In Praise of Antibiotics and DEI Hires
The week my toddler spent in the hospital battling a bacterial infection, I completely ignored the news. The first few days, as his left eye swelled like a tomato following a bout of flu that swept through our household, I curled my body around his small, feverish one in the remote control bed and used my phone primarily as a phone and a notepad. No need to doomscroll when I already felt encased in doom. Instead I noted every temperature reading, every dose of Tylenol, every dose of the stronger stuff: the broad-spectrum antibiotic they injected into Joey’s arm, and the one they added a day later, when I told the attending physician I was worried that his eye was getting worse.
She listened and agreed, and prescribed something called Vancomycin. It arrived in a long syringe and required two staff members to sign off every time it was administered. The blood they had drawn in the emergency department showed evidence of inflammation, but the cultures didn’t yield any particular bacteria. (At first I worried that meant he had some kind of rare mystery bacteria, but it actually just meant the infection wasn’t in his blood. That was a good thing.) We had not ruled out MRSA, the type of staph that is resistant to many common antibiotics. I’d lived in vague fear of MRSA since I first heard about it, but in that time, science had stepped up and found a solution and named it Vancomycin.
As it turned out, Joey did not have MRSA. Five days, one hospital transfer, and a small surgical procedure later (to drain the abscess behind his left eyelid), the labs showed that the culprit was good old strep. Bad old strep. It had taken advantage of his flu-weakened body and wormed its way through his sinuses, into the muscle tissue around his eye.
Throughout the week, I kept in close touch with a handful of family members and friends. The ones who loved our family and the ones who understood my pre-existing medical anxiety, or both. When I mentioned strep to Meg, my editor at MUTHA, she downloaded a trove of knowledge acquired the way that most parents acquire such knowledge: the hard way. After more experience with strep infections than anyone would want, she could literally smell when her children needed to be tested.
Wow, you’re a strep detective! I texted. Apparently I wasn’t even the first to give her that nickname.
A lightbulb went off and I encouraged my partner, C.C., and and our older son, Dash, to get tested. C.C.—who had completely lost her voice and ended up in the ED herself—tested positive.
We were in good hands medically, but I was acutely aware of how much we needed our community as well. We crowdsourced. We consulted. We sent Dash to the home of friends who fed him and soothed his anxiety about his little brother.
By Saturday, the swelling had gone down, and Joey was showing glimmers of his usual self. The child who hadn’t left his bed for days now wanted to press every button in the room, pull the red “help” string next to the toilet, and wash his toy cars in the bidet. I had never been so happy to see him be a menace.
My friend Kim, a public health researcher at a large private university, understands my medical anxiety so well that I call her my Hypochondria Sponsor. Throughout the week, she answered my panicked questions and reminded me that I was literally in the hospital.
The only place safer might be the womb, she texted. (Long ago, when I was briefly pregnant, my own uterus had not seemed safe at all.)
When I said something about the emotional roller coaster of the week, she replied, That’s how I feel about the Trump admin and the NIH…. we’re all circling the drain.
On the last day of January, by order of the Office of Personnel Management, massive amounts of data disappeared from government websites as part of anti-trans legislation issued by Donald Trump. Everything that Kim and her colleagues might use to do such controversial activities as minimize cancer risks for specific populations was just…gone.
Antibiotics are a triumph of the twentieth century. The dual windfall of improved hygiene and the discovery of antibiotics caused infant and child mortality rates to plummet. Knowing that Joey is alive because of research from the early 1900s makes me wonder what diseases my kids and their kids might be at risk for later in the 21st century if today’s research skids to a halt. It makes me feel, well, sick.
That week, I was also late to learn about the fatal plane crash over the Potomac River, which Trump blamed on “individuals with ‘severe intellectual’ disabilities in the FAA.” He railed against the hiring policies of the Biden and Obama administrations.
The doctors who cared for Joey were South Asian, Latina, Korean, and Greek.* The nurses were Latina, Chinese, Armenian, Black, and white. The white female doctor we saw in the ED had a visible disability. She sat with us and took a full history of Joey’s life, bending the pace of the ED to that of an anthropological study. I imagined us on a porch somewhere, drinking ice tea. “I’m very clinical,” she said simply. An infectious disease doctor at the second hospital, a man with an Indian surname, took a similarly detailed history. Just how much time had Joey spent with our neighbors’ rabbits? Had they ever bitten him? I felt confident that no mysteries would go unlocked on their watch. As an aside, he said, “I spent a lot of time in and out of hospitals as a kid.” A nurse who’d grown up with asthma said the same.
“DEI hire” has become a slur—the right is so good at repurposing language; every poet should be deeply envious of their skill and impact—but almost everyone we saw could have fallen under that umbrella. They also had unassailable credentials befitting some of the highest ranked hospitals in the country. But what wasn’t in their online bios felt almost as important: Some of them knew what it was like to lie in a hospital bed while someone poked you with sharp objects. The pediatric ENT said, “I have a two-year-old at home, and I will treat Joey as my own” and proceeded to do just that when she performed a laparoscopic surgery to drain the abscess that was ballooning in his eyelid. At the core of DEI is empathy.
None of them batted an eye at Joey having two moms, or being adopted. I felt like they resided in the same universe as our family, which was a balm amid the disorientation of a hospital stay.
I don’t want to put them on too much of a pedestal; I’m sure they have bad days and biases of their own. They’re human. That’s kind of the point, though. They are human for better and worse, but mostly for better.
The California Wellness Foundation recently launched a funding initiative to build a more diverse body of physicians in the state. They believe that our population (which is 40% Latinx, 34% white, 16% Asian or Pacific Islander, 6% Black, 3% multiracial, and less than 1% Native American or Alaskan Native) would be best served by people who mirror patients’ experiences. Diversity is part of the pursuit of excellence, not an alternative to it.
When I was a kid, a Mexican-American family friend took her daughter to the emergency room with some kind of bug. Our friend reported, “They kept telling me it was something we’d picked up in Cuba. I kept telling them I was born in Arizona. I’m not Cuban and I’ve never been to Cuba.”
I am still confused by why any hospital worker in Southern California would default to assuming a Brown person was from Cuba. But I bet it was a white person. As of 2020, only 6% of active care medical doctors and 10% of registered nurses in California were Latinx. This is due in part to an educational bottleneck that prevents qualified students from entering nursing school (full disclosure: the organization I work for produced the report linked in this paragraph).
When I took Joey for a follow-up appointment with his regular pediatrician, she looked over the notes from his hospital stay. “And it looks like you advocated for him. Good job,” she said.
I almost teared up. I thought about the moment, a day into his stay, when I told the attending physician his infection seemed to be getting worse. To do so had required me to quiet the inner voice that was telling me to be patient and let the professionals do their thing, and listen to the voice that said, If ever there was a time to be pushy, it’s now.
As patients and parents, we need to advocate. We need to call on our communities—the strep detectives and meal-makers. Neither is a substitute for a functioning medical system and research machine. But Trump and company would like to dismantle the Department of Education and put an anti-vaxxer in charge of Health and Human Services. The best tool we have in this fight is each other.
*I’m basing this on their last names and looks, which is not a foolproof method of determining someone’s ethnic background.
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