Photo courtesy of Adrian Mihai.
I’ve been a fan of Dr. Klass for years, admiring her ability to capture in words the range of emotions and fascination with life I suspect we pediatricians all feel at one time or another. Dr. Klass is the author of several works of popular fiction and nonfiction; her medical journalism regularly appears in The New York Times, and has been published in dozens of other publications ranging from The New England Journal of Medicine to Esquire magazine. A professor of both journalism and pediatrics at New York University, a mother of three, the national medical director of Reach Out and Read, and a renowned knitter, it was my pleasure to talk with Dr. Klass. - Stanford T. Shulman, MD
Dr. Shulman: Mother, professor, clinician, author, speaker, knitter, polymath that you are, how do you find the time to do everything you do?
Dr. Klass: I’m not good at time management, and I have attentional issues, so I feel I am usually behind and overdue. But, like many people who choose pediatrics, I am okay with interruptions. I don’t think I am so unusual in having many interests, either. One reason I like academic medicine is because there are so many people who have constructed their jobs out of a whole collection of different interests and skills, and because in pediatrics, they find ways to bring those interests back to children and children’s health.
Dr. Shulman: You are a professor of journalism and pediatrics at New York University. Is it difficult to teach two very different disciplines?
Dr. Klass: I really like teaching both. Actually, I think there is a strong connection between being a reporter and practicing clinical medicine. I have written a bit about this, and thought about it a lot. The connection is that with each, you are trying to help people learn to ask questions, to connect with strangers who live very different lives. A big part of medicine is learning not just to interview your patient, but learning to be able to ask those questions of someone who reminds you disconcertingly of your grandfather, as well as of someone whose life you cannot begin to imagine.I also find that reporting and clinical medicine both draw curious people. It’s interesting to have so many students who want jobs where talking about others is key. Both fields take advantage of people’s busybody impulses. It’s like, “Here I am. I have permission to ask you questions that would not be part of normal discourse.” If you dread asking those questions, or if you really wish that you could keep things polite, you’re in the wrong field.
Dr. Shulman: As national medical director of Reach Out and Read, an effort to bring literacy to children through primary care, how do you feel about the AAP’s guidelines on limiting screen time, particularly for younger children? Clearly, they refer to video game time and television, but as e-books take hold, and more apps — some of which have legitimate learning value — are developed for children of all ages, how will healthy children, screen time, and literacy all intersect, do you think?
Dr. Klass: I think that what we’re all most concerned about is how much face time are these children getting during the critical period when language develops? We have evidence that shows kids do not learn to talk from screens — otherwise kids learning from TV would speak wonderfully. What Reach Out and Read tries to do is get books into a kid’s life early. What kids want is parental attention, they want reassurance, they want parental speech that is not negative. The 1-year-old who follows her mom around with a book is just saying, “I want your attention and your voice.” I care so much about this because if you don’t learn to manage the written word, you’re marginalized. Your voice gets lost. You don’t have a way to make your story known. That’s important.
Dr. Shulman: What do you think is the greatest advancement in pediatrics since you’ve been in practice?
Dr. Klass: We always have to come back to vaccines because the opportunities we’ve had in pediatrics to think about behavior and social issues, and our more sophisticated understanding of early brain development all have been possible only because our patients are no longer subject to all of the vaccine-preventable diseases.
Dr. Shulman: As an educator of the next generation of pediatricians, what do you think is an important issue facing the profession in the future?
Dr. Klass: There’s a concern about primary care, whether our system works and whether people will keep going into primary care and spending their lives taking care of patients. But it does continue to attract people, and it is important. I would ask med school students to look seriously at primary care, and to fight for its value.