The beautiful baby girl fidgets in her mother’s lap as the kindly doctor with a stethoscope around her neck approaches her tiny patient with the affection of a doting grandmother who’s just popped in for a visit.
“OK, my little friend,’’ the doctor says as 10-month-old Alana Nguyen suddenly yawns. “Are you tired? I don’t blame you.’’
That gentle examination the other day at Boston Medical Center was a simple one that Dr. Deborah A. Frank has performed thousands of times across a storied career that now approaches another watershed.
What she has seen — what she has done — has informed her hands-on, no-nonsense practice of medicine, taking care of those who sometimes seem invisible to the more comfortable, the privileged among us from whom she has coaxed — if not demanded — compassion.
She once was maced outside the federal building in Boston where she was protesting the Vietnam War.
She’s bounced across a Native American reservation in New Mexico, riding in a Jeep to deliver a streptomycin shot to a sheep herder afflicted with tuberculosis.
She’s never lost the fire in her belly, or acquired the ability to mince words.
“Our social safety net is nowhere near as generous as most countries for poor people,’’ she told me the other day in her office at BMC. “I think it’s shocking. And it’s stupid. It’s incredibly stupid. We’ve done lots of work to show that food insecurity costs Massachusetts about $2.4 billion in health and special education costs.
“Here you are disabling a whole new generation of workers for lack of investment in food, which in our country is relatively cheap.’’
If those words make makers of public policy uncomfortable — even embarrassed — Frank is doing her job.
It’s a job she started 35 years ago when, as director of the Grow Clinic at BMC, she began collecting cans of food at her desk to feed hungry children. It has blossomed into a food pantry that serves 7,000 families a month.
“You don’t go around saying, ‘People are cold! People are hungry!’ You say, ‘Right. We’ve got to collect some clothes,’ ’’ she said, explaining her pragmatic, can-do approach to demanding action and getting results.
“She’s an icon,’’ said Dr. Megan T. Sandel, a pediatrician and associate director of BMC’s Grow Clinic. “People talk about food as medicine now. Debbie’s been doing that for decades. She’s the consummate triple threat. She’s an incredible clinician. And incredible researcher. And she’s teaching medical students about failure to thrive.’’
If her work sometimes appears as if it’s in Deborah Frank’s DNA, that’s because it is.
The oldest of four children, she was born 71 years ago in Washington, where her father was a psychiatrist who worked for the Veterans Administration after World War II. Her mother, now 101, worked at the National Gallery of Art and later as a mental health counselor. They raised their children in an activist tradition.
“I remember my grandmother in Brooklyn telling me about going out and distributing milk to children in clinics,’’ she recalled. “It was just like: Of course, that’s what people do.’’
Her father was Jerome D. Frank, who before his retirement as a Johns Hopkins professor of psychiatry, was an outspoken critic of the nuclear arms race beginning in the 1950s and, a decade later, a civil rights activist.
“We didn’t go to restaurants that were being boycotted because they wouldn’t let black people eat,’’ she recalled. “That was just what I grew up with.’’
That little girl was paying attention. And she grew into a woman who is instantly animated by social justice, who can shake her fist, for example, at a food stamp benefit program that needs more funding.
“That means taxes,’’ she said as we spoke in her office the other day. “And it means taxing people who have a great deal to help people who have almost nothing. And that is really difficult. But that’s where our values come out. Political choices are written on the bodies of babies.’’
One of those babies was once an undernourished kid named Justina Riopelle. When she first visited Dr. Frank, she was 4 years old and weighed 27 pounds.
“Doctor Frank was a savior for me,’’ said Riopelle, now 19 and a full-time college student. “I think I went through a lot of traumatic things during my time with her. We were poor. We didn’t have a lot. She was very resourceful when it came to getting the necessities we needed in our home.
“We were in one bedroom. All four of us sleeping in one bed. She made sure we had food in our house. She’s very enthusiastic about her patients.’’
Deborah Frank is stepping down this month from her Grow Clinic duties. But she isn’t hanging up her stethoscope for good. She’s going to teach. She’s going to mentor young doctors and medical students. While she will remain a BMC pediatrician, she’s cutting her caseload in half. And she’s going to conduct research about children in poverty.
And there’s no time for resting on laurels. Instead, there is a simmering discontent, anger even. Anger at a stubborn poverty rate. Anger at indifferent policymakers. Anger about social and economic exclusion.
“It still makes me very mad,’’ she said. “Last year, we had 30 percent more new referrals than we had three years ago.
“We have programs but they don’t provide enough benefits and reach everybody. And we have food. We’re not in a famine. We’re not in a war zone. Babies are the canaries in the social mine. They’re growing very fast so their growth changes very fast with deprivation or illness. And so this is a political choice. This is not a volcano or something over which we have no control. It’s a decision.’’
Frank knows that even food insecurity that isn’t severe enough to alter growth, can alter development and learning. If your head aches, and your stomach growls, and you can’t focus because you haven’t eaten in a day, it’s difficult to solve a simple math problem at your classroom desk.
When I told Dr. Frank that the story she tells is so bleak that surely everyone in Massachusetts — all our neighbors, the people we work with, worship with, eat with — would do what it takes to wipe out childhood hunger, she smiled sadly.
“I’ve been saying this for 40 years,’’ she told me. “And I really swear that what you said is just what I thought.’’
She’s tired now. And she doesn’t want exhaustion to affect any of her work.
She’s going to cut back on her hours. And she’ll see how that goes.
“Maybe I’ll get miserable and have to go back into the clinic,’’ she said. “But I don’t know. You know how I’m managing? I’m volunteering at our local preschool in Brookline. Every week I get my fix of little kids. I’m ‘visitor Debbie.’
“I come in and I tie shoes and I read stories. I don’t tell them that I’m a doctor because if you do, the kids will pull up their pants to show you their boo-boos.’’
If that happens, surely a reflex will kick in.
And then Dr. Frank, if briefly, will be back on pediatric duty again.Thomas Farragher is a Globe columnist. He can be reached at firstname.lastname@example.org.