A Secret Killer: The Story of Sepsis

 I attended a sepsis conference in Seattle as part of my research, and wrote a short op-ed about the experience.

The conference was held on the University of Washington campus (Photo: Vanessa Hrvatin).

THE PACIFIC NORTHWEST sepsis conference started at 7 am sharp and as I looked around the room, I realized that I was probably the only person there who didn’t know how to use a stethoscope.

By 8 am, I was frantically taking notes. Shortly after I started to record because neither my hand or my brain was working fast enough. Turns out the ‘no jargon rule’ I’d been preaching about for the past year to a communicating science class I help teach doesn’t apply when you’re in a room full of people who actually understand jargon.

I spent the first half of the day in a bit of a brain-overload daze. After our lunch break Dr. Paul Marik, an ICU physician from Virginia, presented about a sepsis treatment. Currently, the main line of defense against sepsis is antibiotics and fluids, a regiment that has been well accepted for a long time. But Dr. Marik claimed he’d found a much more effective treatment: vitamin C.

I nodded along as he spoke, jotting down notes, thinking, “wow this guy is brilliant, he’s come up with something simple and cheap that could cure sepsis, how exciting!” But as I looked around the room, I found that most people looked pretty unenthused. Hands shot up as the physicians started to drill Dr. Marik on his claim.

For the first time that day, I stopped worrying about taking notes. I put my pen down and started to pay attention to something other than exactly what the doctors were saying—I wanted to understand how the doctors were thinking.

They had been presented with a treatment that has never been formally studied as a solution to sepsis, and they were trying to figure out if it was legitimate. Many technical questions were asked, like “how many clinical trials have you done?” and “what were the patients sequential organ failure assessment scores after they were pumped with vitamin C?” Anyone who has dedicated their life to science needs to know exactly how something works and exactly why it’s working.

After a few minutes, a woman at the back of the room raised her hand and said she’d tried out the treatment on some of her patients and almost all made a full recovery. I found her shortly after Dr. Marik’s presentation, and she agreed to speak with me as long as I didn’t use her name. She told me the reason why people weren’t interested in his discovery is because pharmacy companies won’t make any money from it.

“But I don’t care about that,” she told me. “I was trained to always think about the patients first. This has literally nothing to do with money. If vitamin C is going to save people’s lives, we should be using it.”

Her colleague Dr. Seymour had a different opinion.

“Using vitamin C as a treatment for sepsis is hypothesis driven, and I think it would be really unfair to suggest to my patients that it’s therapy ready,” he tells me. “I can’t risk the health and trust of my patients.”

I went home that night and wondered about the thought process the physicians had gone through when presented with a new type of sepsis treatment. It seemed like they had three trains of thought. The first, was in the scientific process—they wanted to know exactly how this drug would work with respect to sepsis. The second, was how it fit into all the clinical bedside information they knew from years of working as a physician. The third, was whether using a treatment that hadn’t been well tested was ethical.

Vitamin C isn’t even a drug, and yet the amount of thought these medical professionals put into this proposed solution felt shockingly complex to me. I went to bed telling myself that tomorrow, I would solely focus on how the doctors were thinking.

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THE NEXT DAY I agreed to volunteer for one of the break out sessions, where people at the conference were given the opportunity to use new medical equipment and techniques that could help with diagnosing and treating sepsis. My job was to lay down on a table while the clinicians practiced doing an ultrasound on my neck (I still don’t understand what they were trying to find, but I’ll trust that it was legitimate).

I laid down for two hours and watched and listened. Much to my surprise, these doctors and nurses who had years of experience were just as timid and uncomfortable as any high school student is when they’re asked to demonstrate something to the class. Each person spent about 10 minutes practicing on me, and their thought process seemed pretty typical.

At first they were thinking about how to place the ultrasound appropriately on my neck. Then they started to think about what exactly they were looking for, and how they were going to find it. Once they found what they were looking for, they practiced over and over again until they felt confident enough in their ability to use the technology and moved onto the next station.

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SO WHAT DID I take away from this conference? Of course, I learned a lot about sepsis. But I think the most important lessons I learned came from my curiosity about how doctors think. I learned that they see everything as a puzzle with a million pieces to consider, and everyone has slightly different ideas about the best way to complete the puzzle. When they’re presented with something new, they don’t rush to any conclusions. Instead, they take the time to think it through and ask important questions.

Sepsis is a syndrome that effects millions of people worldwide. Hundreds of medical professionals came to talk about it. They shared their knowledge and they learned from others. But think about all the medical conditions these physicians—ICU doctors, emergency room doctors, pediatricians, nurses—have to see in just one day. I’ve spent the better part of the last 8 months consumed with sepsis, and wondering why more effort isn’t put into it and why more doctors don’t think about it. This conference taught me that many of them do think about it, and they do care. But they are humans. And sometimes, you don’t always get the puzzle right on the first try.

View of Seattle from the Space Needle (Photo: Vanessa Hrvatin).