Thirty seconds made him who he is today

John Melville, director of the Division of Child Abuse Pediatrics at the Medical University of South Carolina, knows firsthand how important a matter of seconds can be. He was a young medical resident working with a neurology professor when she asked him a question.

“She said, ‘So do you know why there are so few high-functioning C.P.s like yourself?’”

C.P. stands for cerebral palsy, a condition that affects muscle coordination and can cause other disabilities. Melville was diagnosed with it as a child. His mother suffered from cord prolapse, which means her umbilical cord was compressed, cutting off oxygen and blood to her baby during labor.

“No, tell me,” Melville remembers saying to the neurology professor.

What she said next astounded him. “She knew my C.P. was due to birth trauma and cord prolapse. She said, ‘When you look at of birth trauma like that, the interval between completely normal and absolutely neurologically devastated is about 60 seconds. So to be a high functioning C.P. like you, you have to be born near the middle of that 60-second interval.’”

Melville was born by emergency C-section after a nurse realized he was in danger. “In that whole process, 30 seconds either way and I would not be who I am. I would be somebody else.”

If he were somebody else, that might be medicine’s loss. Melville is not only a pediatrician who runs a division at MUSC Children’s Health but also a teacher, researcher, author and computer whiz who wrote the software his team uses for child abuse evaluations. “I’m a geek. I really like my computers,” Melville says.

“I’ve got a number of irons in a number of fires, just like I’m sure any associate professor would have. The only difference is I move between them on four wheels instead of two feet.”

He calls his wheelchair a small part of his life. “It’s my means of locomotion, but it’s not my identity or what I’m most proud of or how I introduce myself to people,” Melville says. “My disability is an attribute of mine, but it’s not central to my identity. I have my faith, my family, my career, I have so many things that are core to who I am.”

But Melville is proud of the fact that disabled children can see him in action. “I enjoy being a doctor in a wheelchair at a children’s hospital. Many disabled children do not get a lot of exposure to disabled adults.”

Melville didn’t set out to specialize in child abuse pediatrics. He planned to focus on rural medicine, offering care in places that really needed good doctors, and got a job in Alaska.

But once he was there, he wound up overseeing the sexual assault response team and decided to make helping survivors of child abuse his focus. Then, a family issue made it clear that he needed to return to an area with more resources. So Melville headed to San Antonio, where he did a fellowship in child abuse pediatrics at the University of Texas Health Science Center. Then he became site director of the Child Advocacy Center at the Akron Children’s Hospital campus in Boardman, Ohio. He came to MUSC in 2016.

Melville brings more than medical training to his role; he knows the importance of patience and compassion. “One of the things that has struck me in my practice as a child abuse pediatrician is the importance of listening to people. This includes listening to people accused of hurting their children, the non-offending caregivers and, of course, listening to the children themselves. I have found that when treating the psychological effects of abuse, listening itself can be therapeutic,” he says.

“I love my job. The way a kid gets to my office is that an adult has decided to stand up for them and protect them. And the kids get better. They get better over the course of weeks, not months. They go back to learning and developing and doing all of the things kids do because somebody protected them and made sure they got the right treatment.”

Melville enjoys being part of that process.

“I hope that at the end of my career, people won’t need to add the disabled modifier when they describe me,” Melville says. “I hope they’ll talk about things I have written and students I’ve taught and patients I’ve advocated for — the fact that I did it from a wheelchair is more of an implementation detail than anything else. Nobody’s guaranteeing that I’ll achieve that, but that’s what I’d like.”