Lee Gutkind - One Childrens Place: Inside a Childrens Hospital

To my partner, Patricia Park, whose intellectual and emotional support has always been vital

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AFTER DEVOTING THE PAST two years to researching and writing this book, I have come to believe that pediatrics (as compared with surgery, internal medicine, etc.) and the special institutions in which it is practicedchildrens hospitalshave not been accorded the attention and respect they deserve. This is not surprising, considering the fact that children in the United States are not accorded the attention and respect they deserve either. Children are our countrys most crucial natural resource, yet one in five currently lives below the poverty line. To think that we can send satellites to distant planets or pay athletes millions of dollars a year to swat a baseball, shoot hoops, or endorse shaving products, while we fail to feed and educate properly the generation that will succeed us, is an inexcusable and unjustified irony.

Although they treat only about 10 percent of the sick children in the United States, most frequently those whose lives are in jeopardy, childrens hospitalsplaces designed specifically to respond to the physical and emotional needs of kidsbegin to correct that imbalance. And Childrens Hospital of Pittsburgh (official address, One Childrens Place) is especially distinctive because of its responsiveness to the community it serves.

After being accorded complete access to the inner workings of the institution and all of the 2,000 employees that help it function, I have been extraordinarily impressed with the compassion for all children, including the most helpless and disenfranchised, demonstrated by nurses, pediatricians, surgeons; administrators, social workers, therapists, and other staff members from all levels of the hospital.

But of all the people I have come to know during my time behind the scenes at One Childrens Place, it is the familiesthe mothers and fathers who dedicate themselves unwaveringly to the well-being of their childrenwho are most memorable. Never have I witnessed such heroism in the face of such heartbreak, such loyalty in the face of such despair. All parents are not good parents or even good people, I have discovered, but mothers and fathers like Debbie and Danny Burdette have demonstrated the deepest meaning of the concept of nobility.

MARC ROWE, CHIEF OF Surgical Services at Childrens Hospital of Pittsburgh, returned home from Boston, where he had been helping to conduct the surgical certification boards for the American Board of Surgery, at about 9:00 P.M. He sprawled on the sofa in his family room and watched two movies on television, periodically participating in a sporadic conversation with his wife. Although he was not on call that evening, he fully expected to be summoned back to the hospital, so he was on edge, unable to halt the galloping adrenalinethat sense of crisis and immediacy that had been with him throughout his surgical life. But as the hours passed, he began to doze, although it was always difficult to sleep soundly when he suspected, from years of experience, that the telephone would ring, that the voice on the other end would tell him about one of his patients who had taken a bad turn, or a Level I traumaa critically injured childwho needed help. But tonight he was spared the interruption, and he slept for a few hours before waking, dressing quickly, and driving to the hospital through the foggy dawn.

The mens locker room at Childrens Hospital is a shadowed and cramped space with lines of hard wooden benches squeezed between rows of metal lockers. There is a small lounge at the far end of the locker room, off a corridor that leads to the operating suite, and as he undressed, Rowe heard voices coming from that lounge, voices he recognized but did not particularly want to hear at that moment. He pulled on sweat pants, a sweatshirt, and a fairly new pair of running shoes and left the locker room quickly, taking the elevator from 7 down to G, padding softly past the information desk, and breaking out onto Fifth Avenue in a plodding jog.

Watch, watch, watch your back! yells a nurse, as a young resident, masked and in surgical scrubs, arms folded at his chest, backs into a tray of instruments spread out carefully on a blue towel.

Though he has only barely touched the tray with his sleeve, the resident, whose name is Joseph Collela, understands that he has contaminated all the instruments on it and that the entire setup must now be replaced. He rolls his eyes, mumbles an embarrassed apology, and takes a couple of steps sideways, trying to find a safe standing spot here in Operating Room 7 on the sixth level at Childrens Hospital. He is waiting to assist the attending surgeon, Dr. Rowe, who has yet to arrive in the OR that early morning.