Before 1946, when I completed my training in general surgery, I knew very little about the field that eventually became known as pediatric surgery. I knew that children did not get a fair shake in surgery; that was amply proved during my internship and residency. Surgical patients came from the adult world, and children had a difficult time competing with them. Surgeons in general were frightened of children, and they distrusted the ability of anesthetists to wake children up after putting them to sleep, a position not far from that of many anesthetists. The younger and smaller the patient, the more significant the hazard. I knew, also, that in the United States and in Europe, where some surgery of children was more successfully carried out, it fell usually into one of the specialties, especially orthopedics. In those days there was a need for such specialization in the treatment of diseases that are no longer problems: tuberculosis of the bone, osteomyelitis, and polio.
I wish I could say that my knowledge of the sad state of child surgery as I saw it in Philadelphia made me determined to bring about changes for the better. Actually, during the last year of my general surgery training at the Hospital of the University of Pennsylvania, I was invited to become surgeon in chief of the Children's Hospital of Philadelphia. Pediatric surgery was thrust upon me. Nevertheless, I was excited about the chance to make surgery safer for children, and I entered my career with that goal.
The State of General Surgery Residency in the United States