Kappy Advances in Pediatrics 2013

1. Auflage 2014
ISBN: 978-1-4557-7295-7
Verlag: Elsevier HealthScience EN
Format: EPUB
Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

E-Book, Englisch, Band Volume 2013, 100 Seiten

Reihe: Advances

Each year, Advances in Pediatrics brings you the best current thinking from the preeminent practitioners in your field. A distinguished editorial board identifies current areas of major progress and controversy and invites specialists to contribute original articles on these topics. These insightful overviews bring concepts to a clinical level and explore their everyday impact on patient care. Among the topics included in this year's edition are Immunizations, Vitamin D Deficiency, Treatment of Allergic Disease, Interventional Pediatric Cardiology, Sudden Cardiac Death in Young Athletes, and Necrotizing Enterocolitis, to name a few. Each edition has a tradition of honoring those who contributed greatly to pediatrics in the 'Foundations of Pediatrics' segment; this edition features Helen Brook Taussig, MD, leader and innovator in pediatric cardiology, as the annual honoree.

Autoren/Hrsg.

Kappy, Michael S.

Leseproben

Helen Brooke Taussig
Pediatric Cardiology Leader and Innovator
Kathryn Neubauer, MD and Anne M. Murphy, MD*,     Pediatric Cardiology, Johns Hopkins University, Ross Building 1144, 720 Rutland Avenue, Baltimore, MD 21205, USA. E-mail address: [e-mail] *Corresponding author. Keywords Helen Taussig Pediatric cardiology Cyanotic heart defects Johns Hopkins Key points
• Dr Helen Taussig was a pioneer as a woman in academic medicine and as a leader in pediatric cardiology. She was the second woman promoted to Professor at The Johns Hopkins University School of Medicine, although her promotion and recognition occurred much later than her achievements warranted. • The development of treatment of congenital heart defects was hastened by her careful observations as a clinician and her collaboration with Dr Alfred Blalock and other specialists. • Dr Taussig received recognition not only for her pioneering work but also for her advocacy, which led to the Food and Drug Administration not permitting use of thalidomide in the United States and her leadership and election to president of the American Heart Association. She received the Presidential Medal of Freedom in 1964. Early life and education
Helen Brooke Taussig was born on May 24th, 1898 in Cambridge, Massachusetts. Her parents were Frank William Taussig and Edith Guild Taussig (Fig. 1). Helen’s father was a well-known professor at Harvard who authored many economics textbooks and served as head of the United States Tariff Commission from 1917 to 1919. Her mother studied biology and botany at Radcliffe College and had a love of knowledge that she passed on to her daughter. Her paternal grandfather studied chemistry in Prague before immigrating to the United States and served as a physician during the Civil War. The family engrained strong values in their children; in particular, scholarship and learning were valued above material wealth. The family partook in picnics in the country on weekends, and spent summers enjoying the outdoors of their Cape Cod home. When Helen was 11 her mother died from tuberculosis, but she received ongoing strong support and affection from her father who encouraged her education [1–4].
Fig. 1 Photograph of Helen Taussig, MD, in 1940. (Courtesy of the Alan Mason Chesney Medical Archives of the Johns Hopkins Medical Institutions, Baltimore, MD, with permission.) Helen was highly curious as a child and young adult, focusing on many subjects with a lifelong favorite being botany. Although she had an immense love of learning, she struggled with dyslexia, and as a result had difficulty with reading comprehension throughout school [1]. In grade school, teachers would make the students stand and read aloud until they made a mistake, and Helen was embarrassed and frustrated that she made mistakes easily. She worked through her homework and reading with the help of her father who was positive and supportive. Her reading improved but continued to be a struggle [1]. Even into adulthood and her academic life as a pediatric cardiologist, writing remained a challenge, but she persisted, and published more than 100 articles, recognizing that publishing research was necessary to advance medicine and science [4]. Helen spent 2 years at Radcliffe College, her mother’s alma mater. At Radcliffe, she was a strong student and played tennis and basketball. After a trip to California with her father, she transferred to the University of California at Berkeley for her remaining 2 years, graduating in 1921. She flourished in this environment. She continued to do well academically, was a senior advisor to the freshman students, and enjoyed hiking and exploring the outdoors on weekends with her friends. After college, Helen returned to Cambridge. She set up an appointment with the Dean of the Harvard School of Public Health to discuss her career. During this appointment, she was told Harvard would allow women to attend medical classes but would not admit them as degree candidates. She questioned the logic of taking classes without credit and was told the point was that no woman would attend! At this point, Helen told the Dean she would not “disappoint” him by attending [1]. After this encounter, she thought more seriously about becoming a physician, an idea she had considered during college; however, she lacked the prerequisites. She attended a histology class at Harvard where she had to sit in the back of the classroom during lectures and do her laboratory work in a small room without the other students so as not to “contaminate the male students” [1]. Her professor, Dr John Lewis Bremer, recognized her intelligence and spoke to her frankly about not wasting her time at Harvard but going to Boston University where women were welcome to take premedical courses and earn credit for them. Helen Taussig followed this advice directly [1]. While at Boston University she took an anatomy course and once again was noticed for intelligence and perseverance, this time by Dr Alexander Begg, who involved her in research about mammalian cardiac muscle [1]. After much hard work in the laboratory, she was able to demonstrate the intrinsic contractile activity of mammalian cardiac muscle. Scientists had shown reptilian cardiac muscle beat intrinsically, but this had not been previously demonstrated in mammalian cardiac muscle. The paper was published in the American Journal of Physiology, which was a remarkable achievement for such a young student. After she completed her premedical requirements Dr Begg encouraged her to apply to The Johns Hopkins University School of Medicine, which was founded in part because of the philanthropy of a group of women led by Mary Elizabeth Garrett and M. Carey Thomas, under the condition that men and women would be admitted on an equal basis [1]. She was accepted into the class of 1927. Although she studied extremely hard, when it came time to apply for a medical internship, there was only one slot for a woman per year and another woman achieved a slightly higher score. While awaiting the results of her application for internship, she worked in the adult heart clinic at Johns Hopkins run by one of her early mentors at Hopkins, Dr Edward Perkins Carter. After being turned down for the internship position, Dr Carter invited her to finish out the year in the heart clinic [5]. The next year, 1928, Dr Edwards Park, the new chief of pediatrics at Johns Hopkins recognized her talent and offered her a position as a pediatric resident. Early career at Johns Hopkins
At the time Dr Taussig began her residency at Johns Hopkins, Dr Park was making changes in the hospital and clinics. He realized that children with chronic illness were well cared for in the hospital, but their long-term follow-up care was not adequate [2]. Dr Park organized clinics focusing on specific areas, including a cardiology clinic [2]. Dr Park appointed Dr Clifton Briggs Leech to be the first director of the children’s heart station at Johns Hopkins. Dr Leech graduated from Boston University Medical School in 1919. He went on to study a new device, the electrocardiographic apparatus, with Dr Paul Dudley White [6], and he was recruited to Johns Hopkins to start a pediatric heart clinic. While at Johns Hopkins, Dr Leech made many contributions to the heart station and pediatric cardiology including extensive research on endocarditis and congenital heart block. Dr Leech was to leave in a year or two, and Dr Park started approaching Dr Taussig to ask her to be Dr Leech’s successor. At the time, she was doing some additional work in Boston and New York. Initially through letters she said although honored, she did not believe she had the experience or breadth of knowledge to accept the position, but in 1930, Dr Taussig accepted Dr Park’s offer and became the head of the new pediatric cardiology clinic at the Johns Hopkins Hospital [6]. Dr Park gave the clinic radiographic equipment; an electrocardiogram machine; and a new piece of equipment, the fluoroscope. He also served as an academic mentor and prompted Helen to use the equipment to study congenital heart disease. Initially she was reluctant to use the new diagnostic equipment and instead focused her studies and research on rheumatic heart disease, which was the major clinical cardiac problem in children at that time. During the early years as the director of the pediatric cardiology clinic, Dr Taussig began to lose her hearing [1]. This caused problems using her stethoscope, communicating with patients and families, teaching, and attending lectures. She used many types of hearing aids, an amplifying stethoscope, and learned to lip read. None of these worked as well as when she learned to “listen” with her hands, a talent she perfected over the years by laying her hands extremely gently over a child’s chest, feeling murmurs other physicians could not hear with a stethoscope. Thus, although the hearing problem was a disability, it actually may have sharpened her...