The Fractionation of VacciNation

One of the most frustrating conversations I deal with daily is that surrounding vaccines.  Usually involving a mother that has done so much research about the terrible effects vaccines have, but hasn't done enough research to realize that the study claiming a significant correlation between autism and vaccines... was retracted and admittedly tweaked their data.  Vaccines are often a killed version of the very virus we're trying to avoid... why would contracting the real-deal virus be a better chance to take than chancing a vaccine that has been safe and used for 60 years or so?

One of the major things I don't understand with these families, and maybe someone can help me out here.  If you feel you've done your research, and you don't believe in vaccines--one of the cornerstones of medicine...and one of the reasons our life expectancy and population numbers have both increased so much-- then why are you going to a doctor at all?  The practices of medicine are all based in the same sort of evidence based medicine, and the medicines you seek have worse side effect profiles than vaccines do a lot of the time.  I don't quite get that.  If you don't trust me in telling you if you take this shot, your kid is much less likely to die of epiglottitis, then why would you trust me to take care of your kid when they actually get epiglottitis?  I had a expert in the field say to me, "we have to fear something and today, no one knows what a child in an iron lung looks like so we fear the only thing we see, which is the vaccine."  He told me about how he remember that there were riots when the polio vaccine was taken off of shelves for 2 weeks in the 50s.  People knew there was a consequence their kid could CONTRACT polio from the vaccine (during the recall, the vaccine was fixed after this time) and they still were willing to take that risk.  Anything to give them a better chance of immunization for the future.  Anything to keep their loved one from being suffering with a disease that had no cure, but could now be prevented.

As a student of medicine, I am out sacrificing years of my life learning about the minute details of the immune system not so that I can become a millionaire - i'm already so in debt that it's going to take a WHOLE lot of well-child checks to so much as break even and pay off my tiny house-- but so that you don't have to do that and so that you can just enjoy your kid being a kid, and I get to help by watching over your kid and being a way more effective symptom checker than webMD.   You go to a pediatrician because you don't know exactly what to look for to know if your child is developing properly, or maybe because you hate seeing your kid in pain and you haven't been able to fix it, maybe because you are scared of some terrible possibility and want to make sure every little possibility isn't missed.  And that's why I want to be a pediatrician, so I can give you a piece of mind and work together to give you the best chance of the healthiest most fun life your kid can have.  But if you only selectively trust what your pediatrician is thinking, then it's not a fully functional relationship. and nonfunctional machines aren't really worth using.  I mean... If I only trusted my bank sometimes... I'd keep all my money at home.

This isn't to say people aren't entitled to their opinions.  I will admit, I was still within range of receiving the vaccine when Gardisil came out, and I did not receive the immunization.  It was brand new, and I could understand being nervous with that - I was!  Now that it's been out a while, I've seen the results already and I would recommend it to anyone and I would have taken it myself (but i'm out of age-range now).  I also was on the "I'm too cool for the yearly flu vaccine" camp.  But now that I understand the mechanisms of how it all works, I know that my position was not really based in any sort of truth.  I didn't understand the strains of flu and how the strains of flu made into a vaccine are determined, I didn't understand that getting sick FROM the flu vaccine isn't possible due to how our immune system works.  I didn't understand that it takes 4-6 weeks to kick in because your immune system has to process it.  I didn't think about the fact that everyone feels like they are about to get sick or they are exposed to someone, so they remember to go get their vaccine, and what do you know, they get sick after--because as magical as vaccines truly are--they aren't instant protection.  So anyhow, I get it.  It's not like there haven't been major flaw in medicines released in the past... hello thalidomide...but most vaccines we are using aren't new.  they've been around for generations, we've seen their effects: the eradication of suffering associated with losing children, family members, friends. The decrease in watching slow suffering, paralysis, and death that can come with these illnesses.  Unfortunately, the best thing that we've seen with them is becoming one of the things working hardest against them, which is that in my lifetime and in the lifetime of so many others about my age (the current "reproductive" age generation), we've never been exposed to polio, smallpox, diphtheria.  Most people have heard a little about them, maybe seen a picture or two, but have no idea the magnitude of what it is that was erased/subdued and what those sleeping beasts can do.

But I guess we'll find out because herd immunity doesn't last forever.  And if you are one of those mom's that says "I don't believe in herd immunity!" then you're a self-fulfilling prophecy, because it will become non-existent at a faster and faster rate the more parents out there join your movement.  And we'll have on our shoulders the weight of undoing so much hard work of our predecessors, we'll have to start all over with new versions of morphed and evolved viruses, and we'll have to deal with the devastation it will bring.  There are already strange clustered recurrences of illnesses we haven't seen in a long time, I have a sick feeling in my stomach that that is only tiny foreshadowing of what is a possibility in the future.

If you truly understand the exact ingredients, mechanisms of action, and consequential physiological processes that take place in our body, and you look at the trends in public health over the last 100 years on a timeline with vaccine releases, then I can't imagine you could ever be anti-vaccine.

And if you don't trust your doctor with evidence based medicine and the "easy stuff", why trust them on anything else? 

Sunday, April 21, 2013 - 

I was carefully constructing my notes into charts and graphs and everything seemed to be going perfectly.  All my highlighters were laid out in order of color, all my pens were laid out in position next to said highlighters, and my chart lines were as straight as could be.

Sudden an ant materialized out of nowhere, and with strong purpose began to charge toward me across my notepad.  While to the brave ant, I'm sure I seemed a Goliath ready to be taken down, I would not have it.  I grabbed the paper crumpled up next to me from the last page of mistake-ridden notes that I had torn out of my binder and I squashed the little bugger - ending his 1 mile per hour path to bring me down.  I saw him still moving and was overcome with a need to end his misery quickly and also with a desire to complete my victory.  I squashed him again.  

It was only then that I realized that I had squashed an ant all over my lovely notes.  I proceeded to scoop him off my paper using a clean 3M post-in note.  Grabbing a second post it note I began frantically attempting to scrap off the remnants of the battle that had just taken place.  

It was then that Adam walked in.  

I told him I had been under attack and it was critical that I clean all discolorations from my paper, no matter how small they be.  my table was SO pristine before the battle. I continued to frantically scratch the paper and asked for a tissue from across the room as no time could be lost.  He obliged and as he came over and watched me work at cleaning, he was overcome with laughter.  

It was then that he pointed out the irony that I was frantically cleaning a 1 millimeter spot of bug-remains from a table labeled "Manifestations" on a page entitled "Obsessive Compulsive Disorder."

Adam asked if I would be rewriting my notes.  To which I looked blankly at him and then pointed to the second line on the page which read:

"affected people try to suppress these thoughts -- they recognize them as abnormal"

I told him as such, I would NOT be rewriting my notes, no matter how much it bothered me, and turned the page.

There is still a smudge on my Manifestations of OCD table.  We'll call it a draw.  Ant: 1 Mary: 1. 

Adam is still laughing.

my mother pointed out that I haven't been writing in my blog and that it was healthy for me to continue a diary of sorts. so my musings on life will continue, this time as a medical student, an activist, a person that cooks under stress, and an observer of the little things in life.  yeah... not much has changed except that I study a lot more now. 

True Pretzel (Bretzel)

I found this a while back and feel like i should share it with the world because these are amazing. I have made these for barbecues where even the pickiest of kids LOVED these. It may take a couple tries to get it right but once you do... rawr.

Until recently, my father owned and operated a German bakery in Chicago which

did a very good business supplying restaurants and delicatessens with these

pretzels. Well, he just retired, which means I can post the recipe for the

enjoyment of thousands. Sorry, but all of the measures are in terms of

weights, not volumes like we usually see on the net.

Dough: (makes 5 dozen)

1 oz salt

1 oz sugar

1 oz shortening

2 oz yeast

4 lbs flour

1 quart milk (or use water w/ 4 oz milk powder)

Lye Dip:

6 oz caustic soda

1 gallon water

You will also need pretzel salt.

Oven: 400 degrees F

Directions:

Prepare the dough by first disolving the yeast in the milk/water. Mix

in the other ingredients, gradually adding the flour until you obtain

a good stiff dough. Divide the dough into increments and form them

into pretzels as follows. Given a stick of dough, about 1/2 in in

diameter and 8 inches long, roll the stick starting from the middle and

working outwards, so that the stick ends up tapered towards the ends.

Keep rolling, starting over in the middle whenever necessary, until

the piece is about two feet long. Tie a pretzel knot, squeezing the

ends very tightly. Place on a lightly floured towel in a warm place so

that the dough can rise. We used dedicated boards at Schmid's bakery

because we made so many pretzels each day. Keep making the pretzels.

When finished, allow the pretzels to rise until they are about the size

you desire, usually less than one-half hour. Transfer the pretzels to

a cold place in your work area, possibly a refrigerator, although

opening a window and using a fan should work well. After about ten

minutes of exposure, you will notice that the pretzels have a

noticeable 'skin'. They are now ready for dipping and baking.

Put on latex gloves - caustic soda is dangerous stuff - and eye goggles

as well. Dip the pretzels in the caustic soda (see below) and place

them on a hot baking pan. Sprinkle with pretzel salt. Bake in the 400

degree oven until the pretzels are golden brown - around 30 minutes.

Enjoy!

Caustic Soda mix:

Put one gallon of cold water in a large plastic bucket. slowly add six

ounces of caustic soda, stirring constantly. You will want to wear

plastic gloves and glasses whenever handling this stuff. It stores

well (actually it stores forever).

Notes:

1. Don't be scared of dipping the pretzels in the caustic soda.

Yes, it's poisonous, but the baking eliminates the trouble, and it

gives the pretzels the great taste and texture of authentic German pretzels.

2. Some 'soft' pretzel manufacturers use baking soda dips instead of

the caustic soda. While we Schmids thought such practices as

nonsense, we appreciated other bakers doing this, since our pretzel

business was never threatened by them.

3. My father has retired, and I am now in possession of a lot of his

recipes. Unfortunately, most of them start with the statement "use 50

pounds of flour ...." Should I bother posting these? Can people

figure out how to reduce the recipes? My dad owned an authentic German

bakery for over forty years and he really knew his stuff.

4. The hidden trick to this recipe is having a really hot oven. The

lye dip should sizzle as the pretzels are put on the baking surface.

We had a large oven that wouldn't cool off much as we were putting the

pretzels in, kind of like a pizza oven you see at restaurants, only

bigger.

EuroTrip 2011 Not-So-Kick-Off

well, 30 to 30 has sorta kicked off... for those of you who don't know that's 30 days of celebration until Elaine is 30 years old. I arrived in Baltimore on Tuesday with no luggage and departed Thursday after a 3 hour wait in the airplane for the whole 18 minute flight to Philadelphia. Once in Philadelphia i was panicking, because we arrived at... 9:49... and my flight to London departed at...9:50... no worried. i didn't miss it. it was cancelled due to airline maintenance. so after standing in one customer service line for about 20 minutes i got sent to a terminal on the other side of the airport. So me and my new on-her-way-back-to-dublin counterpart began making our way to terminal A. while walking through the airport she turns to me and says:

you know this never happens to James Bond. AND no matter what country he goes to they speak english...

so of course i busted out laughing across the terminal and we bonded... which was important becase we were about to spend the next 3 hours in the next service line together. we all bonded, the two girls visiting dublin before their seminar in france started, the woman going to meet her husband on an 8 day tour of ireland, the james bond dublin grandma who i loved, the man from manchester behind us... there was cookie sharing, spot holding for drink and potty breaks, we were a family. after hours of waiting and hoping and hopping and hunger...it was my turn and miraculously the lady didn't care at all... she hadn't even been around dealing with the 200+ other grumpy customers! the earliest flight that could get me into heathrow would get me in at 10 am saturday, 24 hours exactly after i was supposed to be there. mind you all... i only had about 72 hours in London to being with! that didn't get me down thought... but aside from not being too helpful with a flight... my lovely helpful agent let me know that oh there weren't any comp hotels left so i could just sit and wait for 24 hours until my next flight at 9:50 p.m. I let her know that that wouldn't be happening if there wasn't a 24 hour bar across from her podium and proceeded to find my own hotel room. I didn't find one. adam did though! he sent it to me and off i was. I have a great entourage of helpful people that care in oklahoma - my mom was researching flights and adam found me a GREAT hotel room for the price US airways even wanted to pay! aside from the unkind agent, i was in good spirits. I had no reason not to be, i mean, sure i was missing a third of my london trip but the guy behind me was missing his chance to see his best friend get married in liverpool - i was missing a hair cut... and i couldn't let that get me down. thats rude and this was an adventure! after pacing around for a while longer, i made it to the cabs and got to my hotel that i prayed was decent. it rocked. it was just a motel but it was one of two of the cleanest comfiest motel hotels i've ever been in. i snuggled up in my king size bed with 6 pillows and slept far longer than i should have. waking up i decided it was time to discover how sunny philadelphia really is... it was overcast. BUT THAT didn't matter! it was such a cute place! I got all around by train and walking around and when i was finally overwhelmed by guilt for how stinky i was going to be for my overseas flight neighbor and i couldn't walk with my bag anymore... i decided it was finally time to get back to the airport. so... london... here i come (i hope)

one last thing:

dear U.S. Airways. I wont fly with you again... except for that free ticket i'm going to make sure you give me to compensate me for missing my first time in london and a champagne tour around the city. jerks. oh, and you're paying for my taxi, room, and food for today too. because you were mean. i understand mishaps. but you were mean. and i don't like mean when i've been the chipper-est person in your line over a 4 hour wait.

love, mary.