An evening with Simon: the Master of Pediatrics · his previously rapid stride. Partially bald, and...
1
by Stan L. Block, MD SPECIAL TO INFECTIOUS DISEASES IN CHILDREN H e still has the spryness in his gait as he ambles out to the car, but appears to have al- lowed the years to gently slow down his previously rapid stride. Partially bald, and gray with the sparse re- mainder, he is eager with the smile and overly firm with the handshake. He hops in the car and we depart for my evening with Simon. I received a call a month previous that said he would be arriving in Lou- isville for a few days and inviting me to dinner. Honored and intrigued, I said that of course I would. We exchanged pleasantries about our families. He remembered sev- eral details about my four daughters, much more so than an absent-mind- ed, preoccupied professor of pediat- rics. I covered nearly three decades of each of my daughters’ escapades and achievements. To sum each: MBA working full time as a computer trou- ble shooter; master’s in education, fin- ished this summer and now excitedly teaching fifth grade; entering medical school locally; and entering freshman year college locally. There is also one grandchild now, a boy at that! The wife is still putting up with my antics and “idiot-syncrasies.” He congratu- lated me on their successes. He disarmingly and pleasantly puts one at ease with any personal conver- sation, just like in the old days. He lovingly talks about his wife, Marilyn, and one can readily detect that they are a true team with more than five decades of marriage. He still drives a 1992 Saturn. He’s still frugal, of course. This is Jimmy Simon, MD, a.k.a. “The Boss.” The Boss Although he stands at about 6’ tall and appears wispy and wiry, Simon is truly one of the giants of pediat- rics, a former chairman of the pedi- atric division of Bowman Gray Wake Forest School of Medicine. I stand in awe at his career and dedication to the world of pediatrics. Behind the scenes of the AAP, he has vocifer- ously championed the medical needs for children not only in the state of North Carolina, but also nationally. He traveled almost bimonthly, pre- senting at grand rounds, advocating pediatric teaching and reviewing oth- er teaching programs for competen- cy. When his former house officers hear the words “competency in pedi- atrics,” we are all amazed at his level of knowledge and the skills engen- dered by his teaching and methods. After all, for decades his residents would almost uniformly over-achieve to the incredible status of the top per- centiles in pediatric board scores na- tionally. Here, in the sleepy town of Winston-Salem, N.C.? How? I learned how the first night on call as an intern, when I attempted to de- fer the TB intradermal PPD until after morning rounds on a 4 a.m. admission for probable meningitis. I thought I had performed the remainder of the work- up in a stellar manner. Nope, not good enough for the “the boss!” A stickler for details and compulsive when it came to “his kids,” Simon expected nothing but the best for “his kids.” He turned a blind eye to the mistakes of everyone, except those of his residents. Perfection was demanded and maintained, and I ardently learned the hard way, as each of us did. Yet, during these highly stressful years for us, he allowed us to vent our medical black humor and he over- looked our levity in gracious style. I’ll never forget the day when I, the young upstart intern from Kentucky, timidly presented a child with severe lymphad- enitis on morning rounds. “Three-year-old male with high fever and a ‘pone,’ whose symptoms began two days prior to...” “Whoa, Block! What the heck is a ‘pone’?” “You know, like a corn-pone.” He shakes his head. “A guber?” He shakes his head again. “A festering?” “A what?” “You know, a whopper.” “Block, what are you talking about?” “Sir,” the senior resident, Luther Beasley, MD, interjected. “What this hillbilly is trying to tell you is that this child developed a very large, reddened, painful anterior cervical lymphadenitis of about 4X5 cm in size.” When I think of those hectic resi- dency days, I conjure Simon as being akin to a famous basketball coach, like a kind-hearted “Rick Pitino of pediatrics.” (Forget coach K!) Simon was similarly one of the premiere “mentor and some- times tormentor” for pediatric residents — as would be expected from any good program chair. He truly adored most of his residents, but his style was relentless for the best medical care. Thus, if one had played sports on any level, he was more like the typical coach, out for the best interests of his ac- olytes, but often using tough verbal ca- joling to achieve the highest standards. Well, one should learn those standards somehow. This instilled compulsion for thoroughness, thoughtfulness, and life-long pediatric reading has become second nature to all of us after being ingrained for three years under his tu- telage. This in turn has helped each one of us save and ameliorate countless lives over the decades. Importantly, once one “survived” his program, he became your unconditional best friend and confidante forever, as many of us have learned. For decades, Simon literally ate, slept and drank pediatrics. Every day, and I mean every day except an occasional Sunday, he would go on morning rounds for EVERY patient on the pediatric service for nearly two hours, critiquing and interrogating the entire house staff and students. He established a knowledge peck- ing order on rounds from students to interns to senior residents. Then three afternoons a week, he would grill upper-level residents when they presented an hour-long “evening re- port.” These were perpetual teaching rounds. His knowledge was like an encyclopedia for anything pediat- ric. “What was his SGOT; the cause of low platelets (never forget the ANA and SLE!); the reason for the proteinuria; the amount of sodium in this formula; the primary manifestations of Beckwith- Wiedemann syndrome; the treatment of status epilepticus; the differential for he- maturia plus pneumonia (Goodpasture’s and Wegener’s G); who read the article in Pediatrics this month explaining the relationship between aspirin and Reye’s syndrome.” This went on daily! If you did not know your patients’ details well, along with the differen- tial diagnosis and management of each, one could get “Simonized” as we fondly called it, named affection- ately after the Simonize car wax – sort of like a verbal version of the waxing of hairier body parts. Our appealing second and third year nightly call schedule was lighter than average, but in exchange, one was expected to read avariciously about pediatrics. It worked well for us. Thus, as his former pediatric house officer ,when one conjures up images of Jimmy Simon, MD, feelings such as respect, amazement, overbear- ing and sometimes bemusement will each surface. Simon is not without his foibles. To- night, Simon immediately recounted my very first encounter with him on the patient level. It was Dana P with JRA. I remember him being amazingly warm and kind to both the 8-year-old and her mother. I could sense the fond memory. He said she still remembers me and vis- its him occasionally. But this first visit was also the moment I knew I was in for some good times, possessed with my dark humorous streak. Explaining the uniqueness of the prognosis of JRA to her mother, Simon said, “No two people are different.” Russ Cook, MD, third-year resident, and I restrained our giggles. Yes, he also occasionally twisted common sayings into a full-blown mal- apropism. Heck, he became so upset when a child with chickenpox hit the wards, which he often decried: “This stuff could spread like wildflowers!” As the evening progressed, he ex- plained how he still travels the country bimonthly, reviewing and accrediting residency, fellowship and pediatric subspecialty programs for standards and competency. They could all like- ly benefit from a lesson with him, I suspect. Integrity and honesty are his calling card, sometimes with a hard knock on the door. But we all benefit in the long run, especially “his kids.” For anyone in the medical system is “his kid,” no matter his race, disability and economic status. These are totally irrelevant to his standards. At Wake Forest, he still actively teaches students and residents on rounds and in morning conferences. Lucky them. I hear he has even softened up since the old days and is still loved by all who cross his path in academia. He has received 15 Golden Apple-type teaching awards from students. Nation- ally, he received the prestigious Joseph St. Geme Leadership Award from all of the combined pediatric societies and AAP associations. He paid for my dinner. I teased him that I should pay, knowing his penchant for cheaper pizza and because I am the “rich” LMD. We concluded the night discussing the future of pediatrics and pediatric ed- ucation. His candid insights about the future of pediatrics should be standard listening for all residency faculty. We la- mented about the good old days, when we residents performed four spinal taps, two bladder taps, examined five urine- analyses and spinal fluids under the mi- croscope ourselves — all during our 36 hour straight marathon nights on call. The good old days, huh? IDC For more information: Stan L. Block, MD, has a pediatric practice in Bard- stown, Ky., and is a member of the INFECTIOUS DISEASES IN CHILDREN editorial board. His candid insights about the future of pediatrics should be standard listening for all residency faculty. CLINICAL PRACTICE primer INFECTIOUS DISEASES IN CHILDREN brings you adventures from the trenches. Stan L. Block An evening with Simon: the Master of Pediatrics idinchildren.com | SEPTEMBER 2006 14 IDC0906pgs12-21.indd 14 IDC0906pgs12-21.indd 14 8/23/2006 5:11:39 PM 8/23/2006 5:11:39 PM
Transcript of An evening with Simon: the Master of Pediatrics · his previously rapid stride. Partially bald, and...
by Stan L. Block, MDSPECIAL TO INFECTIOUS DISEASES IN CHILDREN
He still has the spryness in his gait as he ambles out to the car, but appears to have al-
lowed the years to gently slow down his previously rapid stride. Partially bald, and gray with the sparse re-mainder, he is eager with the smile and overly fi rm with the handshake. He hops in the car and we depart for my evening with Simon.
I received a call a month previous that said he would be arriving in Lou-isville for a few days and inviting me to dinner. Honored and intrigued, I said that of course I would.
We exchanged pleasantries about our families. He remembered sev-eral details about my four daughters, much more so than an absent-mind-ed, preoccupied professor of pediat-rics. I covered nearly three decades of each of my daughters’ escapades and achievements. To sum each: MBA working full time as a computer trou-ble shooter; master’s in education, fi n-ished this summer and now excitedly teaching fi fth grade; entering medical school locally; and entering freshman year college locally. There is also one grandchild now, a boy at that! The wife is still putting up with my antics and “idiot-syncrasies.” He congratu-lated me on their successes.
He disarmingly and pleasantly puts one at ease with any personal conver-sation, just like in the old days. He lovingly talks about his wife, Marilyn, and one can readily detect that they are a true team with more than fi ve decades of marriage. He still drives a 1992 Saturn. He’s still frugal, of course. This is Jimmy Simon, MD, a.k.a. “The Boss.”
The BossAlthough he stands at about 6’ tall
and appears wispy and wiry, Simon is truly one of the giants of pediat-rics, a former chairman of the pedi-atric division of Bowman Gray Wake Forest School of Medicine. I stand in awe at his career and dedication to the world of pediatrics. Behind the scenes of the AAP, he has vocifer-ously championed the medical needs for children not only in the state of North Carolina, but also nationally. He traveled almost bimonthly, pre-senting at grand rounds, advocating pediatric teaching and reviewing oth-er teaching programs for competen-cy. When his former house officers
hear the words “competency in pedi-atrics,” we are all amazed at his level of knowledge and the skills engen-dered by his teaching and methods. After all, for decades his residents would almost uniformly over-achieve to the incredible status of the top per-centiles in pediatric board scores na-tionally. Here, in the sleepy town of Winston-Salem, N.C.? How?
I learned how the fi rst night on call as an intern, when I attempted to de-fer the TB intradermal PPD until after morning rounds on a 4 a.m. admission for probable meningitis. I thought I had performed the remainder of the work-up in a stellar manner. Nope, not good enough for the “the boss!” A stickler for details and compulsive when it came to “his kids,” Simon expected nothing but the best for “his kids.” He turned a blind eye to the mistakes of everyone, except those of his residents. Perfection was demanded and maintained, and I ardently learned the hard way, as each of us did.
Yet, during these highly stressful years for us, he allowed us to vent our medical black humor and he over-looked our levity in gracious style. I’ll never forget the day when I, the young upstart intern from Kentucky, timidly presented a child with severe lymphad-enitis on morning rounds.
“Three-year-old male with high fever and a ‘pone,’ whose symptoms began two days prior to...”
“Whoa, Block! What the heck is a ‘pone’?”
“You know, like a corn-pone.” He shakes his head. “A guber?”He shakes his head again. “A festering?” “A what?” “You know, a whopper.” “Block, what are you talking about?”“Sir,” the senior resident, Luther
Beasley, MD, interjected. “What this hillbilly is trying to tell you is that this child developed a very large, reddened, painful anterior cervical lymphadenitis of about 4X5 cm in size.”
When I think of those hectic resi-dency days, I conjure Simon as being akin to a famous basketball coach, like a kind-hearted “Rick Pitino of pediatrics.” (Forget coach K!) Simon was similarly one of the premiere “mentor and some-times tormentor” for pediatric residents — as would be expected from any good program chair. He truly adored most of his residents, but his style was relentless for the best medical care.
Thus, if one had played sports on any level, he was more like the typical coach, out for the best interests of his ac-olytes, but often using tough verbal ca-joling to achieve the highest standards. Well, one should learn those standards somehow. This instilled compulsion for thoroughness, thoughtfulness, and life-long pediatric reading has become second nature to all of us after being ingrained for three years under his tu-telage. This in turn has helped each one of us save and ameliorate countless lives over the decades. Importantly, once one “survived” his program, he became your unconditional best friend and confi dante forever, as many of us have learned.
For decades, Simon literally ate, slept and drank pediatrics. Every day, and I mean every day except an occasional Sunday, he would go on morning rounds for EVERY patient on the pediatric service for nearly two hours, critiquing and interrogating the entire house staff and students. He established a knowledge peck-ing order on rounds from students to interns to senior residents. Then three afternoons a week, he would grill upper-level residents when they presented an hour-long “evening re-port.” These were perpetual teaching rounds. His knowledge was like an encyclopedia for anything pediat-ric. “What was his SGOT; the cause of low platelets (never forget the ANA and SLE!); the reason for the proteinuria; the amount of sodium in this formula; the primary manifestations of Beckwith-Wiedemann syndrome; the treatment of status epilepticus; the differential for he-maturia plus pneumonia (Goodpasture’s and Wegener’s G); who read the article in Pediatrics this month explaining the relationship between aspirin and Reye’s syndrome.” This went on daily!
If you did not know your patients’ details well, along with the differen-tial diagnosis and management of each, one could get “Simonized” as we fondly called it, named affection-ately after the Simonize car wax – sort of like a verbal version of the waxing of hairier body parts. Our appealing second and third year nightly call schedule was lighter than average, but in exchange, one was expected to read avariciously about pediatrics. It worked well for us.
Thus, as his former pediatric house officer ,when one conjures up images of Jimmy Simon, MD, feelings such as respect, amazement, overbear-ing and sometimes bemusement will each surface.
Simon is not without his foibles. To-night, Simon immediately recounted
my very fi rst encounter with him on the patient level. It was Dana P with JRA. I remember him being amazingly warm and kind to both the 8-year-old and her mother. I could sense the fond memory. He said she still remembers me and vis-its him occasionally. But this fi rst visit was also the moment I knew I was in for some good times, possessed with my dark humorous streak. Explaining the uniqueness of the prognosis of JRA to her mother, Simon said, “No two people are different.” Russ Cook, MD, third-year resident, and I restrained our giggles. Yes, he also occasionally twisted common sayings into a full-blown mal-apropism. Heck, he became so upset when a child with chickenpox hit the wards, which he often decried: “This stuff could spread like wildfl owers!”
As the evening progressed, he ex-plained how he still travels the country bimonthly, reviewing and accrediting residency, fellowship and pediatric subspecialty programs for standards and competency. They could all like-ly benefi t from a lesson with him, I suspect. Integrity and honesty are his calling card, sometimes with a hard knock on the door. But we all benefi t in the long run, especially “his kids.” For anyone in the medical system is “his kid,” no matter his race, disability and economic status. These are totally irrelevant to his standards.
At Wake Forest, he still actively teaches students and residents on rounds and in morning conferences. Lucky them. I hear he has even softened up since the old days and is still loved by all who cross his path in academia. He has received 15 Golden Apple-type teaching awards from students. Nation-ally, he received the prestigious Joseph St. Geme Leadership Award from all of the combined pediatric societies and AAP associations.
He paid for my dinner. I teased him that I should pay, knowing his penchant for cheaper pizza and because I am the “rich” LMD.
We concluded the night discussing the future of pediatrics and pediatric ed-ucation. His candid insights about the future of pediatrics should be standard listening for all residency faculty. We la-mented about the good old days, when we residents performed four spinal taps, two bladder taps, examined fi ve urine-analyses and spinal fl uids under the mi-croscope ourselves — all during our 36 hour straight marathon nights on call. The good old days, huh? IDC
For more information:
Stan L. Block, MD, has a pediatric practice in Bard-stown, Ky., and is a member of the INFECTIOUS DISEASES IN CHILDREN editorial board.
His candid insights about the future of pediatrics should be standard listening for all residency faculty.
CLINICAL PRACTICE primer INFECTIOUS DISEASES IN CHILDREN brings you adventures from the trenches.
Stan L. BlockAn evening with Simon: the Master of Pediatrics
idinchildren.com | SEPTEMBER 2006
14
IDC0906pgs12-21.indd 14IDC0906pgs12-21.indd 14 8/23/2006 5:11:39 PM8/23/2006 5:11:39 PM
![Timing Attack against Protected RSA-CRT Implementation ... · There are mainly three timing attacks [[3,4,5], on the RSA with Chinese Re-mainder Theorem (CRT) using Montgomery multiplication](https://static.fdocuments.net/doc/165x107/5fc525c6051adc2414386a51/timing-attack-against-protected-rsa-crt-implementation-there-are-mainly-three.jpg)
![Eutrophication - ssvpgcollege.org · Eutrophication (fro m Greek eutrophos , "well-nourished"), [ 1 ] or hypertrophication , is when a body of water becomes overly enriched with minerals](https://static.fdocuments.net/doc/165x107/5f25a06047a6cb299a1703b3/eutrophication-eutrophication-fro-m-greek-eutrophos-well-nourished.jpg)
