Dominique is csotcina.comedic surgeon pediatrist with the of Limoges and it stuck in its field to undertake an at the same time general-purpose and specialized activity. It was group chief executive of Study in Pediatric csotcina.comaedics during 2004.

 

. : Speak to us about the organization of the and its recent transfer in French company of Pediatric csotcina.comedics…

: The office of the Group of Study in Pediatric csotcina.comaedics is a team joining together four times a year ten elected members who ensure the continuity of the projects. I was among them last year at the time when this transfer of the in i.e. French company of Pediatric csotcina.comedics could be forwarded to all our partners. It is as much conviction than opportunity. The aim was not to break with some society that it is, nor to gain in range, but to confirm our specificity: pediatric csotcina.comaedics. The term of Society makes more readable our work, as well on the national plan as international.

. : How was born the ?

: The was born there is nearly thirty years, within the under the impulse of P. , . , , H. , B. and . . That started, at the time, of the very firm and argued oppositions of certain great names, defenders of an indivisible csotcina.comedy. The facts and the spirits changed little by little, but what feared our elder arrived: in the breach of the of other specialities wanted the same reconnaissance. At the present time, the world of csotcina.comedy changes and the groups which worked within the become society “girls” to find itself at the time of a large gathering with the organization and the means that only the can mobilize. All the dynamics of our reflection was launched starting from this idea of society girl which allowed to be freed from the word “groups”, without shocking nor to divide. We quickly reported ourselves, these last years, that this term of group did not have any significance in the Anglo-Saxon world, in particular at the moment when much among us had acquired their noble letters at the European society which is the and took an active part in the american company i.e. the . Into twenty years the was transformed. The impulse given by our Masters did not weaken and the number of communications and their quality created an incredible dynamism. Thus, we attended the unification of our practices, with the transparency of all our activities, the creative and critical spirit which still reigns in spite of a development which is likely to become a little too consensual with my taste. Singularly, we did not have any equivalent group in Europe, because no country the csotcina.comedic activity of pediatric surgery and none as many had exclusive experts in this speciality. It was that the French exception, and, for the majority among us, the ambition remained hexagonal whereas all around us each nation created his society, small certainly, but joined together by continent; all started to weave a fabric in which we represented only one mesh, on a one only country scale. In spite of that we remained strong and noble, can be with certain reasons, but with little reconnaissance beyond our borders. It was thus necessary to pass to high speed and especially to announce it in these foreign companies. Twenty years ago us did not make a success of the passage of all shuntings. Let us remember the solitary initiative of H. to create the , already our group quivered and sought to open: we invited, Monday morning, with the , of the foreign speakers. Also let us remember the splendid work undertaken by Jean Claude for the summaries and to translate into English best work of these ten last years. However, in spite of the efforts of some, which had woven privileged relations with the United States, England, Italy, Spain, South America, the group itself did not start on the international plan. The barrier of the language was there for much: no foreigner read French, too complex or too long papers, even when they were translated by our valiant corresponding, ! Conversely, very little among us was able to support an argumentation firmly or to establish a durable link by a followed conversation. All that is regrettable, he goes from there thus from any crop, any literature. The chance had given birth to more the workers among us out of French ground with a crop, a specific language. Let us imagine today the flooded by work of Pierre , Jean Claude or so much of other French! Did we never read in the Anglo-Saxon literature of as good papers, if moderated, as those of the Trousseau school, Vincent Saint of Paul or the Ill children? But this immense work was extremely fertile, and it is on him that the most beautiful innovations were based, thanks to the engineering of some, their inventiveness and their dynamism and sometimes their “base”. Let us quote the fields, such as the deviations of the rachis and their approach 3D, traumatology and the , the processing of the inequalities length, etc We then started to be listened, visited, copied! Here is rapidly the inventory of fixtures of these last years, you measure the path traversed since.

. : Which are the relationship between the and the ?

:  Our situation compared to the was clarified in a few months: we preserve and let us be happy we, our statute of society girl, grateful to be lodged gracefully of long years, by making full house; we still keep a specific place in the composition of its Office, the congresses, the Review, the College. All this commits us to maintain a participation of number and in quality. It is necessary to confirm our attachment with the from which we are historically resulting.

. : What is it relations with the French company of Pediatric surgery?

: Our links with the are also very old since we are many surgeons of children and often share with our colleagues the structures, the personnel, like certain therapeutic strategies. These links somewhat distended with time. Because of , our poles of interest separated little by little, the transverse subjects are done rare, remains the specific know-how of the hospitalization of the child and the sharing of a true philosophy of the greeting and human reports. We can reverse the problem. The French company of pediatric surgery is in the same situation that the fifteen years ago. Little by little all the components of the surgery of the child were organized. The general surgery dies out gradually to make place with , fulfilling better the requirements of the families and our supervisions. Today csotcina.comedy, on the following day urology, soon it plastic, the cardiology, the neonatology, etc, all the components of the surgery of the child will require for a space of expression that a large society or pediatric surgical federation will be able to only offer. It is in Saint Sebastien, eight years ago, under the impulse of Claire , Maurice , of Jean , that took the first pitches of a , at the time understood very well. The concept of general surgery had been hustled, the symbol of the single amphitheater made place with two joint meetings and we found ourselves already only for the subjects of general order. It is this concept of society   “sister” who seems to me realistic today, gathering us around the only topic of the care and the hospitalization of the child. At the time or such an amount of hospital mother is built - child, we have to propose much and not only to defend. The reality of the daily newspaper brings back the every day for us in the pediatric world, with this cohabitation necessary. Per hour when our economists speak to limit the number of the specialities,   the shares of our Office go in the direction of a pooling of our trade-union, teaching problems and daily operation. The moment of this transfer finally came, the day before a great congress of medical and surgical pediatry which will be held in Lyon in 2006. There is no error of casting, we follow the line. We will never make the policy of the empty chair: in Rheims, last September was held the congress of the , the csotcina.comedists pediatrists largely covered the time beaches by their communications and their roundtables: the has as a principle always of benefitting from the several half-day appropriateness to forward its work… and to publish them in the which now opens to pages dedicated to society “girls”. But to transform, it is also to create and the obtains statutes more precise and more current than those of the and rules of procedure which clarify our position. It was a large work, it is accomplished today; the future is promising.

. : Let us speak about you. How were attracted towards the pediatric surgery?

: I lived all my childhood in the middle of the cries, of the tears, the pushchairs, the queues, the overloaded timetables of my father and my older brother. Not very many, the pediatrists of the time was inhabited an unbounded passion. Without me to report some, I was soaked by this spirit, and in spite of a little delay to “the ignition”, because with the college and the college I dreamed to become guide of high mountain, I understood that this model was the good and that, genetically undoubtedly, I were impassioned by the world of the care. I returned in Medicine with the conviction that only the surgery interested me in the great despair of my close relations who did not understand this singular vocation. I fortunately shared this passion with some friends, and very quickly, as of the first years, were connected operational aid downtown, the laboratory of anatomy, the preparation of the day school with two marvellous godfathers, Jean Paul and Henri . They are the most beautiful years of my existence, in spite of the change of the rules of the game in the course of party, after the events of 68. Singularly, my first slope was for the visceral surgery and it is in the course of boarding school that I discovered csotcina.comedy and more particularly the pediatric csotcina.comedics. At that time Jean exerted part-time and projected to take with Claude the reins of teaching hospital csotcina.comedy. The csotcina.comedic pediatric crucible was particularly important. Jean Luc Alain had just taken his functions, extremely complete pediatric course, near the best Masters of the time. Claude with Jean , operated several scolioses per month and Jean François made an arrival crashing to pieces in Limoges after his formation with , Saint Vincent of Paul and Toronto. I heard only of Pierre Petit, left invisible reference. In the congresses, like much, I was then fascinated by the clearness and the quickness of mind of Pierre who animated all the debates and covered every month of items the Review of csotcina.comedic surgery on difficult and mysterious subjects. I was consequently interested. I informed Jean of it, who encouraged me and recommended to me at Pierre . All started thus, like always by meetings, affinities, links which were woven and which never deteriorated through all these years. After a stay at Pierre , Jean Paul , Georges and Philippe , returned to here me is among the , and accommodated fortunately well by Jean Luc Alain who developed, with the meticulousness that one knows to him, infantile department of surgery. The task in pediatric csotcina.comedics was difficult, so much were dispersed competences between the and the private clinic. Jean François , fortunately, created the hyphen while coming every Thursday to operate rachis and hips; it was then the time of the , of the great deformations. Despite everything these favorable elements, it was necessary many years for me to understand, assimilate and start to control the discipline. I admire today the patience of Jean Luc Alain and his tolerance knowing his taste for excellence. But the choice was confirmed, after six months enthralling last at Denis Pellerin, of Claire and , I soothsayers certainly a little surgeon pediatrist, but primarily and definitively csotcina.comedist. Pierre prevented me whereas a life was not enough to apprehend the magnitude of this trade. I realize today how much it was right.

. : You took part in a solid groups bibliography; what do you think about it today?

: In the Eighties, we were a dozen, all persuaded which we did not know large-thing and which our incipient speciality was very intricate; it was necessary to share the little which we had succeeded in assimilating. In fact the engineering problems impassioned us, nor files, but of true meetings of bibliography on a given topic which joined together us every two months. One or two among us prepared the subject which opened on long debates, of one or two days, true polemical which made us realize that all had been written and even its opposite. It was the leaven from which the most beautiful inventions would leave, more nice ideas that the majority among us could realize thereafter. Our group called was at the very least rather heteroclite judge: Gerard , Jean Michel , Pierre , , Luc , Alain Tanguy, François then , Jean Michel , Jean Claude de , Pierre !!! Remi imposed his discipline and us to us it meanings, whereas none among us supported the daily discipline of its service! We set out again saturdays or Sunday, the portfolio full with notes or updatings. Each one furbished in its corner, a new project. was on the path of Limoges and with Alain Tanguy we reviewed all the possible csotcina.comedic scenarios. I kept these marvellous preciously duplicated of , they are the basis of all our work and for some the drafts of their more beautiful publications. I do not know better manner of working that these meetings where each one comes from a different horizon to bring a new sound, a contribution. Prepared well, directed especially well, these meetings were in fact of the seminars in miniatures. The choice of the subjects made it possible not to have to undergo a technique or a priori of dominant school. We were not old but already we had discovered the receipt to understand, learn, tolerate and not to age too quickly in a priori. But, I repeat it, so that the receipt is successful, one needs a chief cook of talent, with a singular rigor. Did only one question remains for me unsolved, why Remi have choose us? It is necessary to ask him…

.: Impassioned you are known by teaching…

: Undoubtedly, because I learn and understand slowly, I always had a taste pronounced for clearness in the explanations. All that is intricate to express does not seem easy me to forward. Even the most abstract sciences can be forwarded simply. It is enough to find speed and the terms. It is a happiness to feel that one found the words, the tone, the formula, the images which hold the attention and end up lighting what was, there are a few moments, unknown or mysterious for a student. Isn't it as enthralling to explain the problem of congenital dislocation to a student of the second cycle as to describe the variety of malformations of the lower extremities to experienced surgeons? In both cases, that which you listening must set out again with the feeling of to know as far as you and if it understood, it will retain effortlessly and will never forget. I often tell the students to look at, listen, take part and automatically the desire of more will urge on them. Nobody had by heart learned the description of the model 1990 from Renault 4 and yet in a wink any child was able to recognize it and describe it. Undoubtedly the salesmen of car are they better than us in pedagogy! Our problem today is especially not to miss our target: the students of second cycle, the interns, the general doctors, the surgeons installed, the csotcina.comedists in formation, a&E doctor, see that we are far from the few rare subjects registered with the new program of the second cycle of the medical studies and how much we should be rolled up the handles!

. : How engaged your teaching hospital career?

: I do not think that my life resembles a career but only so that I could realize and teaching remains for me the essential engine. Since the time of the conferences of boarding school until today, I never lost the taste of these means of communication. It should be recognized, that determined my choice for the hospital career because I would not have found my happiness without this daily exercise. My life thus began, very slowly besides, in this channel and I do not regret all this time of ageing after this departure with a a little naive enthusiasm in this speciality, because these years of assistantship were more than necessary. The ideas that we share with all my generation on the need for a broad dissemination of the transverse lesson realize finally and we find with the bosom even of the whole half-days of presentation of files of infantile traumatology which manage to join together more than 500 people: better still, with the last congress, a roundtable on the fractures of the two bones of the front armlever made full house in end of the week! 

. : In are your speciality, which your preferential fields?

: If the study of the physiology and the surgery of the foot granted great moments of happiness to me, it should be recognized that “learning curve” is ungrateful: more as of the my failures was given to me by the surgery of the equine clubfoot ! In spite of that I like always as much this nonrepetitive surgery with, each time, a problem to solve a little different. How that of the hip, the surgery of the foot of the small child and the adolescent seems to me the most accomplished craft industry still today! I lived on this subject long tournaments with Jean Luc Alain between holding and the outcomes of isolated posterior early lengthening, against the whole postéro-intern of which I was of course in favor because it was more modern. I still do not know who rightly…. And that to say difficulties and doubts met in the assumption of responsibility of second hand of hip dislocations known as congenital! Beyond the articular and segmentary surgery, my surgical life was organized around the handicapped person. My first patients were carrying after-effects of myelomeningocele, then I dealt with of so many . There is more than twenty years, the centers photogravure sailors were true temples, held by pediatrists and some doctors ; they knew their patients perfectly and fitted in true circuits of recruitment resulting from the “large houses ”. Its place had to be found, without imposing itself, without shocking, because the elder ones were very listened: , , , . I could benefit from an opportunity to go regularly to Saint Trojan on the Island of , then in , then in Limoges, then in , then to Charente… and to cover thus little by little all the area of the mid-west. I made long tours thus, accompanied by an intern more impressed than convinced. Today, I share with my colleagues a consultation in 13 centers and I still roll long hours so that the flame does not die out, because it is near looking after that one as well as possible judges state of a child and his progress. Our concern of the moment precisely lies in this necessary communication between all the centers and our service. We could develop thanks to all the speakers a card gathering all that is really important for the child: what he likes, how he is expressed, its drawings, its tastes, its photographs, its installations preferred, etc. A stay during the anesthetic evaluation makes it possible to formalize all that to avoid the large pitfalls which are the suffering and insulation. How much time I deplored incomprehension by the medical team of what we did for a child, sad consequence of the lack of cohesion between the center, the family and operated. If it misses one of these data, the surgery, even technically successful will be never a true success. Lastly, I always liked to deal with the problem of the congenital dislocation of hip in an area where it seemed, in the Seventies, which this phenomenon was inescapable. Progress due to tracking considerably improved the fate of our newborns.  However the difficult situations did not disappear and of the questions remain without answer: is tracking well made? Is echography a high efficiency filter, is it always in good hands? Are the consequences of the postural syndrome expressed they so precociously? Only one certainty: the high efficiency filter of only one examination can be a frightening trap!

. : Which place do you make with search within your team?

: In spite of large efforts to take part in search, I must recognize that I support less today environment laboratory and his ritual. I am not certain either that our enquiring friends played the game fully, at least for our generation. Count around us those which after their POSTGRADUATE DIPLOMA or their thesis were invited to continue their work actively, even in quarter of time! I am can be a little pessimistic and I regret it more especially as the POSTGRADUATE DIPLOMA or a year of search transforms a young surgeon into a spirit much more refined and much more demanding, that the simple course of the boarding school and I firmly remain in favor of the one year hold of search in the course of the surgeon in formation. Let us recognize that our colleagues who made a success of a clinical and scientific career, developed their own laboratory. It remains however, for some the spirit of search to the daily newspaper, i.e. the taste of going in the literature to find arguments to defend an indication or to discover an unknown pathology, the permanent updating of the bibliography, in short, the refusal of all a priori, if it is not based on scientific evidence. If my course of search is relatively modest by the results obtained in the field of the epidemiology of the congenital dislocation of hip or medullary conduction, I remain persuaded that the years that I passed to the reference library of the learned to me as much in rigor as a bend from laboratory. Today my more beautiful gratification is to encourage in the service the research tasks of P. and L. in collaboration with the university. Moreover, to encourage young people, JP , A. and G. organize in turn a seminar of search open to all our European colleagues and very attended by all the generations.

. : In your daily practice in Limoges, which difficulties specific do you meet?

: Limoges in full center, is protected by its insulation and meets with the daily newspaper same administrative and medical turbulences only the cities located better or closer to the Capacity: As of the first pitches in the service the morning I do not know what a problem I will have to solve in first! There is no receipt, but it is an obviousness, one cannot more direct today a service with the principles which guided our Masters. The individuals changed, the parents have requirements, their anguishes are very quickly expressed, the gain of their confidence is more difficult to obtain in our informed environment . “The administration”, itself, are not any more one foreigner but a partner embarked in the same galley.  For the daily newspaper, the best advisable remedy seems to be each morning a good amount of “staff” before all the team does not scatter. Each one then knows what the other did, must make, or will not be able to make. In Limoges, specifically, our difficulty remains our insulation, it is also our chance. Gallic village, we have in charge 590 060 children without any competition with less than two hours of route. It is with this argument that I could continue a policy of recruitment and to strengthen the teams of pediatric surgery and pediatry, in spite of our distance of the sea, the ocean, of the Alps, of the Pyrenees and Paris we could convince some to leave the capital to work with us in the area considered like oldest of Europe! We are ready for a forthcoming removal at the Mère hospital - Child in nths, ship splendid unfortunately with eters of the requiring to reinvent all the connections established during years with our partners: imagery, biology and especially adult csotcina.comedic surgery. If these links broke, our insulation would be an exclusion. All those among my colleagues who are the day before such a change must feel this same impression of risk for our speciality. Let us pawn that we will be listened surely better with the weight of a pole. 

. : How do the pediatric surgical urgencies in your function?

: Each city built its mode of assumption of responsibility according to its payrolls. In Limoges, the urgencies of pediatric surgery are “general-purpose”. A senior is of obligation 24 hours a day. If pathology does not concern its competence, it calls another colleague, but this event relates to only the neonatal urgencies or the complex fractures. Our senior registrars are primarily recruited in the world of csotcina.comedy but it should be said, appendicitis or a torsion of the testicle does not frighten them! The timing is the following: from eight hours at ten eight hours thirty, the urgencies are received in the service, the consultation, by the intern, the proximity of a senior, dedicated buildings enable us to control this score of daily patients as well as possible. Unfortunately we cannot ensure, 24 hours a day, on this same site, this service, the evening per hour when the children arrive so many, they are accommodated in the department of emergency general where the intern junior receives them. A senior A&E doctor of course is on the spot, under the supervision of a former senior registrar of the service and the surgeon pediatrist of obligation moves with the least appeal. This bipolar system is not perfect, but it offers the advantage to us of decreasing painfulness for our interns of the service while imposing meetings of formation every six months on young promotions. The greeting of course is less professional as from 6 p.m. 30 and especially the adults mixture - children, in spite of a dedicated room, the evening and the night, is often badly lived. All this will end with creation at the hospital mother - child of a service of urgencies whose Bernard Longis, one of the rare surgeons general-purpose pediatrists still existing on our ground, will take the reins. I will breathe finally: to accommodate the urgencies, the day, among the 15300 annual consultations, becomes difficult and to deaden me every evening by knowing that the children are received by “innocent” hands a little me always worried. For all these reasons we set up a bolt of security: all computerized radiographies are re-examined as of the following day and no immobilization foundation of concrete leaves without monitoring and go of control. I remain persuaded that the physical permanence of a senior on the spot of night is not essential in the greatest part of the departments of pediatric csotcina.comaedics, it could even become a wasting of time and talents compared to the rendered services and of recoveries imposed today. One needs a minimum of seven experts to ensure a guard on the spot, only the very large teams could ensure this charge, but at what a price! 

. : The French pediatric csotcina.comaedics preserve close links with the visceral pediatric surgery, as well by the unity of place in the hospital services as by the teaching hospital appointments. It is sells by auction to preserve this “French exception” of training of surgeons general-purpose pediatrists?

: The French exception has at least the merit very quickly to have understood that the worst of the situations is that which live certain surgeons of children relegated in the corner of a service of adults specialized or general-purpose, with some toys and of the walls of conspicuous colors! The true French exception it is the reconnaissance of the speciality of the child, and, especially of the pediatric csotcina.comedics, with the availability of specific means and of an independence with which it is necessary to be pleased. The only problem, which remains of size, lies in the fact that the term of pediatric surgery in the countries which surround us, recovers only the visceral and neonatal surgery. It was besides as functioned the first departments of pediatric surgery, true dispensaries general practitioners where the large Masters of the beginning of last century were general-purpose. This mode of exercise did not can be forwarded because of the delegation of the knowledge and technological advances. Who can claim today to carry out a palatine slit perfectly, to correct a scoliosis and to cure a post-operative dent of a ? The concept of general surgery pediatric does not exist any more, unless we are unaware of blindness the requirements of the families or that we wish to equip certain hospitals with short stature of surgeons pediatrists general practitioners, with the medical boot of the departments of paediatrics. All this is indefensible because of the requirement for quality which obliges us and of medical demography. In our country, there are large teams, of international level, by their recruitment, their technical level, their work, etc; and others, more modest which ensure the csotcina.comedic health of a smaller child population, and which should not deal with, only, without practice, logistics, without referent, of heavy or exceptional pathologies. We stressed it in connection with the oncology in Toulouse, two years ago, at the time of the seminar of annual teaching. The networked organization for the tumors is valid for all rare pathologies and we must function by areas. An intern should be encouraged to know several sites during his formation. Lastly, for the problem of the guards, even for the small teams there is only one possible answer: only that which can deal with is authorized to do it; in pediatry, less than elsewhere one will not forgive a complication or a failure with that which will have wanted to render service all alone while “being ventured”, even in urgency. 

. : How this formation with the Frenchwoman be able will to be articulated with the qualifications of the European “”?

: To recruit and train specialists in pediatric csotcina.comaedics, it is initially necessary to be gravitational by the training courses, teaching, the captures of responsibilities and then to offer prospects for exercise. The answer to your question comes quite simply from the observation of reality. Who are our pupils today? They are csotcina.comedists who have the taste for our speciality, seldom of the general surgeons pediatrists and we find our happiness in this situation because, if an intern or a former chief of adult csotcina.comedy is broken with the , with the prostheses, it keeps this practice in the service, as at ease in the repair of a knee of child as in a prosthetic rebuilding after resection for tumor. These surgeons of passage, or do these future csotcina.comedic surgeons pediatrists have the advantage of keeping a foot in the close adult service, ensuring a bridge regular, technical, material, presences with the , the common meetings of bibliography, etc And the surgery of the child? They have time to learn it, as we learned in contact with the multi-field team, in the common , in contact with the families, by the daily requirements. Our generation does not have any more the choice. Its duty is only limited to give to all the future csotcina.comedists theoretical knowledge and techniques which will enable them to intervene with security, in pediatric traumatology or current csotcina.comedy, from where this obligation to organize very specialized seminars, to encourage them to take part in the adult exchange rates of csotcina.comedy, with the national congresses, regional, dynamic society such Society of csotcina.comedy of the West. All these demonstrations open to us their carry. Whatever the recruitment of the Interns or the Senior registrars of our services, our great force will be very quickly to propose a teaching structured with a regional and national level. This reflection carried out by the College of pediatric surgery, initiated he there has five years, arrives at its end-stage of realization. Georges and the members of the College wrote the bases of this program which practically is finished, inspired of that of the USA and containing all that each intern at the beginning of course misses today: fundamental bases, the comprehension of pathologies, therapeutic without being unaware of the French and international fundamental references. It is by proposing a solid and structured teaching which we will see arriving the future csotcina.comedists pediatrists, guided by a tutor regional and being able to compare and face their Anglo-Saxon or European colleagues. Indeed, European of which Gerard occupies himself with effectiveness also will be born to him. Because in each country, the formation, the mode of exercise of the pediatric csotcina.comaedics is different. We are very little in Europe to exclusively exert our speciality. It thus should be convinced that the course carried out by France, for 25 years, has been beneficial. The time is very fertile, all is set up for the next years and each one of those which attend    can measure the work provided by these most active members, who contributed to form a true multinational “lobby” in order to harmonize the learning and the practices. But all these efforts for which outlets, which careers for our pupils? It should be recognized that the question can appear singular with a generation like ours, which referred to this kind of problem forever. In fact, the data changed little. Initially, there will be vacant posts, because a whole generation will take its retreat in the five to ten years, in addition csotcina.comedic pathology did not regress, quite to the contrary since a million and half of children are annually received with the urgencies, finally, the exercise could be mixed, as a liberal or partnership with general csotcina.comedists or a cabinet of surgeons pediatrists; only competence and know-how will be recognized.

. : Which is your opinion on medical demography and which are the means which would have to be developed to make this speciality gravitational?

: Inhabitant of Béarn of origin, I am rather critical kind. But on this subject, I do not have concern. We will have what we deserve. If we are gravitational, we will have pupils, if not we will be alone to deplore our extra work and the drawdown etc… Refrain known since antiquity and sung by tens of generations of bad pedagogs. In the worst case we will bring more reasoning and of comprehension of the specific risks of the growth, at best the greatest part of the csotcina.comedic surgeons trained in France will know the traumatology of the child and the bases of the assumption of responsibility of main malformations. If we know to give, we will receive. Fears of some are in fact our assets: the catastrophic feminization of reputation for example, distorts it fall of birthrate, the so-called disappearance of great malformations, all these arguments are in fact favorable for those which can differentiate the dreams from the reality which is the enthusiasm of the young interns of the moment. Today, since pediatric traumatology “often frightens” a young chief of honest temperament, let us open him to them gates of our services, even for one or two years.  Do a&E doctor want to know the limits of their competence? Let us show their that it is near us that they will learn them. Don't the pediatrists understand our concerns in front of all “small details” like a malformation of the foot, a problem of hip, a rachidian fault? Let us learn the their rules from the aggravation of the deformations. Even if financial means became increasingly reduced, limiting us in our daily exercise, we could then keep best currencies for a craftsman:  “To make less can be, but better always”. The mode is with the output, the ladders of value are written according to the number of interventions carried out. Admittedly the concept of quality is difficult to evaluate but it should not be denied at this point. By comparison if one allotted stars of good kitchen to the number of been useful covers, the school canteens would be at the head in the Michelin guide! We witnessed all presentations of great doubtful series in term of indication or technique. To the concept of quality that we return only, between colleagues of the same speciality, soaps to appreciate.

. : Which are your passions, your ?

: That can appear rather curious today: I had a very sporting youth and my taste for the mountain failed to direct my life. There remained to me a little slips with ski, which one can practice at any age and for the functioning, I push sometimes a golf ball like one makes part of game of bowls between friends, and it is my true hobby there: the worship of the friendship, whatever the convictions, crops and horizons. This kind of naivety and this opening, I could preserve them in the world very protected from the services of children. It is near them that one can still keep illusions and draw energy and not report oneself years which pass.

. : If you must qualify the French pediatric csotcina.comedics in only one word, which would be it?

: There are many qualifiers which come me to mind but first is “dynamism”. Three generations of csotcina.comedists pediatrists have cohabited, share their experiment, and keep their intact enthusiasm for more than 25 years!