Protect your child

I wrote this op/ed and unfortunately it was not selected. I believe in the power of vaccination. I will get my word out here.

The flu vaccine is recommended for infants and children 6 months and older. Multiple factors point to this season potentially being a concerning one for our pediatric population. This past fall and winter were unusual with COVID-19 circulating as the predominant virus. Our efforts to keep the spread of COVID-19 down ultimately made the past influenza season almost non-existent. We pediatricians are asking parents to get their children vaccinated against the influenza virus as we are potentially expecting more wide spread influenza this coming season.

Last year many children had school remotely or had COVID precautions in place at school with masking, social distancing and frequent hand cleaning. This school year will potentially be different. Currently many schools in Northwest Indiana are not mandating children to wear masks in school. Even in schools where masks will be mandatory, the influenza virus has the potential to circulate and cause infections in children.

In a recent Morbidity and Mortality Weekly Report by the CDC (Weekly / July 23, 2021 / 70(29);1013–1019 Sonja J. Olsen, PhD,  et al.) concern is raised regarding this upcoming influenza season. With such low circulation of influenza virus this past year we might see more widespread disease this coming season. The pediatric population, especially the very young, may be left more susceptible to influenza infection as they do not have the prior exposure and thus immunity to the virus.  

Just how effective is the flu vaccine in children? Studies show that children who get an influenza vaccine have a reduced risk of needing ICU care by 74% and significantly reduced risk of dying from the flu. In the 2019-20 flu season 188 pediatric deaths were reported in the US. Vaccine efficacy rates can vary due to which strain is circulating, but the efficacy for children is similar to that of adults at 40-60 %. The flu vaccine is given to reduce risk of infection and, as we are seeing with the COVID-19 vaccine, its power to reduce the possibility of severe illness and death is significant.

It is estimated that influenza infections in children cause 12,000 to 46,000 hospitalizations each season. I fear that this coming flu season children will need hospitalization for non-COVID-19 illnesses and those with rare COVID-19-related serious illnesses may not have a bed available at their local hospital. There are no pediatric intensive care beds in Lake County Indiana. Only two Lake County hospitals have pediatric units with a total of less than twenty beds.  Last winter season the hospital I admit to in Northwest Indiana was closed to pediatric admissions. This was in response to the high bed volume needed for adult patients specifically with COVID-19 infections. If other community hospitals in the Chicagoland area need to do the same, we will be relying on our Chicagoland children’s hospitals to take on the number of ill children needing inpatient care. There are only so many beds available.

Influenza infection and COVID-19 infection have similar symptoms. If a child (regardless of having a history COVID-19 vaccine or not) presents with fever, sore throat, cough and runny/stuffy nose, it is likely they will be tested for both viruses if they are living in an area where COVID-19 virus is high in circulation. If a child gets the influenza vaccine, they will be less likely to get flu infection and so less likely to need evaluation and testing for a virus infection.  Parents tell me they don’t want their child to wait in the urgent care or the ER with other sick people. 

It is going to get better, isn’t it?

This cartoon is me.

Is it you too? Probably.

With election day this week, cases of corona virus surging, work pressures, financial strain and the holidays just weeks away you can’t tell me you aren’t feeling some amount of stress.

It reminds me of how I felt when Nolan left for school a second time, when he appeared to be at his best and chose to attend and live at Valpo University.

I was overwhemed with anxiety.

Initially I couldn’t sleep. I texted him daily. How are you? Did you go to class? Did you take your medication?

I had done all I could before he left for school. I had my responsibilities as his parent and I did the best I could. I had to trust him.

I had to let go.

I called and told him I could not keep checking on him daily . I trusted that he would call me if he needed something. He told me thank you. He understood and I know he was relieved I wasn’t stressing about him.

One month later he was gone.

But you know what? I am still here. Four years later I am still breathing, living, working, loving and smiling.

How did I deal with my worry about Nolan? How do I handle my anxiety now?

Take 4 minutes and listen…

So when you wake up at 3am and your brain starts thinking about all the bad things in the world, all the what ifs, the future we all want to know but cannot predict, and the things you can’t control – try and repeat the phrase.

It might work. It does for me.

Four years

Four years. It is how long we take to get through high school. Through college (that is the plan for most parents!)

Medical school is four years.

I should know how four years should feel. I have done four year tasks many times.

These four years have been painful and slow with my grieving.

The first year is all fresh with firsts – first Christmas, first Thanksgiving, first birthday. The Angelversary. You struggle to focus, you are exhausted.

The second year is horrible. It stings and all the milestone days come again and you are reminded he is not coming home. You are still exhausted. Wake, rinse, repeat.

For me the third year was the year of figuring out balance. How to still function as a full time pediatrician, mom and wife yet still honor my need to grieve.

Fourth year? My grief is still here but the need to stay current with the daily changes in a pandemic world keep me more as a doctor and less as a grieving mom. This world is getting harder for those struggling with loss, addiction, depression and anxiety. I have seen so much anxiety in my pediatric population.

I honor Nolan today, his fourth Angelversary.

I really don’t want to cry all day. I don’t have time for that. Life goes on. This day will come again and again. How many more I will have to live through I do not know. I would rather put my energy and grief today into my purpose – why I am supposed to be here.

100% preventable?

You have seen this saying before.

I agree- suicide does not need to happen.

But when a person loses a loved one to suicide this saying can sting. It can be read as “You could have prevented him/her from suicide. You missed the signs. You failed.”

The act of taking your life to end your pain, to be under the trance that suicide is the answer to your problems- that is what COULD be prevented. But not all suicides can be prevented.

The first year of life without Nolan I had no interest in advocating for suicide awareness and prevention.

How could I say it is preventable if I didn’t stop Nolan from ending his life? I FAILED. He was taking his medication and seeing his therapist. We supported his decision to go back to college. He appeared the healthiest he had been the months before.

The good Dr. Gold, a pediatrician with years of experience, she must of known Nolan was that bad, that low.


The months after Nolan died I was a busy detective. What did I miss?

He was doing so much better. He had goals and he had plans. I went through his phone and read his texts. College was going well (at least that is what his professors told me) but he was seeking a relationship. With someone. With anyone. It appears he would have great anxiety (depression and anxiety love to hang together) in social situations. So when rejection happened he wasn’t able to bounce back. It pushed him farther to feeling like he didn’t fit in. Was this the final straw? Was it school and it’s stress? Was it because he couldn’t lose weight? Was his medication dose increase the push to give plan to taking his life?

I still do not know where Nolan was the night before his suicide, nor where he went for most of the day. I imagine he went to the dunes and hung out at the beach. All alone. It was a beautiful September day. What was he thinking? Was he at peace with his decision and enjoying his last day on earth? I understand from my research that people do usual everyday things up to the minutes before they take their life.

I will never know.

The detective mom did see what Nolan did the minutes before he got out of his car with a shotgun, walked a dozen yards to a large rock mound in a construction site in view of his home and ended his life.

He watched a mundane YouTube video on his phone of his favorite gamers. No goodbyes to anyone. No note. No hidden meaning in any texts to anyone. He just ended his pain.

Tell me where the signs are with that?

It will be four years since Nolan died by suicide. The guilt can still try and take over my thoughts.

When the guilt pushes me to think I failed, I remember the following:

  • You cannot control another human being
  • You can make home safe and give tools to find help but you can’t make a person heal
  • Suicide is not the survivor’s fault
  • The act of suicide is not to hurt others, it is to end pain

I see the phrase suicide: 100% preventable in a different light. It reminds me of my role in helping others and bringing awareness to pain that leads to suicide. I cannot prevent every loss from suicide. I can be the person who listens and offers the tools to help and redirect to a path of recovery.