Tough Medicine

I get overly worked up when I defend vaccines.  Because basically, I think that you deciding not to vaccinate your children is going to result in the end of the human race.  There will be successive and inevitable waves of disease and every one of us will die horrible, nasty deaths and it will be all your fault because it was preventable.

Reality check:  Probably not.

But it’s clear how divisive the issue has become and how easily we slide into our respective extremes of position.

I find it ineffective to reason with anti-vaxxers, because reason isn’t what keeps people from getting vaccinated.  Fear and intangibles are.  I can try to tackle every objection to vaccines head-on with fact and statistic, but when it comes to fear, anecdote holds greater sway than science.  If someone tells you that their child was ‘never the same’ after receiving the shot, it’s hard to put your own child at risk with that at the forefront of your mind.

heart pillThere’s a lot at stake for parents.  Being responsible for the well-being of a tiny human is an overwhelming burden and it’s hard to knowingly and willingly put your child (potentially) in harm’s way, especially when that choice is to treat them for illnesses that they don’t have yet and may never be exposed to.  Vaccines are insurance.  You may never need them.  And in the same way that a lot of people make the decision not to buy insurance and opt to take the risk, some parents play a game of weighing the odds and forego the vaccines.

But there is a reason why vaccines, like car insurance, are mandatory.  For the very reason that the risk to self and others by not being vaccinated far outweighs the risk to the individual of negative effects.

And there are negative effects.  I am not going to sugar-coat it.  There is a potential risk for a negative reaction to each and every vaccine.

Just like there is a potential risk for a negative reaction or outcome to any treatment or medication, or in fact, any action in life.

I am not here to minimize how scary that is.

What I am asking for is perspective.

If we return to my own personal fear-based scenario above, the odds of there being a worldwide epidemic due to some parents not vaccinating their children are minimal.  What is reasonable to expect is that with increasing numbers of parents refusing to vaccinate, we will continue to see pockets of outbreaks of diseases that should have been eliminated by now.  Children (and adults) will suffer (and some will die) unnecessarily from diseases that could have been easily prevented.

For an anti-vaxxer, the greatest fear is harm to their child.  But the reality is that the risk of your child experiencing a serious negative reaction to vaccines is minimal.  You put them at greater risk when you put them in your car.  The risk of adverse reactions to penicillin is far greater, but most parents would not refuse antibiotics to treat a child’s infection.  The risk of adverse reactions to measles, mumps, whooping-cough and flu are higher (especially in children under five) still.

The problem with hot-button issues is that it quickly becomes habit to slip into rhetoric when debating either side of the issue.  Emotion is summarily dismissed as irrationality, with a focus on bolstering our arguments with facts and figures.  I’m certainly not going to suggest giving up on statistical evidence or the science supporting vaccines.  But I am willing to concede that every decision which is made in terms of  risk management ultimately involves a gut decision.  Until we acknowledge the emotion and fear surrounding the issue, there will be little positive movement in vaccination rates (and worse, they are likely to continue a steady decline).

More needs to be done to assuage the genuine and at times crippling fear that parents feel, and to do that we need to acknowledge negative outcomes.  Parents need a game plan.

There is a tendency in medical circles to downplay risk without recognizing that an essential component of risk management is the ‘Plan B’.  In evaluating any worst-case scenario, there is always a plan of treatment or course of action to continue to mitigate negative outcomes.

Parents need to know that negative outcome is not doublespeak for ‘irreversible damage’.  In the same way parents are advised that pain can be treated with anti-inflammatory medication and that allergic reactions can be treated with epinephrine, for each negative outcome there needs to be an explanation of a treatment plan.

The problem with fear is that when it is based in reality, even when it is proportionally distorted, it is impossible to entirely dismiss.  And that’s not a bad thing.  Fear is useful when it protects us, just not when it paralyzes us.  If we are to keep that fear in check, we need the tools to manage the anxiety it elicits.

The war against anti-vaxxers won’t be won with intimidation or statistics, and most importantly won’t be won if we treat it as a war at all.  Intimidation only fuels fear.

If strides are truly going to be made in vaccination compliance, it will be through the acknowledgement of fear and risk, and via a change in attitude in terms of how we manage fear-based trepidation as a cooperative effort between parents and physicians.

/rk

(originally posted at http://medium.com/tough-medicine/93e06ce374fc)

 

Advertisements

You Keep Using That Word

We asked for this, you know.  When they changed dictionaries to include ‘figuratively’ as an alternate meaning for literally we were basically asking for trouble.  Literally, even.

thatwordIt turns out religious conservatives were right all along:  It is a slippery slope.  And they’re leading the charge.

The number of words and phrases that are being twisted and misused lately would be humorous, if it weren’t also insidiously shaping our consciousness.  Listed below are a few of my personal (un)favourites (feel free to add yours in the comments):

Intolerance:  Accusing liberals of being ‘intolerant of your intolerance towards homosexuals’, besides making very little common sense, is simply inaccurate.  I am not intolerant of your intolerance; I am outright telling you that you’re a bigot.  People are under no obligation to accept or ignore you being shitty to another human being, whether it’s for religious reasons or just because your’e a jerk.

Fascism:  (commonly coined ‘Liberal Fascism’)  This one goes along with ‘intolerance of my intolerance’.  It gets thrown around a lot when conservatives say things that aren’t politically correct* (e.g. homophobic, racist, misogynist) and there is public outcry.  If you got to say your shitty thing and no one killed you, put you in prison, or overthrew your government by force, and ultimately all you got was your feelings hurt, that’s not fascism.  (Oh — if it got you fired, see freedom of speech**.)

*Politically Correct:  Here’s the thing:  You want to make this sound like a thing that is only correct because people are too ashamed to admit they don’t believe in its correctness.  But you know what?  Most of us just think of those things as ‘correct’.  Also decent and reasonable.  If you don’t really think they are, that’s just you.

**Freedom of Speech:  You are totally free to say any old nasty thing you want.  Free, free, free.  But stop acting all surprised when there are consequences to saying those things.  It’s disingenuous.  Freedom of speech laws like the U.S.’s 1st Amendment protect against repercussions from the government.  That’s it.  It doesn’t mean people can’t tell you you’re wrong (hey look — they have free speech too!) or that your employer can’t fire you.  I mean, when it comes down to it, you’re free to do a lot of things.  You’re free to kill people, for example, but that doesn’t mean people aren’t going to try to stop you or that there won’t be consequences for those actions.  And if your strongest argument for what you have to say is “I’m allowed!” then you’re mostly going to sound like a petulant five-year-old.

Reverse Racism:  First of all, um, that would just be… racism.  Secondly, unless you are part of a group that has been systematically and historically marginalized, then no.  You can convince me that someone was prejudiced against you and was a total jerk, but you are not being subjected to racism.

Bullying:  That one time that person was a jerk to you — not bullying.  Show me a pattern of behaviour and we’ll talk.  The latest take on this involves the new same-sex discrimination law in Mississippi, with accusations that stores that display pro-LGBT shopper stickers are bullying Christians.  Presumably because it will draw a stark contrast to those shops who don’t display them.  But here’s the thing, not having stickers isn’t what will single you out.  How you treat your LGBT patrons will.  If your real goal was to preserve your own rights, you wouldn’t care that people knew where it was safe for them to shop.  Unless maybe your goal was to institute a law that created an environment of intimidation and uneasiness where people were afraid to show their true selves and instead have to conform to your idea of appropriate behaviour lest they suffer the consequences.  You know, unless that.

Words do, it turns out, matter.  They have power.  And while you can’t restrict people’s use of them (nor should you), I think you really have to have your mind open to how they are used to manipulate.  There are very clear patterns here:  One is to co-opt words that have been used against the transgressor and to twist them around and hurl them back at the accuser.  The other is to purposefully use inflammatory words in mundane circumstances.  For example, I refuse to take you seriously if you accuse someone of being a Nazi (e.g. feminazi).  Are they guilty of the genocide of your people?  No.  Then stop using that word.

The problem with this sort of nonsense is that it tends to eliminate any possibility of reasonable discourse or argument. And I know, religious conservatives, you’re probably saying:  But all those other people aren’t being reasonable because they’re saying I’m wrong!  I’m being persecuted!  Here is my basic problem with that assertion:  You are trying to restrict the rights and freedoms of other people.  The only right or freedom that you are being restricted on is your ability to restrict rights and freedoms.  This isn’t a live and let live situation.  You want to impose your beliefs on everyone, legally and institutionally, whether they share those beliefs or not — which sounds a lot more like fascism to me.

But I wouldn’t use that word.

/rk