In my previous critiques of the failure of the American Academy of Pediatrics (AAP), the American Board of Pediatrics (ABP), and the Society for Developmental and Behavioral Pediatrics (SDBP) titled “Why developmental and behavioral pediatrics faces a recruitment collapse,” I argued that “leadership presence without leadership action is theater.” The SDBP strategy had no actionable items.
Any military historian will tell you that in addition to an overall strategy, you have to factor in your resources (logistics) and tactics. This was epitomized by the back-and-forth struggle between Gen. Rommel and multiple British generals in the deserts of North Africa between 1940 and late 1942.
Each side could take territory until their supply lines stretched too thin. A sustained push by the British was a result of American entry into the war and supplies like howitzers and tanks, that Gen. Montgomery built up before the Second Battle of El Alamein.
The supply lines were secured with the addition of American naval and air power. Also, the Allies invaded Morocco and Algeria creating a two-front war.
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General Eisenhower let Berlin bleed down to nearly the last Soviet; Patton secured his flank at Pilsen but obeyed orders to halt. The Czech resistance was left to Soviet tanks, and Prague’s liberation delayed for decades.
The result was three years of relative liberation for Czechoslovakia until the Soviets took control in 1948. The Czechs tried to rebel in the Prague Spring of 1968. The Prague Spring of 1968 was crushed beneath Warsaw Pact tanks. The seedlings of liberalization smothered, the lesson ignored. But the Czechs have learned the lesson. They know, for sure, that Putin wants his remaining tanks back in Prague again.
Putin thought Kyiv would collapse in three days. He overstretched supply lines. One million casualties later, Russia bleeds again. He, like pediatric leadership, never learned from history.
Pediatrics ignores the lessons of logistics.
In pediatrics, the same failure to secure supply lines (trained specialists, sustainable programs, measurable outcomes) has left children stranded in deserts of neglect. The “geniuses” of the pediatric “leadership” fail to understand logistics and tactics. They are incapable of learning from history. When faced with a crisis in developmental care of children, they trot out the same old “solutions” that failed in the past. Children, like nations, cannot afford leaders who recycle failure.
When institutions recycle failed leadership, it’s like slapping a retread tire on a truck: spitting rubber, shedding fragments, and leaving a trail of waste. Instead of traction, you get the same failures repeated, while those of us who came to rebuild are left to witness the wreckage. Every recycled leader is another bald tire, slipping in the rain, skidding on the ice, leaving families in the ditch. They are the casualties of pediatric leadership failure.
Success through strategy, not theater
When I successfully applied for the Leadership Education in Neurodevelopmental Disabilities grant and created the Ohio Rural Developmental and Behavioral Initiative, I had an overarching vision and strategy. To it, I added documentation of resources I had available (logistics) and a plan to carry out the measurable tasks at hand (tactics and measurable outcomes). That is why my application ranked fifth out of the 25 approved and funded applications, and this is why the program remains strong after a quarter century. My competitors had no logistics. No tactics. No outcomes. Just theater.
But the “woke” pediatric leadership hold former military officers in disdain, despite our records of success. I improvised, adapted, overcame, and built programs that endure. They recycled, retreaded, and failed. That is the difference between command and theater.
Because I was not allied with the leadership, I was blackballed and my expertise never put to use. Pediatric leadership could not see past legitimate criticism. Like petulant children, they wished I would go away and die in obscurity. Even after retirement, I have reached out to offer my experience. I remain tall and strong in the arena of public opinion. But I am banned from their sandbox arena and toys.
When I look online, I am not listed as a reformer because I did not rely upon the grace of the pediatric leadership. I was an independent. A rebel with a cause. I refuse to roll over like Congress and beg for a belly rub for doing the president’s doing, including war crimes.
Leadership without logistics is theater. Strategy without tactics is fantasy. I built programs with vision, resources, and measurable outcomes, and they endure. Pediatric leadership recycled failures, blackballed expertise, and banned voices. The result is wreckage. The difference is clear: I improvised, adapted, overcame. They performed theater. And children paid the price.
That is the ledger of failed command.
Ronald L. Lindsay is a retired developmental-behavioral pediatrician whose career spanned military medicine, academic leadership, and national advocacy for dignity-centered neurodevelopmental care. His NIH-funded work with the RUPP Autism Network helped define evidence-based approaches to autism and related developmental disorders.
He directed the LEND Program at The Ohio State University and founded JBLM CARES, a $10 million autism resource center for military families. His writing spans clinical scholarship and long-form fiction. He is the author of The Mercy Directive and the six-novel Cassandra series, a completed political and medical fiction saga tracing the rise of the Cassandra system from its origins to its national and international legacy. His forthcoming memoir, The Quiet Architect, examines how conscience and structure collide in modern medicine.
He shares updates on LinkedIn.
