Permission to Breathe Again

We are waiting for snow
the way we might wait for a train
to arrive with its cold cargo—
it is late already, but surely
it will come.
We are waiting for snow
the way we might wait
for permission
to breathe again.


For only the snow
will release us, only the snow
will be a letting go, a blind falling
towards the body of earth
and towards each other.


And while we wait at this window
whose sheer transparency
is clouded already
with our mutual breath,


it is as if our whole lives depended
on the freezing color
of the sky, on the white
soon to be fractured
gaze of winter.
~Linda Pastan “Interlude” from Queen of a Rainy Country

This poem by Linda Pastan was published in 2008 — it wasn’t written about waiting our turn for the new COVID vaccine, but it could have been.

Most of us are waiting for the vaccine like we wait for the relief of a winter snow storm. It’s as if we are all stuck inside, watching at the window, our noses pressed to the glass, our breath fogging the pane, gazing at the sky and trying to predict when and if the snow will come. We long to see the world clean and smooth and magical again with all its messy, grimy, muddy parts covered up, at least for awhile.

We want to play again and go where our heart wishes and be together with our friends and family. We want permission to breathe deeply, to show off our smiles and sing with gusto.

This second winter of COVID is crueler than the first because we know more now than a year ago: we know what we could have done and should have done but didn’t. We know we’ve lost far more lives than we should have and thousands more struggle to recover.

In order to fracture this COVID winter, to break open this frozen sky of our suspended lives, we seek the vaccine to arrive like the snow, covering all, protecting all, inviting all.

Our lives depend on it.

(I get my first dose today)

Forgetting About the Killers

It’s only been a little over fifty years since vaccinations became routine for the childhood killers like polio, measles, mumps and whooping cough.  People my age and older had no choice but to suffer through childhood infectious diseases given how effectively and quickly they spread through a community.   Most of us survived, subsequently blessed with life long natural immunity.  Some did not survive.  And I think we’ve forgotten that.

As a physician, I help enforce vaccination requirements for a state university.  A day doesn’t go by without my having a discussion with a prospective student (or more likely the student’s parent) about the necessity for our requirement for proof of  mumps, measles, rubella vaccination immunity.  I have been labeled a Nazi, a Communist, a pawn of the pharmaceutical industry and many more unprintable names because I happen to believe in the efficacy of modern vaccine to help keep a community free of infectious disease outbreaks that will kill people.

We have forgotten these are honest to goodness killers of healthy human beings.  We forget that unvaccinated children continue to die in developing countries for lack of access to vaccine.   Yet educated and well-meaning American parents make the decision daily to leave their children unvaccinated, believing they are doing the best thing for their children by protecting them from potentially rare and often unproven vaccine side effects.    I’ve had caring loving parents tell me that God will provide the needed immunity if their child gets sick so taking the risk of a vaccine is unnecessary.    Actually they are banking that everyone else will be vaccinated.  The problem is:  guess again.  There are now too many deciding that they are the ones who can remain vaccine-free.   Babies died in California this past year from becoming infected with whooping cough–in the year 2010– when this is a completely preventable illness.

 

I tell these parents  God does provide  immunity–after suffering through a life threatening disease which threatens those who are unfortunately exposed.  He also provides immunity in the form of a vial of vaccine, a needle and syringe.  I don’t think any one of these parents would deny the life saving miracle of injectable insulin for their child diagnosed with diabetes, nor would they fail to strap their child into a car seat.  Vaccines are miracles and instruments of prevention too, but the rub is that we have to give them to healthy youngsters in order to keep them healthy.

 

As a society, or as clinicians, we simply don’t think about immunizations in the same way as we did in the fifties.  When I received my first DPT vaccination at the age of 4 months, my mother wrote in my baby book:

“Up most of the night with fever 104.5 degrees,  considered a good ‘take’ for the vaccine.”  She truly was relieved that it had made me sick,  as it meant that I would be safe if exposed to those killer diseases that were so common in the 1950s.  Now a febrile reaction like that would almost be considered grounds for a law suit.

 

I’m an old enough physician to have seen deaths from these diseases as well as the ravages of post polio paralysis, the sterility from mumps and deafness from congenital rubella.   My father nearly died from the mumps that I brought home from school when I was eight and he was in his early forties.   My sister-in-law almost didn’t pull through when she was an infant and contracted pertussis.  I’ve seen healthy people develop  encephalitis and pneumonia from chicken pox.    I’ve seen a healthy college student die of influenza within a week of getting ill.   There is an epidemic of fear in our society that is unwarranted: as Seth Mnookin, a journalist covering science topics wrote in Newsweek and his upcoming book “The Panic Virus”, “If only there were a shot for irrational fears.”

 

I wish vaccines were perfect but they aren’t.   Nothing is.  I wish medications that are developed for treatment of some of these illnesses were perfect but we can’t depend on a guarantee of cure once sickened.   I wish our immune systems were perfect, but they too fail and people do die.

 

There will always be a new plague–history has demonstrated that over and over with the appearance of  HIV, SARS, Avian flu, or multidrug resistant tuberculosis.   There is plenty to keep our immune systems at the ready because we don’t yet have effective vaccines widely available.

 

There is simply no good reason to invite the old plagues back into our homes, our schools,  our blood streams, and onto our death certificates.   They deserve to be considered the killers of yesteryear now overcome by modern medicine–merely a footnote in the epidemiology history books.

 

Listen to a child with whooping cough on this link:

Portrait of baby