Readers’ Choice: Author Interview with Dr. Donald E. Greydanus

Posted On 2025-01-30 11:16:32


Donald E. Greydanus1, Jin Ye Yeo2

1Department of Pediatric & Adolescent Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI, USA; 2PM Editorial Office, AME Publishing Company

Correspondence to: Jin Ye Yeo. PM Editorial Office, AME Publishing Company. Email: pm@amegroups.com

This interview can be cited as: Greydanus DE, Yeo JY. Readers’ Choice: Author Interview with Dr. Donald E. Greydanus. Pediatr Med. 2025. Available from: https://pm.amegroups.org/post/view/readers-rsquo-choice-author-interview-with-dr-donald-e-greydanus.


Expert introduction

Dr. Donald E. Greydanus (Figure 1) is Professor and Founding Chair Department of Pediatric and Adolescent Medicine at the Western Michigan University Homer Stryker M.D. School of Medicine (Kalamazoo, Michigan USA). Dr. Greydanus is a 2017 Mayo Clinic Distinguished Alumnus and an honorary fellow in the Indian Academy of Pediatrics. He was elected a member of the Alpha Omega Alpha Honor Medical Society at Michigan State University College of Human Medicine.

Dr. Greydanus is a former Chair of the National Conference & Exhibitions (NCE) for the Amerian Academy of Pediatrics (AAP) and a former Director of Publications for the Society of Adolescent Health & Medicine. He has published numerous scientific papers and books as well as received many national and international awards for his work. In 2010, Dr. Greydanus received the Society for Adolescent Medicine (SAHM)’s Outstanding Achievement in Adolescent Medicine award and also in 2010, the University of Athens (Greece) honorary doctorate degree (Doctor Honoris Causa) for “Distinguished Academic Achievements in Medicine.” In 2017, he received the Mayo Clinic Distinguished Alumni Award.

Dr. Greydanus’s article, “Breast concerns and disorders in adolescent females: a narrative review”, published in our journal, has received an outstanding readership and entered the journal’s Most Read Article List.

Figure 1 Dr. Donald E. Greydanus


Interview

PM: Can you share what inspired you to specialize in adolescent medicine, and how your early career shaped your career path?

Dr. Greydanus: After graduating from medical school, I became an intern (first year of residency) in surgery at the Mayo Clinic, Rochester, Minnesota, USA. During that time, I received a letter from the U.S. Government to serve in the U.S. Navy for two years of active duty. Though I could have deferred this for a later time, I decided to accept it since my family had persons who had served in World War II—some of whom died in this war. As a result of my active duty service, I became a physician in the U.S. Navy on a warship in the North Vietnam area during the U.S. Vietnam War (1963-1975). During this time in an actual war zone, I was fascinated (and somewhat frightened) by the different reactions of various active service persons in dealing with the turmoil of war with the real potential for consequential injury and death. As part of my recovery from such a stressful situation, I decided to switch from a surgical career to look at a neglected area of medicine: adolescent and young adult medicine.

At that time, the best way (in my view) to study this area was to obtain a pediatrics residency followed by a fellowship in adolescent and young adult medicine. I completed my residency in Pediatrics at the Mayo Clinic and then finished a fellowship in Adolescent Medicine at New York University/Bellevue Hospital in New York City (Manhattan). This began my study of how adolescents leave childhood and eventually transition to young adulthood on the way to their adult years, perhaps initiating at 25 years of age (or so!). It was a fascinating journey for me and an amazing area to analyze as well as write about for others to consider for themselves. For me, this was an empirical journey of observation and experience from young people in a war to those growing up rich or poor in the famous island milieu of Manhattan—seeking answers regarding how children emerge into puberty, adolescence, young adulthood, and eventually adulthood itself. Why are some resilient despite experiencing difficult times, and others are not “successful” which results in substance use disorders, mental illnesses, and even suicide? My analysis of this perplexing issue has continued for several decades.

PM: Throughout your career, you have received several prestigious honors. Looking back at your journey, what do these recognitions mean to you, and what do you consider to be your most significant contribution to the field of adolescent medicine?

Dr. Greydanus: These awards are very meaningful to me as a middle-class boy from New Jersey who had a goal of becoming a doctor of medicine (suggested to me by my mother who was a nurse) and then a professor (inspired by a Professor in the Netherlands who was a brother of my paternal grandfather). Medicine is a very competitive field, and as one competes with peers to achieve, minimal recognition is provided as one prepares for a career. Thus, when recognized by one’s peers after the educational process and during the journey of a challenging career, it is very humbling yet gratifying. Being recognized by the place of my residency (Mayo Clinic) was very meaningful to me, with family members around me in Rochester, Minnesota. Being recognized by the National and Kapodistrian University of Athens School of Medicine (Athens, Greece), where Western Medicine began with Hippocrates (460 to 375 BCE), was a lifetime achievement award for me. Medical writing, for me, has always been a way of thanking my many teachers in the past who helped me learn to read, comprehend, and later assimilate the materia medica as well as other germane matters of medicine. How does one reach back to the past to thank them, these instructors of mine? My writing does that in the best way that I can.

My favorite or most meaningful book was my first with my mentor in Adolescent Medicine, Adele D. Hofmann MD at New York University—Bellevue Hospital in NYC. Professor Hofmann was one of the founders of the field of Adolescent Medicine, and she used this book to help get it started. She asked me to write about the medicine of adolescent medicine while she worked with a psychiatrist on the behavioral aspects of this field. At this time, there were no computers, Wikipedia, internet services, or other modern technology to provide answers to questions, and no one had published extensive writing of such knowledge. The question was, “What is the medicine of adolescent medicine?” All one had was a typewriter and countless hours in libraries researching many books of medicine (healthcare) as well as medical journals to identify some insight into this question. It required several years of work (nights, weekends, etc) while one did the “day” job. After laboriously transcribing it all up with my typewriter, I sent it to Professor Hofmann. The book was published in 1983, and as I opened it up, the front of the book was titled: Hofmann AD. Adolescent Medicine, Norwalk, Connecticut: Appleton-Lange Publishing Co., 1983. I wondered—“Where was I?” Inside the book, it said: “In collaboration with Donald E. Greydanus MD.” It was Dr. Hofmann’s book and not mine! We worked on a Second Edition and I continued my educational research as well as typing, supported by seemingly endless searches in libraries with feedback from peers on the book. I said nothing about the “in collaboration with….” It was Professor Hofmann’s book and not ours—yet. The Second Edition came out in 1989, and curiously, I opened the mailed package containing this edition with mixed emotions to read the front cover of the book: Hofmann AD and Greydanus DE (Eds): Adolescent Medicine, Second Edition; Norwalk, Conn: Appleton-Lange Publishing Co., 1-631, 1989. It was now OUR book! My life with computers began in 1990 making such a project a bit easier and a Third Edition of my most meaningful adolescent medicine publication came out in 1997:Hofmann AD and Greydanus DE (Eds): Adolescent Medicine, THIRD EDITION, Norwalk, CT: Appleton-Lange Publishing Co., 913 pages, 1997. Professor Adele D. Hofmann died in 2001 and this book series ended—others would do their own adolescent medicine books but I would not do this specific series without her.

I could now go on my own to develop my own books with those I trained and with other peers. I had finished my own adolescence of writing with my teacher (my Hippocrates) and could do my own adult work. Some articles of mine are in the United States Library of Congress Publication of Medicine (Pub Med) list, and some of my books have reached 3rd, even 5th publication status. The book with Adele Hofmann helped develop the field of adolescent medicine (thanks to her!) and I was one of her chosen helpers in this endeavor. Not bad for a middle-class kid from New Jersey! No ego, just full-hearted gratitude!

PM: Can you share some of the most exciting trends or emerging areas of research in adolescent medicine that you believe will shape the future of the field?

Dr. Greydanus: If clinicians seek to learn about aspects of pediatric gynecology, it will lead them to explore past, current, and future concepts of human sexuality and current research looking at what this means for the normal development of children, adolescents, and young adults. A classic analysis of this topic dealt with such concepts as biological sex, core gender identity, and gender role behavior. Timeless theological teachings have insisted that an expected state of human sexuality is that normal Homo sapiens are XY males and XX females who are heterosexual with attentive acquiescence to populate the world. Anything apart from this definition was considered abnormal or theologically vexatious and contumacious—i.e., people to be piously condemned. Medical aberrations within the biological sex system include such conditions as Turner syndrome, Klinefelter syndrome, and congenital adrenal hyperplasia (late-onset adrenal hyperplasia). Experts emerged in the 19th and 20th centuries and developed further concepts such as the psychosexual stages of Sigmund Freud (1856-1939) in addition to other hypotheses, including the cognitive development of Jean Piaget (1896-1980), psychosocial development of Eric Erikson (1902-1994), and moral development of Lawrence Kohlberg (1927-1987). Many events occurred in the 20th century that stimulated clinicians to look at issues of homosexuality in human beings; these events included the explosion of research in the 1980s on the acquired immunodeficiency syndrome (AIDS) epidemic due to the human immunodeficiency virus (HIV).

Despite ongoing negative views from various sedulous societies, the research on homosexuality within the concepts of human sexuality expanded to studies on what is now called the LGBTQIA+ classification; this refers to persons described as lesbian, gay, bisexual, transgender, questioning (queer), intersexed, agender, asexual, pansexual, genderqueer, and others. These issues will be further studied with changing definitions, persistent pietistical pronouncements, and ongoing iatric declarations of what 21st century JEDIB means (i.e., justice, equity, diversity, inclusion, and belonging). This is where research on human sexuality is going—leading to terms new to some (i.e., pansexual, demisexual, polyamorous) and even new pronouns (i.e., ze, hir, hirs, hirself). This telescopic view leads to other issues such as ableism and fascinating research on human diversity as well as disability. Many amazing developments await the 21st century pediatric clinician with the courage to open new doors that may make some uncomfortable and look in for the sacred sake of truly helping others.

Current and future work on transgender issues will lead to controversial concepts to help those described as trans, transgender, and transsexual. Descriptions may have started with the Greek philosopher, Plutarch (46 to 119 AD); this polyglot historian, who was also a priest at the Temple of Apollo in Delphi (Greece), wrote about an intersex deity (“the great mother”) and other Greek stories of Amazon females with notable (male-like) fighting skills. In the 21st century, trans research and surgery are changing lives with debates on the timing of surgery as well as the complexities of pediatric sports medicine. Behavioral science is looking at associations between diversity and risks for bullying (cyberbullying), depression, and suicidality. The door of diversity is open!

PM: Your article, “Breast concerns and disorders in adolescent females: a narrative review” has received a high readership. What prompted you to focus on this topic, and why do you think this article is so well-received by readers?

Dr. Greydanus: The topic of Breast Concerns and Disorders may not be covered well in the education of pediatric residents in some programs. It is part of a larger arena of sensitive subjects not often focused on in some places of graduate medical education (GME) training; this larger arena includes pediatric/adolescent gynecology and sexuality. Such education may be dependent on the local residency director and what educational motifs s/he emphasizes within the context of having full accreditation by the ACGME (Accreditation Council for Graduate Medical Education). A program director may have minimal interest in having such education provided for the program’s residents, and the residents may come from a medical school with minimal education in these areas (i.e., human sexuality, pediatric/adolescent gynecology). Thus, due to a complex confluence of conflicting factors, the graduating physicians are then not prepared for such issues in their pediatric and adolescent patients. Some residents are in a general pediatric residency as a requirement to move on to pediatric subspecialties (i.e., cardiology, nephrology, hospital medicine, NICU/PICU, and others) that may not emphasize these fields as well. It becomes normalized for some clinicians (most notably males) to understate or soft-pedal sexuality/gynecology in their pediatric patients, especially if they had limited training and are in a system of moving patients along quickly because of a profit-margin mentality to medicine now prevalent in 21st century healthcare. Clinicians who are interested in the full well-being of their pediatric patients may seek information on these topics to apply them to the children and teenagers in their pediatric practices. This has become increasingly necessary in a society saturated with salacious and spurious guidance on sexuality fueled by the internet, the media, and other invasive influencers in the lives of our children. Just as one inoculates our pediatric patients with FDA-approved vaccines, clinicians should inoculate them with guidance regarding principles of normal and healthy sexuality. If gynecologic issues arise in the pediatric female, help her deal with it and continue her amazing journey to an adulthood of accomplishment focused on education-based joie de vivre.  

PM: What do you believe are the most critical gaps in the current research on adolescent health, particularly in the areas of breast health, puberty-related disorders, and female development?

Dr. Greydanus: This is a case of e pluribus unum or better yet, e pluribus pauci —seeking to list a few topics for current and ongoing research in this area:

  1. Research and education for clinicians on pediatric gynecologic examination in suspected sexual abuse of young girls is important.
  2. Research and education for clinicians on dealing with transgenderism and transsexualism in children and adolescents is another one. In such polarizing times in American culture, these issues do not go away and clinicians need training to help these pediatric persons in their search for who they are as well as what they will become. For example, who should receive hormone therapy and transsexual surgery including at what age such management should occur? This also has considerable application and controversy in sports medicine.
  3. An area of diagnostic evaluation for clinicians to learn is that of Point of Care Ultrasound (POC US), which can occur in an office setting to study various body systems without access to classic X-ray technology. Once learned, clinicians can examine breast tissue without the amount of radiation exposed to patients with conventional X-rays and provide one with on-the-spot (i.e., real-time) results. Once learned, POCUS can become an important part of the clinician’s evaluation tools or armamentaria. Check it out!
  4. New medications are under research for the management of malignant breast lesions in adolescent and young adult females. Though rare in this age group, it can occur and clinicians should be aware of this unusual condition in such young female patients. Research on adult females with malignant breast lesions may benefit the pediatric patient in the future.
  5. Management of mastalgia (mastodynia) without utilizing addicting analgesics such as opioid medications. Some children and adolescents who started on opiates/opioids with prescriptions develop opioid use disorder (OUD) later in adolescence or young adulthood. Research is seeking to better understand which persons are at risk for this drug addiction development utilizing, for example, genetic studies and gene therapy. There are many ways of providing pain relief (i.e., anti-nociceptive measures) that are not potentially addicting, and clinicians should be educated in their utilization while being very cautious in the use of prescribing potentially addicting drugs that may maliciously awaken the endogenous opioid system (EOS).
  6. Research is seeking improved management of infections such as seen with breast abscesses that can etiologically involve, for example, Methicillin-resistant Staphylococcus aureus (MRSA) infections.
  7. If one takes a more telescopic look at adolescent medicine, healthcare professionals involved in caring for youth should appreciate the ongoing changes in what “families” are and how these evolving changes affect the children as well as adolescents that surround them. Study how the concept of “the family” has changed from the 18th to 21st centuries and what this means for the development of “healthy” youth as well as what this means for the “effective” clinicians caring for this population in part of the 21st century. One will find this to be a fascinating and stimulating search! Reflect on the changes to this concept that have occurred in these current generations:
    1. Silent: 1928-1945
    2. Boomers: 1946-1964
    3. Generation X: 1965-1980
    4. Millennials: 1981-1996
    5. Generation Z: 1997-2012
    6. Generation Alpha (not yet official terminology): 2012-?!
  8. Finally, one must acknowledge the uncertain effects that artificial intelligence (AI) will have on the practice of medicine in general and adolescent medicine in particular. These effects will certainly be captivating and to some extent, unpredictable!

See: Wartman SA, Densen P, Byyny RL. Editorial. Will artificial intelligence undermine the profession of medicine? The Pharos 2024-Autumn;87(4):2-8.As noted by Publius Vergilius Maro (70-19 BC): Tempus fugit. Or, as noted by the modern author William Gibson (1948-): “The future has already arrived!”

PM: What made you choose Pediatric Medicine (PM) to publish your paper? How do you feel about PM as a place to publish research on this topic?

Dr. Greydanus: As an author seeking to publish an educational research paper to teach clinicians information on a topic (i.e., issues of breast concerns/disorders in pediatrics or other pediatric gynecology subjects), I like to work with publishers who are efficient and seem as interested as I am, in getting the article published for the readers of the journal or book. PM is such a place and I appreciated the opportunity to publish concepts of breast issues/disorders in pediatrics with PM. Some publishers put up various “roadblocks” in the publishing process that can be frustrating to the author. Sometimes a copy editor changes and one that was comfortable to work with becomes another one who may be much more difficult to deal with in the process of publishing. Readers can check out some of my journal publications by using the U.S. Library of Congress Publication of Medications (Pub Med) list to see some of the subjects I have covered and what journals I have favored because of developing a relationship of comfort and efficiency with them.

I have always encouraged those studying and working with me to be authors in chapters of books and/or journal articles. As time goes by, clinicians build up a wealth of knowledge in clinical medicine that should be shared with others. As one matures, authoring various articles is also a good way to stimulate or exercise one’s cerebral cortex and its CNS connections! One should not be afraid of feedback from others if given in the nature of a critique versus a crude criticism. I always advise others writing with me to not be concerned with taking time to review the journal’s galleys to be sure mistakes are corrected before official publication. Finding the typos in these galleys can be a challenging task that requires determination. I try to make light of it as it reminds me of the times I have read books to my grandchildren. Some of our favorites are books with little yellow ducks “hidden” in the story for the grandchild to find. Sometimes, these pictures are very well hidden and it requires careful search to find them. The job of the grandchild is to find the hidden yellow ducks in the pages as the story continues. As the ducks are found, my grandchildren would laugh with great delight and provide me memories of joy in this reading! When I look for typos in the galleys of an article, it reminds me of the times I read to my grandchildren (& years ago when my adult children were young!) that involved finding the little yellow ducks or in the case of the article, find the hidden typos! Contentment develops in finding these typos or “ducks” especially if it is an important one. Meanwhile, one’s CNS is stimulated, and hopefully, readers benefit from the data found in the finalized article.

PM: How can future research collaborations between academic institutions, healthcare providers, and journals like ours help fill the knowledge gaps in adolescent medicine, particularly regarding under-researched conditions or emerging health concerns?

Dr. Greydanus:It is important for medical journals to publish clinically relevant articles that, without bias, teach clinicians the best, up-to-date information on caring for patients. Clinicians remain under various influences and pressures in their vocation of treating their patients; unfortunately, some of these influences are not optimal. Examples of this can be found in current trends noted in these articles:

  1. Relman AS. Shattuck Lecture--the health care industry: where is it taking us? N Engl J Med 1991;325(12):854-9.
  2. Jackler RK, Ling PM. The tobacco industry has no business funding continuing medical education. JAMA 2024;332(24): 2059-2060.
  3. Sun QW, Ross JS. Industry payments to physicians by competing manufacturers within novel therapeutic classes. JAMA 2024;332(24): 2111-2113.
  4. Ejnar Hansen M, David Pickering S. The role of religion and COVID-19 vaccine uptake in England. Vaccine 2024;42(13):3215-3219.
  5. Ladouceur R. Family medicine is not a business. Can Fam Physician 2021;67(6):396.
  6. World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA 2025;333(1): 71-74.