The face of the enemy

by Theresa Wells

Last week I had the honour and somber They were controversial when they were first invented and tested, hundreds of years ago in an effort to stop smallpox. Edward Jenner, using a solution developed from a disease in milkmaids called cowpox, created a vaccine in the hopes of preventing smallpox, until then a scourge across the world that claimed millions of lives. The year was 1796, and Jenner changed history when his vaccine proved successful.
Not everyone believed Jenner would succeed, of course, and there were many critics, but over the course of the next two hundred years or so vaccines for smallpox were refined, with others developed for the other diseases that claimed lives and caused suffering: polio, measles, mumps, tetanus, diphtheria. There was a time when vaccination was so routine it was not even discussed, as I recall being vaccinated like a herd of cattle in school, nary a peep of dissent to be heard as most people had some memory of the diseases in their families, and the tragedies that followed.
My parents, who grew up during the Depression, did not know measles and mumps and polio as diseases of the past, rare and unusual. They had seen these diseases first hand, particularly polio, and there was no doubt in their mind of the value of vaccination. They had lived through the times when fear of polio was rampant, when the children of neighbours were struck down, when people feared to gather in public places because polio could lurk there. My parents vaccinated their children, because they had seen the face of the disease, and they had seen the aftermath.
It is said familiarity breeds contempt, and perhaps this is true for vaccines as well. Perhaps we have become so familiar with a society free of easily transmissible life-threatening diseases that we have become almost contemptuous of them. We don’t know anyone who has had polio or measles. We have never seen what diphtheria does. We have never given a second thought to tetanus. Our only exposure to large-scale outbreaks of disease is the occasional influenza virus and what appears to be a zombie disease on the Walking Dead. But viruses that cause mass suffering, illness, permanent disability and death? We don’t have much experience with those anymore, because vaccines, whatever you think of them, worked.
A physician friend visited some third world countries a couple of years ago. While there she saw diseases virtually eradicated in North America, ones we vaccinate against and that no longer steal the lives of our children. She saw parents desperate to vaccinate their kids, surrounded by an outbreak of disease, but no vaccines were to be had. And if their children contracted the disease there were no Intensive Care Units, no prompt and intense intervention to save their lives. No, the disease ran its course, on occasion with whatever minimal medical care was available, and the children lived or died as fate would have it. My friend came home a changed person – and she changed her medical practice.
Parents in her practice were not required to vaccinate their children – but if they did not she would request they find a new physician. She no longer accepted patients who refused vaccines and would no longer spend hours trying to explain Jenner and smallpox and the history of vaccines and how it felt to watch as a child died of a preventable disease in a country far away. She would give them the names of other physicians, and she would quietly go on vaccinating the children (and adults) in her practice, because she had seen the face of the diseases. She knew the enemy she faced.
It is a contentious subject, vaccination. There are those who are vehemently opposed, who refuse vaccines for themselves and their children. They claim it is their right to do so, although they conveniently neglect to recall that your rights exist only until they infringe on the rights of others. You cannot drive at an excess speed that endangers the lives of others on our roads. You cannot engage in behaviour that may imperil the lives or safety of others. The resurgence of some vaccine preventable diseases, though, imperils the lives of those who cannot be vaccinated due to medical conditions, those too young for vaccines and those with compromised immune systems. When herd immunity fails and we see outbreaks of diseases that were until recently well controlled in North America we see lives being imperilled – and my belief is that your rights to imperil yourself stop when you begin to imperil the lives of others.
Before my mother died a few years ago we were talking about the vaccine debate. My mother, in her late seventies then, shook her head sadly. She said: “If only people understood what those diseases can cost you.” You see my mother knew, because she lost a sister to a preventable disease sixty years before, and she had never forgotten the face of the enemy that stole her sister. It is so easy for us now to debate vaccination, to see it as a choice – because most of us have never experienced the consequences of the disease. I think of my mother and my friend, and I reflect on their experiences – and I thank god for Edward Jenner, and for all those who choose to never see the face of the enemy ever again.
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