Giving Thanks

I’m an incredibly fortunate guy. I have an amazing family, a fulfilling and healthy life, and a rewarding career as both a physician and a leader.  I have much to give thanks for this holiday weekend, but today I give thanks to American healthcare system in which I’ve practiced medicine for nearly a decade.

American medicine takes a lot of knocks, some of which I’ve personally dished out. It’s too expensive, too disconnected, and too far behind much of the world on outcomes that really matter to people’s lives.

But that’s for another post.

We too often focus on what makes American healthcare something that needs fixing and forget about all that makes the United States a beacon that lights world of medicine as brightly as it lights the world at large. Perhaps more powerfully than anywhere else on earth, in America liberty begets freedom – freedom of thought, freedom of action, and freedom to imagine a world beyond that which now exists.

With that in mind, I give thanks to the innovative spirit that permeates the practice of doctors and scientists across this country.  Doctors like Robert Guthrie who in New York in the 1950s pioneered the concept of universal newborn screening by validating the first scalable PKU test.

Sixty years and many revisions later, I was fortunate to use North Carolina’s universal newborn screening as an intern to diagnose an infant with a condition 4x rarer than PKU. It’s a condition that’s totally asymptomatic until a mild viral infection triggers a cascade including low blood sugar, vomiting, and seizures that untreated could lead to death.  Instead, having caught the condition on a newborn screen we could educate the infant’s parents well before their daughter ever got sick on what to do to prevent harm.  She now has a chance to live a totally normal life.

In 1963 Jackie Kennedy gave birth to a premature son named Patrick Bouvier Kennedy.  He died on his second day of life from hyaline membrane disease, a condition that at the time that had no known cause and no known cure.  He was only five weeks early and weighed almost five pounds.

Five decades and countless advances in care for preemies later funded by both public (e.g., the National Institute of Child Health and Human Development) and private entities (e.g., March of Dimes), and today Patrick Bouvier Kennedy would have a nearly 100% chance of surviving.  Not only would he likely survive but he would tower over the other infants in the neonatal intensive care unit like a giant among men.

As a neonatologist, I’ve cared for infants born three times earlier and six times smaller than him and they’ve made it home. The youngest infant I’ve been part of the team to help save was born four months early. The smallest weighed less than a can of soda. Both are now rambunctious toddlers.

America doesn’t own a monopoly on innovation in medicine, but where else in the world do more doctors dream things that never were and ask why not?

So for just a moment let’s set aside the problems with healthcare in the United States – the burnout, the bills, and the inevitable bickering that comes with any changing in the political guard.  Let’s remember why the glow from our fire of liberty, freedom, and innovation lights the world in ways even Kennedy couldn’t imagine just two generations ago. And let us thank those who spend long nights and early mornings both making miracles happen today and asking themselves what unimagined miracles we can create tomorrow.

In the immortal words of Arthur O’Shaugnessy (or of Willy Wonka if you’re so inclined):

We are the music makers,

And we are the dreamers of dreams,

Wandering by lone sea-breakers,

And sitting by desolate streams;—

World-losers and world-forsakers,

On whom the pale moon gleams:

Yet we are the movers and shakers

Of the world for ever, it seems.

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