50 YEARS A PEDIATRICIAN: THE PATIENT COMES FIRST
“I wouldn’t take back a single day,” pediatrician Mary Bukovitz declares as she reflects on her 49 1/2 year career caring for children in Morristown, Tennessee. “There are a lot of challenges, but if you love people and want to help them, it’s the most wonderful profession.”
The daughter of a coal miner, later mine inspector, Mary grew up in Jellico, Tennessee. After graduation from her community high school, she completed pre-medical studies at the University of Tennessee-Knoxville. Medical school in Memphis followed. She was one of three women in her class of 90. Upon graduation in 1967, she married Kenneth Allum, M.D., a resident in internal medicine. Three children and 10 grandchildren grace their union.
A pediatric rotation during her internship convinced Mary to undertake a two-year residency in pediatrics, splitting her time among John Gaston, Le Bonheur and St. Jude’s hospitals.
Mary and Kenneth selected Morristown as the site of their solo, independent practices. Each would add partners to their practices over the years. She cherished her colleagues, who would share consultations, concerns, affection and laughter.
Mary estimates that she cared for thousands of patients during her half-century of work. Many children chose to remain under her care through their years in college. Sometimes she had to suggest to an older patient that it might be time to move to an adult practice. Especially gratifying are instances in which a patient of years earlier identifies himself or herself to Mary: “Dr. Bukovitz. Remember me?”
Vaccines represented one of the most valuable medical advances during her years of practice. DPT and polio vaccines were already established. Before the development of vaccines for bacterial meningitis, Mary and her colleagues performed spinal taps on children whose high fevers, headaches and stiff necks suggested the dread infection. When the test confirmed the presence of meningitis, she admitted the affected child to the community’s hospital for intensive antibiotic therapy. Thanks to vaccines such illnesses are now rare. She is concerned by persistent, anti-vaccine rhetoric.
More recent years brought a rise of social and psychological problems for children in middle and high school. She worries about the number of children who are treated with medications for anxiety and depression without adequate counseling. She believes that children spend too much time on electronic devices, missing opportunities to play together and to be outdoors.
The growing epidemic in opioid abuse generated new problems. She cared for newborn children who suffered from neonatal abstinence syndrome. This occurs when a child is born to a mother who is habituated to opioid medications. She praised grandparents, who assumed the roles of principal caregivers for children whose parents were incarcerated for drug-related crimes.
Along the way there were tragedies. Accidents sometimes took the lives of children. A child might suffer from a progressive, inherited disease for which there were limited options for treatment.
Looking into the future, Mary sees enormous benefits accruing from genetic testing. This technology will allow for early diagnosis of such inherited diseases as cystic fibrosis and muscular dystrophy. Genetic counseling for couples will be facilitated. Gene therapy, for example replacing an abnormal gene, will likely facilitate cures where once there was progressive disease.
The next phase of her career will involve volunteer work with children and mentoring of physicians in training. Retirement is not an option.
Science and technology continually advance. At the heart of clinical practice is the personal engagement of a caring, informed physician, working with a team that includes nurses, laboratory and X-ray technicians and a variety of therapists. That is the unifying factor in the decades-long procession of people who address the health needs of their fellow men, women, and children.