Saturday, April 11, 2009

Fear of Falling

When he was about 14 months old, Max took a big face-planting fall off the arm of the couch, headfirst into the back of a chair that was sitting nearby, onto the floor. It was truly one of the most awful moments of my entire life, that split second of stunned silence between crash and screaming. It's the first time I can remember him having really hurt himself--he'd had stomachaches and other minor ailments before, and he'd certainly been uncomfortable, I'm sure--but he'd never really been hurt before. In the second it took me to get to him on the floor and flip him over, looking for blood or broken teeth or anything visibly terribly wrong with him, I burst into tears too. Dan was in the kitchen correcting papers at the time, and I screamed for him. He came running, I sat on the floor holding Max and wailing, Max flailed wildly and cried, and once he determined that there wasn't anything really wrong with any of us, Dan sat on the floor next to us and comforted his crying wife and son.

He wasn't hurt, luckily. Max is like a cat: it seems to me like he should have gone through all of his nine lives ten or twelve times over by now. I've read more near-misses and horror stories recently: babies who've rolled off their parents' bed onto a hardwood floor, toddlers who've miraculously been caught by a passing stranger as they've fallen from a third-story window, and of course, like nearly every blogging and Twittering mother on the planet, I was shocked and horrified to read earlier this week about little Maddie Spohr.

It's gotten warm here over the last few weeks, and for several hours in the afternoons most days, we've opened the windows, and Max has taken a particular and somewhat peculiar joy in pressing his face against the window screen in his room and screaming out the window at the top of his lungs. Yes, I'm aware that my kid is a bit of a total weirdo, but at any rate, no. We live on the third floor, and there will be absolutely no pressing of our heads against a window screen. The screaming I can live without, but the real issue is the visual I have of the screen giving way and Max falling headfirst out of the window, three stories, into the parking lot below. It's one of the few infractions of the rules that has earned Max a spanking: we only spank for things that could seriously hurt him or someone else.

I can't prevent every header that Max is determined to take off the couch. I just can't. This kid is three and a half. Sometimes they have to fall down, just to check to see if gravity is working. I get that. I can (and do) keep the machetes and heroin and porn out of his grasp (yeah, the heroin and porn are all mine; hands off, kid), but I can't eliminate every sharp corner and edge and forehead-level-everything from our house. And furthermore, I don't want to. He is, after all, three and a half. At some point, you should learn not to walk headfirst into things.

When he was six months old, Max was exposed to whooping cough from a ten-month-old who had not been immunized according to the CDC's childhood vaccination schedule, or, as it turned out, according to any medically-recognized vaccination schedule at all. Max had just received his third dose of the DTaP vaccine when he was exposed, but I was concerned enough to call his pediatrician immediately. I was further concerned a few days later, when I learned that the older baby had, sadly, died. Max has a wonderful pediatrician, a brilliant clinician and an extremely capable woman who's never pooh-poohed my concerns, no matter how outrageous they may have sounded to her, and the first thing she said to me was, "You've done the right thing calling." She immediately looked at his vaccination records to see that he was fully up-to-date, saw that he was, and said, "My immediate thought is that he should be completely fine, but keep a close eye on him over the next two weeks." Done and done, I thought. I was a stay-at-home mother at that point; I had not a whole lot else to do besides keep a close eye on him.

Max never developed so much as a sniffle. In checking with the local health department, I learned that six cases of pertussus were reported in conjunction with the baby who died; all were children who were on "alternative" or "delayed" vaccination schedules. They never ascertained exactly how many people were exposed to pertussus; but no fully-vaccinated children or adults reported becoming ill.

Let me repeat that, because I think it's significant: no vaccinated children or adults reported becoming ill. There has been a lot of talk about vaccination lately; Heather Armstrong at Dooce is a lightning rod for most internet-based parenting controversy and this is no different.

My feelings about vaccination is pretty straightforward: I have and will continue to vaccinate my children on schedule against anything that they have vaccinations for, including measles, mumps, rubella, diptheria, pertussus, polio, varicella, hepatitis A and B, rotavirus, Haemophilus influenzae type b, pneumococcal, influenza, meningococcal, and HPV. These are, by all reliable accounts, medically safe and proven to prevent, not cause, life-threatening and devastating diseases, anecdotal evidence notwithstanding.

I could not be more sympathetic to the parents of children who suffer from autism-spectrum disorders. I have a nephew who's suffering terrible social, developmental, and learning delays due to an autism-spectrum disorder. As a parent of an energetic and precocious pre-schooler, I am struck multiple times a day by how much of a challenge a totally normal kid is; I simply cannot fathom the depth and breadth of challenging a delayed child.

When Max fell head-first off the couch, I immediately blamed myself. I was sitting right next to him; why didn't I grab him? Why did I let him climb the arm of the couch? What was I thinking? He could have broken his skull, his neck. I could be sitting here holding his dead body right now! What is the matter with me? That's why I cried, not because of him getting hurt. I cried because it was my fault he fell.

You spend nine months, minimum, anticipating and growing this tiny little human being, and they hand them to you, and they're perfect, a total stranger to you, but still somehow exactly what you were expecting. When this perfect little person turns out not to be perfect, of course there must be a reason for it. Of course. Of course parents struggle to find some reason that the train has come off the tracks in such a thoroughly hideous way.

Vaccines are taking the heat for things that they're just not responsible for, and as a result, there are individuals out there who are making the decision not to vaccinate. As a result of that decision, diseases that should be practically extinct on this continent are making a comeback, and my kids are being exposed to things like whooping cough. Here's a news story from today, about patients who've been exposed to measles in a local hospital.

I know it's not pleasant, the idea of your baby getting a shot. But at the risk of sounding intolerant, the mothers that tell me, "I'll never vaccinate my precious children, I can't imagine making them get a shot," well, don't get pissed at me or anything, but I'm going to be forced to push you in front of a bus. That's what's known as thinning the herd where I come from.

The same goes for parents who tell me, "I won't vaccinate my children--everyone else does, and they'll never be exposed to anything for that reason." Well, your thinking is flawed, and you clearly don't have much of a grasp on, you know, science, but whatever. Do me a favor and don't let your kid come within twenty yards of my kid, okay? They probably don't wash their hands either.

And for the parents that cite the anecdotal evidence of vaccinations causing developmental delays, I don't know what to tell you, except that I'm afraid of my son falling down. I'm afraid of him falling off the couch, I'm afraid of him falling off the bed, I'm afraid of him falling out the window, I'm afraid of him falling off his bike and off the playground equipment and from the loft in our condo and down the stairs. I'm scared to death of the feeling of helplessly watching him fall, the anticipation of the sound of him colliding with a hard surface, the sight of my own hands reaching toward him just a second too late. I'm afraid of that moment of silence before he starts to cry, of that moment going on and on and on, holding my breath while I wait for him to start to cry, and what will happen if I never hear him cry again, how I'd ever be able to stand it.

But I know he will fall down. I know he will. I know he'll hurt himself, probably, at some point seriously. I did. When I was about Max's age--younger, maybe--I fell skiing and sprained my ankle badly, an ankle I've reinjured numerous times since then, probably due in part to the injury that I sustained when I was three. Kids do that. It happens. You take risks, calculated risks. You spank them for leaning on the window screen on the third floor, but you cheer when they ride away from you on their bikes. You stop them from jumping on the bed, but not from jumping down the last two stairs.

I am vaccinating my children because I feel that it's not only the responsible thing to do for them, but it's also the responsible thing to do for my community. I can't depend on other people to be responsible, so I do my part. Herd immunity is something everyone has to contribute to; I do my part by contributing, and I will continue to do so. I have no good evidence that vaccinations cause anything other than immunization.

Sure, go ahead and don't vaccinate your kid. But don't tell me I'm harming mine by vaccinating him. Don't tell me I'm putting him at risk. I'm not stupid and this is the calculated risk I'm taking: the slim possibility of vaccine reactions versus the much-less-slim possibility of devastating neurological damage or death due to a preventable illness. I get it, okay? You take risks as a parent. This is the devil I know versus the devil I don't.

And do me a favor: if you're not going vaccinate your kid, keep him away from mine. I wasn't kidding about that.


Sarah @ said...

I couldn't agree with you more. When I first heard of a parent not vaccinating or delaying vaccinatins because maybe, somewhere, someone, one time had a negative reaction? I was FURIOUS. And two months later, there was a measles breakout near my nephew's preschool.

I never got it. Have those parents never know anyone who contracted a disease abroad? Have they never known a polio survivor or met someone who had an allergic reaction to the pertussis vaccine? I always look at it this way: let's assume the autisim stuff is true. What's worse, then? Your kid might develop autism, or your kid might die, or your kid might live but cause another child's death. A child like my BIL who was allergic to a vaccine and had to catch it directl to build an immunity, or a child too young to have received the vaccine already, etc.

It's just too risky.

The doctor told us that because I have an autoimmune disorder, we have to delay our early vaccines for two weeks to make sure the baby's immune system doesn't crash. The funny thing is that I thought OKAY, this means I need to keep everybody else away for two weeks because if the baby catches something, it isn't fair for me to let them pass it along. I wish other people thought this way too.

Bibliomama said...

I ended up here because your comment on Suburban Bliss gave me a giggle on a sick and cranky morning, and I just wanted to compliment you on your articulate defense of vaccines. This is exactly what I think, and somehow I can never put it this clearly when face-to-face with a self-righteous anti-vaccinator. And somehow spluttering "you... you... you're just... DUMB!" doesn't have the desired effect.