grateful

The average lifespan at the beginning of the century prior to antibiotics was twenty years, the lecturer told us.  Parents expected that half of their children would die at of their first infection.  He painted a bleak picture of a world in which infection, rather than being a nuisance as it is today, was often deadly, and explored how our definitions of "immunocompetent" and "immunodeficient" were strongly influenced by antibiotics.  Before antibiotics, children often simply died of infection.  Afterwards, for the first time, people routinely lived through multiple infections.

His research focused on how single-gene mutations or variations might make people susceptible to a particular disease - for example, turberculosis.  While scientists have focused almost solely on the microbiological causes of diseases for most of the century, much of his work focused on the genetics of why certain people might be susceptible to certain kinds of infections, while most of us were asymptomatic.  Rather than infection with a pathogenic bacteria being unusual, infection was norm, but pathogenesis - disease - was unusual.

The talk upended the usual ideas about bacteria, genetics, and disease, but as I listened to the rest of the talk, my mind kept drifting back to the sadness and uncertainty of life prior to antibiotics.  We take for granted that children grow up and grow old, barring accidents or rare diseases, but this is a luxury of the modern era.  It was a tossup before whether a child would live to be an adult - life was short and uncertain.

* * *

One of my friends is going through round two of cancer - this time metastatic - in her mid-twenties, and I cannot count how many times I and other friends have asked, "Why?  Why her?  Why so young?"  Was it environment, diet, stress, or genetics?  Why such a rare cancer with none of the typical risk factors?  Did she have some particular suceptibility?

But sitting through the talk shifted my perspective somewhat.  I'm sure so many of the parents a century ago would have been delighted that their children could have an extra decade or two, and they would have looked on all those years with thankfulness.  I suddenly realized that in another time, it's as likely as not (maybe a chance of 1 out of 2 or 1 out of 3) that my friend would not have survived infancy or early childhood.

Knowing this doesn't make my anguish any less, but I found myself unexpectedly suffused with gratitude for the fact that my friend could walk this earth for two decades at all.  Rather than seeing it as a life being cut short, perhaps I should be thankful for the length it was extended.

And I am.  I am thankful.