Below are highlights from our interview with Alex Friedman.
Read the full conversation.

We had an incredible conversation with Alexander Friedman, MPH, Program Manager at Boston Medical Center in the Division of Developmental and Behavioral Pediatrics. Alex discusses his work supporting patients with autism and families who have experienced the unexpected death of their child. He also provides a view of how the programs work to fill gaps in the healthcare system and shape systemic change.

Could you share a little bit about your background and how you got to where you are now? 

I arrived at college thinking that I wanted to work in healthcare, knowing that I wanted to create a healthier world. I understood at that time that my options for this were being a doctor or being a nurse. As such, I began as pre-med! I very quickly realized that was not going to be for me. I had a moment of reckoning and had to figure out what else was out there. I was fortunate to learn about a health sciences program offered at my university that was open to students who may not be interested in going to medical school. ... Early on as part of this bachelor’s program, I got an internship at Boston Medical Center (BMC) in the Department of Pediatrics and essentially never left. Upon graduating with my MPH, I really wanted to work full-time in my same division and was offered a position splitting my time between the hospital’s Child Protection Team, where I had already been working part-time, and the program that supports families after their child dies.

Lots of people, when we are kids, want to grow up and be a certain thing. Then many of us are, as you were, confronted with the fact that it actually is not what we want our life plan to be. How did you process that in your head and heart—to let go of what you thought was your dream?

This was a really challenging moment because we are conditioned over time that success looks one of a few specific ways, especially relying on using your undergraduate education to get into an esteemed program like medical school. To reckon with this not being my path and to hit that wall in such a strong way was really difficult. ... To actually take time to research and see the dozens of options out there really planted a seed for me: there are infinite avenues to explore within the professional working world. Nothing is ever cut and dry relative to what your job must be. Landing at that mindset is what really set me up for success. 

Could you briefly describe the types of services the programs offer and the needs or gaps your work addresses?

.... In our autism program, we support thousands of individuals and their families each year by connecting them with resources, guidance, and direction. But we also think about how we can change systems to better accommodate the needs of autistic individuals. The healthcare system is set up for a very specific type of patient that often is not aligned with the needs and challenges of those with autism. In my work with child fatality, we similarly support families in navigating their deep grief by connecting them with resources, offering commemorative events, and fostering a sense of community to demonstrate they are not alone. But we also think about the systems. We provide training to thousands of professionals—child welfare, law enforcement, healthcare, and childcare professionals—who are looked to as experts in navigating what comes next. We also think about how families can be better armed with the advocacy they need to confront these enormous power systems.

Whether you are a community organizer or work in other ways to challenge and change systems or structures, the weight of the work can take an emotional toll. How do you navigate this aspect of your work?

This is an ongoing and forever process. I would say, first and foremost, it's important to have a team around you that you can lean on, that you can talk to and debrief with. .... I’ve also had to recalibrate how I think about impact. The families we serve are often navigating lifelong journeys; the emotions, complexity, and systemic barriers don’t just disappear. Instead of trying to figure out, “How do I fix this?” I now ask, “How can I make this family’s experience or trajectory even slightly better than it was before?” It’s about scaffolding and supporting—not controlling or insisting.

What advice would you offer students, early-career professionals or even seasoned professionals about taking care of yourself, especially when doing emotionally intense work?

It took me years to be able to end the day with unread emails and step away from a desk with work still on it. That alone was growth. Self-care starts with self-awareness. Who are you? What experiences have shaped you? What do you actually need? ....I ask: how can I reduce ambient stress in my life? What lowers tension in my body and day? .... It looks different for everyone. But if you’re doing emotionally heavy work, tending to yourself isn’t optional. Burnout serves no one—not you, not your colleagues, and certainly not the families you’re trying to support. Taking care of yourself is just as important as answering emails or meeting deadlines.