Faith and the Flu Vaccine

Some trust in God, some trust in nature, others trust in nothing and no-one.

The roots of these feelings lie deep, too deep generally for the light to penetrate.

These feelings are almost religious: they express some faith or, occasionally, a fear of all faith.

If you try to debate feelings of this nature you’ll find them impervious to argument. They are held sacred and well away from the light of enquiry.

If you believed I held a particular faith you might consider my belief absurd. But because of your good manners you’d probably keep that view of my quaint beliefs private. You’d realise argument would not budge me and, out of kindness you’d refrain from locking horns with me.

Circumcision evokes a great example of quasi-religious positions. Whenever you hear the subject discussed you’ll recognise the intensity with which a person expresses a position. Here we find conviction, not opinion. Convictions are guarded fiercely, they are immune to fresh evidence: conviction is the opposite of scientific openness of mind. I have noticed how lay people, doctors and nurses alike defend their positions on the foreskin with religious intensity. I do not argue with the foreskin zealot.

Winter has come to Australia with promise of our regular influenza epidemic. With winter comes a rise in religious sentiment on the matter of immunisation against the flu. The government preaches immunisation, we doctors echo with our own hosannahs, the trusters in nature shriek back. We all talk at each other. We find it hard to listen when our faiths collide. Doctors trust in herd immunity. On Facebook my daughter tells ‘friends’ she trusts her doctor father. One respondent trusts in nature (“I‘ve been vegan for seven years, and I’ve never had the flu during all that time.”). Another respondent trusts no-one and nothing (“ It’s a conspiracy. Big pharma in cahoots with government.”)

I looked up some facts about influenza and vaccination. I found plenty of facts but these will change few minds. (Two thousand proven influenza deaths. Lots of people become unwell in the two weeks following vaccination. Not everyone who is vaccinated with be immunised. Not a single proven death from the vaccine.)

I had been doctor for two weeks when I saw my first influenza death. The patient caught the flu late in pregnancy. She deteriorated rapidly, developed pneumonia and was soon brain-dead. Her baby was delivered by emergency caesarean section and lived. That baby never knew her mother. Mother was twenty-four years of age. That was my own age at the time.

Last week I vaccinated my children and my grandchildren against the flu. I had the vaccine myself. I offer the same vaccines to all my patients. I answer their questions, I provide information, but I don’t enter into religious disputation.

You Can’t Chop your Momma Up in Massachusetts…

In January 2002, I went to Boston to cut a deal. The deal, a covenant really (in Hebrew, a brith), originated between God and Abraham. Abraham was the first to cut the deal. My job in Boston was to renew it in the flesh of my eight-day old great-nephew. When it was all over bar the feasting, all present joined in the heartfelt prayer: Just as he has entered into the brith, so may he enter into the Torah, into the nuptial canopy and into good deeds.

Then we joined in heartfelt feasting.

In the next room the baby, newly named Elisha, slept quietly. Quietly too, he bled into his diaper*.

When we checked on him we found him – as in the vision of the prophet Ezekiel – languishing in his blood. I applied pressure. This works nine times in ten. Elisha bled on. I sutured a little bleeder and waited. The baby boy bled on.

His mother and father and I bundled him up and raced him down the January street to the pediatrician’s* office. Boston is cold in January but we didn’t notice. The paediatrician’s nurse applied a tight bandage, saying reassuringly: ”Pressure always stops this sort of oozing.” Really?

Elisha bled on quietly. He remained pink and warm and peaceful.

An ambulance raced us across town, bells and siren ringing, to the Boston Children’s Hospital. Bearing all the authority of my years and my professional status, expressing myself with composed urgency and gravity, I gave Elisha’s history to a triage nurse; then to a nurse practitioner; after her to a surgical nurse and then to a medical student. All took notes, all reassured us pressure would do the trick, the ooze was slight, it would settle, Elisha looked well. All disappeared without trace.

Finally I met an Accident and Emergency physician from Iran and a Urology Resident from Israel. Beaut fellows both, they understood and honoured the Covenant of Abraham. The Israelite confided the story of his own son’s recent Brith Millah. And he spoke to the truism which comforts all surgeons: Healthy blood will always coagulate.

Meanwhile the sleeping baby boy oozed on. It was midday now, three hours after the Brith. A test gave Elisha’s blood count at forty percent. He slept on. And trickled away.

My brother surgeons took Elisha to the OR where, with the aid of the operating microscope, they ligated some minute bleeders. They invited me into OR where they demonstrated with some pride, a pink rosebud of glans, surrounded by a coronet of catgut sutures. “Look, no ooze”, they said.

No ooze is good news.

It was now three pm and I had missed my flight to the West Coast.

I hung around for an hour longer. At the next diaper change we saw the slightest pink loss. The same at the next change. And the next.

All the clinicians pronounced Elisha well. Cured. I should fly home, confident his little problem was fixed.

Misgiving, guilty at my surgical failure, I flew to LA and rang my niece from the airport. “He looks good, Unc. Hardly any ooze at all.”

I flew home to Australia.

A day later, Elisha’s mum called: “Elisha has haemophilia*, Uncle. The bleeding wasn’t your fault, not anyone’s fault, a mutation.”

Within weeks it became clear Elisha’s haemophilia was graded severe. Every second day of his life, Elisha has an intravenous injection of Clotting Factor Eight. On this regime he’s a healthy fellow.

Last week the World Haemophilia** Congress was underway in Melbourne with Elisha’s mum in attendance. She brought Elisha with her, together with his non-haemophiliac younger brother. Although I haven’t checked the pink rosebud I last saw in OR, the Elisha I see looks brilliantly healthy. Next January his multi-continental kin will gather in Boston to celebrate as, in fulfilment of our prayer, Elisha enters into the Torah at his barmitzvah.

· *In America they spell it thus.

· ** In Oz we spell it this way.