician. The answer is no. I never had any childhood dreams of becoming a doctor. I didn't have any close family members in the medical field. I did fall in love with biology in 6th grade after examining protozoa and other tiny organisms under the microscope, and I did start college as a premed student. But, I was quickly deterred by the offerings of a liberal arts college and became an anthropology major. My decision to apply to medical school was pretty much by default and influenced by my roommates.

Despite my somewhat circuitous path to medicine, I managed to get accepted to Columbia's College of Physicians and Surgeons. Once again, my chosen specialty of pediatrics was a process of elimination, rather than a predestined calling. I felt more akin to the attending pediatricians on the inpatients floors, than the surgeons and internists. I enjoyed the scope of pediatric diseases, and I definitely liked the kids! From Columbia, I went to Children's Hospital of Philadelphia, where I had excellent training in Pediatrics.

In the summer of 1982, I found myself back in Buffalo after 11 years of higher education and postgraduate training. I spent my short vacation before starting my first job as a real doctor, poring over Nelson's Textbook of Pediatrics, making file cards to assist me in my practice of pediatrics. I knew the pediatric party line on when to start spoon feedings, what food to start first, what immunizations were given when, and when a child should achieve normal developmental milestones .I was equipped with my cheat sheets and ready to go.

I came across those index cards recently while cleaning out old files. Fortunately, for my patients, I am now far more flexible in guiding parents in the care of their children.

In my almost 25 years of working in a diverse, urban practice I have learned so much about life. My narrow suburban experience as a child has been enriched, broadened, sometimes jolted by my patients and their families. I have witnessed the incredible strength of parents; single parents caring for severely disabled children in a selfless, steadfast way. I have seen the resilience of children and families in the face of illness or personal tragedy. I have witnessed too much poverty and its tight hold on subsequent generations. I have been sickened by child neglect and abuse. I have seen the joy and pride and anxiety of first parenthood. I have watched again and again the miracle of a newborn baby grow and develop through infancy, toddlerhood, childhood, and adolescence. And a bonus of my age, I have seen those very children become young adults and proudly return with their babies, the ultimate compliment to a pediatrician.

I now know that a nurturing family can take many forms, and that to have a successful partnership with a family takes trust and respect. I also know that I have to work within the family structure and beliefs when developing a treatment plan. I have modified my cookie cutter approach to pediatrics, but I will not let parents abdicate their responsibility as parents. Children are our most precious resource, our hope and future. We must lavish them with love and praise, provide them with a stable, peaceful home, teach them tolerance and respect for others, give them opportunities to grow and mature into caring adults. I am so privileged to be a small part of this process and so happy Pediatrics chose me.

Listener-Commentator Deborah Raiken practices at Allentown Pediatric and Adolescent Medicine in Buffalo.