Great advances have been made in medicine; nevertheless, as I stress throughout my book, Surviving Your Doctors, the United States ranks way below many first world countries in neonatal mortality even though more money is spent per capita in the United States. As cited earlier in this book, the World Health Organization has ranked the United States thirty-seventh in the world in regard to delivery of health care services. Nowhere is this truer than in the field of pediatrics, where our morbidity and mortality rates stand firmly at the thirty-seventh ranking. That is, we are thirty-seven behind most industrialized countries. Costs of care for pediatric patients are twice as much as in other countries, including our neighbor to the north, Canada. Causes for this rating are many, such as lack of health insurance, impoverishment, a lack of universal health care, prenatal care neglect and malnutrition, very young single mothers, drug abuse, and so forth.
Parents often question when to call the doctor. The pat answer is when-ever your gut tells you that something is wrong. There is an old adage in pediatrics: “When a parent thinks the child is sick, even though the doctor doesn’t, believe the mom.” It is important to note that in the first three months of life, when a baby’s natural ability to fight off illness is low, even minor symptoms should be taken seriously. Therefore, during this early period of time try to avoid kissing, handling by strangers, and kids with runny noses. Even a low grade fever may require hospitalizing an infant at this age.
One problem that confronts all physicians and, perhaps, pediatricians, more than others is the injudicious use of antibiotics. Keep this in mind: most fevers and illnesses in kids are caused by itsy-bitsy submicroscopic germs called viruses. With few exceptions, medications have no effect on these critters. Yet, thousands of times a day, they are prescribed unnecessarily for such benign viral illnesses such as the common cold. And it is not necessarily the doctors’ fault. Many parents, frightened by old-wives tales, as well as the media, have come to correlate fever with a life-threatening illness. As a consequence, they expect, indeed, demand, a prescription for antibiotics.
Rather than explain that antibiotics should only be used for infections caused by bacteria, or perhaps for fear of losing the patient, an antibiotic is prescribed. Why is this bad? Well, bacteria have learned to thwart off antibiotics by changing (mutating) to other forms and have become more and more resistant to many of our most common germs. We have all heard stories about methicillin-resistant Staphylococcus aureus (MRSA), a form of bacteria resistant to most if not all antibiotics, and tuberculosis, strep pneumococcus, and hemophilus are further examples of these germs. By giving antibiotics needlessly, we help colonies of germs become resistant and, thus, when they are really needed, they become useless and ineffective. Experts feel that we are fast approaching a time similar to the preantibiotic era. I am sure that if you ask your pediatrician if the antibiotic he or she just prescribed was absolutely necessary, 50 percent of the time he or she would answer no.
Autism, the topic of many talk shows and recently written articles, has many parents frightened. Television loves to talk about it and Larry King has invited celebrities such as Jenny McCarthy, the ex-Playboy model, to vent her feelings regarding the cause. The common thought espoused by the lay press is that autism was first caused by small amounts of mercury, a preservative used in certain vaccines. When it was shown in several studies that autism actually increased or stayed the same in certain populations after the mercury was removed, the so-called experts then blamed the increased number of immunizations that children receive. The cause is still unknown, although there seems to be a genetic link, perhaps acted upon by some environmental factors. There also seems to be an increase in the number of kids being labeled as autistic who previously would have been labeled as brain damaged or as having cerebral dysfunction syndrome or simply as having a speech/language delay.
What isn’t in doubt is the number of children, and adults, who no longer have to worry about dying or being permanently disabled from such scourges as diphtheria, whooping cough, tetanus, polio (infantile paralysis), influenza, rubella (responsible for 50,000 congenital defects such as blindness, congenital heart disease and deafness in the 1960s), mumps, chicken-pox, hepatitis, cervical cancer, a form of severe respiratory disease in babies born prematurely, and a form of diarrhea particularly dangerous in the first year of life. Vaccines have successfully been used to prevent such diseases. Still think shots are bad for your kids?
It seems almost every year, new vaccines are produced for us all, and, unfortunately, some are mandated for our children. Vaccines, in general, protect us from diseases, but sometimes, there can be significant side effects. There is also the cost to society to inoculate a large population to only prevent disease in a small amount of people (shingles vaccine is one example). Furthermore, many vaccines wear off as we age, and it is not that unusual to see thirty or forty year olds develop diseases such as chicken pox, despite the fact that they were vaccinated as children. Immunity from the natural disease is usually lifelong.
Richard S. Klein, M.D. is author of Surviving Your Doctors: Why the Medical System is Dangerous to Your Health and How to Get Through it Alive” (Rowman & Littlefield).