Information on popular complementary and alternative medical topics

A parent’s worst worry is whether he or she has unknowingly infected a child. Fathers worry that they have infected their children through casual contact; mothers worry that they have infected their children during the birth process. If the child was born before the mother became infected, the child is almost certainly uninfected. If the child was born after the parent became infected, the child has a 30 to 35 percent chance of also having the virus. Parents do not always know exactly when they were infected, and do not know if they have passed the virus on to their children. The only way to find this out is to have the child tested. To decide whether to do this”, ask, What would be gained by testing? What would be lost? Parents often decide to have their children tested. If you are worried about this, or if you are about to become a parent, get help with this decision from a mental health professional.     Parents also worry that they haven’t yet done enough parenting. Some try to accelerate the child’s social development, to help the child grow up, and become mature, responsible, and settled in life. Some parents want to teach their children everything immediately, whether the children are of the age to learn or not. Dean had a friend with a young child, and Dean’s friend solved this problem by writing letters for the child to open as she grew up.     Parents with older children worry about being a burden on the children. “My son worries about who will take care of me,” said Dean. “He’s feeling the responsibility.” People can often accept that a friend or relative worries about them, but they are unhappy to think that their children worry about them. The reversal of the normal role of parents and children makes parents uncomfortable; they feel intensely responsible for their children and hate the idea of being a burden on them. The children often understand this without being told, and do what they feel they can do. Some children are less worried about this than their parents are. “I’ve spent more time with my son,” said Dean. “I’m very close to him. But now I’m worried that I don’t want to become-a burden on my son. When I tell him that, he just says, ‘We’ll cross that bridge when wecome to it.’”     Parents with younger children—or with children of any age—worry about who will take care of the children. They worry that their own health may prevent them from caring for their young children, and they feel a moral obligation to provide for that possibility. They are intensely worried, and they are often more distressed about this than about their own health.
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The plan seemed reasonable to generals moving figurines over maps. The British artillery would pummel the German trenches. The infantry would then storm the trenches and mop up the remains of the German troops. The plan might have worked nicely in the Crimean War, over a half century earlier. But at the Western Front of World War I, it turned out to be an effective way to kill and maim your own soldiers at a rate of thousands per hour. The German soldiers took refuge in bunkers deep below their trenches during the bombardment. As soon as the bombardment ended, they were ready at their machine guns. A wall of bullets met the British soldiers as they tried to run the few hundred yards across no-man’s-land. It was a new incarnation of an old mistake: the fighting-the-last-war problem.
Those in charge of health programs often use a war metaphor to communicate their goals and expectations. They are, however, selective. They do not like to compare their programs to the stalemate at the Western Front in the First World War. The more decisive battles of the Second World War provide the preferred model. U.S. political leaders of the 1950s rallied the population for a World War II-style health campaign with the heady success of that war still fresh in everyone’s minds, and with powerful new weapons at hand—penicillin for bacteria, DDT for mosquitoes, chloroquine for malarial parasites, and improved technologies for viral isolation and vaccination. President Dwight D. Eisenhower called for “the unconditional surrender of
microbes.” Secretary of State George C. Marshall foresaw the “imminent conquest of disease.” Senator John F. Kennedy predicted that “children born in the next decade would no longer face the ancient scourge of pestilence.” Medical leaders provided the expert opinion that justified such optimism. A decade after JFK’s prediction, the surgeon general spoke of closing the book on infectious disease. In the 1972 version of their classic book Natural History of Infectious Disease, the Nobel laureate Macfarlane Burnet and his coauthor, David White, predicted that “the future of infectious diseases will be very dull.” The children to whom JFK referred had reached their twenties when the AIDS pandemic erupted, when cervical cancer was recognized as an infectious disease, when hospital-acquired infections were recognized as the tenth leading cause of death in the United States, and when in vitro fertilization came into the vernacular as a way of coping with the epidemic of infertility caused by flourishing venereal diseases.
The victory-in-war metaphor is not just a post-World War II blip on the public health radar screen. It has been invoked, though with less bravado, since the establishment of the germ theory at the end of the nineteenth century. Before the can-do postwar decades, mainstream medicine took for granted that infectious diseases would be conquered. In the midst of World War II, the Yale professor of medicine Charles-Edward Amory Winslow wrote a history of medicine that he matter-of-factly called The Conquest of Disease; Winslow provided no defense of his proposition, and no discussion of the possibility or probability of conquering epidemic disease. It was manifest destiny. He concluded his article with the statement that “the practical application of the principles developed by a series of clear thinkers and brilliant investigators … has forever banished from the earth the major plagues and pestilences of the past.” In his zeal for declaring victory, Winslow seems to have overlooked some diseases. Falciparum malaria, for example, one of the most harmful diseases in human history, had barely been nudged back in 1943 when Winslow was writing. The rich-country bias, which seems to be at the root of Winslow’s hubris, persisted among leading health scientists right up to the late 1970s, when the AIDS epidemic and antibiotic resistance gave us a reality check. Burnet and White showed similar exuberance: “Young people today have had almost no experience of serious infectious disease.” The main problem with this statement was that it didn’t apply to two thirds of the planet’s young
people—those who were living in poor countries at the time.
Though today’s leaders in disease control have been humbled by the limited success at global conquest, they still visualize their approach to infectious disease in terms of warfare. When the science journalist Wendy Orent asked John W. Huggins, an expert on monkey pox, about the possible evolutionary outcomes of monkey pox transmission among humans, Huggins responded, “I don’t think like an evolutionary biologist. I just want to find a drug for these bugs and kill them.” An evolutionary biologist would be disappointed in Huggins’s first sentence and take aim at the word just in the second. The twentieth century has left us with a clear message: it will not be enough to just try to find a drug to use as a lethal weapon against the pathogens of our future. We must understand why they are the way they are, and use this understanding to manage their evolution.
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