I have a vaccine and I know how to use it

Human beings today are blessed with technologies that can analyze and extract the meaning, from tremendous stores of data. But these technologies are only a few years old. It is only in the last few years that researchers have been able to manage massive quantities of information that were unapproachable in the very recent past. The pace at which we are able to solve problems that were until recently beyond us, has to do with the exponential growth in computer capability. So a problem that years ago, may have taken weeks if not months of top-end computer processing to solve, may now be managed within minutes if not seconds. And such capability is truly available to the masses, who can now rent (at reasonable rates) the use of extensive farms of servers spreading across the combined area of multiple football stadiums.

All of this capability makes it even more frustrating when the general public fails to understand basic concepts of data analysis, like “relative risk”. While a parent today will not drive an inch without their children in the proper protective car seats, the same parent may decide that vaccination is too dangerous. Please feel free to ask such a person what the absolute risk is from vaccination. I had asked such a question of the parent of a patient, and I was told by the parent, in the most serious way, that she had read an article by some physician on the Internet who “exposed the truth behind the vaccine conspiracy”. This “Dr. Snowden” was informing the public that vaccines are simply too dangerous to be given to our innocent and still healthy children.

I didn’t let this pass and I asked the mother what the absolute risk was in numbers. Millions upon millions of vaccinations are given every year. I asked the mother, how many children were actually harmed by these vaccinations, based on the article she had read. More so, I asked how many serious illnesses were prevented and how many lives were saved by virtue of these vaccinations, once again based on the article. The mother did not even understand the significance of my asking such questions. Needless to say, the parent was unable to quote any actual numbers.

The child I was treating also needed antibiotics. I asked the mother if she was okay with the use of antibiotics. She said yes. I asked her what she had read online about antibiotics that made her feel so comfortable with their use. Once again, she looked puzzled. She had not heard any claims of dangers associated with antibiotics and thus believed them to be totally safe.

My last question to this mother was as follows: you seem to trust me, and my medical opinion, when it comes to giving your child antibiotics, despite the fact that you have not read extensively on the topic. But you don’t trust me when I tell you that I have read an extensive amount of literature about vaccinations and that they are statistically safer than antibiotics. I looked at the mother and asked her to explain the logic of her decision-making.

I honestly cannot repeat what she said for the simple reason that it was effectively a random stream of sentences that had no unifying thought. I realized at that moment that I had a couple of options, one of which was to deny her partial treatment. In other words, I could’ve said to her that she is completely wrong and that I will not be dictated to by someone who has clearly no understanding of any of the issues involved in this medical decision.

I should make it clear that I welcome a colleague’s and patient’s informed and intelligent argument based on the medical literature. But with regards to this mother, this was a case not significantly different than arguing that aliens were infecting our drinking water.

My other option was to treat the child and to forgo the vaccination, hoping that the child would not turn out to be an example, for the entire community, of the dangers of ignoring vaccination.

Doctors, as I’ve said before, are not wizards and are not privy to divine secrets. Doctors are primarily purveyors of information that is created by many brilliant researchers. Doctors purvey this information to patients who mistakenly assume that the doctor is the one who did the actual research. I am very much in favor of patients reading up on a topic and then asking and even challenging their doctors on information that they have collected. But for every webpage that claims to reveal the evil behind the pharmaceutical companies, there is also a webpage that claims to be able to increase your investments by tenfold, if you simply follow the websites advice.

The people of the world, who at least have access to information, can no longer claim that they were kept ignorant and that this is why they made incorrect choices. A patient should consult with their doctor to find professional and legitimate and easy to read websites that have information that can be trusted. Patients or the loved ones of patients should read such websites and become expert on the medical condition at hand. When my own brother became ill at a young age, I became an expert in his rare condition (and this was before the Internet was readily accessible). In fact, even though I was a medical student at the time, I would be able to relay information even to my professors that they were previously unaware of. It was at that time that I realized that the key to medicine was mastering the vocabulary, learning certain skills, and then reading vociferously on whatever topic was at hand. No magic. No incantations. Just very straightforward study of the topic.

If you are reading these blog posts, then clearly you already are the type of person who is looking to expand their knowledge base. Please share your experience and knowledge with everyone you know. Tell them to read on their own, on any topic that is pertinent to them. Remind them that information is power, and an empowered patient has the best chance of winning over any disease. Let them know that if their doctor cannot match their knowledge, then it is totally legitimate to find a doctor who can.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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