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Chapter 1: What is the background of Lyme disease and its significance?
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When I was learning how to make radio, I had a day job in the file room at my aunt's family medicine practice, just outside of San Francisco. They were old school and didn't really do computers. So there was just a pile of paper, taller than I was, of faxes, doctor's notes, checkups, prescriptions, just everything.
And as I filed that mountain of paper, I saw the community that they had built at that doctor's office. The generations of families, visit after visit, living their lives, trusting their health and their loved ones with my aunt's care. So it resonates with me when Vijay Sikand describes his work as a family physician.
I take care of newborns to 90 and I say, stop at 90 because if you're 90, you don't need me.
Vijay has been a family doctor in a little town in Connecticut ever since he first drove up there with his wife in the 1980s.
And we fell in love with the place. It was a small, charming town where you have a couple of very nice inns on Main Street. And just, you know, it's a lovely spot right there on the Connecticut shoreline at the bottom of the Connecticut River.
But this town was special. the center of a newly uncovered disease that Vijay had only really read about in textbooks.
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Chapter 2: How did Vijay Sikand become involved in Lyme disease research?
So we took the baton and we ran with it. My wife volunteered. Ethically, I'm not the one who did her consent or gave her the shots. And in the pediatric study which followed, both of my kids received the vaccine. And I didn't know and they didn't know whether they were getting vaccine or placebo. Oh, I had neighbors. All manner of people.
I had people, you know, the lady who ran the donut shop across the road. She would, of course, bring donuts every time we... I have to mention this. Years later, my son came home and told me he's getting married, and the woman he was marrying was one of those kids from the vaccine study from 15 years earlier. Wow. It's a small world, and it's fun, and it connects you to people.
Do you feel like it changed your perspective on the community?
Yes, in a way it did, because I was pleasantly surprised to see that so many people would turn out to stick their arms out and have a needle stuck in them. So we gave half the patients a placebo, and we gave half the patients the actual Lyme disease vaccine. And I didn't know what they were getting, vaccine or placebo. It's what we call a double-blind study. It's the gold standard for studies.
And then we followed these individuals for a couple of years through tick seasons. We checked them closely to see if they got symptoms of Lyme disease. We checked them in the most... intense detail. We drew blood beginning of the season, end of the season, and any time you had an illness that might or might not have been Lyme disease during those two years, we drew your blood again.
I had a photographer helping me with photographing the skin rashes patients came down with, etc. We had the guy across the road also next to the bakery who had a Photoshop. And the Photoshop guy, every time I had a patient with a skin rash, he would go out of his way to get the film, develop it overnight, provide a high quality picture for me to then FedEx to the manufacturer.
And so we had the FedEx guy, we had the photo guy, we had the bakery lady bringing in the donuts. It gave me a sense not only of being a physician in the community, but being a part of it in a unique way.
Beyond the vaccine, the drug company funding fueled Vijay's drive to pin down this shape-shifting disease. Take, for example, the first symptom of Lyme disease. the rash.
Everybody talks about the bullseye, but if you have 12 different ways this rash might look, wait a minute, it's not so easy to diagnose. Sometimes the Lyme rash can appear in ways that we never imagined. So we had dozens of different rashes. Anytime a patient in our study had a rash, they'd immediately say, you got to see me, doc. I've got a rash.
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