One of the vaccines was a yellow fever vaccine. Yellow fever is a nasty infection, and getting the vaccine is a good way to prevent it. Those who receive it have a 1 in 100,000 risk of getting a severe reaction that can be life-threatening.
I told the kid about it, he and his father agreed to the vaccine. I looked at all the shots that we were going to give him , "Typhoid, hepatitis A, yellow fever.... we are going to torture you tonight"... he3 he3 he3
The father laughed and the kid nervously smiled. I handled the chart to my assistant to prepare the vaccines and went to review another chart.
Less than five minutes later, I saw her rushing out of the clinic, "I need you right now"
I saw the kid laying on the bed, his body leaning against the wall, not moving. His father almost passed out, and my heart almost stopped beating too.
During residency I did calls where hearts stop and lungs fill with fluid and old people fall on their heads and blood pours out from every hole in the body, but that was expected. Drama is the rule in every night call at a hospital. I even used to get surprised if every thing went alright.
But this was different. Thursdays are our travel clinic days. These are light days with healthy people walking in to get protection against illnesses they might get during their travel, and now I have this: a young healthy kid passing out in front of his father.
In a few minutes he became fully awake and talking. This was just another vaso-vagal syncope, where people pass put because of extreme anxiety. Some people pass out after they see blood, get needles, see dead people, whatever scares the shit out of them. So in this case it wasn't the vaccine, it was the needle. If we had injected him with water he would've also passed out.
But at the moment the teenage kid passed out, the only thing that occurred to me was him getting an anaphylactic life-threatening reaction to the vaccine. It always sucks when you get the one in one hundred thousandth complication (although on the good side, you'd feel more comfortable administering the next 99,999 vaccines)
What would have sucked more is my super confidence, even telling the kid "we are going to torture you" before we literally tortured him. That would have made it to the papers. "Dr. Death: Middle Eastern immigrant tells a minor he'll torture him before he tortures him with needles in front of his father", or "Dr. Kevorkian condemns Dr. Masannat"
Doctors are sometimes overconfident, especially if they're about to do something they've done several times before. I have given this vaccine and many others hundreds of times, never saw a single reaction. If your doctor tells you you might die from a vaccine there's a very good chance you will not take it even if it's good for you. The boy's risk of dying from that vaccine was way less than flying to, driving and staying in Chad and Niger for a few days. If someone tells you before you drive you might die driving you will think twice about it. At times that confidence is necessary, while at other times it's risky. Even rational people don't want to hear about all the risks and benefits of any drug or procedure they're having. "Just do what you think is right" is what a lot of people feel, surprisingly enough.
As the teenage boy left the clinic, smiling (thank God!), his father explained , "Uhm yeah I forgot to tell you that he passes out every time he gets an injection". LOL, thank you for the information man!!