100 YEARS AGO
Social Aspects of Industrial Hygiene
In all health work, in anti-tuberculosis campaigns, in infant welfare agitations, in the elimination of physical and mental strain, fatigue and the neuroses of industry, it is essential that we be not blinded to the underlying, indirect economic and social factors in the etiology of our problem. In health work one finds without difficulty many questions which are on the surface apparently straightforward health and disease problems, and in connection with which, because of the imperativeness of the health aspects, those interested in their solution fail to recognize, and consequently do not attempt to deal with the underlying etiological factors, often of a distinct social and economic character.
From AJPH, June 1916
50 YEARS AGO
Nutrition Education in Schools of Medicine
Medical educators are making valiant efforts to adapt to the large fund of knowledge from which selections must be made to instruct and inform future physicians. . . . [But] a recent survey of nutrition teaching in medical schools undertaken by the Council on Foods and Nutrition of the American Medical Association determined that in general there is inadequate recognition, support, and attention given the subject. . . . To illustrate, most modern courses of biochemistry provide detailed description of systems of carbohydrate, protein, and lipid metabolism with delineation of each enzymatic step and the kinetics involved. Little attention may be given, however, to the food sources which provide the substrates of these reactions.
From AJPH, June 1966
I am not intrinsically a risk taker—not one who seeks an adrenaline rush or relishes jumping from a plane. On the other hand, I do not shy from amusement rides or heights, nor have undue fears. I make educated choices and take precautions when prudent. The fact of the matter is, I am in grave peril by going out in the world each day. I am unprotected from multiple invisible threats: measles, diphtheria, and chicken pox for example. It is a gamble to leave my home, but to accomplish my goals and aspirations, I roll the dice. My daring is a combination of prerogative and risk factor rolled into one. Unfortunately, naïveté is my enemy.
I am a cancer survivor, and am immunocompromised as a result of a life-saving bone marrow transplant. Leukemia could not kill me, and I hope ignorance will not either. I was fully vaccinated before my transplant; however, afterward I build no response to any vaccine and cannot be given ones with live viruses. I am not alone. Chemotherapy patients and those with chronic conditions being treated with immunosuppression share my dilemma. I join all babies before the age of six months—too young to be immunized and, therefore, susceptible to preventable diseases. Herd immunity is our only protection.
I overcame the unfathomable: beating leukemia. My fervent desire was to have the opportunity to make a contribution to the world. I was diagnosed at 19 years old and was not ready to die. On my way in a seven-year combined undergraduate medical school program, cancer stopped me in my tracks. I fought to stay alive, not to hide away. The unvaccinated increase my risk factor for no logical reason. They have hopped a bandwagon driven by falsehoods and are on a crash course of destruction, with me as a potential victim. I am the innocent bystander with no helmet, no body armor, and no way to remove myself from harm’s way. Would that it were so simple as to avoid the unvaccinated. Unfortunately it does not work that way.
Herein lies my predicament: I can become a recluse or I can venture forth totally exposed. Despite my life being in jeopardy, there is no viable alternative. The antivaccination groups’ justifications are misinformation and misguided opinions. They use a catchy moniker: the “anti-vaxxers.” “Catchy” is accurate, since they increase the probability of the public catching illnesses. They put my life at risk each day.
The children of “antivaxxers” are at risk as well. Ironically, their own well-meaning parents have put them in a precarious position. Those same individuals are playing Russian roulette with other peoples’ lives. What would these parents’ choice be if they were to become at risk? If one of their children, a grandparent, or another loved one were being treated for cancer, leaving them unprotected? Would they still make the same choices?
I am devoting my life to helping others through my medical training, and yet I cannot help myself. Education is the best chance to get accurate information in the hands of the masses. Armed with that knowledge, one can only hope that the rational and ethical choice is made.
Transmission is as easy as being at the same place at the same time as the infected. With each breath we take, it is an airborne possibility. For people like me, our best shot at staying safe is in the hands (or shot into the arms) of our community.