I feel like I’ve been exposed to a lot of death in my lifetime, a consequence of my parents’ responsibilities as eldest children in each of their respective clans. They’ve always taken care of other people and, as I was growing up, one of their biggest contributions was helping people through the loss of loved ones. My mom commented once that I had been to more funerals than weddings, a figure which may just now be balancing out. The more I’ve lived the more death I’ve been around, from friends to coworkers to family; usually I’m at least one step removed from the departed and I see the effects of sadness wear down the survivors.

My friend had to leave town suddenly because her niece had fallen very ill and was airlifted to the nearest city to be placed in the ICU. I assumed that everything was fine if hectic and that I would eventually get a phone call or an e-mail saying she was back in town but after several days passed I called to check. The next day I got the e-mail saying that it wasn’t okay, her eight-year-old niece had died in the hospital from a suspected case of meningitis.

What do you say to someone who’s just lost someone? You express your condolences but every word in the dictionary somehow falls short of conveying the intended meaning. I think that the Thatcher on Acid song “26 Letters” sums it up nicely:

A to zed are the boundaries of the world…
There’s a prison and it exists,
26 letters dull my head
in a thousand million combinations

After I expressed my condolences, feeling the disconnect decay any possible meaning the words could aspire to, I stared blankly at the e-mail. When I was growing up everyone dying was older, although not necessarily old. We had neighbors dying of AIDS when I was particularly young, but the thought of a kid dying was unheard of until I was in highschool and one of my mom’s coworkers had a daughter who was losing a battle to disease. A girl I never met, adults who I barely knew, but my mom was there with them though it all and the updates and reports and eventually the death brought a particular burden into our house. This is the first time a child has died in my circle, even if once again I never knew her or met her parents. A little girl went from being perfectly healthy one day to being put in a helicopter the next, almost as sudden as a car wreck or a bullet. Now I have friends who have kids, or who are about to have one, and they all seem so fragile I’m too scared to pick them up.

Meningitis was something that made the news once in a while when some cheerleader in the suburbs would contract it. I understood that it’s a scary illness that could be dangerous but you get a spinal tap and then it’s okay. Except that my friend contracted a bacterial strain when we were in highschool. If memory serves me well I had been over at his house and he began to get a pain in his eye and a general feeling of not well. His eye continued to swell through the night and his condition worsened the next day until his mom decided to bring him to the hospital. Somehow a doctor put two and two together and realized what was going on and they began pumping my friend full of antibiotics immediately– they told him and his mom that he was very lucky she had brought him in when she did because he otherwise probably would have died. That didn’t seem scary at the time, but it finally does now.

There’s two basic forms of meningitis, viral and bacterial. The former is considered much less dangerous and treatment seems to consist of keeping the fever down. The bacterial strain is the killer, and in many cases even surviving the disease leaves people with permanent organ damage or requires amputation. The National Meningitis Association states that there are nearly 3,000 cases of the bacterial strain each year with a 10-12% fatality rate. Of the remaining 88-90% another 20% suffer life-long illness as a direct result. The disease can pass between people like a cold or flu but cannot survive outside of the body very well, mostly requiring a direct fluid exchange such as sharing a glass. Unfortunately the symptoms are also similar to those of colds or the flu such as fever, rash, stiffness in the neck and other common ailments. However once the bacteria begins to operate it infects the fluids in the spinal cord and that which surrounds the brain, causing swelling and sometimes death.

Treatment is pretty severe when it is suspected that meningitis is the culprit. Antibiotics are administered before a diagnosis can be confirmed as time is short; the particular bacterial strain (of which there is one major and several rare breeds) is identified by collecting spinal fluid for analysis– the famous spinal tap. Vaccines have been developed and many states have pending legislation to make it compulsory for children. What’s interesting is that I read (can’t remember where, of course) that many people carry various strains but never get sick whereas some people are very susceptible. The low incidence of the disease in this country makes passing legislation for vaccination very difficult, particularly as evidence mounts that inappropriate antibiotic usage is contributing to more devastating diseases with no treatment options, but there are many countries with much higher infection rates such as Brazil or the “meningitis belt” which runs across sub-Saharan Africa who could probably benefit from easy access to antibiotics.

The CDC has a lot of information about meningitis which was useful, even if I didn’t really summarize things very well. The picture was poached from Flickr user AlexPears and it somehow seems suitable to use here.