HandPrints CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND

Special Pullout Section on Children’s 90th Birthday!

first ten family who’s for kids, inside: days PAGE 5 care PAGE 6 who’s just kidding PAGE 27 fall 2002 ICN STAFF SAVES GAINING A SECOND BUDGET WOES THREATEN A LIFE FAMILY AT CHILDREN’S CHILDREN’S CARE 2 CHILDREN’S HANDPRINTS calendar table of contents OF 3 DEAR READER events 5 Letter from the President SEPTEMBER 13 “What’s Up Doc?” luncheon featuring Renee Wachtel, MD, 4 HEALTH FACTS director of Developmental & Behavioral Pediatrics, CHORI, 510-428-3360 5IN THEIR OWN WORDS 19 Macy’s Passport Fashion Show The First Ten Days Macey spent the first 10 days of her life at and dinner, benefiting Children’s Children’s. It was a time her mother will never forget, and Macey Pediatric HIV/AIDS Program and will never remember, but it changed the lives of both of them. others, Fort Mason, San Francisco 6 20 Children’s Hospital 90th birth- day celebration, 510-428-3367 6 LEAD FEATURE Family Care For the Rexhepi family, the end of one perilous jour- Score Fore Kids Golf Classic, 30 ney marked the beginning of another. This time, their “second Ruby Hill Golf Club, Pleasanton, family” at Children’s helped them face the challenges. 510-428-3128

OCTOBER 9 SPECIAL EDITION 17 Legacy for Children’s Care din- 90th Birthday Scrapbook Nine decades in pictures and clips. ner and celebration, 510-428-3362 9 Pediatrics and Children’s Hospitals: 2,000 Years 19 Rowan Branch Gala Des Enfants, Blackhawk Museum, Danville, 925-937-9638 22 CHILDREN’S HOSPITAL FOUNDATION Building Blocks to Honor Loved Ones Join us as we build the 24 “Who’s For Kids and Who’s hospital of the future and pay tribute to loved ones. Just Kidding” children’s health summit, 510-428-3367 NOVEMBER 24 CHILDREN’S HOSPITAL & RESEARCH CENTER FOUNDATION 8 Tea & Tax Tips, 510-428-3362 Donors Nurture a Family Tradition of Philanthropy 20 Garden Branch Annual Holiday 22 Party, Oakland Airport Hilton, Gift Annuities In a market filled with uncertainties, a gift that Oakland, 510-521-2049 guarantees payment for life.

DECEMBER 2 Richmond/Ermet AIDS 27 ADVOCATING FOR KIDS Who’s for Kids and Who’s Just Kidding Proposed solutions Foundation “Help is on the Way For to budget woes threaten children’s access to health care. the Holidays” benefit concert and gala, Palace of Fine Arts, San Francisco, 415-931-0317 4-13 ASID (American Society for 27 Interior Designers) At Home for the Holidays showcase exhibit benefiting the Center for Child Protection. Mon.–Fri., 9:30 a.m.– 4:00 p.m., San Francisco Design District, 415-626-2743 7 Third Annual Oakland Tribune Holiday Parade, Broadway, Oakland, 510-428-3128 21 Hill Branch Annual Winter Ball, Fairmont Hotel, San Francisco, 510-654-5125 or 510-547-5309

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HandPrints dear reader: A CHILDREN'S HOSPITAL & RESEARCH CENTER AT OAKLAND PUBLICATION

Children’s HandPrints is a publication When we opened our doors 90 years ago, the image of Children’s Hospital & Research of pediatric healthcare was quite different from what Center at Oakland, 747 Fifty Second we see today. The specialty of pediatrics wasn’t very Street, Oakland, CA 94609; Phone: 510-428-3000. widespread, and the idea of a hospital dedicated Written, Designed and Produced by: solely to the care of children was new to the Bay Communications Dept. at Area. Doctors and nurses worked in starched white Children’s Hospital & Research uniforms; today, healthcare providers wear colorful Center at Oakland scrubs or sturdy “civilian” clothes so they can 665 Fifty Third Street Oakland, CA 94609 easily get down to kids’ level for comfort and care. Phone: 510-428-3367 The most eminent threat to children’s health Fax: 510-601-3907 in 1912 (see Pediatrics and Children’s Hospitals: Tony Paap 2,000 Years, page 18) is easily treated today, and President and Chief Executive Officer community epidemics are now a thing of the past. Mary L. Dean Senior Vice President, External Relations Reviewing the remarkable achievements and successes of our first 90 years makes for a very pleasant stroll down memory lane, sometimes with amusing scenery—be Debbie Dare Graphic/Print Designer sure to flip through our pull-out scrapbook with vintage photos of the way we were. But even as we take pride and pleasure in our accomplishments in the past, Susan Foxall it’s important to keep our sights focused clearly on what we need to do in the Operations Manager future. Our mission, then and now, is to provide the high quality pediatric care that Susan Martinez is the birthright of every child. Carrying that mission forward into the 21st century Media/Public Relations Manager will mean planning, practices and business models that may be as different from Vanya Rainova what we knew in the past as today’s streamlined technology is from the clunky Publications Manager machinery of 1912. Cynthia Romanov Editorial Content Manager Considering how we can successfully meet the needs of future generations of kids has been a particularly thoughtful task in the context of reviewing our past this Neile Shea Senior Web Designer birthday year. We can look to the foresight and integrity of our founding mothers who “got” the mission right so many years ago and renew our determination to Contributing Writer: Kim Goetzel continue to fulfill that mission while growing in response to community need.

We have truly come a very long way. Please join us in these pages as we celebrate the past, bring you up to date on the present and envision the future.

Best Wishes,

Tony Paap President and CEO, Children’s Hospital & Research Center at Oakland 4 CHILDREN’S HANDPRINTS health facts

BLOOD DONORS IN SHORT SUPPLY In 1975, neonatal-prenatal medicine An estimated 50 percent of However, only 5 percent donate became a board-certified subspecialty blood to the American Red Cross of pediatrics, and access to neonatal all Americans will receive at nationally, and an even lower 3 intensive care, once limited by the least one blood transfusion percent are donors in the Bay Area. small number of institutions offering The combined effect of low donor care and the few trained specialists at some point in their lives. response and increased blood demand available, became regionalized. This has Northern California experiencing a dramatic blood supply shortage that can change had a significant impact* on the well-being of newborns: In 1970, barely meet the region’s needs for two days. 20 infants died for each 1000 live The Northern California region needs to collect 9600 pints of blood every births. By 1999, than number had slid month to meet the local needs of patients in the 42 Northern California hospitals to 7.1. (Center for Disease Control at where patients being treated for accidents, routine surgeries and serious diseases www.cdc.gov) such as cancer depend on donated blood. READ ABOUT NEONATAL INTENSIVE Ideally, the Red Cross aims for five to seven days worth of blood supply, three CARE IN THE FIRST TEN DAYS ON times as much as is currently available. If the shortage persists, it will affect the PAGE 5. ability of area hospitals to respond to traumas, and may lead to the cancellation of some elective surgeries. An estimated 5 percent of Americans Blood donors must be 17 years or older, weigh no less than 110 lbs. and enjoy —more* than 13 million people—have general good health. To donate, call 1-800-GIVE-LIFE or log on to BeADonor.com post-traumatic stress disorder (PTSD) to schedule an appointment.★ at any given time. Studies have shown that as many as 100 percent of children who witness a parental MEDICAID FUNDING CUTS THREATEN homicide or sexual assault develop CHILDREN’S ACCESS TO HEALTHCARE PTSD. Similarly, 90 percent of sexually abused children, 77 percent of Almost a third of California’s children exposed to a school shooting By far the nation’s largest children are enrolled in Medicaid. and 35 percent of urban youth public provider of children’s Although children make up more than exposed to community violence half of California’s Medicaid popula- develop PTSD. (National Center for health insurance, Medicaid tion, the state spends only 25 percent PTSD at www.ncptsd.org)* is a critical healthcare of Medicaid funds on children. Each READ ABOUT TRAUMA AND PTSD safety net for millions of Medicaid-eligible child costs California IN HEALING—BEYOND THE BAND- just $1,118, on average, compared to AID ON PAGE 6. low-income children. the average cost per adult Medicaid enrollee of $4,027. The first recorded direct acknowl- Between 1994 and 1999, pediatricians and pediatric specialists provided 51 edgement of the psychological and percent of all office visits to children on Medicaid. Unfortunately, low reimbursement physiological* differences of children rates place an unfair burden not only on pediatricians, but also on children and their and the specialized care children families. require appeared in literature in 10 Committed to serving all children regardless of ability to pay, children’s hospitals A.D. The first children’s hospital was provide 40 percent of all inpatient hospital care for children on Medicaid. But state founded almost nine centuries* later. Medicaid payments to children’s hospitals are already low, covering only 69 to 80 READ ABOUT THE HISTORY OF percent of what it actually costs to provide care. PEDIATRICS IN PEDIATRICS AND An estimated 1.7 million California children—more than 1 in 6—are uninsured. If CHILDREN’S HOSPITALS: 2,000 Medicaid funding is cut, that number will grow dramatically. (National Association of YEARS ON PAGE 18. Children’s Hospitals and Research Institutions at www.nachri.org) Read about the challenges to providing health care to all California children in WHO’S FOR KIDS AND WHO’S JUST KIDDING on page 27. ★ www.childrenshospitaloakland.org* FALL 2002 5

I WAS DUE The First both hemorrhaged. JUNE 23, 1999. Macey got the My husband Jon and worst of it. She I had decided to do it had aspirated all: we attended Ten Days blood into both Lamaze, baby CPR, lungs and had parenting and sibling classes; we monitor. In the OR I heard the doctors pulmonary hypertension, blood in her managed healthy diets and never smoked say this was really serious. It had been stomach and a heart murmur. Her right or drank; we walked daily; we went to three minutes since the baby’s last heart lung collapsed, then the left. She needed counseling sessions on how to best beat. Suddenly, everything we had three blood transfusions. No one knew integrate our growing family. worked so hard to perfect was in grave why it had happened; it was one of those At my appointment with the obste- danger. things that happen to one in…oh, who trician on June 16 everything appeared I remember hearing Macey’s weak cares how many women! The possibility to be perfect and status quo, including first cry. Was that right? of losing our daughter haunted my swollen Fred Flintstone feet. No There was so much hustle me. IN THEIR open cervix, no dilation. I got a good- and bustle going on. Then I couldn’t see Macey for five natured warning: “This may take a they brought her to me in an Own days; I had to recover, too. I WORDS while.” Over that weekend I waited. On incubator with tubes and called Children’s every day. The Monday I woke up feeling crummy, and wires everywhere. “She’s BY KIM nurses didn’t mind that I bawled as the day went on, I felt worse. I called being transported to GOETZEL my eyes out with every conversa- my obstetrician, who said, “If you feel Children’s Hospital tion. They were always happy to unsure, come in. It never hurts to Oakland,” the pediatrician talk with me and told me I check.” said. “There’s nothing else we can do for could call as often as I wanted. Those We headed to the hospital, where I her here.” Confused and upset, I said touch-and-go days with only a phone was admitted and hooked up to moni- good-bye to my newborn daughter. connection were difficult, and the nurses tors. Within 15 minutes the nurse came Jon followed Macey to Children’s. He understood. They gave my husband a in to prepare me for a C-section because was told my placenta had detached from my baby’s heart beat kept cutting off the the uterine wall and the baby and I had [CONTINUED ON PAGE 26] 6 CHILDREN’S HANDPRINTS Family

www.childrenshospitaloakland.org FALL 2002 7 Care Three years ago, the Rexhepi family fled the perils of war to find asylum in the United States. Their journey from Kosovo ended in Oakland, where they faced another odyssey marked by fear and uncertainty. This time, they had help from their “second family” at Children’s Hospital Oakland.

On a sunny Saturday morning, thousands of miles and many months away from the horrors of war, 6-year-old Vjollca Rexhepi nestles beside her father, Rabit. Her mom, Mexhide, cradles 1-year- old Doruntina, who was born in the United States. Her older brother Dardan, age 9, is engrossed in Pokemon. In the domestic comfort of their Oakland home, it is hard to imagine this family’s life in a refugee camp, where they shared a tent with as many as 58 people and possessed nothing but two blankets—one for each child. But the Rexhepis will never forget. The grim conditions of the refugee camp were an improvement over what they had faced at home, where Rabit and Mexhide feared for their children’s lives. “Armed [Serbian] soldiers beat my nephew. He was 5 years old. The soldiers threatened his mother with sexual abuse, but she had some money, which she gave them, and they let her go,” Rabit says. “We left to protect our children.” Their journey to the United States was arduous. Five days after their arrival, Vjollca, then 3 years old, started to limp. Her ability to walk rapidly deteriorated, and she lost control over her muscles. “All of a sudden she couldn’t walk, she refused to eat, she just cried all day. I had

to carry her around. I was so scared,” Mexhide recalls. Rainova Photo by Vanya HAPPY FAMILY Dardan, Doruntina and Vjollca in front [CONTINUED ON PAGE 8] of their Oakland home. 8 CHILDREN’S HANDPRINTS

[CONTINUED FROM PAGE 7]

They sought help at the local communi- staff’s patient, persistent and painstaking ty clinic. The family spoke no English, attempts to overcome the language barrier interpreters were not always available, and and ensure that the parents could partici- Mexhide barely understood what she was pate in their daughter’s care even when an being told. At first, doctors assumed Vjollca Albanian medical interpreter wasn’t avail- was just exhausted by the long journey from able. Mexhide reports that nurses took the Albania. Then they suggested her symptoms time to teach her English. Their caregivers might be psychological in origin, the result offered to take them grocery shopping. Dr. of a conversion disorder related to the Lewis told them they could contact her at trauma the little girl had experienced. any hour and never failed to return their “I went there for five days in a row, and pages. The Ruxhepis spent their first they kept telling me that I should give her Thanksgiving with Dr. Pico’s family. Rabit time and she will be okay,” Mexhide notes, “You know, doctors are often close to remembers. “But how could I just sit home the patient. But to be so close to the family, and wait? My child had stopped walking all to do what they did for us, they had to be of a sudden. I was going crazy listening to special.” her cry all day, not knowing what was “I had no friends in this country but my wrong.” She persisted until she got a referral doctors,” Mexhide adds. The relationships for her daughter at Children’s Hospital endured. She still calls them just to say Oakland. hello and ask how they are doing. And they, Children’s pediatricians immediately in turn, continue to look out for the family. diagnosed Vjollca’s illness: Guillain-Barré When Dardan, who had been sociable and syndrome. A rare disorder affecting only 1 outgoing, became anxious, shy and with- in 1000 people, its first symptoms include drawn, Dr. Lewis referred him to Children’s weakness or tingling in the legs. Rapidly Psychiatry department and psychologist worsening muscle weakness follows, some- Judith Libow, PhD. times spreading to the upper limbs and “A child like Dardan could have easily sometimes resulting in paralysis. It can been ‘missed,’” Dr. Libow points out. “In strike at any age. Its cause is not known. many ways he is what some people perceive At Children’s Hospital Oakland, Gena as the ideal child: quiet, cooperative, doesn’t Lewis, MD, and rehabilitation physician stand out as a problem kid.” But his behav- Elaine Pico, MD, cared for Vjollca—and ior had changed. Dardan suffered from her family—during the acute phase of the nightmares and chest pain and often stayed illness and through six months of rehabilita- in the periphery of groups of children. tion treatment. “I will never forget Dr. Dr. Libow identified Dardan’s Lewis and Dr. Pico,” Mexhide says. symptoms as typical of post-traumatic stress It wasn’t just the successful treatment of disorder (PTSD), a consequence of experi- their daughter’s illness that touched the encing or witnessing life-threatening events. family, although full recovery from a disease An estimated 30 percent of adults who have that turns its victims from healthy to help- spent time in a war zone suffer from PTSD, less in a matter of days is cause for celebra- tion. Rabit and Mexhide also treasure the [CONTINUED ON PAGE 21]

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Children’s Scrapbook View Children’s Read about history in pictures the history and paper clippings! of pediatrics! 10 CHILDREN’S HANDPRINTS

1912 Oakland Tribune

1920

1920

1910 1928 New Children’s building on 51st and Grove streets FALL 2002 11

1912 Original Baby Hospital

1910-19: Population: 92,407,000 • Life expectancy: male, 1910-291910-2948.4; female, 51.8 • Average salary: $750/year • Union membership: 2.1 million, strikes 1,204 • Movie attendence: 30 million/week • Divorce: 1/1000 • Vacation: 12-day cruise $60.00 • Whiskey: $3.50/gallon • Milk: $0.32/ gallon • Speeds make automobile safety an issue.

1920-39: Population: 106,521,537 • Life expectancy: male, 53.6; female, 54 • Average salary: $1236/year; teacher's salary: $970/year • 343,000 in military (down from 1,172,601 in 1919) • Dow Jones high 100, low 67 • Illiteracy rate reaches a new low of 6% of the population • It took 13 days to reach California from New York • There were 387,000 miles of paved road.

ital Oakla osp nd c ’s H eleb ren rat ild es its Ch th y! birthda 1913 Annual report

1912 Cracker Jack toys first appear in boxes 1922 Annual report

1929 Children’s X-Ray machine 12 CHILDREN’S HANDPRINTS 1940 Children’s surgery room 1940 Children’s weight room

1940 25th 1949 Anniversary book 1937- Annnual report

1940 1930-39: Population: 123,188,000 • Life expectancy: male, 58.1; Children’s lobby 1930-49female, 61.6 • Average salary: $1,368/year • Huey Long propos- 1930-49es a guaranteed annual income of $2,500 • Milk: $0.14/quart • Bread: $0.09/loaf • Round steak: $0.42/pound. 1940-49: Population: 132,122,000 • Life expectancy: male, 60.8; female, 68.2 • Average salary $1,299/year • National debt $43 billion • Minimum wage $0.43/hour • 55% of U.S. homes have indoor plumbing • Supreme Court affirms blacks have a right to vote • World War II changes the order of world power, the United States and the USSR became super powers • Cold War begins. ital Oakla osp nd c ’s H eleb ren rat ild es its Ch th y! birthda 1930 1941 Children’s heat lamp

1940

1941 Children’s iron lung

1945 The Bambino FALL 2002 13

1962 Children’s founder, Miss Bertha Wright and Mrs. Everett Bertillion–an active Branches member– at an annual meeting

1958 Oakland Tribune

1968 Children’s volunteers

1958 Oakland Tribune 1950-59: Population: 149,1888,000 • Life expectancy: male, 1950-6965.6; female, 71.1 • Average salary: $2,992/year • Average car sales: 6,665,800 • Bread: $0.14/loaf • Bomb shelter plans, such as the government pamphlet “You Can Survive,” become widely available.

1960-69: Population: 177,830,000 • Life expectancy: male, 66.6, female, 73.1 • Average salary $4,743/year • Minimum wage $1.00/hour • An estimated 850,000 “war baby” freshmen enter college; emergency living quarters are set up in dorm lounges, hotels and trailer camps.

ital Oakla osp nd c ’s H eleb ren rat ild es its Ch th y! birthda

1960

1958 Oakland Tribune 14 CHILDREN’S HANDPRINTS 1970 Children’s volunteer

1970-79: Population: 204,879,000 • Life expectancy: male, 67.1; female,1970-89 74.8 • Average salary: $7,564/year • Milk: $0.33/quart • Bread: $0.24/loaf • Round steak: $1.30/pound.

1980-89: Population: 226,546,000 • Life expectancy: male, 69.9; female, 77.6 • Average salary: $15,757/year • Minimum wage: $3.10/hour • BMW cost: $12,000; Mercedes 280 E cost: $14,800 • Movie attendance: 20 million/week • In 1989, Americans gave $115,000,000,000 to charity.

ital Oakla osp nd c ’s H eleb ren rat ild es its Ch th y! birthda

1970

1987 The Bambino

1987 Children’s Family House opens 1970 1994 Construction of the FALL 2002 15 Outpatient Center begins 2002 Oakland Tribune

2002 Groundbreaking for the Western Expansion

1990 1990- present 1990-99: Population: 281,421,906 (2000 Census) • Life expectancy: male 73.1; female 79.1 (1997) • Average salary: $27,274.80/year (1999) • Teacher’s salary: $39,347 (1998) • Minimum wage: $5.15/hour (1997)

ital Oakla osp nd c ’s H eleb ren rat ild es its Ch th ! day birth 2002 Dedication of the Nutritional Genomics Center at CHORI

2002 Renovation of the Outpatient Center atrium is completed

2002 Children’s publishes the premiere issue of HandPrints pital Oaklan Hos d ce n’s lebr dre ates its CHILDREN’S HANDPRINTS hil 16 C th y! birthda HISTORY OF PEDIATRICS Pediatrics and Children’s Hospitals: 2,000 Years

The French were first, when two hundred years ago a Parisian foundling home was transformed into L’Hopital des Enfants Malades, the world’s first hospital just for kids. The English followed about 50 years later with London’s Hospital for Sick Children. An American delegation poo poo chair visited and returned to the United States to found the country’s first pediatric hospital, Children’s Hospital of Philadelphia, in 1855. Considering that the special health needs of children were first acknowl- edged nearly 2,000 years before, these institutions were a long time coming.

The ancients While the father of medicine did not write specifically about pedi- atrics, Hippocrates (470-410 B.C.) did describe clinical phenomena that are well known to pediatricians today: • “Of children, those that be by nature well nourished suck milk not in proportion to their fleshiness • Gross feeders that draw milk do not gain flesh in proportion • With ulcers on the tonsils the presence of a sort of spider-web is not favorable • Not all who are convulsed whilst about teeth, die; many come alker w through it safely.”

Modern pediatricians will recognize in the first two maxims the iron- deficient “milk baby,” and the third as a symptom of diphtheria. In the last, Hippocrates blames teething for seizures, a misconception handed down through the centuries. (The enduring myth of teething as the source of mysterious maladies echoes throughout history. As late as 1919, more than 1,600 deaths in England were attributed to teething, and some modern parents still believe teething causes illness.) The eight-volume De Medicina, completed about 10 A.D., states: “Children require to be treated entirely differently from adults.” This observation—so obvious today—is probably the first recorded direct acknowledgement of the psychological and physiological differences of baby helmet children. It would be another 900 years before the world would see a text devoted to pediatric medicine, coming from China and predating Western pediatric treatises by more than 500 years.

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HISTORY OF PEDIATRICS

Dark Ages Europe’s Dark Ages yielded no significant scientific insight. Little was expected in this life, particularly in childhood, but there is evidence that the death of a child was regarded as a great loss, even in times of plague when rates of infant and child mortality were high. The era’s scant pediatric literature relied on derivative works and translations of writing from other times and cultures. Manuscripts of Islamic sages— grounded in Greek, Roman, Byzantine, Chinese and Indian medicine— found their way to the intellectual wasteland of Europe and were translated into Latin. The front page of a volume of the “Pediatric Baby steps Incunabula” By the end of the 15th century, nearly every European city had hospi- tals and foundling homes where sick, abandoned or plague-displaced children could find shelter. Western pediatric manuscripts first appeared at this time, including four medical treatises on children’s psychology and pathology. Collectively referred to as the “Pediatric Incunabula,” they cover topics ranging from common childhood illnesses to child- rearing advice that has stood the test of time: “It should be known that children should not be too severely pun- ished…Punishment is to be praised when it is just and not too severe and a small fault in a child may be overlooked to prevent some greater one…Children who have reached six years should be sent to a teacher to be taught. They should not be kept at it continually but have recess.” The understanding of medicine in general and pediatrics in particular flourished during the intellectual fervor of the 16th and 17th centuries. Thomas Phaer published the “Boke of Children” (1544) devoted exclusively to children’s diseases, including such entries as “quynsye or swellying of throte, brustynge [hernia], pyssyng in bedde, small pockes and measles, fevers, wormes, and stoppying of the bellye.” But eighteenth-century medicine was still helpless against the cyclical eruptions of devastating epidemics—smallpox, measles, whooping Front page of cough, diphtheria, scarlet fever, mumps and cholera—that took the Thomas Phaer’s lives of thousands of children. During the smallpox epidemic of 1721, “Boke of Children” inoculation, long practiced in the East, was finally introduced in the (1544) American colonies. pital Oaklan Hos d ce n’s lebr dre ates its CHILDREN’S HANDPRINTS hil 18 C th y! birthda

HISTORY OF PEDIATRICS

Modern medicine Pediatrics as a separate field of study became widely recognized and accepted in the 19th century, with those who treated children exclusively called “pediatrists.” Historians locate the advent of modern medicine as the application of the germ theory in the last decade of the 19th century. Louis Pasteur—a scientist, not a clinician—discovered treatments for anthrax, then rabies. Medicine changed more rapidly in the century following Pasteur’s discoveries than in any other equivalent period in history. Community-decimating epidemics of infectious diseases mostly vanished in the West, and international efforts drastically reduced their occurrence worldwide. Mass immunizations for children resulted in Louis Pasteur enormous progress against many once-common deadly diseases. Smallpox had been around since the sixth century; as of May 1980, it was eradicated globally. Diphtheria afflicted 207,000 people in the United States at its peak in 1921; in 1983, there were only five cases. In the early 1950s, polio struck nearly 60,000 people a year in the U.S. alone; in 1994, the Western hemisphere was certified poliovirus-free. Improved hygienic measures reduced the prevalence of serious non- contagious illnesses. When the Baby Hospital—now Children’s Hospital & Research Center at Oakland—was founded in 1912, diarrhea was the leading cause of death in young children. Contaminated cow’s milk was often the culprit, but with refrigeration, pasteurization and increased medical understanding about the importance of keeping body fluids balanced, fewer children died. Later, drugs such as penicillin, cortisone and broad-spectrum antibiotics redefined pediatric illness. As the danger from acute disease receded, attention turned to chronic diseases and conditions. Today, trauma, not illness, is the country’s leading cause of child and infant mortality. More children die from injuries than from the next nine leading causes of death combined, including birth defects, cancer, heart disease, pneumonia and meningitis. Dr. Spock's “Baby and Child Care,” first Pediatrics today published in 1946, Today, pediatricians face a multitude of medical challenges and was the bible of psychosocial problems in the patient population. Pediatric specialists parents during the must focus on the prevention and treatment of modern ills such as baby boom that followed World AIDS/HIV, child abuse, drug and alcohol abuse, venereal diseases, War II. adolescent pregnancy, and violence in schools and on the streets as well as medical disciplines. Children’s Hospital & Research Center at Oakland provides clinical expertise in 30 specialties, from adolescent medicine to urology, and leads research in immunology, hematology and other fields that affect the quality of kids’ lives worldwide.

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HISTORY OF PEDIATRICS

Along with the dramatic technological advances in pediatric medicine, profound changes have evolved in the philosophy of care. Until well into the second half of the 20th century, families were forbidden to see their hospital- ized children outside of strict visiting hours. Now parents or guardians are encouraged to stay with their children around the clock when possible, making for calmer and happier patients—and families. At Children’s Hospital Oakland, kids are more involved in their own treatment than Visitor pass, 1955 even 10 years ago, as with chronic pain patients using a self-controlled analgesic pump, resulting in less pain, less pain medication and a sense of self-determination for the child. Same-day surgery for procedures such as tonsillectomy or hernia repair disrupts family life much less than overnight hospitalization. And today, children and their families are provided support services such as the hospital school program, child life specialists and social workers. ICU NAME:______A basic right endangered DATE:__ __/__ __/__ _ But these remarkable advances in pediatric healthcare _ demonstrate a jarring dichotomy. While basic and clinical pediatric research, as well as overall scientific advances, have captured public imagination and expanded the horizon of CHILDREN possibilities, finances and socioeconomics threaten access to ’S HOSPITAL OAKLAND DO NOT PLACE ON LEA even day-to-day healthcare for many children in the United THER OR SILK FABRIC States. Physicians, policymakers, parents and children face a troubling paradox: when academic, scientific and technological advances Visitor pass today have made so much possible, what is available remains inaccessible to thousands of children. It’s the responsibility of those who care about kids—and the future—to make sure this paradox is resolved and quality specialized healthcare, the legacy of history’s giant strides in pediatrics, is available to every child. 20 CHILDREN’S HANDPRINTS

spital Oakland Ho cel n’s ebra dre tes its hil thth C 909 y! 0birthda It has been—and will continue to be—our privilege and our passion to offer the best of care to all children. Many thanks to all who have supported us throughout the years.

www.childrenshospitaloakland.org FALL 2002 21

Guillain-Barré (Ghee-yan Bah- [CONTINUED FROM PAGE 8] ray) syndrome, also called acute inflammatory demyelinating and the numbers may be An estimated 30 percent of reports that he is polyneuropathy and Landry's higher in children. feeling better. The ascending paralysis, is an inflam- Dardan had seen the adults who have spent time in nightmares have matory disorder of the peripheral effects of violence on a war zone suffer from PTSD, mostly disap- family and friends. He peared, he says, nerves—those outside the brain and the numbers may be had faced soldiers who and his heart and spinal cord. It is characterized were ready to kill, and he higher in children. never races like it by the rapid onset of weakness had been detained with used to before. He and, often, paralysis of the legs, his mother and sister while his father tells his parents that he loves “going to see arms, breathing muscles and face. disappeared into the neutral zone at the his doctors.” So does Vjollca, who fully Macedonian border. His little sister—his recovered from her illness. Although many cases are mild, inseparable companion—had been seriously “It’s incredible, but true,” Rabit says. some patients are virtually para- ill and disabled. Now he was re-living what “My children are joyous when they go to lyzed. Breathing muscles may be he and his family had witnessed and the hospital.” ★ so weakened that a machine is endured. required to keep the patient alive. During Dardan’s weekly play therapy sessions with Dr. Libow, she tries to help Many patients require intensive him engage in expressive play. “He is more care during the early course of comfortable with structured, regulated their illness. Although most people games, which is a sign of trying to contain recover, the length of the illness is and control his emo- tions,” Dr. Libow unpredictable and often months of explains. “He’s very hospitalization are required. The non-competitive and majority of patients eventually concerned about my return to a normal or near-normal feelings. When we play lifestyle, but many endure a pro- board games, for example, he goes out tracted recovery and some remain of his way to make wheelchair-bound indefinitely. sure I win, too,” she The cause of GBS is not known. says. “It is just one Some cases occur shortly after a more way in which he tries to take care of microbial (viral or bacterial) infec- those around him. tion such as a sore throat or diar- Dardan has rhea. Some theories suggest an become more relaxed autoimmune mechanism, in which in recent weeks. He the patient's defense system of laughs at jokes and often smiles. He can antibodies and white blood cells is speak directly about triggered into damaging the nerve the stresses of adjust- covering or insulation, leading to ing to a new culture weakness and abnormal sensation. and learning a new language at school. He 22 CHILDREN’S HANDPRINTS

Building Blocks to Honor Loved Ones

We may outgrow playing with colorful plastic building blocks, but even as adults we retain the desire to build something meaningful. Join us as we build the hospital of the future: a welcoming child-friendly place where all kids can receive the special care they need. By late 2003, visitors to Children’s Plaza floor with Hospital & Research Center at pavers and bricks Oakland will enter the hospital & Associates Woo Artist impression: Kai-Yee through a beautiful plaza leading to a welcoming and colorful reception pavilion. The new family-friendly look message—will fit into a colorful tile Sponsorship opportunities also include is part of the Western Expansion that is mosaic created by our young patients 12-inch square bricks and corner pavers enhancing the hospital’s critical care through the Art for Life Artist in that will cover the plaza floor to wel- services, which are vital to the well- Residence program, and will decorate come guests. Both the bricks and the being of our children. the plaza. Smaller ceramic tiles will pavers can be custom engraved. The vibrant entry will feature bricks border a similar mosaic display in the For more information on how to and ceramic tiles that Children’s Emergency Department waiting area. leave a legacy for Northern California’s Hospital friends, staff and volunteers children and become a part of can purchase to pay tribute to—and Children’s Hospital & Research Center memorialize—loved ones or commem- at Oakland by sponsoring a personal- orate a special occasion. Twelve-inch ized tile, brick or paver, visit us online ceramic stars—with your special at www.chofoundation.org or call Jim Armstrong, Children’s Hospital Foundation vice president at 510-428-3885 ext. 5394. ★

Ceramic Stars

Corner Paver

To learn more about giving opportunities at Plaza Brick Children’s Hospital, please contact Children’s Hospital Foundation at 510-428-3814 or visit www.chofoundation.org. FALL 2002 23

Giving in Memory Holiday Cards of Larry Bossola That Care Did you ever wonder who lived in Every year hundreds of children the little white house wrapped by from throughout the Bay Area show Children’s Hospital Oakland’s parking their support for the kids we treat by garage and Outpatient Center? entering colorful winter-inspired The house belonged to Lawrence artwork into the Children’s Hospital (Larry) Bossola, who lived there Oakland Holiday Art Contest. from the time it was built in 1934. On After 9-year-old Adriana, who Aug. 10, 2001, he passed away. Larry, a was diagnosed with leukemia, received Photo courtesy of Peg Supinski life-long North Oakland resident, a bone marrow transplant here in July Close to 300 friends and supporters joined watched the hospital grow and devel- 2001, she and some friends from her Children’s Hospital Oakland Research op. With Children’s expanding around San Francisco Bay Girl Scout Troop Institute senior scientists Bruce Ames, PhD, and Giovanna Ferro-Luzzi Ames, PhD, for the his house, Larry remained a friend of decided to enter the contest with their grand opening celebration of the landmark the hospital and served as its honorary paintings of surfing snowmen. Contest Nutrition Genomics Center. Funded by ambassador. judges were impressed with their generous grants from the Ames Family Recently, Larry’s godson and friend, creativity, and their artwork was chosen Foundation, the new center is dedicated to Al Gavello, made a $25,000 gift to as one of 12 holiday cards in the studying nutrition’s effect on metabolism, Children’s in Larry’s memory. As a Children’s Hospital Oakland holiday aging, obesity, and the prevention of child, Al was treated here, and he knew card collection. Proceeds from holiday cancer and genetic diseases. The hospital how much his friend loved Children’s. card sales go right back into helping community is grateful for good “The hospital was like Larry’s home. the hospital care for other kids just like friends and I hope his memory will live on.” Adriana. benefactors like We will remember Larry and are Adriana, her friends and her mom the Ameses. grateful for the generosity of friends are happy to be able to give back to the like Al. ★ hospital that made Adriana’s cure and recovery possible. Adriana’s card, along with the IN A FRIEND’S HONOR full collection, is Al Gavello (right) with James Jackson, available for purchase director, Environment of Care. in packs of 12 or in Holiday card larger corporate orders at www.kidsholidaycards.org or by calling Hospital Foundation Photo courtesy of Children’s 510-428-3814. Custom imprinting is The Second Annual KBLX For Kids Radiothon available. ★ was a huge success, raising $220,000 in pledges! Morning show host Kevin Brown’s live broadcast from the hospital brought together patients, families, caregivers, volunteers and donors. Change Bandits like little Eric (above) donated loose change for a big return. A special thank you goes to our lead Radiothon sponsor, the Foresters, a non-profit financial services organization serving as international title sponsor of the Children’s Miracle Network Radiothon program. 24 CHILDREN’S HANDPRINTS

spends less than 10 cents for every dollar raised. We know our money goes to the care of kids, not for solicitation of funds.” Bill graduated from Stanford with a

Photo by Vanya Rainova Photo by Vanya degree in economics. He worked with The Clorox Company in Oakland, retiring as executive vice president of corporate affairs, after 35 years of service, many as a member of the board of directors. Dottie, a University of Kansas graduate with a degree in business and a

BILL AND DOTTIE TOWERS IN THEIR FAMILY HOME IN MORAGA, CALIF. “What we want most for our children is to grow with a generosity of spirit.” Bill and Dottie Towers established an endowment fund to support Children’s Hospital and to inspire philanthropic behaviors in their children and grandchildren. Donors Nurture a Family Tradition o

Upon hearing the story of the family & Research Center Foundation, selecting minor in journal- of Albanian refugees whose children, the hospital as one of two organizations to ism, has worked as Vjollca and Dardan, received care at which they now make major contributions an editor and Children’s Hospital & Research Center at every year. The endowment is a permanent reporter for several Oakland (see Family Care on page 6), fund, annual income from which will be Bay Area publica- Bill and Dottie Towers pronounced it used for the greatest pediatric care needs of tions. “definitely more worthy of the pages of the hospital. The Towers have HandPrints” than their story. But the two “We were giving money to many chari- traveled extensively stories are intertwined: Vjollca’s care and ties, but not enough to make a dent in any throughout the treatment alone cost close to $87,000. The of them,” Bill explains. “So we decided to world, but their family’s Medicaid insurance covered some make significant gifts to fewer organiza- dearest wish remains of the expense, and Children’s absorbed tions, and Children’s was our first choice.” modest. “What we the rest. It is the philanthropic spirit and Two reasons influenced their decision: the want most is for our generosity of people like Bill and Dottie— hospital’s indispensable role in the com- children and their and their family—that ensure our ability munity and the financial profile of the families to grow of XX Photo couresy to provide excellent care to all children foundation. “We’ve observed and experi- with a generosity in today, and in the future. The Towers’ story enced Children’s first-hand and were spirit. We try to set as good an example is just as important as the Rexhepis’. impressed with their work and the broad as possible.” Bill and Dottie have supported spectrum of population the hospital And they do. The value of Bill and Children’s Hospital Oakland—along with served; it was important to us that there Dottie’s gift extends beyond their support many other local non-profit organizations was no discrimination in race, class or of Children’s: with it they offer a priceless —for many years. But recently, they estab- ethnicity,’ the Towers say. “But we were gift to their family by teaching them the lished The William M. and Dorothy Wise also impressed with the financial record of philosophy and culture of philanthropy. Towers Endowment at Children’s Hospital the foundation, which over the years The Towers say they “just married,” but FALL 2002 25

indeed that was 27 years ago. Between the two In a market filled with uncertainties, of them, Bill and Dottie have six children, 21 grandchildren and eight great grandchildren. a gift that guarantees payments for life On holidays, instead of receiving presents from In these financially uncertain times, wouldn’t it be wonderful to receive their family, Bill and Dottie ask them to con- guaranteed payments for life in exchange for a charitable gift? That’s the way tribute to their endowment at the foundation. a Children’s Hospital & Research Center Foundation gift annuity works. “We have given generously to our children, Not only will you have the satisfaction of helping children get the best and they want to give back to us. But we medical care, you will also receive an annuity backed by all the assets of this really don’t need anything, and what we need, charity. For older donors, the annuity rates are often substantially higher we buy,” the Towers say. “So we thought the than the returns on CDs, money market funds, stocks and bonds. endowment would be a nice outlet for them, Here are sample rates currently in effect: and some have really gotten into the whole Single Person Married Couple act.” Last year, the endowment received addi- AGE RATE AGE RATE tional gifts from their children and grandchil- 65 6.7% 65/65 6.3% dren. The youngest Towers to contribute is just 70 7.2% 70/70 6.6% 5 years old, and he donated $50 dollars from 75 7.9% 75/75 7.0% his piggybank. The tradition of philanthropy 80 8.9% 80/80 7.0% has certainly caught on in the Towers family 85 10.4% 85/85 8.7% through their endowment fund. ★ Example: Ethel Smith, 85 years old, has common stock in a company that pays her a dividend of 2 percent per year. Ethel’s $10,000 worth of stock provides her with a quarterly check of only $50—a total of $200 a year. Ethel can transfer this stock to the foundation in exchange for a gift annuity. With a rate of 10.4 percent, she will receive $260 each quarter or $1,040 f Philanthropy each year. She will also enjoy a charitable income tax deduction of $4,848 (based on the August 2002 applicable federal rate). In addition to guaranteed payments, a gift annuity provides other benefits, including: • A significant charitable tax deduction • Payments that are partially tax-free • An annuity rate often higher than the interest paid on current fixed investments • Capital gains tax savings when the donor is one of the annuitants • The satisfaction of helping restore children to good health Our gift annuity donors also become members of the Legacy for Children’s Care. These forward-thinking people are our partners in planning for the care of coming generations of children. Their gift annuities and other planned gifts ensure that vital resources are in the pipeline to help Children’s Hospital carry its mission into the future. In recognition of their foresight and generosity, the names of these donors are included in the new Legacy Memorial located in the atrium of the Outpatient Center and published in the annual Honor Roll of Donors. Donors are also invited to the annual A PART OF THE TOWERS Legacy Celebration, the Chairman’s Circle Dinner, What’s Up Doc? FAMILY GATHERED AROUND Luncheon and other invitation-only events throughout the year. THE CHRISTMAS TREE On Would you like to learn more about Children’s Hospital’s gift annuity holidays, instead of receiving presents program? Emily De Falla, Vice President of Children’s Hospital & Research from their family, Bill and Dottie ask their children and grandchildren to Center Foundation, can provide a tailor-made illustration showing you make gifts to the “family endowment exactly how a gift annuity can work for you. Please call 510-428-3362. fund” at the foundation. This is not legal advice. Any prospective donor should seek the advice of a qualified legal, estate and/or tax professional to determine the consequences of his/her gift. 26 CHILDREN’S HANDPRINTS

[CONTINUED FROM PAGE 5] OwnIN THEIR WORDS

“first picture” of our daughter to deliver to me. How thoughtful of them to do something so sim- ple that meant the world to me! On my first visit with her, Macey lay intubated. I remem- ber seeing her heart race on the monitor and asking why. “She’s crying,” they told me, “but because she’s intubated, there’s no sound.” I watched the nurses take care of her, wanting so badly to hear the sound of her crying. Thinking about how we were going to afford all the medical expenses made me sick to my stomach. But a social worker, Darby Schouten, MSW, came to our rescue. “Don’t worry,” she told us, “whatever your insurance doesn’t cover and Dotty Walczak, REUNITED Macey and ICN nurse you cannot pay, Children’s Hospital will, pital Macey’s nurse, RN Dotty Walczak, RN, having a woman- so just focus on your daughter.” She set , told me to stop crying because this was a happy time, and it truly was. to-woman chat at the 2002 Intensive up a counselor to help us get through Care Nursery Reunion. this tumultuous Children’s staff came to time; she made lac- the rescue of our daugh- tation and “well In 2001, Children's ter and family, yet they I often remember Dotty’s words never asked for anything health” appoint- Hospital Oakland’s before we drove away: “Kim, this is a ments for me. but for me to focus on time you’ll never forget and Macey will As the days Intensive Care Nursery our daughter’s health. never remember,” she said. “So go home passed, Macey Today, Macey is a and enjoy your daughter.” I thank God cared for close to 600 ★ made huge strides. happy and healthy 2- and Children’s Hospital for that. One by one, all the newborns and infants. year-old. We endure the tubes, wires and ups and downs of par- ventilators were enthood, but her crying removed. On the 10th day, she received doesn’t bother me. Instead, it gives me a a clean bill of health, and we could head sense of peace and faith because hearing home and be parents. As we left the hos- it means she’s healthy.

www.childrenshospitaloakland.org FALL 2002 27

Who’s For Kids and Who’s Just Kidding? President & Chief Executive Officer Tony Paap You know things are not well • In addition, families will need to re-enroll Senior Vice President, when in the world’s wealthiest coun- for MediCal benefits several times a year External Relations Mary L. Dean try more than 10 million children instead of annually. This will generate an Senior Vice President & lack health coverage. But when federal enormous amount of paperwork for hospitals Medical Director and state officials try to patch the budget and the state, which hopes that families will William Byrne, MD deficits by dipping into funds essential fail to sign up for benefits and thus be Senior Vice President, Research Burt Lubin, MD for providing care to all children, dropped from the system, “saving” money. Vice President, something’s gone terribly wrong. • The state budget also rolls back physician Patient Care Services More than 50 percent of the chil- reimbursement rates to 1982 levels—an Valerie Roberts, RN dren served by the nation’s pediatric facilities entire generation ago. Consider the numbers: Vice President, Ancillary & Support Services receive Medicaid, which reimburses, on average, the average MediCal visit now reimbursed at James Jackson 70 cents per dollar of actual cost of care. More $20 will drop to $16. The effect of this cut is Vice President, Legal & Risk and more of the remaining expense is absorbed that fewer physicians will be able to care for Management Marva Furmidge, Esq. by children’s hospitals which struggle to main- MediCal patients. Vice President, Chief Information tain the fragile balance between their commit- • The state will “rake off” an administrative fee Officer ment to delivering the best care to all children of already-reduced federal DSH dollars Don Livsey and the complex economic circumstances that intended to go to hospitals, to the tune of $55 Interim Vice President & Chief Financial Officer threaten this mission. It’s never been an easy job, million dollars (though the cost of administer- Roger Roux but recent unprecedented state and federal ing the program statewide is only about $1 Interim Senior Vice President & budget cuts have placed our most vulnerable cit- million). Chief Operations Officer Dave Bertauski izens— and the institutions that serve them—at What is the potential impact of these Children’s Hospital & Research Center great risk. combined cuts? Under the present circumstances at Oakland Board of Directors Consider the facts: Children’s Hospital Oakland is faced with a Harold Davis, Chairman • The federal government allots disproportionate Pamela Cocks, Vice Chair terrible choice. Continuing to provide all the Arthur D’Harlingue, MD, Vice Chair share hospital (DSH) funding to states to be services needed by the kids today puts at risk the Robert C. Goshay, PhD, Vice Chair distributed to eligible hospitals such as hospital’s ability to provide even reduced services Edward Ahearn, MD William Byrne, MD Children’s Hospital & Research Center at to the kids of the future. But, if Children’s Oakland. Since 1998, federal DSH funding to Jeffrey Cheung cannot provide the care needed by all kids in our Michael Duncheon, Esq. children’s hospitals has been reduced by $40 community, who will? Legal Counsel million, and more cuts are slated for next year. Steven Feldman, MD From minor scrapes to major illnesses, Donald Godbold, PhD • In addition, Secretary of Health and Human Children’s meets the needs of more than James Hanson, MD Services Tommy Thompson has slashed the 176,000 kids who visit the hospital annually. Seymour Harris, MD Upper Payment Limit (UPL) reimbursement This number itself is impressive, but more Irma Herrera to hospitals by 30 percent effective May 14. Hyacinth Hewan important are the 176,000 stories of pain and Howard Jackson The UPL helps offset the low reimbursement hope, crisis and recovery, worry and compassion. Watson M. Laetsch, PhD rates provided by MediCal. California’s Any of these children could be a child you Barbara May Alden McElrath children’s hospitals could lose as much as $80 know. For many of them, Children’s offers the million per year as a result of this cut. Masud Mehran only access to quality healthcare. We cannot, Linda Murphy • At the state level, fewer Californians will and must not, let these children fall through the Betty Jo Olson qualify for MediCal because the threshold cracks. Tony Paap income eligibility is being dropped from Rudolph Peterson There is only one reason for a child to be Harold C. Warner, PhD $15,000 per year to $9800 per year (at sent home from the hospital: because they are Chester Weseman, MD $4.71/hour, a rate well below even the better. To shut the door on a helpless child dur- Steven Yedlin, MD minimum wage). ing a time of crisis would be unconscionable. ★ Story requests, comments or suggestions for Children’s HandPrints may be e-mailed directly For more information about how you can become an advocate for children, to Vanya Rainova ([email protected]), or contact Mary L. Dean, Senior Vice President, External Relations at 510-428-3464. sent to 665 Fifty Third Street, Oakland, CA 94609. who's for kids and who's j ust kidding ?

On Oct. 24, 2002, Children’s Hospital & Research Center at Oakland will host a day-long summit on children’s health. Focusing on the relationship between health and education and the importance of community partnerships in maximizing the effect of available services, the summit will combine panel discussions with opportunities for participants to share ideas and insights, and develop a partnership vision and action plans for children’s health and well-being.

For further information, please contact: Mary L. Dean, Senior Vice President, External Relations, at 510-428-3464.

www.childrenshospitaloakland.org

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