EDITORIAL

Millennium matters

What did you think you'd be doing in 2000? 1 remember once as a childcalculating with my mother how old she and I would be at the turn of thecentury. That was long enough ago, and 2000 seemed far enough away, thatshe was sure she would not be alive to bring in the millennium. Fortunately,she was wrong. Calculating that I would be in my 50s, I was young enoughthen to doubt whether I'd make it either.

Feelings about the symbolic importance of the new century and millenniumseem to vary depending upon one's expectations about living to see it. Olderindividuals, many of whom have lived through two world wars and social andeconomic changes that have transformed this country, seem almost as surprisedthat the planet is still revolving as they are that they are still here.For our children, who have had limited time to become accustomed to 19--,the change to 20-- doesn't seem any more momentous than the release of anew album by their favorite singer or the victory of their favorite collegebasketball team in the Final Four. It is those of us in the middle who aremost predisposed to predict what the world will be like in the future. Wewho have lived through enough of the 20th century to appreciate some ofits turmoil but anticipate witnessing at least the early developments ofthe 21st seem to appreciate most actively the potential for progress.

Some predictions about children's health are easy and likely to be realizedearly in the new century. We can expect the worldwide eradication of polio,and with any luck, of HIV. There is some hope that cancer will be treatedmore successfully and with less toxic effects than it is today. But thesepredictions accept familiar types of solutions: active intervention forthe passive recipient (immunization) and treatment of already establisheddisease. If the future is to be truly rosier for children, however, thechanges required will also involve modification of human nature as we recognizeit at the end of the 20th century. And the shift in expectation and interactionthat will allow all children to realize their intellectual and physicalpotential free from abuse, neglect, poverty, malnutrition, and war is notlikely to come from those of us still reveling in the remarkable progressof the past century. It will come from kids who have never changed the channelon the television set with anything but a remote control box, who communicatemore easily through e-mail than on the telephone, and who have never fearedpolio or rheumatic fever. How will they define progress?

Julia A. McMillan, MD, Editor-in-chief of Contemporary Pediatrics,is Vice Chair, Pediatric Education, and Director, Residency Training, JohnsHopkins University School of Medicine, Baltimore.

Julia McMillan. Millennium matters.

Contemporary Pediatrics

2000;1:9.