Duke University School of Medicine - Aesculapian Yearbook (Durham, NC)

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PEDIATRICS Pediatrics has been dehned as the study of the growth and development of the child from the moment of con- ception through adolescence, and the science and art of the prevention, diagnosis, and treatment of all diseases from the moment of birth through adolescence, whether these disturbances be on a physical, emotional, or mental basis. It is a profound concern with, and an abiding in- terest in everything that goes to make the final product -the healthy adult ready to assume his position in lifef' This definition indicates the broadened horizons of this specialty which, when it was founded about the turn of the century, was designed primarily to help children through the hazards of acute diseases such as dysentery which claimed so many young lives. Mere survival through infancy and childhood at that time was, in itself, a sufficient achievement. However, as these acute prob- lems were met and solved fat least in the developed countriesj the scope of pediatrics has expanded. New and fascinating areas of study have been explored and applied to our central focus,-the growing child. These trends have added to 'Lgeneral pediatrics, a number of pediatric subspecialties such as cardiology, hematology, endocrinology, allergy, infectious disease, and a host of others. Many of these are already represented within our own Department of Pediatrics and more of them will be added in the years to come with the natural growth and expansion of the Department. In addition, these broad- ening goals of Pediatrics have encouraged pediatricians into interdisciplinary cooperation with a number of other helds of human endeavor. Thus pediatrics, already in- volved in biochemistry and preventive medicine for ex- ample, must join forces with genetics, for this governs the directions and potentialities of development, with DR. H.ARRIS obstetrics, in a cooperative endeavor to understand the effect of prenatal events on the nature and later course of the infant, and with psychiatry, better to understand the psychological development of the child. The need to develop areas within pediatrics and with other dis- ciplines in order to achieve pediatric goals has led this past year to a new joint endeavor between the Depart- ments of Pediatrics and Psychiatry in a training program to enable pediatricians and medical students to function more effectively in recognizing, planning for, and deal- ing with the emotional aspects of childhood growth and development, the emotional impact of childhood illness on the family, and the emotional crises of children which have psychopathological significance. To this end, a team of pediatric psychiatrists Qqualified both in pedi- atrics and psychiatryj, a psychologist interested in mental and emotional development, and a social worker sim- fC0nzinued on page 1342 DR. SIDBURY DR. DEES DR. STEIXIPFEL twenty-four

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DR. PICKRELL DR. GLExN DR. Onoxt emergency, and his powers of diagnosis and of decision may be blunted. These facts of life distinguish a surgeon from his medical colleagues. Indeed, in some localities, the lament is how to get the surgeon into the laboratory and how to get the internist back with the patient! The surgeon must keep one foot in the laboratory, for he alone can apply the discoveries in the biologic sciences in practical form to a surgical problem which the basic scientist has difhculty in understanding. It is this ability of the surgeon to seize upon the advances in the natural sciences and take them into his own labora- tory to test and apply to his own problems that has re- sulted in the phenomenal advances in surgery in recent years. Students must accept these facts. Learning to become a surgeon takes time. It requires thorough knowledge of the basic sciences, and understanding of the natural history of disease processes, and an ability to apply all of the newer knowledge in the natural sciences to surgical problems. It also requires knowledge of opera- tive procedures and manual dexterity and technical skill. The latter, though important, is subordinate to the former, and is learned during the period of postgraduate training. The former takes the longest to learn, indeed, its learning is a lifetime process. CLARENCE E. GARDNER, IR. Chairman of thc' Department DR, GREGG DR. STEPIIEN DR. AxnERsox tufenzy-zf11'fc'

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OBST TRICS GTNECOLOGT The opporttinity to think and to recall the experiences in the basic sciences and in the introductory physical diag- nosis gives the student scholar the opportunity in the disa eases of women for application and broadening the con- cepts for diagnosis and care based on the ability to continue to think and to apply the remembered knowledge. The problems of the female as a growing individual, who must develop and mature properly, who has to experi- ence adulthood, childbearing and the inevitable aging processes, are legion. ln each epoch of growth there are specific problems related to anatomy, physiology, bio- chemistry, hormonal chemistry, genetics, bacteriology. The growing and mature female may be subjected to all the various diseases which may be found in any popu- lation. In addition she is forced to face the problems which are related exclusively to her sex. The patient is an individual and is entitled to all specialized care which proper thinking by the physician deems best for her. Her work-up is not exclusively as an endocrine problem, a neoplastic problem, a childbearing problem, a psychiatric problem or a geriatric problem. She must be managed as an individual who is entitled to ordered and disciplined thinking by her medical attendant. The efforts to encourage orderly and disciplined think- ing find their expression in the care of the patients by an orderly, scholarly, scientific and thinking indi- vidual. Continuation education means the continued thinking by the student scholar of his defects in the pic- ture of the patient as a whole and not alone as a problem in a disease category or designation. Ability to see patients, to listen to them, to examine Q t t. ts is X DR. C.aR'rE.R them will recall the great fund of knowledge which lies in back of the present day mental attitudes toward any form of disease process. The student who brings to the fields of Obstetrics, Gynecology, and Gynecologic Endocrinology an in- ability to think and reason, will miss a great opportunity. The student who can think and reason, who has a sound concept of basic principles of human growth and de- velopment, can under supervision and enlightened criti- cism, gain much to prepare for continuation education which is simply the ability to think and reason and to know sources from which some help for the thinking and reasoning processes may be obtained. Withciut thinking and reasoning, experience is shackled: with thinking, reasoning, and supervision, experience is valuable, rational and rewarding. This is the type of experience we would hope for in the short time which may be used by the department in presenting the prob- lems of the diseases of women for due consideration and thought' F. l5.xY.ut1i fl.-XRTER, M.D. Chtl1il'7lIL1I7 of the Department DR. CHERNY DR. PARKER DR. PEETE twenty-fue