Tuesday, July 24, 2012


As I write this Tuesday evening I am unaware of any local developments that deserve comments. Perhaps, the morning paper will have some local news of concern.

During the last decades of my practice my worry was that I would miss the first new case of diphtheria seen in the area. It was a justified worry since I doubt that there had been any cases since the early 50s. With the advent of an effective vaccine it had disappeared from everywhere except third world nations. Even there it was being brought under control.

Thus no one would really be thinking about it when diagnosing sore throats. Certainly today none of the present docs has ever seen or thought about it. The danger is even greater since most primary care now a day is delegated to Nurse Practioners or Pas whose training has been even less intense.

Why would one be concerned? This contagious and if not fatal bacterial disease might result in paralysis of the swallowing muscles causing chocking or aspiration of material into the lungs with a fatal pneumonia. Other complications could be weakened heart muscles.
Thus the first few new cases would not be treated appropriately and all would suffer except the malpractice lawyers.

What brought this to mind were the reports on TV that there has been a significant increase in reported cases of whooping cough this year over previous years.

That once common childhood diseases although not often fatal was debilitating and could last for months weakening the patients resistance to other contagions that were more likely to have serious outcomes.  The development of the effective pertusis vaccine had resulted in two generations of children immune from this infection.

Thus the presence of new cases means that for some reason, weird parent concepts, ill-advised religious beliefs, or even parental neglect children were not receiving the trivalent protective vaccine starting at age 2 months.

Likewise, since that vaccine also protects from Tetanus and Diphtheria in should be only a matter of time before an epidemic of that dangerous disease erupts. In New Jersey this vaccination is required for all children in pre-school and from kindergarten up. However there are exemptions for medical reasons and religious beliefs but not for philosophical beliefs. .

 Addendum: One might wonder if there is a realistic difference between an seemingly mentally individual who would shoot up the audience in a theater  or parents who would risk the lives of their children for an irrational belief. One has become a killer of the innocent, the others are potential killers.

Monday, my cat, Mick, who is fifteen years old did not wake me. When he did not appear for "breakfast" and his share of my cereal milk we became very concerned. A search found him hiding under a bed where he could not be reached. He would not move or even meow. The kicker was that he would not go for a "pounce" 

When  cats think the end is near they try to go and hide. So of to the vet we went. There was no indication  of a serious illness but once more at home he was back under the bed and did not stir.

This morning about 3am I was awake and in the kitchen for something to drink when he appeared and  begged for a treat. He then ate a small amount of his food. He reappeared at breakfast time for his "lick" and some fresh food. Mick spent a good deal of the day asleep in his chair.  

He still does not act like a normal feline of his years.  This cat that never wanted to be held for any period of time today wishes to be picked up and petted. He is not eating well . However he is 100% better than Monday which  we hope was just a temporary aberration.


  1. Hang in there Mick.

  2. 9:16, Mick thanks you or your concern. This morning he was more like the Mick I know;At my door at6am, purring when picked up, fussing to be fed. He took his medicine without more than for show fuss. He waited for his cereal milk and enjoyed it. Meantime he wolfed (catted) down his morning food and promptly anointed the floor. Just a noprmal morning.

  3. Perhaps he suffers from what ever mystery illness appears and we can't diagnose it...we call it "summer complaint"..hope he continues to feel better!