It’s Not About You

When a child shrieks out in searing pain, you never forget the sound.

“What does he have?” asked my steadfast Haitian translator. I barely paused, though I’d only ever read about the disease in my medical school text books. “Polio,” I said, fighting back a new conglomerate sensation best described as a combination of anxiety, shortness of breath and vertigo.

The boy was 9-years old. He lived with his destitute family in the Haitian village of Noyo, an hour’s hike from the nearest road. His cries were in response to his heroic efforts to stand, as his soiled diaper slid down his cable-stiff legs. He inched forward on his toes, unable to relax his calf or quad muscles, unable to remain continent. His wail turned into a barking gurgle as he inched his way forward.

There are certain smells, sights, sounds that stay with survivors and observers of tragedy. The smell of burning flesh, for example, never leaves you. I learned this from my patients when I worked in the wounded warrior unit in Landstuhl, Germany. But for me, it will always be the awful, persistent sound of a child crying out in abject pain and misery.

“How, in the name of God, do we stop this?” My translator asked.

“Vaccines.” I said. “And, funny you should ask in the name of God. I can’t think of anyone else who gave us the intellectual capacity to invent something, anything, that could stop such horror.”

Here in Washington State just last week, the boy’s pain came to mind as I sat with a patient in my clinic, talking about the flu shot. “I never get the flu shot, doc. Never have,” he said.

“Oh? Why’s that?” I asked.

“I don’t need it,” he said. “In 65 years, I’ve never gotten the flu.”

“I certainly understand your reasoning,” I replied. “You’re effectively choosing empirical data to drive your choice, right?”

“Like, there’s no evidence that I’ve ever gotten the flu?”

“Exactly. Totally reasonable, except that the problem lies in what you can’t sense. There is every possibility you’ve had the flu in your life. Maybe many times. It just didn’t make you very sick.”

“So, same thing: I don’t need a flu shot for something that doesn’t make me sick.”

“Respectfully,” I replied, “It’s not about you.” He looked quizzical. We’ll call him James. He’s a highly intelligent man from what I gather, not accustomed to new data further informing an already-considered opinion.

“It’s not uncommon for viral illnesses to spread before you have symptoms, or to spread when you are infected but never have symptoms at all. This puts the young, the weak, the old, the immunosuppressed at great risk. We don’t want you to get immunized for you. We’re worried about them.”

He gave me a flat stare, “That angle of the vaccine debate is under-emphasized,” he said. “You really should focus on that part of the issue. It was never really clear to me before now.”

If I were to design a pro-vaccine campaign, I’d make simple Signs and T-shirts and stickers. All black, with white letters that say:

It’s Not About You

(Get Vaccinated)

I’m continually surprised to see how many people don’t quite understand the effects of their reasoning regarding vaccines. The idea is to halt disease in the one person you can control – YOU – so that it doesn’t create unmitigated misery in those you can’t control (others). Somehow, this message just isn’t making the rounds.

One theory about why: Maybe Americans don’t really see awful suffering all that much. We think we have a grasp of it but we really don’t. We talk about some in this country being vastly more privileged than others, and to a degree this is true. But it’s worth remembering that all except the very tiny minority of the poorest Americans are vastly more wealthy, protected and privileged than much of the rest of the world. It’s been said that if you have a fridge and a cell phone, you’re rich by definition. And trust me, all but the worst in America is a Country Club compared to Port Au Prince.

I recognize, it IS hard to act on things you can’t see or perceive. And so in this case, despite whatever risks of masks or vaccines, I wish I could bring all my countrymen back to that moment in the crumbling concrete church in the rocky hills of Noyo where we ran our little aid clinic. And while I wouldn’t wish the lingering sounds of those tortured screams on anyone, I do wish I could convey their effect. When you see it, when you hear it, you can’t forget. Within the helpless sorrow of that misery, vaccines are an easy choice.

**Images not used with permission. I hope I don’t get busted here. They DO link to the sites from which I “borrowed” them. I’m trying to do a good thing here; there’s no money headed my way from their use.