Hofstra Magazine

Part of the Solution

by Doug Vandewinckel

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Disease. Poverty.
Natural disasters.
Acts of terrorism.

There’s plenty to worry about in today’s world, but for physician, activist, author and disaster response expert Irwin Redlener, M.D., ’64, one concern is paramount:

How will it affect our children?

There’s plenty to worry about in today’s world, but for physician, activist, author and disaster response expert Irwin Redlener, M.D., ’64, one concern is paramount: How will it affect our children?

In 1971, 27-year-old pediatric resident Irwin Redlener’s life was changed by a poster with a now time-worn sentiment: If you’re not part of the solution, you’re part of the problem. One week later, he began a life journey that would touch the lives of more children than he could have imagined.

“I was in residency at University of Colorado Medical Center, heading toward a career as a pediatric cardiologist,” said Dr. Redlener. “I’m carrying my tray in the cafeteria when I see this poster calling for VISTA doctors to serve in Lee County, Arkansas, which was then the sixth poorest county in the country. There was this black and white picture of a doctor walking away down a country road, carrying his black bag, and it just seemed right, like ‘that’s what it’s supposed to be about.’ So the next weekend I took a trip to see for myself, and it was unbelievable. Here we were, the richest country in the world, but these kids were growing up in hard-core poverty with practically no medical care. How could we have let that happen? And how could I not do something?”

Since those early years of his career, Dr. Redlener has made an impact in more ways than most could hope to achieve, as a physician, activist, relief worker, public health expert and one of the nation’s leading voices in disaster preparedness. He has walked with stars and talked with national leaders about issues from children’s health to nuclear proliferation. And yet, despite his ability to grasp such an array of lofty, complex matters, Irwin Redlener’s greatest gift seems to be his ability to remain focused on the simpler, more compelling question within: how will today’s problems affect tomorrow’s children?

Acting Locally

Born in Brooklyn in 1943, Irwin Redlener and his family lived in California and rural Pennsylvania in his early school years, finally moving to Long Island when he was in his teens. While casting about for a college choice, his interest was piqued by Hofstra University’s New College.

“The professors were uniformly remarkable and inspiring,” said Dr. Redlener. “They helped us not only grasp individual topics, but also relate them to larger concepts, and see how different issues and ideas are interconnected.”

After graduating from Hofstra in 1964, Irwin Redlener attended the University of Miami School of Medicine, and from there went to Columbia-Presbyterian Hospital in New York. He was about to complete his second year of residency at University of Colorado Medical Center when he took his detour to VISTA, the domestic equivalent of the Peace Corps.

“When I started my work in Arkansas, the aura of activism from the Kennedy-Johnson years was still running strong,” noted Dr. Redlener. “We all had that spiritual connection to the idea of doing something ourselves to make the world a better place ... The VISTA job was a way to put my money where my mouth was. And we were full of hope. I was actually predicting that our problems of poverty and access to basic health care would be resolved in a decade!” he added ruefully.

After two years, Dr. Redlener returned to complete his residency and begin work in pediatric intensive care, but continued to be involved in public health initiatives, creating a new Child Action Center to study and treat child abuse, and leading medical relief missions to Central America. In 1979, after a brief stint in neonatal intensive care at Albert Einstein College of Medicine in the Bronx, he left academics to establish a private practice in Utica, New York, torn between academic intensive care and his ideal of the hands-on country physician. He would return to academics in 1987, joining the staff of the New York Hospital-Cornell Medical Center, where he directed ambulatory pediatrics. In 1990 Dr. Redlener moved to Montefiore Medical Center, where he led efforts to create a model children’s hospital, serving as its president until 2003.

But between Utica and the Bronx, Irwin Redlener’s world expanded in unexpected ways.

Thinking Globally

Despite his retreat to small-town medicine, Dr. Redlener soon became involved in larger world issues, particularly as a leader in the anti-nuclear organization Physicians for Social Responsibility. While maintaining an active pediatric practice, he traveled often, speaking about what he still perceives as one of the greatest dangers we face today. But in 1985, a chance conversation with a patient led to a unique challenge: distributing the funds raised by United Support of Artists (USA) for Africa through the sale of its multi-star, mega-platinum anthem and album, We Are The World. More than 20 million records were sold, raising more than $63 million for humanitarian aid in Africa and the United States. Dr. Redlener joined the organization’s board, and was soon was named USA for Africa’s medical director and director of grants.

“I’d seen all kinds of terrible conditions in Arkansas and Miami and Central America,” said Dr. Redlener. “But what was happening in Africa was extraordinary, almost beyond comprehension ... it was an emotional experience that even today I have a hard time explaining. The level of suffering and starvation, the rampant disease ... and on the other side this incredible outpouring of public support and dedication. It was this crazy, complex experience that was heartbreaking, yet somehow beautiful in its chaos.”

In 1986 one of the “We Are the World” performers, singer- songwriter Paul Simon, contacted USA for Africa seeking help closer to home: New York City’s children of poverty and homelessness. Dr. Redlener arranged for what he called “the tour from hell,” and he and Simon visited one of the city’s most notorious welfare shelters, the Martinique Hotel in Herald Square.

“The place was teeming with children ... thousands of children and families warehoused in this wreck of a building. On the mezzanine above, people were hanging over the railing looking down at us, absolutely hopeless. We saw hundreds of people waiting for a hot meal ... talked to mothers who couldn’t get basic medical care for their kids. By the time we left, we were utterly speechless.”

In response, Dr. Redlener wrote a concept paper about improving access to health care by using mobile pediatric clinics. “We figured if we couldn’t get the children to the doctor, we’d bring the doctors to the children, like that country doctor making a house call, but now with the whole clinic stuffed into his black bag.”

Dr. Redlener and Simon recruited Irwin’s wife, Karen, to serve as executive director of what was to become Children’s Health Fund (CHF). Karen Redlener herself had a long history in social services; she and Irwin had met working together at the Arkansas clinic and married a few years later. By the fall of 1987, CHF’s first mobile pediatric unit, hit the streets of New York. Today, CHF operates 38 mobile clinics in a network of 24 sites around the United States, bringing health care and hope to children who once had precious little of either.

Starting a New Mission

The advantages of the mobile pediatric clinic concept were fully revealed in the wake of Hurricane Andrew’s 1992 devastation of South Florida, and again on September 11, 2001, as CHF dispatched three units to help perform triage at Ground Zero. For Dr. Redlener, the events of that terrible day and its aftermath were a catalyst.

“September 11 showed us just how unprepared we were to handle a major disaster. Our intentions were good, and our efforts were heroic, but our planning was completely inadequate. There just weren’t enough resources in place to handle even a limited disaster effectively, and virtually nothing for children specifically.”

In 2003 Dr. Redlener was given the chance to act on his growing concerns when he was recruited to establish the National Center for Disaster Preparedness (NCDP) at Columbia University’s Mailman School of Public Health. The post dovetailed seamlessly with his diverse interests, as was demonstrated when the NCDP teamed with the Children’s Health Fund on the post-Katrina recovery effort, Operation Assist.

“Disaster response wasn’t part of our initial plans,” said Dr. Redlener. “But after Hurricane Andrew, we realized that an organized network of mobile medical clinics had an important role to play. When Katrina hit, we deployed eight mobile units to the area. We now have six units working out of permanent programs in New Orleans, Baton Rouge and Mississippi, and we’ve served more than 80,000 children. We’re also conducting studies to see how children in the Gulf are faring medically and academically, so we can do a better job next time.”

According to a 2008 report by the CHF and NCPD, the well-being of the poorest Katrina kids had “declined to an alarming level.” Forty-two percent were diagnosed with anemia and respiratory infections, and more than half with mental health problems. Much of the blame was placed on the “unending bureaucratic haggling” at federal and state levels over how to provide services and rebuild health centers for the Gulf’s poor. In a Newsweek article following the release of the report, Dr. Redlener noted that government’s response to the disaster had actually made a bad situation much worse. “As awful as the initial response to Katrina looked on television, it’s been dwarfed by the ineptitude and disorganization of the recovery,” he said.

Dr. Redlener remains disappointed with the state of affairs in the Gulf and is still very much involved. In fact, this interview was conducted over the course of several days in which Dr. Redlener attended President Barack Obama’s visit to a New Orleans school on October 15, 2009, having provided briefing materials to the White House recovery team in the days prior to the visit. At that time, he expressed mixed feelings about the president’s trip.

“Some people are upset because he’s spending so little time here. And I understand, because they’ve waited a long time for somebody to finally pay attention. But beyond its symbolism, the president’s visit isn’t that important. What matters more is that his Cabinet members and other people spend time here, and that is happening. But we’ve got a long way to go ... the region’s health infrastructure is still fractured, and there are thousands of families that have fallen through the cracks.”

Dr. Redlener’s exasperation led him to become one of the most outspoken critics of the Bush administration’s handling of Katrina, quoted in countless articles and appearing on such shows as Charlie Rose and The Daily Show with Jon Stewart. It also led to his authorship of Americans At Risk: Why We Are Not Prepared for Megadisasters and What We Can Do Now. Published in 2006 and touted by former President Bill Clinton as “compelling” and “eye-opening,” the book presents a razor-sharp analysis of how the nation’s lack of preparedness played out in Katrina. It also describes five natural and man-made disaster scenarios and where we have fallen short in preparation. At the top of his nightmare list is an act of biological or nuclear terror.

“High-level U.S. targets are accessible, soft and plentiful,” said Dr. Redlener. “But the danger has morphed from total annihilation to a single act of nuclear or biological terrorism that would most likely involve a smaller weapon. Yet to this day I know of no American city that has developed effective plans to deal with a nuclear detonation. Part of the problem is that the emergency planners themselves are psychologically overwhelmed by the thought of nuclear catastrophe. They’re still living in the Cold War, thinking, ‘My God, what’s the point? Everything will be gone!’ We’re trying to make people understand that now we can and should prepare for even the worst imaginable disasters and dramatically increase the number of survivors by doing so.”

Accentuate the Positive

Long after most of his generation’s best intentions were left by the wayside, Irwin Redlener is still fighting the good fight, driven onward by two very different forces. The first, and most important to his sanity, is his relationship with his family, and with his wife, Karen, in particular.

“One of the major antidotes to what otherwise might be seen as a despairing career agenda has been having an extremely positive relationship with my family. We have always included our children in the work we do, and we all still get together at least weekly. And this might sound funny, but I think Karen and I working together has been incredibly romantic ... Our lives, our work and our personal missions are practically inseparable, and our shared values keep both of us going. I’m constantly sleep deprived, but at the same time I’m constantly energized by the work we do together.”

Dr. Redlener’s other motivation is living in what he calls “a state of chronic outrage.” “I’m involved in a lot of things that can be tough to think about, let alone deal with, but I don’t think any of these situations are unfixable. We need to push ourselves and our society, and come together to support political leaders who can see beyond the next election. But you only have to look at the health care reform fight to see that change in this country is a slow, incremental process. I’ve been doing this a long time, so as a practical matter, I get that. But on a personal level, I’m deeply impatient and chronically outraged by the inequities we allow in our world, especially regarding children.