Japan’s declining birthrate is often discussed in terms of how to encourage people to have more children. But supporting children after they are born is just as important. Pediatric medicine, including pediatric pathology, is part of that safety net. A recent visit from a pediatric oncologist from Warsaw reminded me how fragile highly specialized pediatric services can become when case numbers are small and staffing is limited.
A manuscript review that I had rather carelessly agreed to take on was withdrawn without my realizing it, just when I had finished putting together about half of my comments.
I suppose I should feel relieved, although part of me also thought that I would have liked to see it through to the end.
Still, when I think about the possibility of having to review the revised manuscript again afterward, I decided that this time I would simply leave it alone.
So the time I had set aside for the review suddenly became available, and things became a little easier.
I had given presentations at academic meetings for two consecutive weeks and was also carrying two manuscript reviews, one of which was the one I had “carelessly accepted.” Recently, I have almost been pushing work through by sheer momentum. But mistakes are not allowed, so it has been quite demanding.
Today and tomorrow I have rather intensive conferences to prepare for, and now I should be able to spend a little more time getting ready for them.
I have also resumed preparations for the academic meeting I will be organizing in February, and yesterday I sent out emails calling for general abstract submissions and took care of several related matters.
Even though I had gained a little extra time, yesterday a pediatric oncologist who had come all the way from Warsaw visited our hospital and also stopped by the pathology department.
I showed her several representative pediatric cancer cases that we have encountered here, while explaining how pathologists work together with oncologists, surgeons, radiologists, and other specialists in our hospital.
Our pathology department is separate from the adult hospital next door, so I work essentially as a pediatric pathologist.
Because obstetrics is located in the adult hospital, I go over there to handle placental pathology, but pathologists from the adult hospital rarely come to our side.
About the only time we consult them is when an adult-type malignant tumor, such as a carcinoma, develops in a child.
At her hospital, however, although the adult and pediatric facilities are separate, there are too few pathologists, so they have to cover both.
Because the number of pediatric cases is also limited, pediatric pathology inevitably tends to receive less attention.
I told her that we hold regular multidisciplinary conferences, and that many surgeons and oncologists personally bring specimens to the pathology department, giving us frequent opportunities to discuss individual cases in detail.
She said that when she returned home, she would try to establish something similar.
I wonder whether my comments were of at least some use to her.
There was also a pediatric pathology meeting recently, and it was clear that pathologists at many institutions are struggling in various ways.
The declining birthrate, together with the decline in obstetric activity, is steadily affecting pediatric medicine.
Pathology is particularly vulnerable because the number of cases is not very large to begin with, and staffing and equipment tend to be given lower priority.
Some people complain that they are told,
“Surely one person is enough?”
I cannot help feeling sorry for them.
I myself joined my current hospital after the previous pathologist had suddenly left, meaning that I arrived at a department with no pathologist at all.
Even during the COVID-19 pandemic, there was still a steady number of sick children, so I remained reasonably busy. In a sense, though, it helped that overall social activity had slowed down.
Now the pandemic is over, and I have managed to find a somewhat younger pathologist to work with me. We currently operate as a two-person team, and I consider myself very fortunate.
If we are going to talk seriously about policies to address the declining birthrate, we need to think not only about encouraging people to have and raise children, but also about maintaining pediatric medicine as one of the safety nets that supports families throughout that process.
Policies should not focus only on increasing the number of children.
Maintaining a healthcare system that properly protects the children who are actually born should also be considered part of any meaningful response to the declining birthrate.
I would like to see pediatric medicine strengthened as a matter of public policy, with greater attention also paid to pediatric pathology, which forms part of its foundation.
Unfortunately, things do not always move in that direction.
Supporting children after they are born should be just as important as encouraging more children to be born.
・・・
declining birthrate
出生率の低下、少子化。
safety net
困った時に人を支える制度や仕組み。ここでは小児医療を指している。
see something through
始めたことを最後までやり遂げる。
by sheer momentum
勢いだけで何とか進める、というニュアンス。
multidisciplinary conference
複数の診療科・専門職が参加する合同カンファレンス。
receive less attention
十分な関心や優先順位を与えられない。
vulnerable
影響を受けやすい、脆弱な。
give lower priority
優先順位を低くする、後回しにする。
meaningful response
実効性のある対応、本質的な対策。
form part of its foundation
その基盤の一部を成す。
#DecliningBirthrate
#PediatricMedicine
#PediatricPathology
#HealthcarePolicy
#ChildrensHealthcare
#Kamakura
#JapanesePathologist
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