One of my goals as a physician and particularly as a pediatrician is to touch young lives and make them better. Health is not just about check ups and sports physicals and vaccines (although all of those are important components of healthy living). Health is about embodying a spirit of wellness and adopting a lifestyle that nurtures that spirit. This is part of what drew me to medicine – the opportunity to look into the face of our youth and encourage their spirit; to see the potential rising in children and partner with families and communities to protect that potential and mold young lives around healthy concepts of living and growing. For me, this goal is personal and professional.

This past week, I completed a project where I hung old photos of my family and dearest friends around the head of my bed. I did it so that when I dream, when I think of all the possibilities of what life holds for me, I am surrounded by the faces of people who love me and support me and whose encouragement lifts me up.

I think James Baldwin said it best when he said, “Your crown has been bought and paid for. All you have to do is put it on your head.”

What an important and wonderful concept to internalize. The idea that -

You are valuable and you cannot escape that value because it is already yours by virtue of the work and sacrifices of the people who have gone before you – be they family, community, or historical ancestors.

This principle reminds of why those faces now hang above my bed; they create a space where I am free to acknowledge my personal worth and the people whose love, time, support, and prayer softens the ground below my daily steps.

As a professional who works in the art of healing, this lesson from my personal life also finds meaning in my professional life.

As a pediatrician, I know there are vulnerable periods in a child’s life when physical, emotional, financial, and social stress can impair mental and physical development. Some refer to that stress as “toxic stress,” because when chronically exposed to it, the physiology of children’s bodies and brains are changed – down to their very genes – in a way that places them at risk for a number of poor health outcomes over the course of their lifetime AND passes that risk on to their progeny (Have you ever wondered why poverty can be generational?). If I know that stress retards growth and development and keeps children from realizing the potential of a full and healthy life, what is my role as a pediatrician in providing children and communities with the tools to build resilience – a psycho-physiologic shield against the adverse effects of stress, or, a potential protector.

Others, have also pondered this and it is becoming more professionally accepted that physicians and pediatricians must be the faces in the community that encourage the spirit of children to protect their value and potential. So how can pediatrics as a field and I, as a professional, systematically create spaces that recognize and utilize the value of every child; such that children are free to know their potential and build healthy relationships and lifestyles in partnership with the community around them? And how do we as a field, begin to understand how issues of poverty separate children and adolescents from knowing and working towards their value, a value that has been paid for generation after generation?

The short answer is, I don’t know. But I have joined a group of bold pediatricians from across the nation charged to address issues of poverty and toxic stress through medical practice. While part of our work will challenge traditional concepts of the role of physicians in community and increase public awareness of the adverse health effects of poverty, I also hope the outcome of our work directly helps children internalize their value and rise to their potential. Because the longer answer recognizes that poverty does not just create physical barriers to health, but also complicates the path by which children come to know and live out their value in the world. Thus as doctors, as champions of health, we must also be purveyors of justice and defenders of the value and potential in the most vulnerable among us.

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Comment by Laura Gottlieb on September 21, 2013 at 2:03pm

Inspiring post, Rhea. Thanks so much for sharing with the HB community. Is the group of "bold pediatricians" something we could help develop in other specialties? 

Comment by Rhea Boyd on September 13, 2013 at 8:10am

Thank you Linda! Yes, Fredrick Douglass was right about a lot of things and doing right by children does right by all of us.

Comment by Linda Sharp on September 12, 2013 at 11:50pm

Thank you for sharing your perspective and the articles from Pediatrics on the relationship between stress and health.  Important work for upstreamists to know about!  I like this quote: "It is easier to build strong children than fix broken men" - Frederick Douglass

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