BY LORI ACKEN | PHOTO BY LAURA DIERBECK
I met Dr. Michael Gutzeit more than 25 years ago when I was a scared young mom new to Milwaukee, and he was the perfect pediatrician to help guide me through the myriad decisions tied to my disabled daughter’s care. And to reassure me that I was capable of that daunting job.
As we began to shape this issue, I wondered how Gutzeit — now the chief medical officer at Children’s Wisconsin — viewed his three decades spent caring for Southeastern Wisconsin’s kids, and how that mission has evolved.
“At Children’s, we really feel that our vision is to have the healthiest kids in the country right here in Wisconsin — which is aspirational and bold,” Gutzeit began. “But it’s also very important, because when we talk about the healthiest kids, we’re not just talking about hospital care. We’re talking about the entire spectrum of care that is part of what a child or a youth experiences. We’re talking about mental health, behavioral health and social health. We’re talking about physical health. We’re talking about environmental health. All of those things are important, because we really feel that the best way to treat kids is to prevent things from happening in the first place.”
Gutzeit agrees that raising children in today’s fast-paced, technology-driven world is especially challenging, which makes the effort to care for them comprehensively equally complex.
“There are many more pressures on children, adolescents and teens as they are faced with a multitude of decisions, peer pressures and other things that are really influencing them,” Gutzeit says. “And I think social media has been a big driver of this. That’s not necessarily to be pejorative about social media, but it really does open the door to a lot of things that kids are exposed to that they weren’t previously until they had more maturity and more ability to manage the tremendous amount of information that comes at them.”
As an example, Gutzeit notes that social media’s demand for constant, instant input contributes to an already impulsive age group making decisions that will impact them long after they click send. And adds an extra, endless layer of peer pressure and bullying. That sobering reality — coupled with more parents’ willingness to seek help for their struggling kids — has inspired Children’s Wisconsin to redouble its commitment to kids’ emotional and social health, now and in the long term.
“We feel we need to be investing in the training for individuals for the future needs of our patients,” Gutzeit explains. “We need to train more psychologists, more psychiatrists, more therapists — but we also need to provide better access for those services too. … The supply and demand are mismatched a little bit right now.”
An effective step in that mission, Gutzeit says, is screening each teen who comes into the Children’s system for any reason, “so that we get an assessment about do they have depression, or do they have an unmet mental or behavioral health need? That helps to open the door for the conversation … and being able to offer meaningful resources that allow the initiation of therapy and really begin the process of healing or improving.”
In summer 2019, members of the Children’s Wisconsin team garnered national attention when they were first to make the connection between vaping and catastrophic lung damage cases cropping up in otherwise healthy young people.
Gutzeit says the phenomenon is a harrowing but valuable lesson that health systems need a truly comprehensive understanding of how kids operate and what questions to ask to gain vital information. His team, he explains, “used developmentally appropriate interviews, to understand the physiology of the patients that they were seeing and how it didn’t fit the normal pattern that you would expect for teens and adolescents.”
With little existing information to guide them in what they were learning, the team kept digging and discussing until they zeroed in on the patients’ shared electronic cigarette use — an activity, Gutzeit notes, that took root in the U.S. more than a decade ago, but mushroomed in recent years. “To be honest with you, this was a stunning revelation for us,” he says. “We weren’t sure if it was just a local cluster or something that had more dire implications to the population in general. But the only thing we could link it to was vaping.”
Recognizing the public health implications of their discovery, the group spread the word as quickly as possible in hopes that the national health community could also band together to source potential treatments. “We are learning about this and its impact on youth in a model that doesn’t really have any history for us,” Gutzeit says. “There’s no path to tell us ‘This is the approach that we needed to take.’ So, we’re learning, in deriving that treatment path, as we go along, which makes it even more important to stress that the best treatment is prevention. We really need to get the message out, and legislate for ways to reduce vaping in teens because of the impact of their health.”
The good news, he adds, is that parents, parent groups and school districts are reaching out in droves to learn meaningful, respectful ways to speak to their kids — another in a growing roster of community partnerships that Gutzeit says are crucial to local youth and their families.
“This,” he says, “is about wrapping all of these resources around a family, with a child in the middle of that circle.” MKE