AUGUSTA — Two-year-old Lucille Rae McNally clambered up on a chair and looked at the adults standing in the small examining room at Kennebec Pediatrics before opening a large picture book.

Dr. Sydney Sewall asked if he could look at her ears and then leaned over to check them. All clear.

Lucille grabbed for the shiny instrument. Without missing a beat, Sewall, with his usual calm, easy-going manner, swung around, pulled a paper-wrapped tongue-depressor from a drawer and made a quick trade. Then he handed a second tongue-depressor to mom, Dr. Jessica McNally, an ophthalmologist in Augusta, to take home to Lucille’s older brother, William, ensuring no one was left out.

Sewall’s smooth interaction with his young patient and her family results from decades as a pediatrician — 34 of those years working for Kennebec Pediatrics in Augusta. Last week, Sewall, 67, retired from that job and will begin another in September as a faculty member teaching pediatrics in the Maine-Dartmouth Family Medicine Residency Program, which is based in a nearby building and is embedded with MaineGeneral Medical Center.

“I’m sure I’ll still hear babies crying over there,” Sewall said, as a baby in an adjacent room started to wail. “Plus my grandchildren — they can put out some good noise.”

He estimated he’s seen more than 12,000 children over his three-plus decades, many still in the area.

“It’s been amazing these last weeks how many parents tell me I was their doctor,” Sewall said, wearing a tie covered in small elephants, lions and zebras that was hand-crafted by the daughter of the office administrator. “Sometimes I recognize them because they look the same, but some mothers with different last names I don’t know,” he said.

There are even a few of his former patients — teens he doctored when he started in 1982 — now bringing their grandchildren to him.

Over the summer, he’ll continue to sail his 13-foot Laser on Cobbossee most Thursday evenings, ride his bicycle on a 13-mile loop around Hallowell, where he lives, and play the violin with the Augusta Symphony Orchestra and chamber music with friends.

Back in the office, Sewall said it was Lucille’s lucky day. In for her two-year, well-baby checkup, she didn’t need any immunizations because they were all up to date.

Sewall has championed immunizations over the years and said the administration of those immunizations has changed significantly.

“We used to give one shot at a time. Now it’s three or four,” he said, mentioning two of the newer vaccines against Haemophilus influenzae type b and pneumococcal vaccine for children. While the shots might distress the children and stress the parents holding them, “We are willing to do it because we protect against all these diseases,” he said. “Back in the old days, we used to do spinal taps a couple of times a month. Now we don’t have to worry if they’ve been immunized. Prevention is always the big thing.”

He said medication and treatment have improved for many ailments that can affect children, including asthma and diabetes. For the rare incidence of children diagnosed with cancer, he added, “Therapies are a lot safer and a lot more effective than they were years ago. The other thing that’s gotten better is the way we get images of things,” pointing to the use of ultrasound technology rather than more invasive diagnostic methods.

A graduate of Harvard University, Sewall earned his medical degree at the University of Cincinnati and planned a career in psychiatry before changing his mind.

“I chose pediatrics because I like that rotation the best,” he said.

He spent time out West early in his career, working with the Indian Health Service, part of the U.S. Public Health Service, in Tuba City, Arizona.

Then he and his wife Deb decided to return East, where their families were, ending up in Maine.

“I kind of liked being in somewhat rural areas,” he said. “This place seemed like a nice place to come to, so we moved.”

He joined Drs. Terrance Sheehan and Charles Danielson at Kennebec Pediatrics and stayed far longer than the four to five years he anticipated.

“There’s been great joy for me for having seen generations grow up,” he said.

Sewall said some children really surprised him by being much more successful than he expected, and others saddened him by running into difficulties.

“Our next challenge in pediatrics is dealing with what psychologists call toxic stress,” he said. He said it most affects children growing up in a difficult environment, and pediatricians will have to find ways to help them become successful as adults.

“It’s emotional health, now that serious infections are mostly preventable,” he said.

As Sewall reflected in his office on the changes in pediatric medicine, Dr. Kieran Kammerer, medical director of Kennebec Pediatrics, stopped at the door to say good-night. The two worked together for 23 years.

“If he wasn’t here, I wouldn’t have joined the practice,” Kammerer said. “He was the reason I joined.”

Dr. Barbara Crowley worked with Sewall for 20 years before she and he sold Kennebec Pediatrics to MaineGeneral Medical Center in 1996.

“He’s probably one of the smartest pediatricians in the state,” said Crowley, now executive vice president of MaineGeneral Health. “So whenever I had a diagnostic dilemma, I could call him. He was enormously generous with his time in teaching others, both in teaching residents and teaching Pediatric Advanced Life Support for decades.”

Crowley said that certification is required for doctors attending any child in critical or life-threatening conditions.

“Families loved him,” she said. “He was especially patient, kind and caring with those who had attention deficient disorders or developmental delays. He loved newborns, and whenever there was a newborn issue, he wanted to be called in. Whatever the situation was, he was calm and competent.”

While a good-bye party put on by the office and MaineGeneral won’t be held until July 14, Sewall has already removed most of his personal items from the office in anticipation of a new doctor taking up residence.

“I told them I wanted to retire next year,” Sewall said, and he encouraged the hospital to begin the recruitment process for a replacement. However, a young physician with ties to Maine was available sooner, and Sewall, seeking a smooth transition, made another choice.

“I’ll retire a year early so you won’t be stuck,” he said.

That enabled him to take the offer from the family residence program, where he said he’ll be replacing Dr. Chiedza G. Jokonya, his coauthor on the “Little Black Book of Pediatrics,” published in 2011.

Sewall is a former president of the Maine Chapter of the American Academy of Pediatrics and active with Physicians for Social Responsibility where he is currently treasurer of the Maine chapter.

He and his wife have two grown children who live in Canada and in Tennessee and four grandsons, ages 1-5, all of whom are planning to visit him in Maine this summer, he said.

Betty Adams — 621-5631

badams@centralmaine.com

Twitter: @betadams