The Most Important Question in Pediatrics (Pedcast)

Welcome to another pedcast. If you are a new listener, let me introduce myself…I am Dr. Paul Smolen, a board certified pediatrician and curator of the blog, home of the pediatric podcast I call a pedcast. The other day I was doing a thought experiment, you know the way Albert Einstein did when he imagined what the world would look like if he were moving at the speed of light. These mind experiments are really fun if you have never tried them. My experiment certainly was not on the level of Dr. Einstein’s, but it was interesting to me nonetheless. I was thinking what would it be like if I were dropped off in some isolated, rural part of the world where there was a febrile, really sick child, and I was responsible for their health. An enormous challenge without all the modern diagnostic tools I usually have, but even more so since I could only ask the patient’s family one question. What would that question be? I only have one question that I can ask to sort out this child’s fever. Said another way, what is the most important question to ask the family of a sick pediatric patient? Since I’m a pediatrician and most fevers in children are caused by infections, the child’s fever is likely coming from an infectious disease; but which infectious disease? Would I ask if the child was born by C-section or was premature; or would it be does the child drink formula or is being breast-fed; or maybe I should ask about whether this child drinks city water or well water; or maybe I need to know whether the child lives in the city or in a rural area near animals?

What would that one question be that might really help me sort out their sickness, a question that is so important and vital to this child’s health? For me, the answer is simple…”Is this child immunized?” is clearly the most important question when it comes to this child’s health. This is because being immunized–fully immunized–takes so much potential illness off the table. If they are immunized, the child can’t have diphtheria, polio, tetanus, most kinds of meningitis, hepatitis A or B, measles, mumps, rubella, or chickenpox. This is why so many pediatricians and family practitioners hesitate at seeing children whose families don’t immunize their children. Being fully immunized is the most important thing we can do to protect children.

We’ve heard all the arguments from those that oppose vaccines, but as I have pointed out before, where is the alternative to vaccines? Vaccines are a child’s best chance of avoiding and surviving the myriad of infectious diseases that have killed so many. We take it for granted that children in this part of the world are immunized and can’t get any of those horrible diseases that our grandmothers and great-grandmothers struggled so mightily against. But in much of the world it’s not that way. We can’t take for granted that children all over the world are immunized. We are making progress, however. Take a look at what the World Health Organization has published in terms of the number of cases of vaccine preventable disease. What you notice in this chart is that even though the world’s population has increased by about 50% since 1980, the number of children dying and suffering from horrible childhood diseases like pertussis and tetanus has dramatically dropped.

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So, I’m back in the tent in rural Wherever. I barely speak any of their language, and I can only ask one question. What is that question going to be? For me, there is no doubt it would be, “Is this child immunized?” Make sure your children are fully immunized, and take full advantage of the phenomenal technology that modern vaccines provide.

If you enjoyed this pedcast, take a few minutes to write a review or a comment at my blog, or on iTunes. This is your host, Dr. Paul Smolen, hoping you will be Johnny on the spot for your child’s next shot.  Until next time.

Smo Notes: Thought Experiment