American College of Physicians: Internal Medicine — Doctors for Adults ®

Wednesday, November 23, 2016

The lives of your children are in your hands

I've never lost a patient to polio. Or tetanus. Or whooping cough, but to be honest, I have an unfair advantage on the whooping cough: only kids die of whooping cough, and I only treat adults. I have seen my fair share of pertussis cases (as whooping cough is more properly known). It's terrible; uncontrollable fits of coughing, so violent that people vomit, wet their pants, break ribs. But adults, at least, don't die.

Babies are another matter. About half of kids under a year old who get whooping cough end up in the hospital. About 1/100 die of it. And you and I are to blame. (This link will take you to a video of a baby with whooping cough. It's hard to watch, but do it anyway.)

We're to blame in two ways: first, we fail to vaccinate our babies against pertussis, even though it couldn't be easier. Second, we fail to vaccinate ourselves. Immunity from the vaccine doesn't last very long, but it lasts long enough to get a baby through that critical first year. By the time we're adults, though, our protection has often worn off, unless we get a booster shot.

Adults can walk around with whooping cough, thinking they have a nasty cold. They can then pass it to parents or babies. And watching a kid with pertussis try to breathe is terrifying.

It's so simple, really. We vaccinate parents before babies are born, and I try to make sure all my patients have their shots up to date. But there will always be people in whom the shot doesn't work well, and there will always be people who say “no” to it, either on their own behalf or their child's. And that's a tragedy.

As you, dear reader, know, whooping cough isn't the only disease we can prevent with vaccination. Thankfully, there are dozens of known killers that we have locked up with the help of medical science. Some of them, like polio, haven't yet returned to the U.S., thanks in large part to vaccination and to public health measures such as the delivery of clean water. Others, like measles, mumps and whooping cough are enjoying a resurgence, thanks in large part to adults who refuse to get vaccinated, and deny their children this simple life-saving treatment.

I know I'm asking a lot of you to keep reading a long piece on a nice fall day, but stick with me because this is important.

At the University of Wisconsin, Madison, health officials are scrambling to get meningitis shots to all students. Two have come down with meningitis type b, a somewhat uncommon brain infection. And while it is rare compared to, say, influenza, it's deadly. Over the last several years outbreaks have occurred on U.S. college campuses, often killing young adults. Until one woman in Michigan lost her daughter to this rapidly fatal disease, a vaccine wasn't available in the U.S. Alicia Stillman made it her mission to bring the vaccination here and promote its use so no child would die of a preventable disease and no parent will suffer the same loss. She's been incredibly successful in getting the word out, and the shot into people's arms.

And now it's flu season, a time when hundreds of thousands of Americans get very, very ill, and thousands die from a preventable disease. The flu is one of the most contagious human viruses, but also one of the most preventable. Flu shots protect millions every year from losing time at work, from ending up in the hospital, from getting pneumonia, and from death. Since there is not a single downside to the shot (at least not compared to the disease itself), it's a massive public health failure that so many Americans miss it each year.

Cancer. We have a vaccine against cancer. Not all of the hundreds of kinds of cancers that affect humans, but against a bunch of them. Human papilloma virus (HPV) causes cancers of the cervix, penis, head and neck (e.g. tonsils, back of the throat), and anus. As an astute reader you've caught on to the pattern here: some cancers are sexually transmitted.

Every time you go for your Pap smear that's what they are looking for: pre-cancerous changes, and cancer cells on the cervix. And now there is a shot that can prevent that callback from the gynecologist, that fear, the painful surgeries. It can prevent the radiation treatments to the neck that dry up your saliva and burn your throat while trying to save your life. This vaccine saves lives. The trick is, it's best to get it before any sexual activity, so basically, in pre-adolescence. Some parents are scared of the idea of their kids growing up and having healthy sex lives, but it's going to happen. There's no conceivable reason to deny your kids this life-saving shot. Other than the pain of the needle, there are no side-effects. Despite what you might read on facebook or anti-vaccine blogs, this shot is as safe as safe can be, and it prevents cancer from attacking your children.

And this is the frustration I face as a medical professional and as a father. There is a small but vocal subset of people who think they are public health experts despite the obvious fact that they are not. I have spent the last twenty-some-odd years studying and practicing medicine. I've learned how to read and interpret medical studies, how to sift through data to find the difference between tall tales and facts. This is not knowledge that is available to everyone, because it takes years to become an expert. Anyone can learn to be a good parent, but not everyone can learn to be a doctor. I spent the time, money, sweat, and sleepless nights learning this because I could. I have been given the responsibility to help care for my fellow human beings. And I take responsibility this very seriously.

While getting parenting advice from strangers online may be helpful, getting medical advice from the same “experts” isn't so smart. What we do is very hard. And what you do, and who you listen to, will make the difference between saving the lives of you and your children, or giving them up to an amoral microbial world that doesn't care what you read online.

Get your shots. Save your life, and the lives of your kids. I'd much rather hold my daughter's hand as she cries from a shot than hold it while she gets chemo.

Save a life. It's as easy as calling your doctor.

Labels: , , , , , ,


Post a Comment

Subscribe to Post Comments [Atom]

<< Home

This is a printer-friendly version of this page

Print this page  |  Close the preview




Contact ACP Internist

Send comments to ACP Internist staff at

Blog log

Members of the American College of Physicians contribute posts from their own sites to ACP Internistand ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

And Thus, It Begins
Amanda Xi, ACP Medical Student Member, is a first-year medical student at the OUWB School of Medicine, charter class of 2015, in Rochester, Mich., from which she which chronicles her journey through medical training from day 1 of medical school.

Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.

Zackary Berger
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.

Controversies in Hospital Infection Prevention
Run by three ACP Fellows, this blog ponders vexing issues in infection prevention and control, inside and outside the hospital. Daniel J Diekema, MD, FACP, practices infectious diseases, clinical microbiology, and hospital epidemiology in Iowa City, Iowa, splitting time between seeing patients with infectious diseases, diagnosing infections in the microbiology laboratory, and trying to prevent infections in the hospital. Michael B. Edmond, MD, FACP, is a hospital epidemiologist in Iowa City, IA, with a focus on understanding why infections occur in the hospital and ways to prevent these infections, and sees patients in the inpatient and outpatient settings. Eli N. Perencevich, MD, ACP Member, is an infectious disease physician and epidemiologist in Iowa City, Iowa, who studies methods to halt the spread of resistant bacteria in our hospitals (including novel ways to get everyone to wash their hands).

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Suneel Dhand, MD, ACP Member
Suneel Dhand, MD, ACP Member, is a practicing physician in Massachusetts. He has published numerous articles in clinical medicine, covering a wide range of specialty areas including; pulmonology, cardiology, endocrinology, hematology, and infectious disease. He has also authored chapters in the prestigious "5-Minute Clinical Consult" medical textbook. His other clinical interests include quality improvement, hospital safety, hospital utilization, and the use of technology in health care.

Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
Mike Aref, MD, PhD, FACP, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Informatics Professor
William Hersh, MD, FACP, Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, posts his thoughts on various topics related to biomedical and health informatics.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, FACP, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Mired in MedEd
Alexander M. Djuricich, MD, FACP, is the Associate Dean for Continuing Medical Education (CME), and a Program Director in Medicine-Pediatrics at the Indiana University School of Medicine in Indianapolis, where he blogs about medical education.

More Musings
Rob Lamberts, MD, ACP Member, a med-peds and general practice internist, returns with "volume 2" of his personal musings about medicine, life, armadillos and Sasquatch at More Musings (of a Distractible Kind).

David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

The Blog of Paul Sufka
Paul Sufka, MD, ACP Member, is a board certified rheumatologist in St. Paul, Minn. He was a chief resident in internal medicine with the University of Minnesota and then completed his fellowship training in rheumatology in June 2011 at the University of Minnesota Department of Rheumatology. His interests include the use of technology in medicine.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

Peter A. Lipson, MD
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

Why is American Health Care So Expensive?
Janice Boughton, MD, FACP, practiced internal medicine for 20 years before adopting a career in hospital and primary care medicine as a locum tenens physician. She lives in Idaho when not traveling.

World's Best Site
Daniel Ginsberg, MD, FACP, is an internal medicine physician who has avidly applied computers to medicine since 1986, when he first wrote medically oriented computer programs. He is in practice in Tacoma, Washington.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

Powered by Blogger

RSS feed