Foreword

In the early 1960s when I started a clinic at the University of Minnesota Medical School for the treatment of infants with cystic fibrosis of the pancreas, the doyen pediatrician in Minneapolis told me, “Warren, let them die. It will be better for everyone.”

My reply was, “These are normal babies. Like other children, they catch normal diseases, from which some will die. We just need to improve our preventions and treatments so they can lead normal lives.”

Teaching and practicing with that view has made the Minnesota Cystic Fibrosis Center one of the outstanding CF Centers in the world. But we have not yet reached the goal of normal lives for all of our patients.

I met the Warners in 1981 when their baby was diagnosed as having CF. I told Don and Linda that Angie was a normal baby, and with successful preventive treatments, she would grow up to become a normal adult. I cared for Angie for sixteen years. The Warners carried out the best practice of our knowledge perfectly and, so doing, proved my prediction to be true. Angie’s full life was one of happiness and many successes, many more than her father has shared in this book.

And yet in 2002 and 2003, we found our knowledge of prevention incomplete. We failed to avert, halt, or reverse the course of the last three months of Angie’s life despite the brave and tremendous efforts by Angie and her parents. That part of this book is a strong tale of bravery and sadness. But Don and Linda’s plans to brighten the future for older surviving CF patients, through the Angela Warner Foundation, inspires us to do more to help make those adult lives as normal and free of CF problems as possible.

A new part of my research has been stimulated by Don Warner’s book; my research will now include the review of 35 years of computerized medical records of our CF patients to discover the little things we doctors may have passed over because these details appeared too minor to fuss about at the time. Perhaps, making such a discovery will prevent a future disaster from happening.

We have reason to look forward with hope to the future, for as of January 1, 2008; at the Minnesota Cystic Fibrosis Center there are 69 CF patients over age 40 with an average age of 48 years. In another ten years, I hope we can write that the Minnesota CF Center has 69 patients over age 50, average age 58 years, and that we have prevented another outcome from occurring like Angie’s last months.

Warren J. Warwick, MD
Professor of Pediatrics
First Annalisa Marzotto Professor for Cystic Fibrosis Patient Care
University of Minnesota Medical School