Since I decided to retire as of July 1, I have thought about how things have changed in pediatrics over the past half-century. Fifty years ago I became a board-certified pediatrician and after two years of caring for children of Army people as a captain/pediatrician I opened my first office in the Lindenwood part of Howard Beach.
So how are things different? An office visit was $6 and a house call was $10 (there was no insurance, and there were house calls). I remember on one house call to a sick child in Brooklyn, the neighbor was in labor and waiting for her husband — but the baby couldn’t wait, so I delivered the baby. Fortunately, the experience of delivering about 50 babies under a professor’s supervision at Metropolitan Hospital four years before had stayed with me.
The mom was so appreciative she named the baby after me. So there is a 48-year-old man out there named Allan. I’m not sure how he looks but as a baby he was cute.
There were no beepers or cell phones or even touch-tone phones (remember rotary dialing?). I did have a copy machine; it was one of the earliest ones and made a wet copy, which could make things messy. Of course there were no fax machines or computers. How did we survive?
There were no office CBC blood count machines or rapid strep tests or office screening tests for lead poisoning, middle ear fluid, hearing loss or lung function as we have now.
A brief word about vaccines. I had a newborn girl patient born without hearing because her mother had rubella (German measles) in early pregnancy. This was two years before the rubella vaccine became available in 1969. Several times a year I saw children suffering from high fever and croupy cough, who had difficulty breathing and were turning blue. They were given oxygen and a high-speed ride down Linden Boulevard to Brookdale Hospital. Since the HIB vaccine became available in 1985, that condition, acute epiglottises, is rarely seen.
When I was in the Army I saw an 8-year-old girl with high fever, rash and red eyes. It was measles, and followed a typical course until the fourth day, when she became worse and now had measles encephalitis. After a long stay in the hospital and a month in rehab she was back to normal — she was lucky. This was six months before the measles vaccine became available in 1965. The moral of the story: Vaccines, when available and used, make a significant impact on our quality of life.
Do we have more of any particular conditions? Yes, asthma and autism. Thirty to 50 years ago I saw four or five children with asthma per year, and now I often see four or five per day. Is pollution in the air causing more asthma? Are chemicals in our food causing more autism? We don’t know. There are no definite answers, even though more money and effort are being spent on research than ever before. I hope we will soon know the causes and then medical teams will develop both preventions and cures.
So pediatrics has changed, but have parents or children changed? I think not. Parents still look for two attributes in a doctor: knowledge and compassion. Some children are cuter and some are smarter, but somehow over the past 50 years all my patients were always the smartest and the cutest.
Thank you for trusting me with your most precious possessions, and allowing me to say my work for the last 50 years has been child’s play.
Dr. Allan Rothenberg practices medicine at Queens Pediatric Care, located at 158-49 84 St. in Howard Beach.