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Highlights from this issue
  1. Ian Wacogne, Edition Editor
  1. General Paediatrics, Birmingham Childrens Hospital, Birmingham, UK
  1. Correspondence to Dr Ian Wacogne; ianwacogne{at}

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I’ve been thinking a bit about wisdom. It’s one of those qualities which is seldom possessed by someone who professes to have it. In fact, there is probably an inverse relationship between the expression that one is wise, and one’s actual wisdom. In this sense, it is a bit like describing that one has ‘the best words’, or that one is really, really wacky. The observation that somebody has wisdom is most often bestowed by an observer, and it implies a recognition that someone knows what they are talking about, that they have some life experience in that area, and that they can exercise sound judgement. There’s something interesting about being a healthcare professional in that observers (non medical) can assume wisdom. In this sense I think it must be a bit like my feeling at when at school that somehow, if I become a senior, or a sixth former, or even a prefect, then somehow maturity would be bestowed upon me. I’m still waiting. (Hint: It didn’t happen when I became a consultant either).

In our profession, people look at us and often think: That person is a doctor, so they must know some things, and they must be wise. And the former—that you know some things, for example, that steroids are used to treat minimal change disease nephrotic syndrome—is usually true. And when it isn’t true, it is fairly straightforward to acquire. However, the second half takes a lot of time. The assumption of wisdom is never more strange when people come to me as a paediatrician and expect me to know about how to get their child to sleep, or behave, or to eat their dinner. I think I’ve got the hang of talking about some of these things now, but it is interesting that the folk at the sharp end of some of these conversations—the ones where the family attend in the middle of the night and describe a baby who isn’t latching to breast feed—are handled by people who often haven’t had much of that sort of life experience.

Ilana Levene and Annabel Williams present some advice about managing the child who is a fussy eater ( see page 71 ). This is one of those subjects in which we mostly acquire knowledge—and perhaps wisdom—by life experience. It was a genuinely puzzling question to be asked when I was a senior house officer in my late 20s, before I was a parent, and before I’d been around a while. In my transactional way, I think I’d thought: Well, you give them some food, and they can like it or leave it, what’s the big deal? Of course, poor eating is a very big deal indeed for families immersed and up close to the complex task of spending many hours a day keeping a fussy eater well nourished. And those families expect that we should understand it, and be able to offer wise advice. This paper offers some shortcuts to that wisdom which, if themselves wisely applied, could help us all help these families. It’s my editor’s choice this month.

The rest of the edition is packed with great articles. Just a reminder that if there is something you want to read that you’re not seeing, or something that you want to write, please do get in touch. I’d be particularly interested in ways in which we might be able to augment your wisdom—it would be great to hear about the things that you struggle with that aren’t just a series of memorised fact, but instead you need tips and techniques to help you with.


  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.