Since I know all three of you readers out there were dying from suspense, here’s my final draft of “the real thing.”
“The lure of the distant and the difficult is deceptive. The great opportunity is where you are.”—John Burroughs
What’s the difference between children growing up in inner city Houston, rural Texas, and rural Africa? Don’t all children deserve to grow up healthy and free of disease, well nourished, with the opportunity to meet developmental milestones, in a safe environment that allows for play and encourages literacy?
To a girl who grew up reading fairy tales and adventure stories, dreaming of exotic places, Burroughs’ quote was problematic. Along with my extended family’s assortment of teachers and globetrotters, I wanted to experience everything the world had to offer. My parents are the sole members of their respective families with feet firmly planted on the ground. They encouraged me to be inquisitive, liberal-minded, and charitable—although their personal preferences contradicted with my wanderlust, the values they taught me did not.
At fifteen, a teacher gave me a book of field accounts about the Centers for Disease Control Epidemic Intelligence Officers, and my fate was set. I would pursue a life combining adventure, intellectual discovery, and altruism, even if I wasn’t sure exactly how. At Baylor University my beliefs were informed and refined by social justice concepts, which led to graduate studies in Epidemiology and Global Health. When applying to medical school I thought both of my personal goals, and again of Burroughs. Texas Tech presented an opportunity to serve my native West Texas, and to train in El Paso, one of the most exotic locations a U.S. medical school could offer. I took it.
I entered school expecting to specialize in Internal Medicine and later pursue a fellowship in infectious disease, but the contrasts between my Internal Medicine and Pediatrics clerkships left me favoring children’s medicine instead. In adult medicine, clinical miracles seem to mostly postpone, not alter the negative consequences from a lifetime of societal circumstances and personal choices. At my hospital, physicians are often so overwhelmed that it is all we can do to stabilize immediate problems rather than holistically promote the health of a patient. More than once I was accused of ‘thinking like a pediatrician,’ when philosophy from my public health training surfaced. In January, I found myself helping care for a girl with congenitally acquired HIV. She hated the way trips to the hospital interrupted her college education, her attempt to be a normal teenager. I was struck by her wasted potential, the carelessness of her parents, our societal failure to treat her condition definitively. Of course, we can often prevent vertical transmission, and in the U.S., cases like hers are now blessedly rare. A pediatrician’s optimism rests in the chance to make major quality-of-life impacts through prevention and early care. Care for the acutely ill can be rewarding, but I want to be a part of long-term solutions as well.
Though pediatric problems are challenging, the ideals of the profession closely align to my own aptitudes and principles. From infections like malaria and HIV that disproportionately attack pediatric populations, to childhood obesity and diabetes, public health-focused pediatrics is needed now as much as ever. The great opportunity of my life is now, in pediatrics and global health. To pursue anything else would be chasing after the distant and the difficult. By following my strengths, I plan to help children grow up healthy and strong and find their own strengths in time—no matter where I happen to be practicing.