(This is another special posting by Suzy. I hope you enjoy it.)
Walt’s Mother has been ill for quite awhile so we have become acquainted with various facets of the health care industry as we’ve learned to care for her changing condition. The other day we were talking to one of the people we interact with when it dawned on me just how much health care has changed during my life. Injections, how they are given and for what illnesses, are one aspect that has changed quite a bit.
My mother became a registered nurse at the beginning of World War II when it was a two-year program at Presbyterian Hospital, which then, as now, is associated with the University of Pennsylvania in Philadelphia. Throughout my growing up I first looked at all the diagrams and black and white photos in her textbooks, and later read much of them. When she began there were no antibiotics; a nurse owned her own syringes that she sharpened and made sure were cleaned in the autoclave. Mom described hours of practicing her injection technique with an orange. Her goal was to slip the needle under the rind in such a way that she didn’t puncture a segment. She prided herself on sharpening her syringe needles after each use so she would cause as little discomfort as possible. She admired the ability of a nurse, or corpsman, who could administer an injection without leaving a bruise or sore spot, and taught me to do the same. Today the needles are disposable and much thinner. To be “poked” with something of comparable size one needs to have blood drawn or have an IV.
HUP, home of Presby’s nurses training, has always been a forward-looking teaching hospital. Mom lived their philosophy her entire life. She believed in the concept of “First, do no harm,” as well as exploring all that was new in medicine. While in her twenties she contracted what was then called yellow jaundice and we now know as hepatitis. At the time, penicillin was a brand new miracle drug that doctors wanted to try on many maladies even though they were unsure how large a dose was needed to be effective. So they suggested to Mom a course of injections coming every four hours. The song “Five-foot two, Eyes of Blue” described my mother, so she soon had more penicillin than her body could absorb. She said that it got to the point where she felt like a pincushion and that as the nurse would push the serum in the new entry point some would exit a previous injection sight. She recovered rapidly and always credited the treatment with preventing her from contracting colds for the rest of her life.
One of the critical health problems in the first half of the twentieth century was poliomyelitis. This had caused Franklin Roosevelt’s paralysis. Most of us knew at least one child in our class who walked with the characteristic limp of those who were fortunate enough to recover from the virus. Frequently, that person would “disappear” all summer for a follow-up operation. Military and their dependents are an ideal sample group for medical tests because they can be tracked. So when Dr. Jonas Salk wanted to begin field trials inoculating children with anti-polio vaccine Mom saw that I was in one of the first groups. We were living in San Diego at the time. I can remember being driven to a near-by high school where large numbers of us were to get our “shot.” As I was in elementary school, being on a high school campus was exciting, getting an inoculation not so much so. It became even less exciting when I learned that it was a three-dose vaccination. Mom was a firm believer in vaccinations against various diseases so I had had many shots by then. The first injection was interesting because it was my first experience with an inoculation air gun, a wonderful device that eliminated needles. The second was an annoying interruption to my play. The morning after the second shot I woke up thinking my back was breaking. Then I really began to panic when I couldn’t inhale. I had a fever and ached all over. Dr. Salk’s vaccine was to have been manufactured with dead virus. The batch I had gotten had had some live virus in it. Dad, of course, was on a carrier somewhere in the Pacific Ocean. So Mom had to take care of business on her own. She rolled me in the blankets on my bed and put me across the back seat of the car. She couldn’t leave my baby brother by himself and didn’t want to take the time to find a neighbor so she put him in the front seat. This was all wrong all around. I am not a good patient. I detest being sick. I was the eldest by six years. If anyone should have been in the front seat it was me. I didn’t even have the breath to protest. Mom drove across Claremont Mesa, down the hill to Pacific Highway, around the bay to the foot of Broadway and the ferry across to Coronado and the Naval Hospital on North Island. After we saw the doctor I felt Mom begin to relax. I felt let down. After all the excitement all I got was some cough syrup that was cherry flavored with a horribly strong, bitter after taste. Turns out I only had lumbar pneumonia, not polio. I don’t remember getting the third injection, but I believe Mom followed through after I got over the pneumonia.
She didn’t give up on polio vaccines. When I was in high school and my brother was in elementary we were living in Naples, Italy. The Navy medical wing decided that all dependent minors would take Dr. Sabin’s oral version. It was a pink liquid dropped on sugar cubes that we both got. Those administering it told us we would enjoy the sugar cubes. It had a bit of a bitter after taste as well.
In the early 60’s when we were living in Naples, a person wasn’t allowed back into the US if their smallpox vaccine was more than six months old. There were still epidemics of smallpox, especially in Africa, which had a lot of economic contact with Southern Europe. Since Dad’s orders were usually for early fall travel, we all got vaccinated every summer we were overseas. At that point our government was also vigilant about those visiting, or in our case living, in areas that had cases of typhoid, typhus, cholera and a couple of others. I filled more than one little yellow injection record card with all the initial series and boosters. During the time we were in Naples there was an especially virulent epidemic in Ethiopia that spread across Northern Africa. The air gun to be used in mass inoculation settings was very popular. Navy corpsman were to be sent to the affected areas in an attempt to halt the spread of whichever disease it was. Before they were deployed they were to inoculate all Americans in the Neapolitan area. However, as with any tool, the operator needs to know how to use it. The air power behind the “shooting” of the serum is a setting. The corpsman at one table had left his set for grown men and the first undersize child, rather than having a mist pushed through the skin, lost some of his skin. It was somewhat painful as the kid yelled loudly enough to get everyone’s attention, and it was messy. They told us that it wasn’t serious nor permanently disfiguring. I don’t hear anything about inoculation air guns anymore. I sometimes wonder what happened to them.
As our sons were growing I saw that they got all of the vaccines scheduled for children at that time. By then, small pox vaccinations were no longer necessary, as the virus only existed in a few labs. Their polio shots were given when they were babies. In the few places in our world where it still exists polio, or the program to vaccinate against it, is more a political issue than a health one. When they were given their MMR vaccines against measles it was thought to be a lifelong protection. However while they were in school a measles breakout occurred in the San Diego area and boosters were given. That, in part, is due to parents who do not have their children vaccinated because they fear a bad outcome. This is a truly sad thing as it not only leaves their children susceptible to whichever disease they choose not to prevent, but they also turn their children into possible disease vectors for any other people these children come in contact with.
Now as Walt and I are ageing we are back into getting vaccines. We get our flu shots every year. We keep our pneumonia vaccines up to date, and, yes, we have had our anti-shingles virus vaccines.
I really appreciate preventative medicine and its ability to eradicate various strains of disease. I hate to be sick.
The last word:
One of the side effects of age is that I get to have blood work done every 6-9 months. Since I need to fast for 12 hours prior to the “donation,” I get the blood drawn when the lab first opens at 7 AM. Any day that starts with the poke of a sharp stick can only get better.
In the 1920s, diesel engines were being made in large quantities, and one risk when working on them was accidental injection by the fuel injectors. In 1960, Aaron Ismach invented and patented the Jet Injector Gun, probably the gun Suzy experienced. There was both an electric powered version and, for remote operation, a foot-powered injection gun. In 1976, the air gun was instrumental in eradicating smallpox in Africa and Asia. However, sometimes the injection process dislodged infected matter from a patient onto the nozzle thus risking cross-infection. In 1997 the US Department of Defense, the largest user of injection guns, announced it would no longer use them due to those concerns.
Keep your sense of humor.