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Pediatric pulmonology, ever changing, but happily in the same, old boat.

DOI:10.1097/MOP.0000000000000761 Over the past 5 or so decades, pediatric pulmonology has embraced change, evolving as new knowledge moved from pipette to patient and, at times, patient to pipette. From the days when the best of care, even in most progressive medical centers and universities, could be little more than supportive, until today, when deep genotyping and thin phenotyping permit precise and effective care [1]. Today pulmonologists still enter patient rooms, stethoscope in hand, ready to listen, watch, examine, diagnose and learn. Imagine, for a moment, the joy and wonder if pulmonologists, patients or families of decades past could behold the delivery of surfactant to a struggling near term infant, or a young adult with cystic fibrosis (CF) graduating from medical school or an asthmatic child never spending a single night in hospital. Indeed, with each successive year, pulmonary medicine has gained more healing power, driven by science, undergirded by compassion. Pediatric pulmonary medicine, as exemplified by the pieces in the present edition of Current Opinion in Pediatrics is happily, ever changing. Yet, and still, pediatric pulmonology, retains an identity and culture that spans decades and continents. It is a puzzle, different, but the same. How is it, asks the philosopher, Plutarch, that the sailing ship, Theseus, was still the same ship when over time, in ports near and far, each plank and board was replaced until not a single original piece remained [2]. If the boat was no longer the Theseus, when did it actually become a different boat? Even with all pieces replaced, was it still the Theseus? So, do we still sail on the same pediatric pulmonary boat, navigating waters known and known? Considering the pieces in present edition might provide guidance. In the article entitled ‘Genetic Causes of Surfactant Abnormalities’, (pp. 330–339) Dr Nogee elegantly weaves a thread from the physiology encountered in the nursery to the cell biology that underlies the clinical condition and finally, the underlying genetic cause. Dr Christopher Baker’s careful review of the long-term challenges that confront some patients term (pp. 357–366). Willen et al. (pp. 349–356) comprehensively and elegantly review