An audible conversation if i could have everybodys attention, good evening. Im the co owner of politics and prose along with my wife and on behalf of the entire staff here, welcome. A few quick notes now would be a good time to certain you could turn off your cell phones. Before you come up to get your books signetheirbooks signed thd appreciate if you would fold up chair youre sitting in and cleacleaned them up against the column or bookshelf. It really is a special pleasure for me to be hosting kurt neumann. Ive known him more than two decades when i first got involved with the Childrens National Medical Center the way that many parents do. That is when one of our kids needs help. He was a fulltime practicing surgeon and you could tell he was not just interested in what he did in the operating room and the Bigger Picture of medical research and the advancement of care. He also was a people person who contacted very easily with kids and their parents and with the help of the gift they oversaw develop and of the institute for pediatric surgical innovation which is focused on making surgery for children minimally invasive and theme three. Now the chief of surgery was the top job but kurt had aspired to and having shown vision and great administrative skills he was tasked to become the ceo of the first childrens physician to the hospital but has risen in the ring of the nations best Medical Centers that care for kids. Anyone who gets involved with children here is story after story receiving phenomenal treatment. In healing children he shares a number of personal stories and history and offers a short but useful section for parents about how to get the best care for their children but theres a larger message in this book and that is it remains undervalued and resource given to adult diseases in the country. When he joined as a surgical following 1984 he worked for the first fulltime pediatric surgeon in the Nations Capital that was just a little more than 30 years ago. The world of Pediatric Medicine has come a long way since then but we may not realize how fortunate we are to have separate hospital devoted to kids. Only about three dozen other such hospitals in the United States there maybe a couple hundred of that operate as integrated Health System but that compares to 5,000 focused primarily on adult health care. He makes a persuasive case that pediatric Specialty Care and research should be a national priority. If we can get the care for kids right to make caring for the adults cost and effective. Please join me in welcoming kurt neumann. [applause] its hard to know what to say after the owner and proprietor of this Iconic Institution here in washington, d. C. Introduces you when you think about politics and prose, i feel like i need it. Its a special moment for me to see all of you but if i want to say a special moment theyve been longtime friends of mine. I know this isnt supposed to be about Childrens National, its about my book. It is when your three kids were playing soccer [inaudible] they were all terrific athletes and i know because i coached one of them so it is an honor to be here and i want to thank you. The staff has been terrific at hosting the official launch. This is an institution that hasnt been around as long as almost 150 years and its just wonderful to be in this room and see the faces that make childrens what it is and therefore make this the possib possible. I could use my entire time thinking people around the room and there are so many i could thank. Theres lots of Great Stories but im grateful for all of your support. I want to call out to my wife that is here. She even agreed the story is in the book and this is a little bit of a joke. If you read the story you will realize that there is a long shot at that. But shes been with me every step of the way as i wrote this book saying are you kidding. But we forced to settle the way through to now. Its better than i thought it would be. We are making progress. Thank you for your support. [laughter] i was trying to think about a lot of ways i could talk about the book and a prophet helps keep focus because when we talked about all the different adult hospitals, Childrens Hospitals i just want to get your focus on something that might help. It is a three d. Printer of a babys heart. I tell a story in the book about a girl and i was with her today on television if anybody was watching on Channel Seven this morning. When she came in i alternated because her heart was abou is ao stop and was this big around. But this is this is a baby hearh the operate on. Its maybe the size of a large walnuts and this is what heart surgeons and children do everyday. We think about our children differently but people think its just all may be one thing and onesizefitsall. In my career as a surgeon i would get these stories in many of you were on the other end of the phone call and what t wouldm here in the Emergency Department you dont have a specialist, my child has a concussion. I took them somewhere and they havent seen too many children where we are here about to have surgery and they told me the anesthesiologist does a couple cases a month. I finally just got tired of that and i got a little bit angry and thats what motivated me to write the book. To empower parents and take what i learned over 30 years of practice and getting those kind of phone calls working with pediatricians who are just as frustrated to get that message out the reason i wrote the book was to try. Through these stories. And to understand the difference in a Childrens Hospital in the hospital that takes care of mostly adults but also of children. So at a place like Childrens National, thats all anybody does. So theres this whole world of Pediatric Medicine specialists, pediatrician they are in washingtothere in washingtonand. It is in a way blessed to have a hospital that is completely focused on children and that is all anybody does because if i bring it back to this, children are not just different because youre smaller but the whole biology is different. They are so resilient. I told that story i started wi with. So 14yearsold, shes standing outside her Junior High School in a nice perk up washington and happened to be a champion in washington, d. C. And she was shot in the chest and immediately collapsed and they knew what to do and to take her to childrens and her heart stopped on the hospital. That is just not a given. As her heart came back to beating again it started spurting out of that hole and i know it sounds dramatic that i put my finger over the whole and that saved her life. [laughter] it was the most incredible thing we didnt know whether she would be able to get first off the operating table whether she would make it through. Two days later she woke up and smiled with a breathing tube still in and that is what kids are about. They have this kind of innate ability to. We know that and we take that into account. Its part of the deal. So a concussion for example in an 8yearold is different than a 20yearold so this is your childs brain. You want somebody that understands it, not just the most convenient place that its easy to go to. That is when i get angry. Okay im going to get a little tough. But soccer team their kid would play for. People wont drive 5 miles to get the Emergency Department at one of the best hospitals in the country. I mean think about that. So that is the kind of thing that motivated me. We want people to understand it and then we want parents to because it is easy to say you should do that if you dont give people the tools, then it is also amazing that we dont make it easy for parents to figure this out like parents are not helping and they are saying you should go to a neo native intensive care nursery tha but s also specialists and things that are needed to make sure this could be complicated ahead of time. I tried to give parents some of the tools but also the philosophy that its okay to advocate. To switch and find the right thing and really into the very deferential to physicians but more and more, but i seen this to be successful you have to be an advocate and take on that role for your children. The results will be better. Its different treatments where we will take orthopedics for example. You want an Orthopedic Surgeon that knows about the growth of the bones. So you have to know about growth plates and what happens in the joints and to be able to interpret in the face of what happens if that growth in mind. We were fortunate because our sons got the best orthopedic care in the country. But it wasnt easy and there were some serious in journeys around the way. The key is if things are not taken care of properly and done right up front, you miss so much opportunity. Thats another principle of dealing with children is there is so much that we can do early and if you look at a lot of the things we have in our country now and a lot of the issues children are facing whether it is Mental Health or heart disease, obesity, diabetes, these are on the cusp of being able to solve early and if we make these are the kind of diagnosis early, we can present a live the things that can happen later in adult diseases into patties one of the exciting things thats out there so this whole area of field medicine diagnosis and what we called prenatal pediatrics are made ahead of time and i tell a story in the book about a family that i got to know very well about mothers. The biggest mistake ever made as a surgeon were often when i didnt listen to the mother and that was true in my own home. [laughter] i was the great minimizer so here i am pontificating. The fact he can barely breathe and turning blue and pediatrician says if your wife wasnt a nurse he would be there right now kind of thing. But there is so that we can learn in a story. I tell the story about a mother and grandmother who came to see me where they had been given some advice based on an ultrasound and that was by the obstetrician. To go through that story real quick, what they were told when they came to see me for a Second Opinion determination wasnt really necessary this was something that could probably be taken care of after the baby was born and everything so i had a great radiologist all she does is look at the bx race all day long. Why would he want a radiologistt is the only part of their job thats all she did. So it turned out to be true and the obstetrician was very unhappy with me and called me and said i had done a disservice but to be fair after the baby was born, she called me to say how wrong she had been and appreciated what he had done. We are fortunate to have that type of resource here in washington but thats not true across the country. Do we need to do more . And im also concerned, i dont get into it is deep in the book that i think its important to say right now that we are at a wrote crossroads in our country. So we are talking about the conversations i hear are about cutting things like medicaid and you know cutting the nih and doing all these things when we are on the cusp of such terrific discoveries and when you think about half of the people that are on medicaid, half of the beneficiaries are children so who is going to get her . Why do we want to do that . We are not doing that to the elderly on medicare. We ought to double down and really put more into our children because its really costeffective. Its wise because we can prevent a lot of these diseases. So im getting real serious here. The book also tells some funny stories on myself. I wasnt always destined to be a surgeon, a pediatric surgeon. I had my own Health Situation when i was in medical school and at the time i met some amazing mentors over the year that you would hear about. Jeff randolph was an icon here in washington d. C. I took care of so many children and families and build one of the top departments of surgery in the country. Thats what brought me down here i talk about some great pediatricians. Dr. On, dark there stroud and many people here in the audience great pediatricians here in washington. I talk about joe robert, another just incredible visionary that helps me think through how we could make Childrens National a leading hospital for children in the world through our department of surgery and now all the great things. And a lot of the doctors and nurses at childrens that are the real heroes. I see one that i caught out of the corner of my eye. Dr. Jerry joy is here. Is probably world expert in childhood concussions and he is in the book. In fact one of the hardest parts that i write in this book was knowing what not to put in and trying to figure that out because there were so many people in so many stories and all that. My editor is here in the green bear. She is the one they really said you cant do that. [laughter] but she took this mass of stories and helped me craft it into a book and you know i hope you enjoy it and find a way to spread the word. I hope you feel empowered as you spread the word about the value, the special value of childrens medicine, about what it can offer, what it can offer parents but also what it can offer our country. I think its something we can all rally around you know, so it has been a lot of fun. People say you now how long did it take and my answer is the technical answer is it took about four years and it started, i was in the low club if he could believe that and we would sit around and tell stories. My friend said, you need to be telling these stories beyond here but we told stories because we never read the books. [laughter] i know what goes on in book clubs, so dont make this book one of those books that nobody reads. I see a lot of my friends from High School Days at pcc and i keep joking about how there is going to be a. At the book sale. There will be 20 books being sold. Thats why i am autographing them all with their names on them so i knew know who is returning these books for 10 cents and i know who you guys are. But the real thing was you know its really been 30 years and thinking about and away writing this book and the experience i have had first as a surgeon for 25 years and then actually 12 years, 10 years before that in training and education and in the last five years is the ceo of childrens. So, but its been worth it and i will tell you why its really been worth it is because the kids that have come back to me and some of the families that i have reconnected with, their stories are so amazing. They are the real heroes of the book. Thats what drives the book. I was just this week with a young man, actually the baby, i will give a little bit of the story away, when i one of our first dates and i thought i would impress her. I got called in. Hey do you want to come down and see me, kind of cool you know . I thought it was going to be a quick easy operation. And she would be really impressed. The nurse said it was okay so she came there to observe and this baby had one of the most complicated things i have ever seen. It was so complicated i even called my boss dr. Randolph to tell him, to ask him for his advice and he said well kurt, i guess you are on your own. [laughter] i wasnt counting on that answer but i had some colleagues that called in and meanwhile i forgot about allison and i was just trying to concentrate and figure this thing out. If there had been a burglar but we sorted things out and did something at that time the saved his life. Youll read about it in the book but allison at the end of that evening did not go well. She was not impressed and she also educated me about how i needed to pay more attention to the babys needs and he needs to be cuddled. He needed to be warm and he needed somebody there so that he knew that there was somebody looking out for him because his mother was not there and babies know that stuff and nobody was paying attention to that. But fastforward, he just came back to childrens a couple of nights ago for a little event i was having for some of the doctors and a couple of the patients in this book and we stood there. I had been at his wedding. This was at your 22 operations. I dont know how many hospitalizations and he was somebody we never thought would get married. And then he now has a 7monthold son and he is the most healthy, most amazing baby and of course tyler who in some ways is one of the real heroes of the book says he has perfect genes. We had them checked out top to bottom but if he ever breaks his arm im bringing him to Childrens National. So anyway the book is healing children. I will be signing some books and im happy to take some questions now. Thank you. [applause] dr. Newman thank you very much for your work. I am a local college student. Im on the autism spectrum and regularly advocate for inclusion in a righty of constructs. After completing my education im seriously thinking about working in it profession in which it will be possible to help individuals who have special needs and particularly children to achieve their dreams. My question is, my question is what you think is particularly important for individuals such as myself who are considering working in that area to know and understand . Well, first of all congratulations. You know it sounds like you have a great career ahead of you and are doing such wonderful things in school and i would like to talk to you more about what your ideas and plans are. I think what i have learned, and there is a little story in the book that dr. Randolph used to say, Something Like you can never tell by looking at them how far a frog can jump so excuse my southern dialect attempt there and by that i mean i think we tend to categorize people in diagnoses and things way too quickly and we really need to think about the individual and special potential of every individual and so i would say there are many things i want to say about your question. First of all research. I think there is so much opportunity to find out what causes Something Like autism and maybe autism isnt one thing. You have got one thing and i dont know your name. Nathan. This is nathans problem and then there is georgias problem. I think we make a mistake by lumping them all together and makes it hard to figure out whats really going on and then we tailor treatments and approaches individually to peoples situations and try to look at their potential and not where they are right now. That is what i would say. I would say we have a lot of work to do in that area but people like you are champions for that and you are examples for all of us about what can happen and what people can achieve so thank you for that. [applause] i am not an audience plant and i am here, you really answered my question already because i was going to ask you about medicine but i do want to give you all a shout out. One and this is where the nexus of my question is. As a person who works in house policy but as a parent of children, how do you fill your pipeline and we are into cbm and all that stuff. So how do you figure out and i will give you a couple, an example personally. I remember when my son was going into surgery the surgeon said you have to have a little faith. And we did and it was wonderful. I remember when we were going into anesthesia and you are talking about personalized medicine, he was all wrapped up in his little blank he and they took the blanket off and the doctor said no, no hes going into surgery. The blank he is and are safe at home and our child is at college. How do you figure out all being counters were so based in science and evidence yet theres this face and its really personalize and its not just involves working with moms and dads. How do you do that . Well, i think, i have learned a lot and im not the expert but i have learned a lot from being in the role particularly now as the ceo of the hospital. I think a lot of it is about listening. I have parents and their in the room, the come with great ideas and sometimes they come with they are not so much ideas but, i dont want to call them observations. Sometimes they are patients about how we do things better and we do tend to sometimes in medicine and science focus on the medicine and the science. But what we are learning about is that more and more experience and thats why the title of my book is about healing. I thought a lot about security and i was leaning towards science but it really is about healing children and it is a balance. So i think one of the great things about Childrens Hospital and i try and talk about it, is that hold the mention of art, music, schoolwork, friends, family that is critical and crucial and i think the science is beginning to catch up because the studies are starting to show that when you have that people heal and particularly children heal more could he become the Childrens National we have great friends and allies here that i would love to shout out to but people say well how can you work here because must be really sad. It must be depressing and you know in fact most of the publishers except mine thought that the book was too discouraging and it was going to be a lot about children that were sick or whatever and some children that did make it but really when you werent there the children dont have that perspective. It actually takes on the five of the happy place and its our job to support that and to reinforce that and empower that healing. So i think, im not sure im answering your question direct it but there is a story in the book where i was brought up short by a young man who said that one of our first town meetings after i had become ceo he said you know, he stood up and he said you know dr. New menu are doing great things for children here but im a teenager and you dont have anything for teenagers. We have our own music. We need our own space and we dont want to read there with the kids and a little teddy bears. We have our own video games and you need a hospital that respects that. So with some great partners we moved along that path. But it is a balance and i think you dont want to lose sight of the science. That is just so promising and many things that were incurable at one point now are things we treat and there are so many different lethal diseases i talk about and we also never quite know what works sometimes. So why tell the story and one of the stories in the book is about a young man who was from washington but was down in South Carolina for his Summer Vacation with his family. He was playing basketball and he got need in the abdomen and went into shock. What happened was the blow had basically cracked a big liver tumor and he started leaving and went into shock and got transported to the closest hospital. They were so sedated him. The family wanted him to be brought to childrens forest treatment because by the statistics and this is going back to the statistics in the bestcase scenario he only had a 10 chance of surviving and because it had spread and it was the worst kind of liver cancer so he was in eighth grade and he was about to go into high school the statistics were against him. We gave it our all with surgery and we knew we hadnt gotten it all. We had gotten just about everything but thats not good enough when you are dealing with this kind of cancer. I talked his parents and i had told him that but there is a certain serenity but the way never knew that. All he knew was he wanted to get better. We gave him chemotherapy and we started everything and within five months he had made the Baseball Team as a freshman at gonzaga with the porter in place we thought we were going to have to do a liver transplant. His liver had grown back. There was no evidence of any cancer in their. Two years later he sent me a picture. He is carrying the olympics porch when the torch came through here on the way to the atlanta olympics. He graduated from college and now has gone to Business School and just got engaged to be married. Even with all the science its got to stay individual lies because you just dont know. These kids will surprise you every time and thats why you want doctors and the hospital to have that mindset. One of the great pediatricians of all time. You are way too kind but i will take it. It wasnt a plant that is such a great question going to have gipra my patients are down in southern maryland. They do come up to Childrens National at the same question they gave me which i think is such a great question is what can parents do in advance especially parents like mine that are down in cobb island or further, what can they do to prepare themselves just in case theres an emergency other than having my phone number and saying you need to go childrens . Thats a good place to start because i think you know i think it really is about preparation and education and to know there are resources that there are some practical pointers and i will famously pitch my book here but one of the things i would wanted to do was give parents some practical advice so there is a section that bradley mentioned called the eight ways to get the best medical care for your kids. The basic theme is preparation. Just like you got a plan if theres a fire in your house, where the fire escapes are and you know who you are going to call and all that. You need that for your children so you need to know ahead of time. I would figure out where you are going to take your child that theres an emergency and downs where you are maybe its the local hospital for certain things but maybe for other things it can wait. You can make it to a pediatric Emergency Department but dont wait until it happens to find out where that is before you park or how you navigate into the system. Why not do a dry run so you know because when you are in the middle of a crisis, its not the time to figure this stuff out and that happens way too often. Most people dont know whether their insurance covers a Childrens Hospital or not and more and more these days hospitals can be carved out of your health plan so you want to know if thats the case and if it is you probably want to switch health plans if they are not going to allow you to use a resource like Childrens Hospital. You are going to want to talk to your pediatrician because although you are very wise and experienced pediatrician and you have a set that would predict, a set of what specialists he referred to so i would want to know if you refer me to have surgery that my child is going to have an anesthesiologist that thats all they do. Why would i want to take a chance im going to a Surgery Center somewhere where the surgery may be the least complicated part of what is happening for those year tubes or whatever when its the anesthesia that can really make the difference. These are questions you can ask ahead of time and you are in your right to ask those questions just like you would when you are checking out of school or checking anything else out. I think one of the things that i advocate for is to be an act that member of your team, of a childs team. More and more the great hospitals encourage parent participation whether its on rounds. They like to be challenged and asked questions. Dont be afraid to do that in there usually resources within the hospital to help you with that. More and more their navigators and we have one and in fact where is nathan . Did he take off . There he is. One of the improvements i made is some of the kids are on the autism spectrum, a little younger than you. They are parents, one of the parents came to me and was very angry because a lot of the things to do in the hospital and a lot of these kids came to the hospital for different things, actually triggered off a lot of the things that made them nervous and anxious. We didnt have a personalized approach so back to the question about personalized medicine. Every person, there may be something that makes them feel more comfortable or more relaxed and we want them to have that. There are resources out there embedded in the hospital but the problem is and this is frustrating. How did tap in. Its not made as easy it should be for people to know that. So i will stop there. I could keep going on and on about saudi the biggest thing is check these things out. Push it before you needed and if you are in a special circumstance where you are thinking about having a baby and you are going down that road, and you are starting to talk about where the baby is going to be born or maybe theres going to be issues have a plan ahead of time. Know if theres a complication. What level of neonatal intensive care do you need to deliver and if thats not enough where are you going to be set and why is that the best place . Have that whole because you may want to switch. The a time to have that discussion is while you are healthy, while you are not in a crisis situation of having delivered the baby and now, can i swear here . All hell is breaking loose. Thats not the time to be worried about specialists and all of that. You want that seamlessly set up ahead of time. So many things now are sorted out ahead of time. You want the best advice for that situation. We have time for one more question. Hello. You describe very convincingly the importance of teamwork and how that contributes to the outcomes and most of the descriptions understandably from a pediatric surgeon are from the surgical perspective but i also know that childrens is very wellregarded for chronic care issues for children with diabetes and asthma. How is that replicated for kids with chronic conditions . Well thank you. My good friend ann mahoney, Public Health nurse. If i didnt credit the team then i would be remiss because it is a team sport. To get the best outcomes requires the team and i do talk a lot in the book about nursing in our chief operating officer for example is a nurse and thats one of the stories about how important it is and i thought it symbolize this to have a chief operating officer as a nurse. It would send a message plus shes terrific. She is the real deal. But it is about the team. Its about all of those supports that help children with chronic disease and because one of the great perspective so its a lot of these chronic diseases we can really have an impact on early and whether its an early diagnosis and their achievements now. I talk a lot in the book about a couple of situations where Cystic Fibrosis that we would never see now because the treatments are so good. Diabetes, we are making big advances. You need that perspective of children, development, compliance in kids that are so different than adults whether they are going to take their medicine or whether they are going to stick to a diet, the whole psychology of and if you dont have that team in place than the care and the outcomes are not going to be there. It really is that holistic approach and probably essential to that team is a great mother and probably father. Its fathers day i will throw a father plug in there too. Siblings, we forget about siblings but this is the kind of approach you need to really get the best out of kids. [applause] i did want to add in case you are thinking im going to be a millionaire and retire all the proceeds go to the charity that supports research of children that most of which will go to Childrens National but also worthy institutions so thank you all for being here and your support. Spread the word. [applause] books are available and he will be up here signing. Please form a line to the right of the table. Please help us out by folding up your chairs. [inaudible conversations]