Remarks [at the] Dedication [of the] Richard D. Wood Ambulatory Care Center [Children's Hospital of Philadelphia]
NOTE: The cover page of the original is very light.
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21 (417,921 Bytes)
1989-09-17 (September 17, 1989)
Koop, C. Everett
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Medical Subject Headings (MeSH):
Child Health Services
Health Care Costs
"Remarks [at the] Dedication [of the] Richard D. Wood Ambulatory Care Center, Children's Hospital of Philadelphia"
Box Number: 9
Folder Number: 1989 Sep 17
Richard D. Wood Ambulatory Care Center
September 17, 1989
When I spoke at the dedication of the new Children's Hospital and Child Guidance Center in 1974, it was a time of extraordinary
expectation. The atmosphere tingled with excitement.
A large crowd had gathered for the festive occasion, including Princess Margaret and Lord Snowdon.
We have no princess today, but we do have Dick Wood.
Back in 1974, the new Children's Hospital of Philadelphia was the most expensive building ever built in the state of Pennsylvania.
There were so many fluorescent lights in the new hospital, that when we turned off half of them, we could still see quite
We offered the best in medical technology.
We boasted a staff second to none.
We were at the dawn of a new era.
But we had one great concern.
The new hospital had far more beds than the old one.
How would we fill all the beds?
Where would the sick children come from?
From where would we get referrals?
Some of you may recall that on the occasion of that last dedication, in 1974, I brought Charles Dickens with me, and spoke
of the famous author's commitment to the rights of children, and of his own efforts as a fund-raiser to help construct
the first Children's Hospital in the English-speaking world, London's venerable Hospital for Sick Children, Great
Ormond Street. I also used Dickens' famous words from the beginning of A Tale of Two Cities to describe the world into
which our own new hospital was born:
"It was the best of times, it was the worst of times . . . it was the season of light, it was the season of darkness,
it was the spring of hope, it was the winter of despair . . . "
I said it was the best of times because of the medical expertise and engineering skills we possessed.
I said it was the best of times because of the pace of medical progress, as I recalled my medical school days when there were
no sulfa drugs -- much less antibiotics -- the combat infection.
In 1974 I said that the most perplexing surgical problem in newborns was a rather new disease process known as necrotizing
enterocolitis. It was common then only because we never before had been able to salvage these stressed newborns so that they
survived to develop the problem.
At that time I wondered if in 10 years enterocolitis might have gone the way of diphtheria.
Would that it had.
We began to see the drop-off of cases, but with the rise of the use of cocaine and pregnant women, the future for the incidence
of this disease looks less bright than it did 1974.
I said it was the best of times because of the convergence of the aims of government, pediatric societies, and the public
for the comprehensive care of children. I think here we did make progress.
Some of the things I am most pleased about are not the headline-grabbers with which my name has been associated. We now have
a type of comprehensive, family-centered, community-based care for children with special needs that is sweeping its way across
This is my accomplishment of which I am most proud, and it started right here in December 1982 with the Surgeon General's
Workshop on Handicapped Children and Their Families.
I said it was the best of times because of the proximity of this new Clinical Center to the surrounding research facilities.
And certainly the transfer of knowledge and technology has speeded up.
I said it was the best of times because of the enthusiasm we all felt, and enthusiasm born not only of expectation, but also
of a solid base of experience.
But I also warned that it was the worst of times.
I said it was the worst of times because of the tension between economic and demographic trends.
Modern medicine costs more and more, as both public and the practitioners clamored for the most sophisticated equipment and
services . . . at a time when government penny-pinching had replaced generous grants.
And as costs soared, we feared a precipitous decline in patient population.
In 1974 the baby boom had come to an end.
The contraceptive pill and the recent Supreme Court decision favoring abortion had led to birth rate only half of what it
had been five years earlier.
The flight to the suburbs, to suburban shopping malls, to suburban hospitals, raised even more questions about the fate of
How would we fill all those beds?
We were concerned enough even to employ marketing techniques to attract patients to this magnificent hospital.
And now look at us.
Only 15 years later.
Dedicating a new building.
The economic and demographic trends that concerned us have continued in a direction that should have been detrimental to this
The cost of medical care has risen, and continues to rise at a higher and more accelerated rate than other services.
The past eight years certainly did not pour government money into pediatric causes.
We broke even on the birthrate.
How did you fill all those beds?
You filled them because of the magnet this hospital has become.
A magnet because of its staff -- their expertise and accomplishments.
A magnet because of the steady quality of the house staff in the hospital's continued ability to attract bright and caring
young men and women.
To quote the inscription on the Children's Hospital medal, "Quippe qui numquam immemor esset puerorum -- you were
never unmindful of children."
Now we are here to dedicate a new building, -- but more than that we are here to dedicate the Richard D. Wood Pediatric Ambulatory
And, Dick, as I said when you dedicated the C. Everett Koop Comprehensive Surgical Center, I'm so glad it's not a
memorial! I know you feel that way today!
Richard D. Wood has been the quintessential hospital manager.
I seem to recall more than one financial crisis in the old Children's Hospital. And on each of those occasions I remember
that it was Dick Wood who assumed hands-on care to bring us out of our difficulties.
In one such crisis I remember that Dick established a command post, Friday afternoons at the Rittenhouse Club, where several
of us together with him to assess the progress of the past week, and plan the next week. That kind of interest, tenacity,
and skill not only endeared Dick Wood to all of us, but also sustained the institution.
Hospital trustees always understand problems of maintenance of the building and servicing of debts, but they do not always
show the same depth of understanding about the needs of patients.
Dick Wood understood it all.
In the nearly 35 years I was Surgeon-in-Chief I was never disappointed by him when I went to him and requested expenditure
or change in policy that touched the lives of children.
Dick and I go back a long way.
And, over the years I always feared the day when he would lose interest, and would leave us.
I expressed that concern when we dedicated the Wood Lounge.
His response was, "I'll stay as long as I'm having fun."
So, ladies and gentlemen, friends of the hospital, residents and fellows, members of the staff, administrators, and volunteers
. . .