I’m on the clinical service this week. Please excuse the brevity of this letter while I simultaneously prepare for our fantastic IDWeek schedule and share these three observations on pediatric ID:
- The complexity of care in pediatric ID continues to increase. I long for the halcyon days of an uncomplicated acute hematogenous osteomyelitis. Instead, we are frequently consulted for children with a deletion on the tip of a chromosome who has recurrent pneumonias and now has an ESBL producing Enterobacterales. My head hurts.
- The interest in pediatric ID remains. I have three students on service right now. One has committed to pediatrics, one to emergency medicine, and one is just learning where the restrooms are. They want to learn. They recognize the value of pediatric ID whether they want to pursue ID as a career or not. I’ve loved teaching them.
- The medical system creates challenges that we should help remedy. I am constantly torn between the ‘right’ thing and the ‘cost-effective’ thing; between the ‘probable’ and the ‘possible’; between the ‘guidelines’ and the ‘patient in front of me.’ I have no clear answers, but I am confident that the knowing more of the pathogenesis, epidemiology, and natural history of childhood infections will make me a better provider.
Our days are often fragmented between clinical care, education, research, and administration. We are often frustrated by the systems we work in. We are compensated less than some of our colleagues.
But, let’s be honest – we get to care for children. There is no greater privilege. We have one of the best jobs in the world.