Karen Sheehan, MD, MPH is a Professor in Pediatrics-Emergency Medicine and Preventive Medicine at Northwestern University. She is a distinguished alumna of the Northwestern Medical School Class of 1989 and earned her MPH from the University of Illinois-Chicago in 1996. Her work in public health has spanned many interests, and she currently is the Medical Director of the Injury Prevention and Research Center at the Ann & Robert H. Lurie Children’s Hospital of Chicago. Additionally, she is a founding volunteer of the Chicago Youth Programs, the Medical Director of Strengthening Chicago’s Youth, the Associate Chair of Advocacy for the Department of Pediatrics, and the Interim Co-Director of the Mary Ann & J. Milburn Smith Child Health Research Program.
Kristen Unti: Dr. Sheehan, what originally got you interested in public health?
Dr. Karen Sheehan: Well, for a long time, I didn’t even know what public health was. I stumbled across it when I started medical school at Northwestern [University]. I heard about a new program that Joseph DiCara, MD, MPH, and several other medical students were starting called the Cabrini Green Youth Program, which would later become the Chicago Youth Programs (CYP). I thought it was really terrific that we’d go to Cabrini Green, bring kids back to Northwestern on Saturday mornings, and play in the gym with them at the Lake Shore Dorm. I ended up spending a lot of time in the community, and I went on to become a pediatrician because I wanted to help make kids healthy so they could reach their full potential. It became apparent that a once-a-year, well-child visit was not enough to improve the health of children, and that you had to address social and physical environments if you really wanted to improve their health. The Cabrini Green Youth Program was my introduction to public health. We went on to build CYP with the thought that the only way to really improve a child’s health is to get him or her out of poverty. For most, education is the surest route out of poverty.
KU: What is the biggest barrier that you faced in building CYP or any of your other public health endeavors, and what did you do to overcome it?
KS: Well, I always hate these questions because I never really think of anything as a barrier. People tell me “no” all the time, but I get creative and think of another way around it. But one time occurred with my first big coalition, the Stop the Falls Campaign. Susan Avila, RN, MPH, who is a trauma nurse at the John H. Stroger, Jr., Cook County Hospital, came to me saying that many kids in their ER had fallen from windows, and we had to put a stop to it. We got all of the pediatric hospitals and the Chicago Dept. of Public Health to work together. We wanted the Chicago Fire Department to endorse the campaign as well. However, the commissioner refused, out of fear that the installation of releasable window guards would be a problem in terms of people being able to get out if there was a fire. It was an especially touchy topic since historically Chicago has this thing about fire. They refused to meet with us; they wouldn’t talk to us or return our phone calls. So we pursued other strategies until eventually a new commissioner was appointed who liked the campaign and now advertises our campaign on the Chicago Fire Department website. I couldn’t get the endorsement of the Mayor of Chicago without the Chicago Fire Department, but we just kept going and it worked out eventually. I think that if something is the right thing to do, then you either find another path or take a smaller step, but you will always move forward. That’s the whole thing about public health and advocacy. You just have to be patient. And it all adds up. I mean, CYP is 30 years old this year! It’s incredible that it has survived without going bankrupt or having any scandals. And in the clinic we now have second-generation patients, which is very cool.
KU: Certainly! For those of us considering multidisciplinary careers, how do you balance your roles in advocacy, policy, research, and being a practicing physician?
KS: Well, it was adding up to be too much to do primary care, pediatric emergency medicine, my research, and so forth. For the last couple of years, I have only been in the ER once or twice a month. But what I think is great for people involved in both health care and advocacy is that it all works together! One role doesn’t end, you just see the big picture, and it helps inform your ways. That’s why I am doing injury prevention. I was working in ERs, and I was dumbfounded to see kids falling out of windows. So I thought, “Let’s prevent it.”
And what I’ve found taking care of the second generation of kids is that I didn’t always do a very good job as a pediatrician. I tried to be a good pediatrician, but we just didn’t have the knowledge back then. For example, I’d ask how kids were doing in school and they were passing, so I assumed they were doing just fine. But in reality, the Chicago Public Schools at the time were instead just passing students along. There are some kids with learning disabilities that slipped through the cracks. Now with children of their own, the parents are super bright people, but they can’t get good jobs because they can’t read. I am trying to get them into adult literacy programs, but if I could have picked that up sooner by asking better questions earlier on, I could have made a huge difference. I can see intergenerational influences that will be hard to overcome. On the other hand, I no longer see the families of kids who succeeded and are living happy lives. It’s the ones who had the harder times who are still coming to us—which is good. It still gives us a chance to intervene. And we understand so much more about early childhood adverse experiences and the effects on health in adulthood. In medicine and public health, you keep learning. I guess that’s why they call it the “practice of medicine.” I’m a better pediatrician now than I was 20 years ago.
KU: As students just starting in our public health and advocacy careers, what advice would you give in terms of how to begin to make an impact in the field of public health?
KS: I think you need to find what you are passionate about, and it will follow. And be patient. You often feel like you are starting below ground and digging and digging to try to climb up. It takes forever to get going, but then things start to snowball. One activity builds upon the other and you get mini-successes. And it just takes off! So have patience, perseverance and passion. And then it doesn’t seem like work. My job is so much fun! That is when you know you’ve found a balance in your career—when it’s fun and you do good things as well. It makes it worthwhile.
Interview conducted on January 31, 2014 in Chicago, Illinois.
Karen Sheehan, MD, MPH
Kristen Unti (right) is a third-year MD/MPH student at Northwestern University. Desiring to become a pediatrician, her public health interests are focused around public policy and advocacy surrounding issues affecting children. Additionally, she has growing experience in patient safety and quality improvement.