Thanksgiving

When I saw this video I cried.

The words of Nie Nie’s other half brought tears because I remembered my service month in the Burn Unit back in medical school.  I remember the older couple who sustained burns after a plane accident like Nie Nie.  I remember the day they were stable enough to finally be transferred to another hospital in their hometown.  I remember the college kid who had been wasted and drunk with friends up the canyon…he had fallen into a smoldering firepit and roasted for hours.  I remember the day he finally woke up – surrounded by some of those friends who changed their ways because of the accident.  I remember the little toddler burned from abuse.  I remember their acute situations, but never had a chance to find out how well or if they recovered.  One month isn’t long enough to fully understand the care of a patient in such critical condition.  My prayers are with Nie Nie too.

Foreign Body

This happened a while ago,

but every now and then

when a new patient presents

with ear complaints I am reminded of it…

Chief Complaint: I felt something crawl into my ear

Physical Examination: (via otoscope) Hairy skinny insect leg protruding from auditory canal

Diagnosis: Cockroach in the ear

Teenagers

New patient to our office arrives for a first visit to establish care.

LPN: What are we doing for your child today?

Mother: Examination.

LPN: (leaves the patient/mother in my office)

Doctor (me): Hello. It is very nice to meet you. How can I help you today?

Mother: I want to speak to you alone. (pulls me into another exam room)

Teenage Daughter: Mom! (starts crying in my office)

Mother: I want you to check if she’s still a virgin.

Doctor: (groan) This is the first time I am meeting both you and your daughter. I genuinely appreciate your concern for her. However, I cannot force any examination on a patient without their consent/request. In addition, she has rights as a patient that I am legally bound to. Please trust that as your daughter’s physician I will provide the appropriate care.

 Can you tell? I’ve had to say this on many occasions…so now it’s well-rehearsed.

Prevention

I spent this past week in Washington DC at a medical conference for all Infectious Disease physicians in our country. It was attended by thousands of us in addition to physicians from countries across the world that gathered to learn about the cutting-edge research and issues facing us at this very critical time.

Now my particular interest in infectious disease is regarding prevention of these diseases for children.

Prevention = Vaccines.

I have spent the greater part of the last two years researching and studying vaccines. This is an amazing and exciting area to research, especially when you think about how much has been accomplished in the past few decades. Let’s discuss in detail.

Vaccines have literally transformed the landscape of medicine over the course of the 20th century.

Before vaccines, parents in the United States could expect that EVERY YEAR:

• Polio would paralyze 10,000 children.
• Rubella (German measles) would cause birth defects and mental retardation in as many as 20,000 newborns.
• Measles would infect about 4 million children, killing 3,000.
• Diphtheria would be one of the most common causes of death in school-aged children.
• A bacteria called Haemophilus influenzae type b (Hib) would cause meningitis in 15,000 children, leaving many with permanent brain damage.
• Pertussis (whooping cough) would kill thousands of infants.
• Rotavirus would infect half a million children, causing severe diarrhea and dehydration.
• A bacteria called Streptococcus Pneumonia would cause thousands of cases of pneumonia, meningitis, and bloodstream infections.

I hope people agree that the decrease in disease is remarkable. I am extremely grateful that my 6-month-old daughter has now recieved all of her primary immunizations and that she lives in a country where vaccines are available to all children. It is a great relief to know she is protected from such debilitating and deadly diseases.

I have studied the disturbing anti-vaccine trend for about a year now. Most people who prescribe to this trend are concerned that vaccines cause Autism.

Vaccines do not cause Autism.

The studies have been done and millions of dollars have been spent to investigate this, and the science is clear. I think people need to understand that a paper in The Lancet years ago by a Dr. Wakefield brought up a theory that the Measles vaccine infected the intestine and somehow caused Autism. The paper got a lot of attention, and his findings could never be replicated and most of the authors who wrote that paper actually retracted it. It is a huge embarrassment as a scientist when you have to retract your paper because the science is so poorly done. So at the end of the day Dr. Wakefield’s theory is debunked.

Then there is my favorite- the thimerasol in vaccines causes Autism. Well, the proof is in the pudding with this one.  There has been no thimerasol in vaccines for 8 years now, and the Autism rates have skyrocketed. Thimerasol does not cause Autism.

The argument that I internally roll my eyes at is, “Jenny Mcarthy said vaccines caused her son’s Autism.” Not to belittle a personal experience, but it is a common thing that vaccines are given in the first two years of life and Autism is usually diagnosed in that same period. This does not mean that one thing causes another. We all know things that are temporally related usually do not cause each other. For example children often eat peanut butter sandwiches – often near the time Autism is diagnosed, but the peanut butter sandwich did not cause the Autism.

Now will I ever be able to absolutely prove that nothing in a vaccine will never cause Autism? No, that is a scientific impossibilty. You can never prove a negative. I can tell you the true statement that I have never been to Russia. You will never prove that I have never been to Russia, but I can show you all the pictures of me on all my vacations and none of them are in Russia.

One of the most concerning things to me is the trend that everyone is concerned only about themselves. Vaccines save individual lives! They also decrease disease for society in general. Polio is a great example of this. The generations before me vaccinated for Polio religiously and vaccination has eradicated this disease. I am grateful I was never exposed to Polio and that the people before me chose what is good for society. Our current generation makes choices based on the ‘me’ factor instead of the ‘we’ factor. People have studied if an appeal to vaccinate for the good of society would increase vaccination rates, and it won’t.  Sad commentary on how little we care for those around us.

At the end of the day please vaccinate your children and keep your own vaccinations up to date. Please do it. Go to the CDC website to investigate about vaccines and not some garbage website. You don’t want to be THAT parent in the ER or office with a very sick baby and the docs can’t get the diagnosis or treat your baby until they remember to ask the question- “did he receive his vaccines?” When you say ‘no’, we groan inside.  When your child is critically ill from a disease that was totally prevetable, we feel as if we have failed in our job – to protect children.  So vaccinate! I know that vaccines can cause fever and soreness-it is better than the alternative- so trust me; vaccines save children’s lives.

Dr.C