Past President's Message
The APA lost one of its great pioneers and leaders this month: Joel Alpert. While many have written memoirs and tributes to Joel for this issue of the Newsletter and elsewhere, I feel compelled to add my own thoughts. I also took this opportunity to read some of Joel's manuscripts and writings.
Joel loved the APA! I encourage everyone to read his lovingly constructed history of the APA, which is posted permanently on the APA website. With every word, the reader feels Joel's pride in the APA and in the role he played in forging the APA to become the robust organization for advocacy, research, education and health care delivery in Academic and General Pediatrics that it has become. He wrote, "My involvement with the APA began at the 1962 meeting in Atlantic City. I presented my first paper at a national meeting at the 1965 APA Meeting, and I was elected to the APA Board in 1966, becoming President in 1969. My APA activity continued through regular attendance at annual meetings, as a participant in a number of APA projects, as an APA spokesman regarding federal funding of primary care residencies and workforce issues, and as a continued presenter, frequent commentator, and debater at the annual scientific and business meeting. The APA has been my most important scholarly affiliation". .
Joel loved to debate and discuss at annual APA meetings. He wrote, "Imagine meetings where corporal punishment, formula boycotts, accepting industry funds, abortion, infant auto restraints, nuclear arms, the environment, daycare and Vietnam were debated. Imagine an organization in which debate was spontaneous, passionate and entertaining, but not bitter." I believe he was wistful about the development of business meetings that started and ended on time "with little fanfare in between". Joel cared deeply about the name of the APA, and resisted over the years several attempts to change it. However, Joel finally came to accept our name change in 2007 from Ambulatory Pediatric Association to Academic Pediatric Association. Joel wrote to Marge Degnon just last year, "You warned me that one day change would happen, and you were wise and right. I resisted and was wrong To me, our organization will always simply be the APA!"
Joel was passionate about health care for children and about the relationship between poverty, health care access and health outcomes. He wrote in a NEJM letter, "Health Insurance coverage for all infants, children and adolescents in this country should be a right, regardless of their economic situation. Such coverage must offer high-quality care that is accessible, continuous, comprehensive, family-centered, coordinated and compassionate. We should expect no less of our children" (NEJM 1999;341:917-921). And in Pediatrics, (2003;112:713-715) he wrote, "It is unconscionable that the United States does not insure all of its citizens. It is even more unconscionable that the United States does not insure all of its children. There are few, if any, more glaring inequities and disparities in our society. A child with health insurance has a healthier childhood and becomes a healthier and more productive adult. This should be sufficient in a rational world to persuade people that financial barriers to health insurance and access to care must be removed, but we do not live in a rational world." He cared deeply about continuity of care. He wrote a commentary in Pediatrics (2004, 1985-1987) entitled, "Mommy, Who is My doctor?" "We want our patients and their families to know the name of their physician, and we want them to benefit from the repeated and regular contacts that make up continuity of care. Far too many of America's children already lack health insurance. Apparently, too many children also go without their "own" doctor."
Robert Vinci was quoted in an obituary for Joel: "When Joel believed in something, he went after it, and there was nothing that was going to stop him." He really believed that pediatricians should be advocates, that our voices should be heard. "I think the lifeblood of the APA should be advocacy", Joel said in his interview for the 50th Anniversary of the APA. In addition to advocating for universal child health insurance, Joel campaigned tirelessly for gun control-and he proudly referred to his position on the National Rifle Association's enemies list. (I checked, and he is still on it. I think I will have to work harder to get on it myself.)
My closing paragraph in tribute to Joel contains some musings on recent activities in firearm injury prevention in children. Since my Presidential speech, I have been asked to present Grand Rounds on the topic of firearm injuries in Philadelphia and Louisville. In each case, I saved a place in my remarks for a recent mass shooting event, and in each case, events occurred within a week of my scheduled lectures. On November 1, 2013, just a few days before my scheduled Philadelphia rounds, a gunman at Los Angeles International Airport murdered a TSA agent and shot two other persons. On December 13, 2013, a gunman murdered a student in a school in Centennial, Colorado; on January 14, 2014 in Roswell, New Mexico, two students were shot in school, one critically injured; and on January 25, 2014, two people were shot to death in a mall in Columbia, Maryland. What is remarkable about these incidents, and other mass shootings that have occurred since Newtown, is that they stirred virtually no official response among legislators and policy makers. It seems that shootings in schools are becoming a part of American culture.
I found a newspaper article in the January 30 edition of the St. Louis Post Dispatch with the headline: "Shooter drill preps teachers, students". The article contains photographs of moulaged students with gunshot wounds running, hiding, and lying on the ground. The exercise is one example of active shooter response training-part of a program for schools established by a new state law. So in Missouri, where I reside, the legislature is debating a law that would make it illegal to enforce any federal gun regulations, but the state has mandated that schools provide shooter response training.
A second article I found was an op-ed by Dana Milbank entitled, Gun Violence: Activists wait for nation to come to its senses. Mr. Milbank described the weekly vigil organized and conducted by a group of Washington, DC women, who meet outside the White House every Monday with signs and conversation to call attention to the gun violence in the United States. They began after the Aurora shooting in July 2012, and have met 77 times on nearly every Monday since. They have vowed to meet weekly until the nation comes to its senses on guns. Are they crazy, quixotically tilting at windmills? Despite the setbacks at the national level and the dearth of meaningful response to shooting after shooting, the women protesters remain optimistic. "We haven't given up hope real gun control will happen in our lifetime."
While it is easy to become discouraged in today's political climate, I like to take energy from examples like those provided by the women conducting the weekly White House vigil, and by our late former president, Joel Alpert, I am pleased to announce that Barbara Stoll and I will be co-chairing a topic symposium at the 2014 PAS entitled "Firearm Injury in Children: Establishing a Research Agenda". We have invited four superb speakers who will address domains in which research is needed, including epidemiology and risk factors, suicide and unintentional firearm deaths, firearms and personal defense, and the role of pediatricians in counseling patients and families about firearm safety. The symposium will occur on Sunday, May 4, 2014 from 8:00 until 10:00 AM. I hope many of you will be able to attend. I believe that Joel Alpert will be there, encouraging us, the proud members of the APA to tackle tough issues and make our children's environment safer "in our lifetime."
Immediate Past President
Academic Pediatric Association
- October 2013
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- December 2012
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- August 2011
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