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Pediatrics: Generations and the state of our union
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In the future days, which we seek to make secure, we look forward to a world founded upon four essential human freedoms.
The first is freedom of speech and expression — everywhere in the world.
The second is freedom of every person to worship God in his own way — everywhere in the world.
The third is freedom from want — which, translated into world terms, means economic understandings which will secure to every nation a healthy peacetime life for its inhabitants — everywhere in the world.
The fourth is freedom from fear — which, translated into world terms, means a world-wide reduction of armaments … anywhere in the world.
— “The Four Freedoms,” Franklin D. Roosevelt, State of the Union Address, 1941
In the attics of my life, full of cloudy dreams unreal.
Full of tastes no tongue can know, and lights no eyes can see.
When there was no ear to hear, you sang to me.
I have spent my life seeking all that’s still unsung.
Bent my ear to hear the tune, and closed my eyes to see.
When there was no strings to play, you played to me.
— “Attics of My Life,” Grateful Dead, 1970
For those of you unfortunate enough not to live in subzero winter climes, you miss out on the excitement of staying indoors so that your feet — on most nights — don’t freeze. It does, however, give one the opportunity to pay closer attention to things others might normally miss, like State of the Union addresses.
Two things became clear to me watching President Barack Obama’s latest address. First, as part of an overall focus on economic inequalities, Obama paid long overdue attention to family issues, in particular childcare and sick leave, though there was neither a robust context nor plea to truly invest in the earliest years of our children’s lives. Secondly, my thoughts were drawn to our own state of the union — that of pediatrics, pediatricians and the future well-being of all of our children. To both points, I believe we need to voice a dynamic vision of the future. As part of an ongoing three-part series, I will attempt to more fully explore these themes.
History, generations, well-being
To contrast visions, we will be coming up on the semisesquicentennial since Franklin D. Roosevelt presented the aforementioned distinctly American vision for framing the future. Born from a gestation crippled by economic depression and menaced by global tyranny, his message that afternoon galvanized this nation. In anticipation of an anniversary for which many will attempt to redefine the meaning of this speech, let me get a head start and apply a pediatric brush stroke.
William T. Gerson
While not designed to focus on the needs of children in American society, the “Four Freedoms” speech was nurtured in a progressive belief in the value of an investment by a society in the well-being of its citizenry, no matter their age. The generational passing of well-being depended on the dignity of our democracy. Freedom from want and fear are the minimum necessity for our children if we are a just society. While we have come a long way in the past 75 years in assuring care for our elderly, we appear to have failed our children as far too many continue to live in poverty.
Let us not forget — let us remember
We are all the children and grandchildren of the generation that saved this nation from the destruction of the Great Depression and the totalitarianism of the Second World War. In the greatest tradition America extends this inclusiveness to those whose parents were not even Americans. Our public schools taught civics and allowed immigrant children to stand and state that “our” first president was George Washington. Our greatest gift as a nation is the relearning and the reteaching of this message from one generation to the next. Better, of course, would be placing the elimination of childhood poverty as a national goal.
In recent essays, I have spoken about the importance of acknowledging heroes in our profession. Please allow me to briefly honor my greatest hero. In the name of a vision of democracy embodied by the “Four Freedoms,” more than 16 million Americans put on uniforms of the armed forces of the United States; my father was one of those men. On the upcoming anniversary of that speech, he will be 94 years old, having heard those words first as a high school student in New York City shortly after arriving there with his mother, a few books, and limited English in a desperate escape from Europe on the cusp of war. As a citizen of this country, he returned to Europe in uniform as an infantry soldier by way of the shores of North Africa, the beaches of Normandy and the frozen ground at the Battle of the Bulge. All this time, he carried a small folded message from FDR addressed to all members of the United States Army Expeditionary Forces, a letter that reminded each soldier that upon the outcome of their endeavor depended the freedoms enunciated in his State of the Union address. Fortunately, he, along with millions of other young American men, would return to build a more progressive nation — a prosperous and hopeful land with a chance to fulfill promises of freedom, responsibility, opportunity and cooperation.
That folded paper remained by my father’s desk until recently when his memory of those times, and unfortunately all others, finally receded as the severity of his dementia left them only to his family. Will we, as a nation, continue to carry a progressive message of hope for the next generation and their children? I love my father, and I wish I could once more let him know that in a meaningful manner. Perhaps it will happen, as in the Grateful Dead tune, without strings to play nor ears to hear, in the attics of my life and his.
The goal of future generational well-being, like my father’s personal memory, needs someone else to pass it forward.
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William T. Gerson, MD, is Clinical Professor of Pediatrics at the University of Vermont College of Medicine and a member of the Infectious Diseases in Children Editorial Board. He can be reached at 52 Timber Lane, S. Burlington, VT 05403; email: William.Gerson@uvm.edu.
Disclosure: Gerson reports no relevant financial disclosures.