Pediatric Phylogeny and Lessons Learned in the Garden

Abstract

Pediatrics is a dynamic, organic, and evolving medical specialty. It is a living and breathing entity the substrate of which is the collective work of the many dedicated women and men who are members of the Ambulatory Pediatric Association (APA) and the other member organizations of these Pediatric Academic Societies (PAS) meetings. Of course, pediatrics includes not only the physicians who care for children, but also other health care providers. In describing pediatrics, we often use language that speaks to the biologic growth and development of our profession. For example, we call pediatrics a branch of medicine; we refer to the growth of subspecialties; and note the fruits of our work. In this address, I would like to exploit that metaphor of pediatrics as an organic growth, a living breathing species, and trace its phylogeny. Phylogeny (phy-log-e-ny) n. The development or evolution of a kind or type of animal or plant. My endeavor is to examine what has happened in the growth of pediatrics and, in particular, general pediatrics. In addition, I hope to explore some of the lessons learned in the garden, to underscore some cautions and suggest some new directions. I love to spend time in the garden. Although I work in the heart of the city, I am blessed by living in a green area. My home office looks over a garden and I often look to that small bit of land for personal comfort and inspiration. Like many of you who garden, I find it a place to think or dig my way through unresolved emotions and worries. It is a place where I can get my hands dirty and where I can think away from the electronic pests of pager devices, telephones, e-mails, or faxes. Thus far, the garden has served as psychiatrist, muse, and intellectual personal trainer. Francis Bacon wrote 1