A special remembering the classics
Ray Kinsella: “Fifty years ago, for five minutes you came within... y-you came this close. It would kill some men to get so close to their dream and not touch it. God, they'd consider it a tragedy”.
Dr. Graham: “Son, if I'd only gotten to be a doctor for five minutes... now that would have been a tragedy”. From the movie Field of Dreams
The White Sox and Yankees will take part in the 2021 Field of Dreams Game in Iowa today. I (Myron) am sure that you’ve all seen the movie, probably more than once, and remember its iconic line "If you build it, they will come”. Dr. Randy Flick, of the Mayo clinic and former Society for Pediatric Anesthesia president, reminded me this morning that one of the iconic characters in the movie, Doc “Moonlight” Graham (“he could run faster than moonlight”), was a legendary community doctor, who practiced medicine in Chisholm MN for more than 50 years. Before becoming a doctor, “Moonlight”, played minor, and very briefly, major league baseball. What I (MY) didn’t know was that Dr. Graham in 1945 published a seminal paper, his one and only publication, on blood pressure measurement in children. I’ve asked Randy to co-edit this PAAD with me. Before getting started though, we would urge you, if you have a moment, to watch the video produced by the Mayo clinic and narrated by the great Vin Scully on the life of Dr. Graham. Unfortunately, because the paper was published in 1945, we can’t provide a link to the original paper. On the other hand, Randy was able to make a PDF and if you would like a copy, contact either one of us and we can send it to you.
Original article
Archibald W. Graham, M.D. Chisholm, Minn and Edgar A. Hines Jr., M.D. and Robert P. Gage, M.S. Rochester, Minn. Blood Pressures in Children Between the Ages of Five and Sixteen Years. Am J of Diseases in Children. 1945; 69:203-207
We take blood pressure measurement for granted today. It’s measured non-invasively and automatically every 5 minutes or so in the OR as a vital sign, it can be obtained in patients of all ages almost effortlessly just about everywhere, in a local pharmacy, fire station, or barber shop, and tables of normal values are easily available in most textbooks, mobile apps, electronic medical records, etc. Indeed, it is so important that in developing the SPA’s Pedi Crisis app V 2 (if you haven’t downloaded it yet, do it now!), the normal BP chart was considered an essential element in its design. So, it’s hard to imagine that for much of the first half of the last century, BP was not measured in children at all because hypertension was not thought to exist in children. Even how to measure it was not completely clear and normal BP ranges were unknown. Stepping up the plate, Dr. Graham, who was the primary and school doctor in his community, embarked on a 25-year quest of measuring blood pressure in all children attending school in Chisholm. He sent his meticulously kept data to the Mayo clinic for analysis and the rest, as they say, is history.
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