Most physicians see patterns. The exceptional ones act on them.
In 2007, at a clinic in San Francisco’s Bayview Hunters Point neighborhood, children kept showing up with the same confusing cluster of symptoms. Growth delays. Chronic illnesses. Behavioral issues that didn’t fit neat diagnostic boxes. For a pediatrician trained to fix what’s broken, this was maddening. The kids weren’t getting better, and the usual playbook wasn’t working.
Dr. Nadine Burke Harris didn’t just see sick children. She saw a system missing the point entirely.
The Breaking Point
Burke Harris remembers Diego. A young boy who stopped growing after experiencing sexual assault. His body had essentially shut down, refusing to develop. Standard medical interventions failed. Something deeper was happening, something that textbooks hadn’t prepared her for. That case became the catalyst.
She started digging into research from Kaiser Permanente and the CDC—a massive study of over 17,000 adults that linked childhood adversity to adult disease. The data was staggering. Adverse Childhood Experiences, from abuse and neglect to household dysfunction, weren’t just psychological wounds. They were biological time bombs, rewiring stress responses and metabolic systems in ways that persisted for decades.
Burke Harris had her answer. Her patients weren’t experiencing disconnected health problems. They were living with the aftermath of toxic stress.
Building the Framework
In 2011, she founded the Center for Youth Wellness with a clear mission: stop treating symptoms and start addressing root causes. This wasn’t about feel-good wellness programs. It was about rigorous science translated into clinical practice.
She developed screening protocols that could identify ACEs in young patients during routine checkups. Not after a crisis. Not when the damage was done. Early. The interventions that followed—from mindfulness training to family support programs—were evidence-based and measurable. Within years, clinicians from 15 countries had downloaded her screening tools.
The work caught attention beyond medical circles. Her TED talk, “How Childhood Trauma Affects Health Across the Lifetime,” has been viewed over 10 million times. Her book, The Deepest Well, was called indispensable by The New York Times. Paul Tough profiled her work in How Children Succeed. Media coverage followed—NPR, CNN, The New Yorker.
But Burke Harris wasn’t interested in becoming a thought leader. She wanted infrastructure.
California’s First Surgeon General
In January 2019, California Governor Gavin Newsom created a role that had never existed at the state level: Surgeon General of California. He appointed Burke Harris to fill it. She became the first person to hold the position, with a mandate that went beyond public health messaging.
Her goal was audacious: cut ACEs in half within one generation.
She immediately pushed for systemic change. By June 2019, California’s budget allocated $45 million to reimburse Medicaid providers for ACEs screening and another $50 million to train primary care providers. It was unprecedented. For the first time, a state was embedding trauma-informed care into its healthcare infrastructure.
Then COVID-19 hit.
Burke Harris co-chaired the committee that recommended vaccine allocation strategies for California. The state achieved the lowest cumulative mortality rate among large states during the pandemic. Simultaneously, she launched a statewide effort to train over 20,000 primary care providers on ACEs screening and trauma-informed care, during a pandemic.
She didn’t slow down. She scaled up.
The Personal Cost
In February 2022, Burke Harris resigned. Her mother was hospitalized in the ICU at Stanford during the pandemic, and COVID restrictions meant she couldn’t visit. She had four young sons at home. The same woman who had dedicated her career to understanding how stress damages the body was watching her own family pay the price.
She left to care for herself and her family. It wasn’t defeat. It was clarity.
The Model That Endures
Burke Harris completed her medical degree at UC Davis in 2001 and her Master of Public Health at Harvard in 2002. She did her residency at Stanford. Her credentials are impeccable, but they’re not the story. The story is what she did with them.
She co-authored consensus reports for the National Academies of Sciences. She served on the American Academy of Pediatrics’ National Advisory Board for Screening. She received the Heinz Award for the Human Condition, the Arnold P. Gold Foundation Humanism in Medicine Award, and in 2023, the David G. Nichol Health Equity Award.
But her real legacy is operational. California now has the infrastructure to screen children for ACEs at scale. Thousands of providers have been trained. The biology of adversity is no longer a fringe concept; it’s embedded in how the state thinks about child health.
Burke Harris proved that pediatric medicine could be rebuilt around prevention rather than reaction. She turned research into policy, policy into funding, and funding into practice. She didn’t just write about childhood trauma. She built the systems to address it.
For healthcare executives and policymakers watching the mental health crisis unfold, Burke Harris offers a blueprint. Don’t wait for consensus. Don’t wait for perfect data. Identify the pattern, build the intervention, and fight for the infrastructure to make it stick.
That’s how you change an industry.
