Why am I a pediatrician?

I would say it's because I told my fourth grade teacher that I wanted to be a pediatrician and I'm too hard headed to admit that I'm wrong, but that might be over-simplified.

That would also discredit the fact that I told my mom one time that I could never be a pediatrician because I couldn't deal with babies screaming all the time.

In reality, my goals and reasons practicing medicine and pediatrics have changed over time and I'd like to walk you along that journey to give you an idea of why I became a pediatrician.

Junior high and high school

I’m blessed. Understanding large amounts of complex information comes easy to me and I enjoy learning so much. People with this ability often become either doctors or lawyers. Prosecutors aren’t paid what they are worth and I’m not sure I could defend people for murder that I know are guilty (I read too many John Grisham books).  So I guess being a doctor makes sense.  I followed a radiologist for a day so I figured, why not radiology? They used to be listed as big wage earners and low stress (not even sure if that's true anymore - haven't had a reason to look in a while). I didn't think about it at the time, but when I followed the radiologist we spent 90 percent of the day locked away in a dark room staring at some pictures (on an old fashioned light board - this was 15 years ago). That’s a special skillset and they are tremendously important in diagnosing patients. But I need a little more human interaction.

College

I had a great opportunity to work as an intern in the Children's Ministry at the church I attended. I would love to say that I applied to the job because I liked kids a whole lot, but it actually had a little more to do with the fact that it paid $1,000/month and really only required me to work two days a week. I had to be available to build sets and brainstorm and do whatever else my boss might randomly ask during the week but the calls were pretty infrequent. What happened during that time is that I grew to really love kids. I developed skills interacting with them that I would've otherwise never had. I walked them through family issues and other problems, learning along the way that I really did want to work with kids. I was still pre-med and convinced that medicine was right for me, so it seemed pretty natural that pediatrics was the way to go.

Medical school

I loved just about every rotation I did in medical school. I liked obstetrics (OB), especially delivering babies, but couldn't really imagine myself doing pelvic exams all day every day. I liked surgery, but wasn't really all that great at it. I loved psychiatry and would have strongly considered it but tucked away at the back end of my third year was my pediatrics rotation. I had saved it till the end of all the primary rotations so I could experience everything else with an open mind (and have something to look forward to).  

For the first time in pediatrics, I was able to sit alongside a sick child and scared family and see what it takes to interact with them in a way that shows you are capable, but sad that they are experiencing what they are going through. (most of that was by observation because you really don't know much as a third-year medical student, but still.) So, at this point my mind was set.

Residency

I was sure when I entered residency that I needed something a little more "exciting" than general pediatrics, but I also wanted to do something where I had a close relationship with my patients. I was convinced that pediatric oncology was the right fit for me. I was prepped to start extra training when I completed residency and excited about some research I was involved in about leukemia and Down syndrome. If you like the graph above (and really, who wouldn’t?), you can read more about it here  (but would most of you want to? And, that’s why we have doctors).

 And then …

Plans change and I was recruited to join the practice of my old pediatrician in Abilene, Texas. Of course, I was never going to do that but if any of you know my old partners, you know that they can be particularly persuasive.  I was able to see just how interesting general pediatrics could be and learned the joy of walking through those steps with parents as they learn how to be, well, parents.

I love walking into a room where mom has a list of questions (no, really).  What that means is I am going to provide relevant answers and suggestions important to that family right then and not just drone on about what I think is important. I can talk for about 10 minutes straight at each check-up with my own advice, but who cares?  There are a few things that I make to cover, but those things are insignificant compared to my parents' concerns at that time.

Now

Now, I have three children all 5 and under, so I’m going through my own parenting journey. I know the fears associated with a hard fall and a large, rapidly expanding goose egg. I know the joys of celebrating that first poop in the potty.  I also know how confusing all the different advice you can get out there can be. There are so many messages out there.  You receive wanted (and un-wanted) advice from the Internet, news, books, friends and family (am I leaving anyone out?). Often the advice is directly contradictory.  

So, where do you go? I hope you would turn to me. Why? Because that's my reason for dedicating my practice  to pediatrics. That’s the reason I spend time writing and interacting with people online.

I want to help you go through your own journey and make the best decisions for your family.

I want to provide solid, evidence-based advice.

When there are multiple right answers (as there often are), I want help you gather your information and let you decide.

About the author

Justin Smith, M.D., is a Cook Children's pediatrician in Lewisville . He attended University of Texas, Southwestern Medical School and did his pediatric training at Baylor College of Medicine. He joins Cook Children's after practicing in his hometown of Abilene for four years. He has a particular interest in development, behavior and care for children struggling with obesity. In his spare time, he enjoys playing with his 3 young children, exercising, reading and writing about parenting and pediatric health issues.