If the media and Internet are to be believed (and these days, really, what is the difference?), the act of parenting has become a full-scale cultural war.  How to raise your kids.  On what to raise your kids.  How your kids sleep, eat, play, and practice “Little White Donkey” on the piano–nowadays, these are all grist for the mill.

But if modern parenting feels like a war, its bloodiest battlefield surely must be that of the vaccine debate–namely, between parents who decide to vaccinate their children in accordance with recommended medical guidelines, and those parents who do not.  Vaccines.  At this point, even the word itself is polarizing, sending parents skittering in opposite directions, like scattered iron filings between two magnets.

This is not going to be, at its core, a piece about the vaccine debate.  At this point, I trust it’s a story we all know well.  Regardless of which side of the debate you align yourself, it is difficult to argue against the fact that the development of vaccines is one of the greatest advances in modern medicine–right up there with antibiotics and anesthesia.  Vaccines, of course, are biological agents, prepared in a number of different ways, which strengthen the body’s own immunity to a number of dangerous or potentially fatal diseases.  When they were developed, vaccines were heralded as nothing less than a miracle.  Over the years, potentially fatal diseases like the measles, polio, and smallpox were virtually eliminated with routine immunization.

Ask parents who choose against vaccinating about the reasons behind their decision, and you may hear a handful of different answers, both specific and vague.  But direct or indirect, it is difficult to ignore the influence of one particular man named Andrew Wakefield, who in 1998 published a paper in The Lancet about a link between the measles, mumps and rubella (MMR) vaccine and the development of autism.  The study has since been roundly debunked and condemned several years ago by the scientific community at large, but the damage, it seems, was already done.  The word was out: vaccines are dangerous.  And despite best scientific evidence, that’s the sole message that remains for many.  As easy as it was to scare people, it becomes impossible, now, to un-scare them.

All this, like I mentioned before, is old news, and at this point, you honestly don’t need me to tell you about any of it.  What I do want to address, however, is the way in which this debate has pitted parents against doctors, creating an adversarial relationship when it comes to the task that both parties have at heart–namely, raising healthy children.  Somehow, the rhetoric from the most vocal portion of the anti-vaccine contingent has turned particularly antagonistic, painting doctors and the drug companies who develop vaccines as greedy, ignorant, maleficent perpetrators of a giant medical conspiracy, and who recognize the supposed harm of vaccines but who willfully force them on children anyway.

This is the part where I have to admit that, as a doctor who also just so happens to be a parent, this topic never fails to enrage me. To be clear, my reaction to people who don’t vaccinate is not annoyance, not puzzlement, not dismay, but actual, visceral anger, like I’m taking people’s anti-vaccination sentiments as a personal affront.  I’ve worked in both pediatric and adult medicine, and I’ve had more than my share of patients disagree with my medical assessments, but this is one of the few issues that I take so much to heart, that can make me this upset, and it makes me wonder why.

The fact is, when people tell me that they decided not to vaccinate their children, I am taking it personally.

Here is why.

As someone who works in healthcare, with sick patients, I see every day the injustice and horror that is illness. Preventative healthcare is a wonderful thing, perhaps the best kind of medicine that we can practice. Along with a healthy lifestyle, protecting against preventable illness is a big part of that. As a doctor, it’s quite simply the very best that we know how to do.

So when I stumble upon those internet parenting boards, read the anti-vaccination literature and hear the rhetoric, I see people who are not only rejecting we have to offer, but are vilifying doctors and other healthcare workers–who have devoted decades of their lives to caring for children and families and continue to work their hardest to give patients the highest quality care we know how.  And quite frankly, it hurts my feelings. It’s not just paternalism, it’s not about me wanting to tell patients what to do and for them to comply mindlessly, it’s about me wanting to do my job and do it well, always, for everyone.  And when I feel like people reject my efforts and recast my motives as somehow evil, greedy, or just plain ignorant, it hurts my feelings.

So yeah, I take it personally. I respect a parent’s intuition and I respect the fact that no one feels great, myself included, about bringing their baby in, making them cry by jamming them with needles filled with seemingly mysterious antigens and preservatives. As a doctor I know fever and irritability is part of the immune process in action, but as a parent, I still hate to see it.  The rational mind understands the biology, but I know first-hand that the desire to protect your children from all real or potential harm is beyond conscious thought–it is, pure and simple, instinct.

But I respect science, too, and I have based my life around that. In lieu of religion, I have science. And the impulse to prosthelytise is equally strong. And just like people who prosthelytise about religious faith, I am doing so not to force you to be like me, not to scorn or humiliate you for possibly being of a different faith, but because I care about you and your children and families, and I want what all best evidence I have points to being the most effective way to stay out of my hospital.

Doctors aren’t always the best communicators, and though the vaccine debate in some ways feels like it has inflamed beyond the easy fix of rational discussion, I wanted to at least offer one doctor’s viewpoint.  Because when you tie a doctor’s hands to do their very best for you and your family, it’s not just that they’re angry at you for doing it.  It’s because most doctors are people who went into medicine to “first, do no harm,” and as much as anything, they’re angry at themselves for letting you down.

Michelle Au is an anesthesiologist and author of This Won’t Hurt A Bit (and other white lies): My Education in Medicine and Motherhood. She blogs at This Won’t Hurt at Bit and the underwear drawer.  This article is reprinted with the author’s permission.

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