Dr. Neil Schechter begins this interview by describing the state of the pediatric pain field during the late 1970s. As he was training, he "felt it was a bit wrong" to have the disciplines dealing with physical and emotional/mental well-being so divorced from one another, especially with unaddressed psychosocial care for pediatric patients and families during complex chronic conditions such as cancer and sickle cell. Dr. Schechter also recalls a prevalent fear in the medical community of addicting children to pain medication, which kept clinicians from treating children's pain at all. Dr. Schechter questioned why pain was so chronically undertreated in pediatric patients and participated in numerous academic research inquiries into how to safely prevent pain. With a small community of like minds that he fostered, Dr. Schechter ventured forth into broadly exploring and reframing the way pain was thought of by clinicians. After Dr. Schechter began to develop a pediatric pain program at the University of Connecticut, he found that pain was often thought of as a psychological construct that was divorced from any biological implications. He worried that this commonly held theory was prolonging harm and suffering experienced by pediatric patients, while also weighing heavily on the clinicians that were referred to work with the suffering children. In several of his works, Dr. Schechter investigated common medical practices and concluded that many of them were causing unnecessary biological and psychosocial harm to children. He also challenged his clinician peers to think about why they would do something to children that they would not do to adults getting the same treatments. Dr. Schechter discuss how his work built on the foundational work of his colleagues and peers. He recalls several instances he was able to rally similar minds to collectively publish research texts informing and advocating for medical practices to change. In his local institutions, Dr. Schechter was successful in advocating for institutional reform to improve care that was committed to causing no further biological or psychosocial harm to kids. This also spurred him to found the nonprofit ChildKind that is committed to aiding institutions in preventing pain for pediatric patients. Dr. Schechter then goes on to describe the various challenges he faced in his career including peer clinician resistance, divisive national sensationalism of his work, and medical models that were incomplete or lacking in understanding of holistic human well-being. He also explains that some of the bad habits of the past are continuing into the present day practice. He concludes the interview by describing practices that could be altered to achieve a better understanding of patient health, such as reexamining why hospitals don't prevent needlestick pain when it is within their ability to do so. Dr. Schechter also celebrates the positive advances that have been made for pediatric pain.
Pediatric Palliative Care Oral History Project
Bernard Becker Medical Library, Washington University in St. Louis
"Neil Schechter Oral History." (2019). OH154-S30-i01, Bernard Becker Medical Library, Washington University in St. Louis.