Sunday, February 8, 2015

Not Zen 148: Immunity

The inner door of the urgent care clinic swung open. A family of three stepped into the hall from the lobby, a tall, middle-aged man, a woman with a swollen neck, and their crying child. The father held the door for his wife as she staggered through. He pulled on his daughter's arm after the oak slab swung closed behind.

"Come on," he whispered.

The nurse waved for them to move forward. The family was her first appointment of the day.

"I was going to ask what was troubling you," she said to the woman. "But it must be your neck. Are you having trouble talking?"

The woman nodded.

"That's fine. I'll have your husband answer the easy questions. If we leave out something important, just wave or speak up."

"Thanks," he woman huffed. With effort, she followed the nurse into an office and pulled herself up onto the examination table.

A few minutes later, the nurse left with her notepad filled with answers. The doctor arrived not long after, a short man with dark hair and a bald spot. He held the same notepad. He read the patient report as he walked.

"Problems breathing?" he said. He glanced up. "Oh my. She wasn't exaggerating about the neck."

He introduced himself. The husband shook hands with the doctor. The daughter hid behind his leg. The doctor had everyone sit in chairs while he did a physical inspection of the woman's ears and nose. He pulled out a stethoscope and listened to her breathing. He took a tongue depressor from a drawer and peered down her throat.

"Yep, there's membrane on her tonsils." He sighed. He asked his patient, "You aren't having chest pain, are you?"

She nodded and gave him a smile. Her right hand went over her heart. "Hurts."

"You have myocarditis. This is very serious."

"What did you call it?"

"Myocarditis is a heart problem. The bull neck, the membrane in her throat, and the myocarditis are three classic symptoms of an old disease. It's called diphtheria. Her diphtheria has reached an advanced stage. The heart issue may be life threatening. Likewise for the membrane partially obstructing her throat. We need to get her to the hospital."

"What's diphtheria?"

"It's a respiratory disease. When it's bad, it kills. Diphtheria was fairly common in our country a long time ago. Now it's rare. I'm pretty sure she's the first case in more than a year."

"It's awful."

The doctor leaned his head out out the office door. He called for the nurse.

"Will she be safe in a hospital?" The husband stood for a moment. He made himself sit back down, hands clasped in front of him. "Hospitals transmit diseases."

The doctor barked a laugh. He turned to the husband. After he closed his eyes for a second, his expression grew calm.

"Yes, sometimes people catch diseases in hospitals." He shook his head. "But in this case, your wife will put others at risk, not the other way around. There won't be anything in the hospital to threaten her as much as this."

Her husband frowned. He looked at his clasped hands.

"I haven't seen you come to the urgent care center before. Are you new to the area?" the doctor asked.

"Yes," croaked the mother. "It's my husband's job."

"We move around." Her husband raised his gaze to them. "My business transfers me."

"Have you been overseas?"

"Oh yes." They both smiled, the wife with some difficulty. "We just got back."

"I see. Maybe you skipped some vaccination shots." The doctor began to pace.


"Why?" He threw out his hands.

"We were moving fast." The father scowled. "And we both felt that the vaccinations themselves are a risk."

"There are hardly any negative reactions at all." The doctor looked to his patient for confirmation. She had a scowl on her face similar to her husband's.

"The shots have mercury in them," the fellow continued. His wife nodded in agreement. "That's poisonous."

"That's totally wrong in every important way. They have thiomersal. That has mercury atoms."

"It's still mercury." Again, the wife nodded in response to her husband's words.

"Not to your body. How can I explain? This is basic chemistry. The atoms of mercury are tied up in a safe, stable chemical compound."

"I don't know what that is."

"Okay. You know that chlorine is deadly, a poisonous gas. Sodium is deadly. But your body can't live without sodium chloride. That's a stable, chemical compound."

"It doesn't sound safe."

"It's table salt. Sodium chloride is salt and it's essential to your diet. Chlorine and sodium don't come apart in your body and kill you. It's the same for thiomersal. It doesn't react with anything to form plain old mercury, which would certainly be a poison although still not as deadly as chlorine. Didn't you learn any of this in school?"

"Chemistry? Not much. Neither of us are eggheads. Anyway, it's like the old saying, 'The learned are not wise.' We don't trust in science."

"Lao Tzu, right? He wrote that as he was describing the problems of scholars who like to argue for the sake of appearing smart."

"Sounds like eggheads."

"This seems like a great example of latching onto a saying out of context. You shouldn't cite Lao Tzu as if it somehow makes you wise. Ignorance is not a noble thing. And learning isn't foolish. You may not understand the science of vaccinations. That's understandable. But now you need to fix that. Aha."

The nurse appeared in the doorway. The doctor motioned her over. The two of them leaned their heads together for a moment. The doctor whispered. The nurse looked at her hands as if she wanted to wash them. 

"I'll make the call. I'll ask for the disease containment unit," she said.

"Thank you," the doctor replied.

The nurse turned to go. At the edge of her vision, she noticed the little girl. The girl was red in the face from her whining and complaining. That had been minutes ago and she still seemed flushed. The nurse knelt and stretched out her right hand. The girl walked over to it. While she held the girl with intertwined fingers, the nurse raised her left hand to the girl's forehead.

"I think you should look at this," she called.

The doctor had been trying to reassure his patient that the disease containment unit would let her move around. Why she wanted to move around, he grumbled, he didn't understand. When his nurse called to him, he took a deep breath.

"What is it?" he said. His gaze drifted downward. He saw the young girl. "Oh."

He knelt and stretched out an arm. His gesture was gentle. The girl didn't shy away. He touched her throat. She winced.

"Her, too."

"What?" said the husband.

"She's got it too." He pulled out his otoscope and popped off the part that fit into the mother's ear. Now it was a flashlight. He opened his mouth at the girl. She opened hers back, wide, and he looked in. "Yep. She's getting the membrane covering. In kids, the disease works faster. Let's skip waiting a day and get her right to the hospital."

"How did she get it?" her father wailed.

Her mother let out a burbling noise. She started to cry. The doctor seemed unmoved.

"Not considering the consequences of decisions doesn't make you immune from them." He rose to his feet. "And sometimes the consequences fall on others."

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