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pounds), wasn't expected to survive. "Dr. Little sat by the mother's bedside and said they hadn't ever had a child survive at that weight," Delaney-Black says. But Diana did live.
"Ginny has the compassion and skills, and a real drive to make sure the right things are done for her patients," says Little. "And she does it in a way that wears well in an academic clinical environment."
Today, it's much more likely that a baby like Diana will survive. There are more treatment options, better ventilators and monitors, and different antibiotics. But even so, Delaney-Black says that it's always hard when a newborn doesn't pull through. "I don't know how anyone can prepare you for the idea that a child might not survive," she says. A psychologist colleague at Wayne State once told her that the day a child's death gets easy for her to accept is the day she should turn in her stethoscope.
After leaving the Upper Valley in 1977, Delaney-Black did a second fellowship in neonatal-perinatal medicine, at the University of Colorado, and subsequently became an assistant professor of pediatrics there. Then, in 1980, she moved to Detroit to join the department of pediatrics at Wayne State, Hutzel Hospital, and Children's Hospital of Michigan. Toward the end of the 1980s, she decided to shift her primary focus from patient care to research. She recognized that drug and alcohol use during pregnancy was a major epidemic in Detroit and elsewhere, so she sought a grant from the National Institutes of Health to fund a study on prenatal exposure to cocaine. Later, she received nearly $2 million from the National Institute on Drug Abuse for a long-term project investigating prenatal exposure to both cocaine and alcohol. And since receiving her master's in public health from Harvard in 1998, she's continued to focus her research on children who were subjected to drugs and alcohol in the womb.
Initially, Delaney-Black reported the outcomes of prenatal cocaine exposure on six- and seven-year-olds. But recently,
"Ginny has the compassion and skills, and a real drive to make sure the right things are done for her patients," says neonatologist George Little, one of her DMS mentors.
she's been collecting data on the effects of prenatal exposure on 13-year-old adolescents. After controlling for factors such as the child's home environment, the mother's use of alcohol, and the family's contact with violence, Delaney-Black has found that the effects of prenatal drug use in 13-year-olds are similar to those in six- or seven-year-olds. Greater exposure leads to more pronounced problems in behavior, motor skills, and cognitive skills such as abstract thinking—especially in boys. Still, girls who were persistently subjected to cocaine in the womb do display some cognitive effects related to speech and language development. Delaney-Black was surprised at first that gender plays such a significant role. But she says her work confirms previous animal studies suggesting that gender plays a role in the effects of cocaine exposure.
Delaney-Black has also found that even low levels of prenatal alcohol exposure have deleterious effects. She recently documented that mothers who have just one cocktail a week during pregnancy are three times more likely than mothers who don't drink at all to have children with behavioral problems. Recently, she has been studying how exposure to violence affects children's behavioral and cognitive outcomes. She is also investigating outcomes related to fetal exposure to environmental toxins.
"She's done some of the hallmark studies in outcomes research," says Little, who considers Delaney-Black a close friend and colleague. "She's an individual who's exactly what you'd hope an active pediatrician would be. She's done great research and has been involved in numerous academic and clinical endeavors."
It's difficult to schedule a meeting with Delaney-Black, but as she rattles off all the activities she's
involved in, it's easy to see why. In addition to spending four to six weeks a year attending in the neonatal intensive care unit, she sees patients enrolled in her research projects a half-day each week, teaches an undergraduate course in medical ethics at Wayne State, chairs one of the university's pediatric human investigation committees, and holds a half-time position as the associate director of the Children's Research Center of Michigan. There, she writes research grants and consults on ethical questions, such as protecting research patients' privacy rights. "I'm not done with half of the things on my to-do list for today," laughs Delaney-Black—at a little after 4:00 p.m. "I don't know how to say no."
Fortunately, she keeps herself balanced with numerous interests outside medicine. Photography is one of her current passions, and she'll commute to Richmond, Va., this summer to take a class using her fancy new digital camera. (Her husband, whom she met on vacation in Maine in 1999, is a psychologist in Richmond.) She'll also find time to visit her son from her first marriage. He's a commodities broker in the Chicago area, and she considers him her "number-one source of pride."
Delaney-Black shows no signs of slowing down, even though she and her husband are planning to build a retirement home in Boothbay Harbor, Maine. As she looks toward the future, she hopes to renew her association with DMS, which honored her as a notable alumnus in a 1997-98 exhibit, "200 Years of Alumni Achievements." In fact, she and Little have discussed ideas for a joint research project. "I'd like to keep my finger in the pot somewhere, and Dartmouth's a good place to do that," she says.
Given her tireless work ethic, Delaney- Black doesn't expect she'll ever stop working; she hopes even at age 80 to still be doing research or participating on committees. She's thinking about patients like Sean and Diana when she considers her legacy as a doctor. When asked how she'd like to be remembered, Delaney-Black has a simple answer: "As somebody who cared."
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Jon Douglas, a 1992 graduate of Dartmouth College, is a freelance writer who was until recently based in Chicago. Patients' names have been changed to protect their privacy.
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