Abstract
Here at the 30th annual meeting of the Section on Urology of the American Academy of Pediatrics it is instructive to look back at the origin of our species, pediatric urology, and to consider our organizational evolution. The story of pediatric urology offers an instructive case study in the development of the conceptual basis of medical practice. In the grand scheme of epistemology, the study of human knowledge, our field of pediatric urology may seem to be only a small footnote, a recent addition to the phylogeny of medical wisdom. Yet as a field of endeavor and study it occupies the lives and daily work of a growing worldwide cadre of physicians, nurses and scientists, who take responsibility for a range of difficult problems in children. A brief and personal reflection is presented on how we got here, what we are and what we should do next. One curious reality in our expanding universe is the increasing complexity, diversity and arborization of structures, life and human thought. We can explain this by the presence of divinity, idiosyncratic luck or the principles of natural selection. Somehow stardust became synapses. Between the singularity of creation and the chaos of ultimate entropy human reality now exists, for some unfathomable reason, on an island of rationality and ordered progress. The concept Darwin applied to the origin of species can be extended, in some fair measure, to the structures of the cosmos and human knowledge. This idea can be expressed by the old adage that nature abhors a vacuum; where there is time and space, opportunity is created and a niche is filled. Pediatric urology has become a legitimate and distinct entity of the tree of human knowledge, residing in a small niche on the branch of medical specialties (Appendix 1). Just as pediatrics split away from general medicine and urology diverged from general surgery, it was inevitable that a distinct field of intellectual and technical endeavor would form around pediatric genitourinary disorders.
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