Lawrence R. Ricci M.D. - What Happened in the Woodshed

by Stephen Ludwig, MD

This book unveils the harsh reality of hidden abuses that children encounter and also takes us along on the mission of a new breed of amazing men and women who have dedicated their careers to detecting and protecting these most vulnerable members of our society.

As a third year medical student in 1969, I walked into a Grand Rounds Conference at St. Christophers Hospital for Children being given by a pediatrician named Dr. Ray Helfer. That talk would change my life. It was a presentation about child abuse, which was, at the time, not widely recognized by either medicine or the wider public. I was captivated. I wanted to know more, but information on the topic was scarce.

Years later, I was a pediatric resident at the Childrens Hospital National Medical Center in Washington, DC. There, child abuse became reality to me in the emergency room, clinic, and inpatient service. It was no longer theoretical. It was real, sometimes even a life and death issue. Working with fellow residents, social workers, nurses, and faculty, we started a child abuse team in 1971 to better care for the scores of abused and neglected children we saw each year. Later, at the Childrens Hospital of Philadelphia, I continued my care of abused children, on an intense quest to learn more about the how and why of this abuse and neglect, and what could help protect these children.

As time passed, I learned a great deal about abuse. I worked with almost every specialty and subspecialty group of physicians, nurses, social workers, community workers, child protective service workers, police, lawyers, judges, and parents. What was once the mystery of child abuse became clearer, although no less sad. I helped train some younger colleagues who have now become career specialists in the care of abused and neglected children, some of whom have gone on to especially distinguished careers and are contributors to this book. During those years, throughout the United States and the world, like-minded professional also took up the mission. As their numbers increased, we formed the Helfer Society, named after that man who was my first teacher on the problem of child abuse and also my inspiration to take action against it. We ultimately, in 2009, created a distinct pediatric subspecialtychild abuse pediatrics.

This books editor, Larry Ricci, MD, was at the forefront of that movement. He too had seen the results of abuse and was determined to make a difference. This volume is just one manifestation of his career devoted to children and families.

What Happened in the Woodshed tells the stories of children who have been abused, and the stories of their families. Their usually secret lives shared here show the range of the effects of abuse, from the physical and sexual to neglect, or Munchausen, and to the fatal. The second vital narrative in this text is that of the professional response, the stories of those men and women on a mission, and the scientific work that has been done to advance our understanding of abuse and neglect, hopefully leading closer to prevention and amelioration of pain, disability, and death.

Still, even today, there remain some abuse nay-sayers. These are people who do not believe that abuse occurs, or who think that there are other explanations for the scientifically proven evidence of abuse. They are often legal experts who do not have medical or research expertise. The child abuse professionals and their work chronicled in this text are not here to judge these individuals. That judgment will come in time.

First and last, this book is the story of its editor, Dr. Ricci, who is a combination of great passion and compassion. His honesty and commitment fill every page. I thank Dr. Ricci for such a wonderful contribution. This volume is a tribute to his work.

Yes, things do happen in the woodshed, the home, the apartment, and elsewhere. This book is a must read for all medical students, physicians, nurses, health care, and law enforcement professionals. And it is a must read for informed citizens, neighbors, and relatives.

Stephen Ludwig, MD
Professor of Pediatrics
Perelman School of Medicine
University of Pennsylvania
Philadelphia, PA
2017