Our Little Ones

I had never been so glad to see a doctor act out in what was also a moment of vicarious catharsis for me. He was angry, pacing and cursing. Moments before, we were all brokenhearted to see the first yellow drop of a spinal tap, again. Another premature baby had syphilis.

Parents who were without homes, used drugs, did not go to their obstetrics appointments, did not take prenatal vitamins, did not take their medications or get screenings. These babies did not stand a chance. How unfair that I was born to a loving and caring family, and these children were in the NICU while social services figured out what to do with them.

The syphilis was even in their bones! When have you heard of that? Day after day, I saw the noble neonatal intensivist care for these sick, abandoned babies, and I wondered how his spirit withstood his career. I was only there for a month, and I felt defeated. I couldn’t bear seeing these innocent souls get their chance to thrive in life robbed from them before coming into this world.

Going on pediatric consults with the ophthalmologist and his resident sent shivers down my spine. Traumatic injuries, genetic conditions, child abuse. Later that day, after the consults, I had a conversation with a friend in nursing school who recounted how she and the other nurses gathered the strength to act professionally while speaking to parents who were abusing their child, repeatedly landing him in the hospital while social services accomplished nothing. You fail to comprehend the wickedness of a being that beats a helpless little one unconscious.

How is it that the systems we put in place to protect these children are failing them so miserably, and we don’t talk about it? We talk about every other issue: immigration, economy, education, Obama’s birth certificate, for God’s sake. But as a collective, we have failed to protect the most vulnerable among us.

I went home after my day with the ophthalmologist and cried. I felt defeated in my ability to make a change. After all, what was a medical student going to do about the failings of multiple systems put into place to protect those babies.

We need to do better for our children.

Perhaps one day we will fight as ardently for them once they’re outside the womb as when they’re in it. We can begin to tackle this issue by improving social services, boosting financial support for parents, creating robust legislature, and enhancing enforcement of policies. However, I will speak to the issue I know best, which is the dwindling pool of underappreciated pediatricians and pediatric subspecialists.

Pediatrics has one of the lowest compensation rates among medical specialties. Some say this is because pediatrics is a female-dominated field, but hospitals will tell you that insurance does not compensate them well enough for “children’s problems.” We see pediatric residencies go unfilled year after year. Even if they start out wanting to pursue pediatric specialties, medical students are often taken aback by the monetary devaluation of the training and commitment that awaits them. If we want children to have a fighting chance, we need to support those ready to fight for them.

You will see medical journals talk about what we can do to better promote the specialties that students and residents are not pursuing, discussing everything but the real issue at hand. It is simple. If we value children, then we need to pay pediatricians more, and reduce the amount of non-medical labor they are burdened with. It is not easy managing changing physiology, complex relationships with parents, and an ever-increasing administrative workload. The good news is, we can change things. To all the hardworking pediatricians, your calling does not mean that your skillset deserves to be devalued. You have the right to ask for what you deserve.

As a student who has trained with countless wonderful physicians, I have always admired the dedication and heart of all doctors. Patients seldom understand how much we care about them and their well-being, but those who care for children are different. They carry a strength in their hearts and a softness in their souls that I’m not sure I possess. This is precisely why I want to thank all the doctors, nurses, and staff who make our little ones feel loved, safe, and cared for.