The Dec. 31 online news article “U.S. vaccination rates are plunging. Look up where your school stands.” about declining kindergarten vaccination rates was sobering. It painted a picture that can leave many clinicians feeling defeated and powerless, especially in light of the measles outbreak in South Carolina, where families with newborns are isolating and pediatricians are adapting care to reduce exposure. Politics, legislation and a crowded online ecosystem allow misinformation to travel faster and louder than careful conversation.
But there is another truth that deserves equal attention: Most parents still trust in vaccines. And when parents feel uncertain, trust in their health care provider remains the strongest influence on vaccine decisions. That reality matters.
When pediatric clinicians, like myself, visit a patient, we do so with a responsibility to offer recommendations grounded in evidence and guided by care. Clear and confident vaccine recommendations are part of good medicine. Avoiding the conversation, offering weak guidance or sidestepping vaccine conversations altogether allows fear and misinformation to take root.
Families need to be heard, to feel understood, and to be met by clinicians willing to speak honestly and humanly.
The path forward is through one conversation at a time.
Diego R Hijano, Memphis
The writer is a pediatric infectious diseases physician at St. Jude Children’s Research Hospital.
Thank you, doctor
Regarding the Dec. 31 Metro article “Regular people, extraordinary lives”:
My family had the great fortune of having Dr. Frank Midgley perform his heart surgery magic on our 2½-year-old daughter, who is now 34.
Besides being a superb surgeon, he was also an accomplished comforter of anxious parents.
When we were first discussing the prospect of his sewing a patch of fabric over a hole in our precious little girl’s heart, I asked a question which, in retrospect, tells me just how freaked out I was: “Will this piece of fabric last her whole life?”
My guess is he had been asked the question before because his answer was instant: “Let me put it this way. Far in the future, when archaeologists from Pluto are sifting through the remains of our civilization to try to figure out what went wrong, and they come to your daughter’s grave, this is all they are going to find.”
The laughter helped. A lot. When the operation was over, we asked when we should bring her back in for a follow-up. He said, “Oh, that won’t be necessary. She’s now a perfect little girl with a scar.” He was right.
Thomas M. Sneeringer, Washington
The SSA must do better
The Dec. 30 online news article “How Social Security has gotten worse under Trump” vividly depicted the suffering that occurs when government agencies undergo major transitions. The Social Security Administration’s new “digital-first” mantra should not come at the expense of individuals who depend on their Social Security benefits to live.
There is no doubt that SSA is ripe for a technology-driven overhaul to improve its customer service, especially in dealing with overwhelming disability benefit claim backlogs. Some critical areas that cry out for assistance include: the quality and timeliness of disability benefit decisions; explanations of benefit determinations to claimants; and the burdensome benefit application and review process.
Historically, SSA has been an exemplary federal agency that has treated beneficiaries with compassion. “Dignity first” should be its driving force.
William J. Arnone, Washington
The writer is chief executive officer emeritus at the National Academy of Social Insurance.
‘The Irish Girl’s’ story
I enjoyed Sebastian Smee’s Dec. 28 Great Works, In Focus column, “Is this girl’s indelible expression a rebuke to Victorian heroism?” about the 1860 painting “The Irish Girl.”
Smee let us know that “In fact, Brown’s painting strikes me as a beautiful (and, no doubt, unintentional) rebuke to Victorian heroism.” I would not disagree with his sentiment, and I agree that the work is a small masterpiece, but there is a lot more to the story of the painting.
My great-grandfather Joseph Maddix fled the potato famine and was literally washed up on the North American shore when his transport sank, so I am familiar with the associations that the 19th-century viewer might have had on viewing this painting. The girl’s hair is wild and unkempt, an allusion to the wild nature that was thought to inhabit Irish people. This imaginary alien spirit was part of what made it difficult for the British to organize effective relief for the potato famine, a horrible natural disaster turned into a catastrophe by governmental indifference, incompetence and outright prejudice.
The girl’s drawn mouth and the downcast gaze display sadness, her red shawl symbolizes her fierce inner emotions, and the small wildflower in her hand symbolizes her hope in the face of harrowing experience. In viewing the painting, I am reminded of the less haunted but equally determined Afghan refugee Sharbat Gula, who was depicted in Steve McCurry’s famous 1985 National Geographic cover. Like her, the Irish Girl has seen awful things but survived.
Stuart Gallant, Belmont, Massachusetts
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