Good morning, friends and colleagues, members, and guests. I am honored to have had the opportunity to serve as the President of the Society for Pediatric Research (SPR). My Presidential year, and the years that I have been involved with SPR, have been enriching, stimulating, and truly memorable.

The past year in American politics has been unforgettable, even magical. I am confident that many of you were riveted to the images of the inauguration of President Barack Obama. In his inaugural address, President Obama conveyed his appreciation of American military personnel. He said, and I quote, “… we remember with humble gratitude those brave Americans who, at this very hour, patrol far-off deserts and distant mountains …. We honor them… because they embody the spirit of service; a willingness to find meaning in something greater than themselves.” (www.nytimes.com, accessed January 26, 2009). I was privileged to witness the inauguration of President Obama with Dr. Gary Freed and a large group of pediatric colleagues at the University of Michigan, my alma mater. When I heard President Obama use the phrase “the spirit of service,” the phrase resonated deeply with me, and I decided that I would borrow the phrase as the title of my Presidential address.

To begin, I would like to present a working definition of the word “service,” so we have a common understanding. Wikipedia defines service as “doing something for someone else without thought of reward or payment” (www.wikipedia.com, accessed February 1, 2009). Although you may wonder about the connection between service and pediatrics, I believe very strongly that medicine is a service profession and that we have an obligation to serve. However, I recognize that my view may not be universally accepted. Furthermore, the relationship between service and academic pediatrics may be tenuous to some people.

In my experience, people have strong reactions to the word “service” as it relates to their activities, sometimes reacting as if ‘service' were a four-letter word that should not be said in mixed company! For example, I have heard fellows and junior faculty say that they have been warned against academic service by their mentors and division chiefs. In the minds of junior faculty, service is something that will come in the fullness of time, when time pressures ease. Others act as if service were an activity to be avoided for fear of quarantine or other isolation. Or perhaps a communicable disease for which a vaccine has yet to be developed.

In an image of a mentoring meeting between a division chief and a junior faculty member, when the issue of service is mentioned in the conversation, either by the junior faculty member or the division chief, it is as if a ‘danger' sign were lit over their heads! Some people consider ‘service' a dead-end road that should be avoided at all costs.

I would like to offer a different perspective on the issue of service in pediatrics. Consider the metaphor that we use for the pillars of academic life. We describe the duties as a ‘three-legged stool.' We visualize the academic missions, or essential components, as an equilateral triangle with research, clinical care, and education at the corners. However, my question is ‘Where's service?' Where does service fit into the three-legged stool or the traditional academic paradigm?

Some people consider that service should be concentrated in one area, such as research component. On the other hand, others consider that the service component should be concentrated in the clinical and educational areas of academic work. I would suggest that service is an important component of all areas of academic medicine and pediatrics. In my opinion, service should be considered as an essential component of academic life rather than an element to be incorporated into one specific aspect of academics.

Instead of the three-legged stool, I believe we should use a new metaphor, a chair, which is supported by four legs. Just as a chair requires four legs of equal length to be stable, I believe that service is an essential component for academics. Additionally, a chair is a more comfortable seat than a stool, and I believe it is time to change our metaphor.

To be clear, I am not suggesting that service is as important as research, clinical care, or education, but rather that service is an essential component in the academic portfolio. If service is to be counted, however, it should be listed on the CV and evaluated by advancement and promotions committees. At my institution, we list professional and personal service on our CV's, and this element is considered in our promotions process.

In fact, service is an essential component of the four societies that comprise the Pediatric Academic Societies (PAS). Our societies are powered by the volunteer efforts of countless pediatricians and other child health professionals who make the choice of investing time and energy into the societies' activities. I daresay that the societies, as well as many of the alliance societies and other partners, could not function without the many people who volunteer to serve in countless capacities. Marian Wright Edelman is known as a tireless and passionate advocate for children through her work with the Children's Defense Fund. In her words, “service is the rent we pay to be living. It is the very purpose of life and not something you do in your spare time.”

Building on the words of Marian Wright Edelman and my own experiences, I consider service to be a useful, generalizable skill. Each of us participates in some type of service activity such as student precepting, mentoring junior faculty, or faculty search committees. Once you have acquired some service skills, it is easy to use these valuable skills for professional societies, like SPR. Similarly, service skills are highly valued in personal activities. You could use these skills in search committees like a Head of School search committee.

I have served in numerous capacities and found my experiences to be highly rewarding. As a newly minted junior faculty member, I was invited to participate in many interesting committees. Like many women, I have always had trouble saying no, and my first impulse was to accept these assignments. In retrospect, I may have been invited to serve as a type of token, but I have always believed that every seat at the table is valued and that one has a responsibility to serve to the best of one's ability. Thus, I may have been appointed as token, but I never accepted the role of token.

Along the way, I have served on departmental committees, school-wide committees, campus-wide committees, and broader committees. One of my most memorable service commitments was my 4-year tenure on the Advisory Council of the National Institute of Child Health and Human Development, under Dr. Duane Alexander's leadership. Although I will probably never know why I was nominated for a position on SPR council, I eagerly accepted the nomination and was honored to serve as an at-large member. On council I was privileged to work with amazing and dedicated members of our society, including Ora Pescovitz, Gail Demmler-Harrison, one of this year's award winners, and Nancy Andrews, who recently became the first female Dean of a US medical school (Duke).

There is a note of caution, however, because the reward for good work is more work! Gandhi urged us to pursue service and said “The best way to find yourself is to lose yourself in service to others.” Thus, service can be a powerful tool for self-knowledge.

I would like to challenge each of you to meet the ‘service challenge.' I hope you will add at least one service activity in the next year. It could be professional service, volunteering for a search committee, or mentoring a junior faculty member. It could be service through a professional organization, such as SPR. We would welcome your participation through mentoring a summer student, reviewing abstracts for the Vancouver meeting or getting involved in your regional society. You could also consider personal service in a community organization or a school.

I chose three priorities for my Presidential year, which fell into the convenient acronym S – P – R. The first priority was strategic planning, which is essential for all organizations, particularly groups with long organizational histories but short institutional memories. The SPR council had planned to undertake such a process before I became President, but we activated the process in the Fall of 2008. The council considered several professionals and firms to guide our strategic planning process and settled on Development Strategies Plus, and we have worked with Susan Newton. The Council worked with Ms. Newton to create the strategic planning process. We fielded a web-based survey in the early Spring of 2009, and we are pleased to have received responses from 1200 people, a 44% response rate. This may not sound impressive but remember that we offered no incentive for completing the survey! Ms. Newton also conducted phone interviews with SPR council members and a random selection of SPR members. The SPR council will be meeting in late August to finalize the strategic planning process, and we look forward to sharing the results at next year's PAS meeting.

The second “S” priority is sustainability. Our SPR staff has worked with the PAS program committee to implement sustainability practices at our meeting. I hope you will do your part to support our efforts.

The second priority area for my Presidency was the Public Policy Council (PPC). The PPC is a collaboration of the four PAS partners, and I worked with leaders from the other organizations to revise the PPC guidelines, which serve as an operating manual for the council. Dr. Mike Genel has served admirably as Chair of the PPC since its inception in 1984. On the occasion of his ‘silver' anniversary as Chair, Dr. Genel has informed me of his decision to step aside. We will begin the challenging process of replacing Dr. Genel with a new chair. Dr. Jimmy Simon was also an inaugural member of the PPC, and he rotated off the PPC past year. On behalf of the constituent societies, we offer our thanks to Dr. Simon for his dedicated service. I am sad to announce that Karen Hendricks, who works in the American Academy of Pediatrics' Washington Office and provides service of inestimable value to the PPC, will be leaving the pediatric community at the end of the month. After 18 y at the Academy and 18 y of service to the PPC, she will become the director of policy development for the Trust for America's Health. We know that this is a great opportunity for her to think “big thoughts,” but we will miss her, and the PPC will not be the same without her experience, expertise, and leadership. Many of you were present last year, when Karen received the Thomas Hazinski Award for distinguished service to the SPR in recognition of her work on the PPC.

The final priority for my Presidential year was the Regional SPR meetings. We have four regions, and I attended the annual meeting of each society. I began with the Midwestern SPR meeting in Cleveland and enjoyed the vibrant meeting. In January, I attended the Western SPR meeting in Carmel, followed by a trip to New Orleans in February for the meeting of the Southern SPR. Finally, in March, I traveled to Philadelphia for the meeting of the Eastern SPR. I'd like to thank the four Presidents of the regional societies, Jalal Abu-Shaweesh, Curt Bennett, Ajay Talati, and Larry Nogee, and their council members, for welcoming me to their meetings. I learned a great deal about the regional societies and hope to strengthen these relationships. Rounding out the society meetings, in October, I was invited to the European SPR meeting in Nice. It was a wonderful meeting, and I'd like to thank President Tom Stiris for his warm hospitality.

They say that no woman is an island. However, we should really say that no SPR President is an island. I have many people to thank for their support and guidance during the year. Thanks to our previous presidents, Phyllis Dennery and Gary Freed, who were exemplary SPR Presidents. Thanks to David Cornfield, who will become SPR President after the meeting and brings a great deal of passion and energy to the society. Thanks to Mark Schleiss, our outgoing Secretary-Treasurer and former Council member. Mark has generously served the SPR and represented us in many ways. Mark helped steward our society's resources and helped us safeguard our precious funds. Thanks to Marie Egan, our outgoing Membership Secretary, for her creative efforts to streamline and improve the SPR membership review process.

Thanks to Jana Wells, our Executive Secretary, who helped me in innumerable ways, always with a smile. Thanks also to the other amazing SPR staff, Kathy Cannon, Brenda Peat, Linda Baker, Jesse Osman, and Barbara Anagnostelis. Thanks to Debbie Anagnostelis, the Executive Director of SPR, who has served our society in so many ways and who was an invaluable partner throughout the year.

Tina Cheng, who served as President of the Academic Pediatric Association this year, has been a close friend since we were interns. It is been a pleasure to serve as Presidents during the same year and work together to minimize the barriers that sometimes arise between organizations. Thanks to my compadre, George Lister, who served as President of the American Pediatric Society and is a marvelous example of the spirit of service. Tina, George, and I have tried to bring our organizations together, and I hope that future leaders will continue this trajectory of collaboration.

Thanks to the people in San Francisco who have supported me throughout this year, beginning with my colleagues at San Francisco General Hospital, who were flexible and supportive throughout the year. Thanks to Jay Tureen, who nominated me for SPR membership and was my first mentor. Thanks to Donna Ferriero, who encouraged me to run for a position on SPR council and continues to inspire me. Thanks to Sam Hawgood, my department chair, who encouraged me to pursue leadership opportunities in SPR. Thanks to Gene Washington, University of California at San Francisco Provost, who has been an invaluable career mentor and role model. Thanks to Eliseo Perez-Stable, in the Department of Medicine at UCSF, who has been an amazing research mentor.

We know that there is an inherent conflict between work and home, and we cannot be in two places at the same time. Thanks to my husband, Peter, for the freedom to invest additional time and energy in the SPR, particularly during this year. Finally, thanks to my sons, Andrés and Tomás, who make everything worthwhile.

Thank you for this honor.