Science is a way to teach how something gets to be known, to what extent things are known (for nothing is known absolutely), how to handle doubt and uncertainty, what the rules of evidence are, how to think about things so that judgments can be made, how to distinguish truth from fraud and from show.
-– Robert Feynman
While the story I am about to tell is fictional, this fact is still true; a young, immunocompromised woman recently died from measles. This death was the first confirmed case of mortality from measles in over a decade.
She had so much to live for, her family, her fiancé, her future career as a chef, but then breast cancer interrupted those plans. Shawna was lucky, her diagnosis has come early, and the physicians told her that her chances of survival were good. It was a tough period, going through chemotherapy, but she had come out of the trial, and the cancer was gone! It has been a couple of months now, and it appeared she had beat it. There would always be that little concern in the back of her mind, but chances of recurrence became less and less with each passing checkup. Life was beginning to get back on track, and this Fall was the perfect time to get back to chef school and finally start making wedding plans.
The last checkup at the clinic had gone well, but this weekend Shawna started feeling just off and then began having trouble breathing. The coughing seemed to be non-stop, and Steve, her fiance, finally insisted they go to the emergency room. Shawna was feeling more and more tired and could not catch her breath.
It had been a slow day at the ER for Dr. Christine Smith, which wasn’t unusual for a Thursday. The weekend evenings were when things got crazy. She was glad not to be working that shift. Then an unexpected case came in; a young woman was having difficulty breathing. Her face was flushed, and she was sweating a little. After a few questions, Dr. Smith took her temperature, slightly above average, and then listened to her lungs. The characteristic rattle of pneumonia was present. The concern of Dr. Smith considerably increased as she learned of Shawna’s medical history and realized she was probably still immunosuppressed from the recent chemotherapy treatment. After admission to the hospital, Shawna underwent an aggressive treatment with the antibiotic Levofloxacin, which seemed the logical course. However, lab tests showed no evidence of bacterial infection. By this time, Shawna was barely breathing and quickly admitted into intensive care, but it was to no avail. In a matter of days, she was gone.
What had killed her? Most viral cases of pneumonia are not this aggressive, even in immunocompromised hosts. The medical examiner requested an autopsy, and an examination of the lungs showed multinucleated inclusion-bearing giant cells, a characteristic sign of measles infection. Shawna had died of measles! An investigation by the CDC revealed that the clinic where she had her checkup had also seen children who had measles that same day. Measles is one of the most contagious diseases known, and it had spread from these children to Shawna. But why? An aggressive campaign in the second half of the 20th century had eradicated measles from the United States, how could this deadly disease make a come back? In one word, misinformation. The population of unvaccinated children susceptible to measles was on the rise because a large enough group of parents misled themselves into believing that the risk of vaccination was greater than the potential harm the disease would cause. Herd immunity had dropped low enough in the population that the virus could spread again, laying the groundwork for an epidemic. They were wrong, so wrong that they cost a young woman her life. Measles cases continue to increase in the US, with 2019 having the worst outbreak in nearly three decades.
Not knowing the truth can be deadly and this chapter will teach you how to find the truth and how to distinguish it from fraud and from show. These are the most powerful skills that a scientist or anyone can have and it will serve you well.