For decades, I practiced developmental-behavioral pediatrics with a focus on coordinated care, measurable goals, and clinical accountability. I believed that if we could define a child’s needs clearly and track progress with integrity, we could build systems that honored both science and dignity.

But I now realize I missed something critical.

After reviewing the #BanABA initiative and speaking with Dr. Henny Kupferstein, I’ve come to understand the full scope of harm linked …

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The terrain I refused to leave

At Madigan Army Medical Center, I built a diagnostic model that delivered autism answers in under 30 minutes. No shortcuts, just smarter care. A Ph.D. pediatric nurse practitioner performed triage. I conducted the Screening Tool for Autism in Toddlers (STAT-MD), a targeted autism screening protocol developed at Vanderbilt, confirmed criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and families left …

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I learned that in a rural exam room where four agencies circled a child with autism; and no one moved. Not the nurse. Not the case manager. Not the system. The child failed the Autism Screening Test. He was nonverbal, avoided eye contact, even with his parents, and flapped his hands while playing with toys in unusual ways. The signs were classic. The diagnosis was clear. I spoke the “A” …

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Florida has seen over 1,300 pertussis cases this year, an 81 percent increase from 2024. I didn’t speak as a retired pediatrician. I spoke as a witness: a witness to systems retreat, a witness to the dismantling of public health, and a witness to the consequences of ignoring coordinated care.

The numbers are staggering. Over 1,500 confirmed measles cases in 2025. Three deaths, the first measles-related fatalities in the U.S. in …

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I entered medicine not just to treat illness, but to confront injustice. I wanted to be a force for good, battling death, yes, but also misinformation, institutional neglect, and the quiet superstition that children with developmental disabilities were somehow less worthy of coordinated care. That conviction led me to align my career with the legacy of Eunice Kennedy Shriver, whose advocacy gave rise to the Special Olympics and helped shape …

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In 1995, I stood at the edge of a map most policymakers ignored: Appalachian Ohio. The Surgeon General’s 2002 report, “Closing the Gap: A National Blueprint to Improve the Health of Persons with Mental Retardation,” would later cite our work as a model for rural specialty outreach. But long before that recognition, we were ledgering care into counties where children with developmental disabilities had no clear path to diagnosis, let …

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My wife, Kathy, had stage 4 end-stage renal disease. She was slowly dying, but never stopped living. Her resilience in managing peritoneal dialysis made travel possible, even with the logistical complexities involved. Ireland had long been on our bucket list, inspired by Kathy and Stephanie’s earlier visit while we lived in Peoria. With careful planning, we booked our flights using points out of Orlando, knowing the drive would minimize Kathy’s …

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In Minot, I practiced a kind of pediatrics no flowchart could predict: improvised, airborne, and often surgical. Minot didn’t always follow the flowchart. One night, a toddler arrived in the emergency room, inebriated. Her father had given her vodka for teething pain, never imagining she’d swallow it. She did. She stopped breathing. I called a code and began CPR, ordering a blood alcohol level (BAL) and routine labs. Her BAL …

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I was not just a contributor. I was the pediatrician in the room, the one who translated clinical reality into research clarity, even when the system preferred abstraction.

From 1997 to 2003, I lived a six-year burst of energy: equal parts clinical invention, research precision, and institutional resistance. It was my Trinity Site: a catalytic moment where everything fused: rural care delivery, editorial rigor, and systems reform. The fallout still shapes …

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He was five, wiry, and fast, so fast his mother looped her purse strap around his wrist in the waiting room. She spoke softly, in Spanish, explaining that he could not sit still, could not sleep, could not stop. As she described his meltdowns, he interrupted with nonsense sentences, unrelated to her words, untethered from context. It was not defiance; it was overflow.

I and my team of CNA Spanish interpreters …

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