Still writing in edges of pediatric care handbook

  • Article by: MEREDITH COHN , Baltimore Sun
  • Updated: July 26, 2014 - 3:00 PM

Trainees can still be seen with “the Lane” 60 years later.

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Johns Hopkins’ Drs. Branden Engorn, Tina Navidi and Emily Krennerich paged through a 1955 copy of the Harriet Lane Handbook. They all contributed to the most recent edition.

Photo: Kim Hairston • Baltimore Sun,

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In the early 1950s, six pediatric residents at Johns Hopkins Hospital sat down at a table and jotted down notes they thought would help as they began treating patients.

They made copies and put them in loose-leaf notebooks. Every few years, other residents would add information about tests, results, diagnoses and drugs for children.

Hopkins residents are still editing the Harriet Lane Handbook six decades later, but now the pearls of wisdom are professionally published and distributed so widely that they’ve been translated into more than a dozen languages. Dr. Branden Engorn, the chief resident at Hopkins in charge of the latest edition, said new doctors there still cling to copies.

“It was the kind of book that when you got yours, you wrote your name in black Sharpie on all corners,” he said. “If you put it down, you knew it was yours because there were so many floating around.”

He also said crops of trainees often could be identified by the color of their copies. Engorn had a pink one in medical school at Virginia Commonwealth University, and he got a green one when he began at Hopkins in 2009. The latest edition is blue, but incoming residents might be better known by their smartphones. “The Lane,” as the book is known, now comes with an app.

Engorn said paper still rules with many doctors, and it’s common to see markings, notes and colored tabs pasted on important pages, such as those with blood pressure readings and medication dosages that change with height, weight and age. In all, the book is now 1,132 pages, printed in type small enough to allow the paperback technically to fit into a lab coat pocket.

Several doctors said there are now other popular references, largely online, but perhaps none as comprehensive and ubiquitous. And among the nonvirtual offerings, it’s one of the cheapest at $50.

Every three years, more than 100,000 copies are printed and distributed by Elsevier, a medical and scientific publisher, which makes the book one of its big sellers.

The book was named for Harriet Lane, who founded the nation’s first children’s clinic at Hopkins more than a century ago.

There’s no telling how many children’s lives it has saved or improved since then, said Dr. Robert Haslam, who edited the fourth version in 1965 while he was recovering from spinal surgery and in a cast.

The book traveled with Haslam throughout a career as a pediatric neurologist that eventually took him to the University of Toronto, where he served as chairman of pediatrics, and the university-affiliated Hospital for Sick Children, where he was pediatrician in chief. Like many other hospitals in modern times, doctors there produced an institution-specific version.

Still, he said, newer editions of the Lane can be found there, as well as at top-rated U.S. medical schools and children’s hospitals.

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