4.27.2009

Bracing myself

I was a senior pediatric resident at NYU in late 2001. As part of my residency requirements, I had to do a lecture for the other residents, plus any faculty that felt compelled to show up. (I don't think any did, which was their loss -- I gave out chocolate bars.) Whether because of indolent clairvoyance or a morbid streak, I chose to do my talk on bioterrorism, with a particular focus on smallpox and anthrax. Not long thereafter came the September 11 attacks, followed closely by the outbreak of anthrax. (While the child who subsequently developed cutaneous anthrax was admitted to NYU, and I was familiar with his care, I was not directly involved in it.)

This particular sequence of events led to the disorienting experience of making me, briefly, the go-to guy for the department for questions about anthrax. In particular, I found myself answered questions about whether or not anxious parents should be supplied with ciprofloxacin, a potent antibiotic, to have on hand just in case their kid (or, for that matter, they themselves) showed any signs of anthrax. The answer was, of course, no. It would have led to wide-spread treatment of the "worried well," with resultant adverse effects (some of which are nasty) and potential for resistance to a medication whose potency we need to safeguard.

I mention all of this by way of prefacing my reaction to the current swine flu anxiety, which has managed to become Topic #1 on everyone's mind over the weekend. All I can think is "Hoo, boy." Because I know that people are going to want to Do Something, which will probably mean asking for a prescription for Tamiflu should little Caitlyn or Dexter develop the sniffles. Just in case. Side effects be damned. And my poor triage nurse is going to have to explain that we will require testing for flu before we prescribe it, and heaven only knows how many kids with colds I'm going to see as a result.

As a somewhat snarky Jim Carrey vaccine lunacy post-script, I wonder how quickly certain parents' anxiety about thimerosal will evaporate if they develop a swine flu vaccine that contains it. I suspect that their risk calculations will suddenly recalibrate.

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