Lets call her Sarah, although that wasnt her name. Id had the privilege of delivering her, and the fun of watching her grow into a precocious toddler, with an impish smile and a joyous laugh. Then I had the responsibility of explaining her autopsy report to her devastated parents.
Shed died from an infection that her young, previously healthy body just couldnt fight. It hadnt taken long; shed started running a fever the night before, and her parents brought her to the clinic the next afternoon. The flight crew hadnt even gotten to our ER before she lost the battle.
Of course we all had what ifs to torment ourselves with. What if mom had breast fed for longer? What if dad hadnt taken her to that play date, with the little friend who had a runny nose? What if the doctor (me) been more detailed in the how to tell when shes really sick discussion? What if her parents had brought her to the ER that morning, instead of to the clinic that afternoon?
The what if that has tormented me the most, though, is what if shed been born just a year or two later?
The infection that killed my little patient was caused by streptococcus pneumoniae. The original version of the Prevnar vaccine, which taught a childs immune system to fight seven strains of that bacteria, was introduced in 2000. Shortly after, the rates of serious infections from these bacteria dropped precipitously, and not just in the children who got the shots. Adults also benefited, to varying degrees.
One modernized version of the Hippocratic oath contains the phrase I will prevent disease whenever I can, for prevention is preferable to cure. I dont remember if my classmates and I said those particular words on graduation day, but its a philosophy I wholeheartedly endorse, and one I try to live by. I nag my patients to eat more fruits and vegetables, and to get their calcium. I nag them to exercise more. I nag them to quit smoking. I urge them to get to the eye doctor, and to the dentist. I remind them that seatbelts save lives, that helmets save lives, that smoke detectors save lives. That vaccines save lives.
I dont know that the Prevnar vaccine would have saved little Sarah. No vaccine is perfectly protective. She might still have gotten seriously ill. She might still have died.
But I do know it would have shifted the odds in her favor.
Dr. Debra Johnston is a family medicine physician at Avera Medical Group Brookings in Brookings. She serves as one of the Prairie Doc volunteer hosts during its 24th season providing health education based on science, built on trust. Follow The Prairie Doc at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc, a medical Q&A show (most Thursdays at 7 p.m. on SDPB, YouTube and streaming on Facebook), two podcasts, and a radio program (on SDPB, Sundays at 6 a.m. and 1 p.m).
Leave a Reply