3 year old Jimmy was excited when he saw his Daddy’s truck coming up the driveway. The subtle bump as the giant 4×4 ran over Jimmy’s abdomen was almost missed, but Jimmy’s cry was heard by dad in the cab and mom in the house. He was awake and alert, boarded and collared as our trauma team descended. The large tire tread mark over his abdomen was the only obvious injury as we pounced upon him masked and gloved, with hands palpating, scissors tearing and IVs plunging. As I peered down all forehead and nose to his view he looked back with terror. Calmly, quietly I did my best to explain in terms a 3 year old would understand the action unfolding. He was being incredibly brave as I assessed him. As I tried to illicit any other injuries I asked, “Jimmy what hurts?” He looked straight up into my eyes and responded, “Being run over by daddy’s truck.”
We’ve all told our students, residents, colleagues, and kids there are no stupid questions (I’m not so sure we give that consideration to our significant others), but as Jimmy so poignantly noted yes there are! I shouldn’t have been so surprised when a friend, former colleague at a major university EM program and now the chair of said program greeted me at ACEP14 with “Jeff, what are you doing here?” I looked at him thinking “Dude, I’ve been doing pediatric emergency medicine for more than 20 years, you had me co-teach airway , procedural sedation and ACEP simulation courses with you for years, and you’re asking what I’m doing here?!!!” Remembering that I was now a newly elected Pediatric section officer, I paused but couldn’t help myself and said “After more than 20 years in Peds EM, I belong here amongst my brethren!” He murmured “I know that, but are you giving a lecture or doing a workshop?” all while thinking damn why is he so defensive? We moved beyond the awkward moment and then had a great time reacquainting, catching up on our families and friends.
Later at ACEP14 during the Peds section meeting we listened intently as the originators shared the struggles of bringing this section to fruition. Not surprisingly the past 25 years have been filled with negotiation as pediatric emergency medicine emerged from within both Emergency Medicine and Pediatrics. As we shared in the exuberance of 25 years of success, I had to laugh at myself for taking my latest job at a University where we would be reinventing this wheel once more starting a brand new Pediatric Emergency division. I was invigorated hearing these stories and challenges, and was struck by some of the subtle changes that have occurred. In particular while I love that pediatric emergency medicine is better defined, I am thrilled that Emergency Medicine physicians seek out more and more pediatric exposure. I’ve noted over the last 25 years that the focus of pediatric emergency training is now of equal importance within emergency medicine and pediatric programs. I was also struck by how many of the stupid questions persist: Are we EM? Are we Peds? Does any of this positioning really matter?
These thoughts swirled through my head as Deb, my wife of 27 years, and I sipped Szaracs in some of Chicago’s best bars while watching the Giants win the World Series. What is our section? Does it want to be the section where Peds EM docs can nestle away separate but equal to our Emergency Medicine colleagues, or is it a vibrant ACEP section inclusive of all who are committed to improving our knowledge and skills in treating kids? My hope is that our section continues to speak for all emergency physicians who care for kids, regardless of training. All of us in the pit have something to offer and need to be at that table. As my older brother taught me years ago there are house painters and artists in all fields (some house painters are artists). The goal is to surround yourself with the artists. Our section strives to provide the canvas for all of us to channel our inner Monet or Picasso, and our Microsite and Newsletter will provide paintbrushes to those so moved. You already have the paint, it’s in your head so let it flow and contribute! While I do fancy myself an artist, I generally refrain from telling parents that I am channeling my inner Picasso while suturing their kids face…I’m just saying.
Jimmy’s spleen laceration did not require surgery and he was discharged home in a few days. I recount his story often, stressing the importance of age appropriate language when working with children. It is humbling when I’m the one with the stupid question, and I love that Jimmy is there to remind me.