ORIGINAL REMARKS BY C, EVERETT KOOP, M,D, SURGEON GENERAL US, PUBLIC HEALTH SERVICE AND DEPUTY ASSISTANT SECRETARY FOR HEALTH U,S, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRESENTED ON "PEDIATRIC SURGERY DAY" TO THE STUDENTS AND FACULTY OF THE UNIFORMED SERVICES UNIVERSITY FOR THE HEALTH SCIENCES BETHESDA, MARYLAND JANUARY 9, 1987 (GREETINGS TO HOSTS, GUESTS, FRIENDS, ETCJ I'M DELIGHTED TO HAVE THIS CHANCE TO TALK WITH YOU, AND I'M ESPECIALLY PLEASED THAT WE'RE BROUGHT TOGETHER THIS AFTERNOON AS INDIVIDUALS CONCERNED ABOUT CHILD HEALTH, SOMETIMES I FIND IT HARD TO BELIEVE THAT ONLY 6 YEARS HAVE PASSED, SINCE THE DAYS WHEN I WAS DEEPLY AND -- SO I THOUGHT -- INEXTRICABLY INVOLVED IN PEDIATRIC SURGERY, SO MUCH HAS HAPPENED IN THESE PAST 6 YEARS THAT IT SOMETIMES FEELS AS IF I'M GOING THROUGH A SECOND LIFETIME AND A SECOND FULL CAREER, DR, GARCIA AND HIS COLLEAGUES, WHO ORGANIZED THIS EVENT, MADE THE MISTAKE OF GIVING ME CARTE BLANCHE FOR MY TOPIC, I WAS TOLD I COULD TALK ABOUT -- QUOTE -- "ANY SUBJECT OF MUTUAL INTEREST" -- UNQUOTE, 2 SO I HAVE CHOSEN TO TALK ABOUT THE HANDICAPPED, ,,AND MOSTLY, BUT NOT EXCLUSIVELY, HANDICAPPED CHILDREN, HOWEVER, BEFORE I GO ANY FURTHER, LET ME WARN YOU THAT I'M NOT GOING TO PRESENT ONE OF THOSE "GRAND ROUNDS" LECTURES ABOUT A NUMBER OF DIFFICULT CASES AND HOW I SOLVED THEM, I DON'T DARE, THERE ARE A NUMBER OF EXCELLENT PEDIATRICIANS AND SURGEONS IN THIS AUDIENCE AND, FRANKLY, I'D RATHER HEAR THEM ON "GRAND ROUNDS" THAN HEAR ME, WHAT I WANT TO DO INSTEAD IS TO RAISE AN IMPORTANT QUESTION WITH YOU, IT'S A QUESTION THAT IS VERY FAMILIAR TO ME, IT HAS FOLLOWED ME AROUND AND TANTALIZED ME FOR FOUR DECADES, AND THIS IS IT: "WHO ARE THE TRULY DISABLED AMONG US?" 3 WE ALL LIKE TO THINK WE KNOW THE ANSWER BECAUSE, OVER THE YEARS, WE'VE ACCUMULATED A GREAT DEAL OF EXPERIENCE REGARDING DISABILITIES, AND WE'VE CONSTRUCTED NEW DISCIPLINES AND NUANCES OF LANGUAGE TO INTERPRET THAT EXPERIENCE, AND ALL THOSE NEW THINGS HAVE BEEN USED TO EXPLAIN IN MORE AND MORE EXQUISITE DETAIL JUST WHO THE DISABLED PERSON IS, SO THAT WE, THE SO-CALLED "ABLE-BODIED" PEOPLE, CAN UNDERSTAND AND PROCESS THAT INFORMATION, BUT MANY TIMES DURING MY CAREER I WANTED TO PUT ASIDE MUCH OF THAT EXPERIENCE AND THAT RHETORIC -- WHAT MIGHT BE CALLED THE "CONVENTIONAL WISDOM" OF DISABILITY, 4 I WAS MADE ESPECIALY AWARE OF THIS ABOUT A YEAR AGO, A YOUNG FRIEND OF MINE, WHOM I WILL CALL "PAUL," GRADUATED FROM A FINE SECONDARY SCHOOL IN DELAWARE COUNTY, PENNSYLVANIA, HE FINISHED WITH A VERY GOOD ACADEMIC RECORD, HE WAS ON THE VARSITY BASKETBALL TEAM, AND HE WAS THE VALEDICTORIAN FOR HIS GRADUATING CLASS, PAUL DID RATHER WELL, BUT I THINK THE "CONVENTIONAL WISDOM" OF DISABILITY WOULD PROBABLY HAVE WRITTEN HIM OFF MANY YEARS AGO, PAUL IS A GRADUATE NOT ONLY OF SECONDARY SCHOOL -- BUT OF 55 OPERATIONS,, , EACH ONE DIFFICULT, EACH ONE NECESSARY, EACH ONE A TERRIBLE AND TRAUMATIC INTERRUPTION IN THE LIFE OF A GROWING BOY, I KNOW ABOUT THOSE OPERATIONS BECAUSE I PERFORMED WELL OVER HALF OF THEM, PAUL SURVIVED THEM ALL -- AND HE SURVIVED THE GROWING PAINS OF ADOLESCENCE, TOO, WHICH ARE SOMETIMES MUCH WORSE THAN ANY SURGERY -- AND TODAY HE IS A STRONG, DECENT, BRIGHT YOUNG MAN, 5 I'LL MAKE A CONFESSION RIGHT HERE AND ADMIT THAT I DON'T REALLY KNOW HOW HE DID IT, BUT THROUGH THE YEARS HE ABSORBED THE SHOCK OF THOSE REPEATED OPERATIONS, HE HAS ABSORBED THE HIGHS OF LOVING, TENDER CARE AND THE LOWS OF REJECTION BY ERSTWHILE FRIENDS YEAR AFTER YEAR, HE HAS HAD TO ABSORB AND PROCESS A GREAT DEAL OF INFORMATION ABOUT HOW TO GO ON LIVING DURING THE MASSIVE RECONSTRUC- TIONS THAT WERE DONE TO HIS FACE AND HIS BODY, THE CONVENTIONAL WISDOM SAYS THAT WE SHOULD CALL HIM A "DISABLED, HANDICAPPED" CHILD, BUT PAUL ,,,SO COURAGEOUS AND SO INNOCENT, ,,HAS REFUSED TO BE "DISABLED" AND "HANDICAPPED," 6 AND SO HE HAS ENDED THIS CHAOTIC AND PAINFULLY LONG PERIOD OF CHILDHOOD, PUBERTY, AND ADOLESCENCE AS AN IMPORTANT YOUNG MAN, THE VALEDICTORIAN OF HIS GRADUATING CLASS, I COULDN'T HAVE DONE IT, I KNOW VERY FEW PEOPLE WHO COULD, AND TO BE PERFECTLY HONEST ABOUT IT, I THINK MOST OF Us ARE TOO "DISABLED" IN FAITH OR IN SPIRIT OR IN COURAGE TO HAVE COME THROUGH SUCH AN ORDEAL OF PHYSICAL AND EMOTIONAL RECONSTRUCTION, NO, THE ONLY PERSON WHO COULD HAVE SUCCESSFULLY WEATHERED THE YEARS OF REPEATED SURGICAL ASSAULT IS, OF COURSEmPAUL HIMSELF, HE HAS HAD THE ABILITY, AND I AM VERY, VERY PROUD TO CALL HIM MY FRIEND, 7 BUT LET ME ADD JUST A WORD ABOUT HIS FAMILY, A NUMBER OF YEARS AGO, I WAS INVITED TO CANADA TO DELIVER A LECTURE ON A MEDICAL SUBJECT RELATED TO PAUL'S EXPERIENCE, I WAS TO SPEAK BEFORE A PROFESSIONAL AUDIENCE, MUCH LIKE THIS ONE, I APPROACHED PAUL'S MOTHER AND ASKED HER FOR ANY OBSERVATIONS SHE MIGHT WANT TO HAVE ME INCORPORATE INTO MY REMARKS, FOR EXAMPLE, I ASKED HER, "WHAT WAS THE WORST THING THAT EVER HAPPENED TO YOU IN YOUR LIFE?" AT THAT TIME, PAUL WAS ABOUT TWO-THIRDS THE WAY THROUGH HIS LONG SURGICAL ORDEAL, SHE ANSWERED, "THE WORST THING IN MY LIFE WAS TO HAVE OUR SON BORN WITH ALL THOSE DEFECTS THAT HAVE REQUIRED 37 OPERATIONS TO CORRECT SO FAR," 8 IT WAS A HEART-RENDING ANSWER, ,,BUT IT WAS NOT A SURPRISE, I KNEW SHE HAD A STRONG FAMILY, A DEVOTED HUSBAND, AND THREE OTHER CHILDREN WHO WERE BORN HEALTHY AND HAVE BEEN LOVING SIBLINGS TO HER SON, SO I ASKED HER, "ALL RIGHT, WHAT WAS THE BEST THING THAT EVER HAPPENED IN YOUR LIFE?" AND SHE ANSWERED, "THE BEST THING IN MY LIFE WAS HAVING OUR SON, PAUL, EVEN THOUGH HE WAS BORN WITH ALL THOSE DEFECTS THAT REQUIRED 37 OPERATIONS TO CORRECT," I'LL LEAVE THE STORY OF PAUL AND GO ON TO ANOTHER ONE, THIS ONE IS ABOUT ANOTHER FORMER PATIENT OF MINE, A YOUNG MAN NAMED CHRISTOPHER, 9 I MET CHRISTOPHER 20 YEARS AGO WHEN HE WAS ONLY 4 DAYS OLD, AND HE WAS A MESS, HE HAD NO RECTUM, AND HE WAS A "FLOPPY BABY",, #PROBABLY MILDLY RETARDED,, JOULDN'T REALLY TELL, THREE OTHER PHYSICIANS HAD DECIDED THAT CHRISTOPHER WOULD NOT BE WORTH THE EFFORT AND THE COST OF SAVING HIM WITH REPARATIVE SURGERY, THEY TOLD CHRISTOPHER'S MOTHER SOMETHING THAT NOBODY -- AND CERTAINLY NO PHYSICIAN -- CAN EVER PREDICT: AND THAT IS, THE KIND OF LIFE A NEWBORN CHILD IS GOING TO HAVE, CHRISTOPHER'S MOTHER HAD 5 OTHER CHILDREN -- ALL NORMAL, HEALTHY GIRLS, NUMBER 6 WAS HER LAST CHANCE FOR A BOY, AND SHE GOT HIM, BUT CHRISTOPHER WAS NOT THE ROBUST, ABLE-BODIED LITTLE BOY HIS PARENTS HAD WANTED, 10 CHRISTOPHER HAD A LEARNING DISABILITY, FROM THE VERY BEGINNING, HE NEEDED A LOT OF HELP AND A LOT OF LOVE, AND HE GOT BOTH, A BIT LATER, HIS MOTHER ALSO THOUGHT THAT CHRISTOPHER, SURROUNDED AND DOTED ON BY 5 SISTERS, NEEDED SOMETHING ELSE: A BROTHER, SO, WITH THE HELP OF CHRISTOPHER'S FATHER, WHO IS A SUPPORTIVE AND A LOVING MAN, CHRISTOPHER'S MOTHER SOON DELIVERED A 7TH CHILD, AND IT WAS A LITTLE BOY WHO, WE ALL SOON DISCOVERED, WAS SOMETHING OF A GIFTED CHILD, NOW, LET ME EMPHASIZE SOMETHING THAT'S VERY IMPORTANT ABOUT CHRISTOPHER'S FAMILY, THEY STARTED OUT REALLY AS NOTHING VERY SPECIAL, THEY WERE PRETTY MUCH LIKE MOST AMERICAN FAMILIES, YOU MEET PEOPLE LIKE HIS MOTHER AND FATHER EVERY DAY ANYWHERE IN THIS COUNTRY, 11 BUT THEY HAVE THIS SPECIAL ADVANTAGE: THEY HAVE CHRISTOPHER, LITTLE CHRISTOPHER HAS TAUGHT THEM A GREAT DEAL ABOUT LIFE, WE WOULD SAY HE WAS AND Is A DISABLED CHILD, YET HE MADE THE REST OF HIS FAMILY,, , ABLE TO CARE DEEPLY ABOUT EACH OTHER,, , ABLE TO GIVE EACH OTHER GENUINE, UNABASHED LOVE AND AFFECTION, ,a AND MADE THEM ABLE TO EXTRACT FROM THEIR OWN HEARTS AND SPIRITS THE FINEST, PUREST INSTINCTS OF HUMANITY, CHRISTOPHER BROUGHT ABOUT AN EXTRAORDINARY CHANGE IN THE LIFE OF THIS OTHERWISE ORDINARY FAMILY, HE HAD ENRICHED IT SO, THAT HIS FAMILY MADE A MOMENTOUS DECISION, THEY MOVED TO A LARGER HOUSE ON A FARM OUTSIDE OF TOWN AND ADOPTED 12 MORE RETARDED CHILDREN, 12 THEY BROUGHT THOSE KIDS INTO A SNUG, LOVING HOME, WHERE EVERYONE GROWS UP WITH THE RATHER SPECIAL AND RATHER PRECIOUS ABILITY TO CARE VERY DEEPLY ABOUT THE PEOPLE SITTING ON HIS OR HER RIGHT AND LEFT, WHEN CHRISTOPHER WAS JUST ENTERING PUBERTY, HE JOINED THE BOY SCOUTS, HE TOLD ME ABOUT IT DURING A VISIT TO MY OFFICE AT THE CHILDREN'S HOSPITAL OF PHILADELPHIA, HE TOLD ME THAT HE HAD A GREAT AMBITION, HE SAID HE HOPED TO BE AN EAGLE SCOUT SOME DAY, YOU SEE, CHRISTOPHER NEVER,, #EVER,, ,ACCEPTED THE FACT THAT HE WAS A DISABLED YOUNG MAN WITH LIMITATIONS ON HIS PERSONAL LIFE AND AMBI- TIONS, I SAID, "CHRISTOPHER, I'M TICKLED THAT YOU'VE JOINED THE SCOUTS, AND I WANT YOU TO PROMISE TO TELL ME WHEN YOU BECOME AN EAGLE SCOUT, I WANT TO BE THERE WHEN YOU GET YOUR BADGE," 13 HE PROMISED HE WOULD TELL ME, AND HE DID, AND JUST A LITTLE WHILE AGO I WENT UP TO PHILADELPHIA TO TAKE PART IN A MODEST CEREMONY IN WHICH I PINNED THE EAGLE SCOUT BADGE ON MY FRIEND CHRISTOPHER, HE STOOD UP ON THE STAGE AND THANKED HIS PARENTS, HIS SCOUT- MASTER, HIS DOCTOR, HIS FIVE HEALTHY, NORMAL SISTERS, HIS GIFTED YOUNGER BROTHER, AND HIS 12 ADOPTED BROTHERS AND SISTERS, HE THANKED US FOR ALL THE HELP AND ENCOURAGEMENT WE'D GIVEN HIM SO THAT HE COULD ACHIEVE HIS AMBITION OF BEING AN EAGLE SCOUT, NOW, I MUST TELL YOU THAT MY FRIEND CHRISTOPHER IS A TEXTBOOK EXAMPLE OF A "DISABLED, HANDICAPPED" CHILD, OF COURSE, IT'S OUR TEXTBOOK, ,,NOT HIS, AND THANK GOODNESS FOR THE DIFFERENCE, 14 THESE TWO YOUNG PEOPLE -- PAUL AND CHRISTOPHER -- ARE JUST TWO OF A LARGE NUMBER OF DISABLED YOUNG MEN AND WOMEN THAT I'VE HAD THE PRIVILEGE TO KNOW AND TO HELP DURING MY PROFESSIONAL LIFE IN MEDICINE, THEY'RE ALL VERY SPECIAL PEOPLE TO ME, THEY WERE ALL BROUGHT TO ME BECAUSE THEY WERE HURT OR DAMAGED OR IN SOME WAY INCOMPLETE, IN THE EYES OF MEDICINE AND OF SOCIETY, TOO, THEY WERE DISABLED ,,,HANDICAPPED,,,IMPERFECTdJNFINISHED LITTLE PEOPLE, BUT I'VE LEARNED IMPORTANT THINGS FROM EVERYONE OF THEM, AND I'VE HAD TO ASK MYSELF, "JUST HOW COMPLETE AND ABLE AND PERFECT AM I, IF THEY CAN TEACH ME SO MUCH ABOUT THE WONDER OF LIFE?" AND THE ANSWER IS QUITE HUMBLINGwAND HUMILITY, AS YOU KNOW, IS A QUALITY NOT COMMONLY FOUND AMONG SURGEONS, 15 NOW, IT'S A DANGEORUS BUSINESS TO ROMANTICIZE ILLNESS AND DISABILITY, THAT'S NOT A HEALTHY THING TO DO, AND I HOPE YOU DON'T THINK THE STORIES ABOUT PAUL AND CHRISTOPHER WERE ROMANTIC OR FANCIFUL, THEY AREN'T, QUITE THE OPPOSITE, THEY'RE STORIES ABOUT TWO VERY REAL YOUNG MEN, AND THAT REALITY IS WHAT WE MUST KEEP IN MIND EVERY TIME WE COME UPON A CHILD WHO IS "DISABLED," I'M AFRAID THAT MOST OF THE YOUNG PEOPLE WE CALL "DISABLED" HAVE A DIFFICULT TIME GROWING UP IN OUR SOCIETY, THAT LABEL TENDS TO BE USED BROADLY 8, JNDISCRIMINATELY n, &WHEN IT REALLY SHOULD BE APPLIED QUITE NARROWLY, 16 YES, THE DISABLED CHILD fi "DIFFERENT" -- BUT DIFFERENT IN SPECIAL, DISCREET WAYS, NOT DIFFERENT ALTOGETHER, THE PRESENCE OF A PHYSICAL OR MENTAL DISABILITY SHOULD NOT SUGGEST OR PRE-SUPPOSE THAT AN EMOTIONAL OR SPIRITUAL DISABILITY IS PRESENT, ALSO, IF WE CANNOT MAKE THESE KINDS OF DISTINCTIONS, THEN WE ARE THE ONES WITH THE MORE SERIOUS DISABLITYwTHE DISABILITY OF IMPRECISION ,,,OF INDISCRIMINATION,,,THE DISABILITY OF THE CASUAL GENERALIST, AND SO THAT QUESTION COMES BACK INTO OUR CONSCIOUSNESS: "WHICH OF US IS DISABLED?" NOW, LET ME TAKE YET ANOTHER STEP ALONG THIS LINE OF THOUGHT, I'VE SPENT MY LIFE IN MEDICINE AND IT'S BEEN A MARVELOUS EXPERIENCE, I'VE SEEN SOME EXTRAORDINARY DEVELOPMENTS TAKE PLACE: * INTENSIVE CARE UNITS, FOR EXAMPLEmIN FACT, I BUILT THE FIRST NEONATAL INTENSIVE CARE UNIT IN THIS COUNTRY * AIR, SEA, AND HIGHWAY EMERGENCY MEDICAL SERVICES * IMPLANTS AND TRANSPLANTS AND * ARTIFICIAL ORGANS, BY ANY MEASUREMENT, WE'VE GOT THE MOST SOPHISTICATED SYSTEM OF MEDICAL AND HEALTH CARE IN THE WORLD, BUT I SUGGEST THAT SUCH A SYSTEM MAY WELL BE PART OF OUR PROBLEM, 18 WHETHER YOU'RE IN HEALTH CARE OR IN SOCIAL SERVICES OR IN EDUCA- TION, I BELIEVE THAT, AS AMERICANS, WE ARE ALL ATTRACTED BY THE WONDERS OF HIGH TECHNOLOGYmWE'RE MESMERIZED BY SYSTEMS DESIGN, ,,AND WE CHEERFULLY BECOME ENSNARED IN THE WEBS OF PROCESS, THEY'RE INCREDIBLE TOYS AND WE LOVE THEM ALL, BUT MEGA-SYSTEMS AND HIGH-TECH PROCESSES ARE ALL SEVERELY LIMIT- ING, ##THEY'RE OUR HANDICAPS, WHEN WE TRY TO RESPOND TO THE NEEDS OF DISABLED CHILDREN, TRUE, SOME HARDWARE AND SOME SOFTWARE CAN BE HELPFUL, I KNOW BECAUSE I'VE MADE GOOD USE OF MANY NEW TOOLS AND PROCEDURES AS THEY CAME ALONG IN PEDIATRIC SURGERY, 19 BUT IN ALMOST EVERY CARING ENDEAVOR -- WHETHER IT'S MEDICINE OR EDUCATION OR THE SOCIAL SERVICES -- WE MUST ULTIMATELY RELY ON THE PERSONAL WARMTH AND COMPASSION OF ONE HUMAN BEING HELPING ANOTHER, IN FACT, THE WORST THING WE CAN DO IS TO ERECT SYSTEMS OF TECH- NOLOGY THAT ARE SUPPOSED TO HELP, BUT ACTUALLY BECOME BARRIERS THAT SEPARATE ONE PERSON FROM ANOTHER, IT SEEMS TO ME THAT, NEXT TO THE BIRTH EVENT ITSELF, THERE'S NOTHING MORE MYSTERIOUS AND MORE AWE-INSPIRING THAN THE GROWTH OF A CHILD, YOU NEVER KNOW WHAT'S GOING TO HAPPEN NEXT, AND NEITHER DOES THE CHILD, YOU HOPE FOR THE BEST,,,BUT YOU LEARN TO ACCEPT WHAT YOU GET, 20 IN MANY WAYS, NATURE FUNCTIONS WITH WHAT MAY SEEM TO BE SOME VERY LOW-GRADE TECHNOLOGIES,,,REALLY CLUMSY SYSTEMSwAND VERY CIRCUITOUS AND INEFFICIENT PROCESSES, YET, I AGREE WITH THE PSALMIST, WHO SAID THAT "WE ARE FEARFULLY AND WONDERFULLY MADE," AND SO, MOST OF THE TIME, THE OUTCOMES ARE TERRIFIC, BUT NOW AND THEN MOTHER NATURE SLIPS UP, AND A YOUNG PERSON WILL RECEIVE LESS THAN HIS OR HER NORMAL SHARE OF BODY AND MIND, WE SAY THAT SUCH A YOUNG PERSON IS "DISABLED," AND OUR INSTINCT IS IMMEDIATELY TO TREAT THAT CHILD WITH OUR OWN "SUPERIOR" TECHNOLO- GIES IN ORDER TO COMPENSATE FOR NATURE'S CLUMSINESS, 21 THAT INSTINCT MAY BE, BY ITSELF, OUR OWN WORST HANDICAP, IT HAS THE POTENTIAL FOR PREVENTING THE SHARING BACK AND FORTH OF GENUINE HUMAN LOVE AND CARINGwNOT ONLY FROM THE CARE-GIVER TO THE DISABLED YOUTH BUT ALSO FROM THAT YOUTH TO THE CARE-GIVER, a ,AND TO THE FAMILY ,,,AND TO THE COMMUNITY, "WHICH ONE OF US IS DISABLED?" IS IT THE YOUNG MAN WITH MUSCULAR DYSTROPHY WHO RESOLUTELY NEGOTIATES THE SCHOOL HALLWAYS AND STAIRS SO AS NOT TO BE LATE FOR ANYTHING? OR IS IT THE THERAPIST WHO SEES THAT YOUNG MAN ONLY AS A DISABLED VICTIM OF THE DISEASE? 22 IS IT THE MILDLY RETARDED YOUNG WOMAN WHO IS IN PERPETUAL MOTION, CONSTANTLY DOING A HUNDRED-AND-ONE LITTLE CHORES FOR HER FAMILY AND FRIENDS? OR IS IT HER TEACHER WHO METICULOUSLY CONCENTRATES ONLY ON A HANDFUL OF BASIC SKILLS? IS IT THE CHILD WITH IMPAIRED VISION, NEARLY BLIND, BUT STRUGGLING TO LEARN THE PIANO? OR IS IT THE NEIGHBOR WHO SAYS SHE CAN'T PUT UP WITH THE NOISE FOR ONE MORE DAY? I BELIEVE WE ALL HAVE TO REMIND OURSELVES NOW AND AGAIN THAT MOST OF OUR DISABLED CHILDREN HAVE EXTRAORDINARY ABILITIES AS TOTAL HUMAN BEINGS, 23 AND I'M NOT LIMITING THIS CONCLUSION JUST TO THE CHRISTOPHERS AND THE PAULS -- WHO HAVE BEEN SPECIAL TO ME -- BUT I'M APPLYING IT TO THE GREAT MAJORITY OF YOUNG PEOPLE WHO HAVE BEEN DAMAGED BY NATURE OR BY THEIR FELLOW MAN, THEIR DISABLILITIES MAY BE PARTICULARmBUT THEIR HUMANITY IS GENERAL, AND I WOULD ASK YOU TO LOOK AT YOURSELVES AND YOUR COLLEAGUES, JUST HOW "ABLE" ARE YOU TO PROVIDE NOT JUST TECHNICAL ASSISTANCE BUT PERSONAL, HUMAN ASSISTANCEmTHE KIND OF ASSISTANCE THAT RECOGNIZES, RESPECTS, AND NURTURES ALL THE DIMENSIONS OF HUMAN EXPERIENCE, I SUPPOSE IT WOULD'VE BEEN NICE IF I HAD COME HERE THIS AFTERNOON TO DELIVER A BRAND-NEW MESSAGE IN HONOR OF "PEDIATRIC SURGERY DAY," BUT INSTEAD I WANTED TO HONOR THIS OCCASION BY DELIVERING A VERY OLD MESSAGE, 24 THE TEXT IS FROM THE ETHICS OF ARISTOTLE, WHO MADE THIS OBSERVA- TION SOME 2400 YEARS AGO, I DON'T ALWAYS AGREE WITH ARISTOTLE, BUT I'LL NEVER QUIBBLE ON THIS SENTIMENT: "THE NATURE OF MAN," HE SAID, "IS NOT WHAT HE WAS BORN AS, BUT WHAT HE WAS BORN FOR/' SOME PEOPLE ARE BORN &DISABLED OR & HANDICAPPED PERSONS, BUT, AS ARISTOTLE INSTRUCTS US, THAT'S NOT WHAT THEY WERE BORN FOR, AND IN MILLIONS OF LITTLE WAYS, SUCH HANDICAPPED PEOPLE DEMONSTRATE THE POWER OF THAT IDEA EVERY DAY OF THEIR LIVES, SO IT IS MY DEEPEST HOPE THAT EACH OF US IN THIS MARVELOUS SPECIALTY OF PEDIATRICS,,,WHETHER WE ARE DISABLED OR ABLE-BODIED,,,1 HOPE WE WILL ALWAYS RECOGNIZE AND NURTURE WHAT THE OTHER PERSON WAS BORN &&a THANK YOU, #####