This month marks 10 years since Dell Children’s Medical Center opened its doors, giving children in the 46-county area of Central Texas a pediatric Level I Trauma Center and a Level IV NICU. Dr. Eric Higginbotham was there from the beginning—in fact, before the doors opened patients were turning up, and Dr. Higginbotham recalls doing his best to treat children in the not-quite-open facility, searching for paper to create charts and tracking down instruments and supplies.

Since 2013, Dr. Higginbotham has served as Chief of Pediatric Emergency Medicine. He took time recently to talk with us about the hospital and his time there.

AF: What drew you to this field?

Higginbotham: I started my training at Duke, thinking I was going to do a combination of internal medicine and pediatrics. I like to tell people I graduated both of those programs just in time to realize I didn’t want to have an office practice in either one of them. I struggled with what I was going to do. I had a mentor who had done strictly pediatric emergency care, and I had the opportunity to practice in the emergency department. After two years there, I knew that’s what I wanted to do.

What attracts me is how quickly you can affect a positive change in someone. Today I took care of a poor kid who had a cut on the brow from running into something. We had him in and out, the problem completely taken care of in about an hour and 30 minutes. It’s a really good feeling to be able to step in and help.

AF: Describe a typical day for us.

Higginbotham: Today was a good day. I was the first guy to get there in the morning, a shift that starts about 6 o’clock. There were some patients left from the night shift. I inherited those patients from the doctor who was going off overnight. About 8 or so it starts to pick up. I saw lacerations, psychiatric emergencies, abdominal pain that ended up being appendicitis, a couple of wrist fractures.

It was a good day because there wasn’t major trauma. The area that Dell Children’s covers is close to the size of Ohio. We take all the motor vehicle accidents. This is sad, but it sometimes happens: we see gunshot wounds and knife wounds involving kids. We also take all the snake bites—everything that carries with it a pretty significant injury.

AF: Do you ever get to see patients later, outside the hospital?

Higginbotham: I do. I’m always careful not to give too many details because of confidentiality, but there was a case of a young man that had been involved in a pretty bad boating accident, and then about six months later I happened to be at a fundraiser. He’d been invited there and I got a chance to talk to him. It was nice to talk to him with the stress of that injury out of the way and the kid having recovered fully. It was a special moment.

I run into people all the time at HEB or Whole Foods or Central Market. It generally takes them a minute to recognize me out of my scrubs, and me to recognize them when they’re not wearing a hospital gown. It’s a continuation of that connection that you make.

Almost nobody starts their day saying they’re going to go to the emergency department, especially with their kids. Something really unfortunate happens, and they end up being there.

AF: What are some of the big accomplishments you’ve seen at Dell Children’s?

Higginbotham: One thing many people don’t understand is that we have every kind of sub-specialist. There’s at least two pediatric emergency doctors here at all times, every day, even Christmas. There’s always a pediatric surgeon, a pediatric intensivist, a pediatric anesthesiologist. We can marshal all of them in a few minutes to make sure that kid gets optimal care. Eye specialists, ear nose and throat specialists, rehabilitation—you name it, we have the pediatric equivalent at our hospital.

And we’re expanding our services to Seton Medical Center Hays and Seton Northwest Hospital through care guidelines and links to specialists at Dell Children’s, so we can now impact patients that never come to Dell Children’s. We’re a single hospital, but we’ve educated staff at other sites to provide the best care, improve outcomes and reduce stays.

AF: What are you excited to see in the future?

Higginbotham: It’s exciting to have Dell Medical School students rotate through. It’s invigorating to remember what you were like 20 years ago. It’s nice to have someone you can help shape as a physician.

AF: What are some of the challenges ahead?

Higginbotham: The biggest one is the uncertainty in healthcare—the insurance and what people have to pay. We’re just not sure how this will affect patients. There are a lot of unknowns. And as the city grows, we have a challenge to continue to deliver focused care for kids. And we’re challenged in rolling out the Dell experience to other sites in a high-quality way. To grow these Dell Emergency Care sites and give the same experience as Dell Children’s.

AF: If you could talk to parents before there’s an emergency, what would you advise? 

Higginbotham: Every summer, we see pediatric drownings. Pay attention and be at arms’ length. I encourage swimming lessons. And I see a lot of results from auto accidents. The level of injury in kids not properly restrained—it’s worlds of difference. I’m going to keep my kids in car seats until they’re in college. I don’t see a downside to it.

Dr. Eric Higginbotham is the chief of pediatric emergency medicine at Dell Children’s Medical Center, a member of Seton and a part of Ascension, the largest nonprofit health system in the US. Photo courtesy of Seton.

By Sherida Mock

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