Remarks on receiving the C. Anderson Aldrich award.

I take the honour which is being bestowed on me today as another welcome sign that the estrangement between pediatrics and child psychology is nearing its end and the partners on either side are contemplating a serious engagement, if not the propect of future marriage with each other. There are many other indications which point in the same direction. I only need to mention the fact that there are now places of learning where the head of the department combines in his own person training and functions in physical as well as mental child care; or that pediatricians are considered essential consultants in child guidance clinics, or that some pediatricians participate in the discussions of interdisciplinary hospital groups, or that, occasionally, child psychiatrists and even child analysts are called to the bedside of hospitalized children for consultation. There is no reason, on the other hand, to feel entirely optimistic and to relax efforts towards further re-alignment. Cooperative attitudes between the two disciplines can also be regarded still as few and far between and, above all, confined to selected medical specialities and a small number of selected, furthest advanced, and enlightened centers. There exist still many children’s wards where bodily care is so paramount that any thought about the child’s mental concerns is excluded as intrusive and disruptive. There are, above all, the many surgeons who, rightly or wrongly, feel that their difficult task cannot be accomplished except by determined and exclusive concentration on the defective body part which needs repair. Whenever in ophthalmology the eyesight of a child is in question, this concern seems to blot out any regard for the repercussions on his mind. The same is true whenever a child’s actual survival is endangered, as it is in the most severe illnesses, after burns, serious road accidents, etc. There are many instances to show that it is possible to save a child’s physical life, but to do so at the expense of his present and future mental equilibrium. I think we would be in a better position to carry cooperation into these disputed areas also, if we asked ourselves more consistently how, when, and why the initial split between the two aspects of the child was accomplished at all. It did not exist, certainly, in classical times when a sane body was considered the necessary prerequisite for a sane mind. There were, possibly, later repercussions in the medical field from the philosophical deliberations on the body-mind problem. But, it seems to me, that the two sides did not really fall apart until science and professional training made significant advances. There was too much to be taught and learned in either the physical and mental field to allow for time and interest to be spent on the other. Thus, specialization set in and, among others, the child became not only its beneficiary but also its victim. By definition then, the only people who escape specialization today are the untaught nonprofessionals. A mother is severely criticized if all she does is looking after her child’s body without playing with him, talking with him, and stimulating his interests, or if she neglects his physical needs, is helpless when faced with his illnesses, and only concerned with his mental advances. No nursemaid is considered satisfactory unless she can entertain and comfort the child as well as feed and bathe him. In contrast, hospital, clinic, and school personnel are expected to remain strictly within their own professional confines. For a busy ward sister to concern herself with the child’s distress, fear, or boredom in addition to his physical symptoms may be considered a misuse of professional time by many hospital authorities.