I have been at the Pediatric Academic Societies' meetings in
Vancouver the last few days, where thousands of pediatricians from
around the world are presenting research and learning and talking
about all sorts of issues in how we provide the very best medical
care for children. (Vancouver is, by the way, a really great
Sitting in the PAS meeting's opening session in that great city,
I couldn't help but remember one of my recent patients in Kenya.
David was a 3-year-old who had had fevers and diarrhea for too many
days. When I went to see him on the pediatric ward of the hospital,
he was sick and pale and dehydrated. He was struggling to remain
conscious because of how sick he was.
His mother sat in the hospital bed with him, a hand resting
gently on his shoulder, her bright red and yellow fabric leso still
wrapped partly around him and partly around her own shoulders. I
think she was keeping him conscious with the physical connection
between the two of them.
Heaven knows we were not able to do too much else to keep him
conscious. Our intravenous fluids and antibiotics and the one
remaining oxygen connection on the ward were all too little, too
With big sad eyes, David's mother watched him die. My eyes
were sad, too, when the resident came to find me to tell me that
the little boy had died. I wanted to DO SOMETHING, but there was
not more that we could do at this time and in this place, for this
I thought of David because he was the name I put on the
statistics I was hearing from the podium when Dr. Chris Elias,
Director of Global Development for the Gates Foundation, talked
about the current state of under-5 mortality. When Dr. Elias
recites our grim global statistic - that 6.6 million children under
the age of 5 will die this year - that statistic has a face for me.
This time, it was David's face.
My statistics have a face. My statistics have
mothers. My statistics still make me cry with the waste
and shame and injustice of a child dying before his 5th birthday.
(This is how a person who really doesn't like math remains
motivated in a career with lots and lots of numbers.)
I also thought about David when Dr. Lewis First outlined
his principles for how we could revolutionize the field of
Pediatrics by becoming not just excellent pediatricians, but
"leadiatricians." Dr. First is a legendarily funny, engaging, and
excellent pediatrician who may single-handedly have improved the
health of children in Vermont and inspired countless new
pediatricians. Dr. First urged everyone to embrace this motto:
"Change something for the better each and every day in what
we do for children!"
And, really, that's why I am a pediatrician doing global health
research. I want to make things better for children like David. I
want to do something that will make it better for the world's
children each and every day.
We know why so many children like David die. Complications at
birth, pneumonia, and diarrhea (like my little boy) are what kill
most of them. Not having enough food plays a huge part in this.
Malnutrition contributes to at least ½ of these deaths.
We know how to prevent these conditions. We know how to
David could have been saved if his family had a better way to
get clean water. He could have been saved with earlier antibiotics
and fluids. We could stop these 6 million kids from dying by
getting them simple things like oral rehydration therapy,
antibiotics, and vaccines. If we could get them enough food or if
we could get their mothers skilled care during pregnancy and
childbirth, we could do even better.
Change something for the better each and every day in
what we do for children. We can, each and every one of us, do