[HF3387, A 50-50 Chance, 1967, Length: 00:27:50, Color, Sound, This Beta SP was duplicated from a 16mm answer print by Bono Film and Video, Inc. for the National Library of Medicine, February 2009] [Screen goes dark] [Numbers count down] [The U.S. Department of Health, Education, and Welfare Public Health Service Presents M-1415] [A Public Health Service Audiovisual Facility Production] [A 50-50 Chance] [Woman writhes uncomfortably in hospital bed.] [Carol Winney:] Jerry. Don't worry, dear. I'll be all right. What about the kids? Who's with them? [Jerry Winney:] They're okay, honey. Sally's taking care of them. [Carol Winney:] You should be with them, dear. They're so young, and they'll imagine all sorts of... Why don't you go home for dinner? They'll take good care of me here. [Dr. Simmons:] Carol's right, Jerry. The children need some reassurance now. There'll be a nurse on duty in this room around the clock. Myself or another doctor within call. You better go home. [Jerry Winney:] All right, but I'll be back first thing in the morning. I love you, honey. Bye. [Music] [Jerry and Dr. Simmons leave the hospital room as a nurse walks in.] Dr. Simmons, what is this with Carol? How bad is she? You've known us for years. I want you to give it to me straight. What's happening to her? [Dr. Simmons:] I'll be frank with you, Jerry. She has tetanus, a highly dangerous disease. She's going to be a very sick girl. Right now, I can't honestly tell you how sick, but be prepared for this. She's going to have a rough time. At the very best, she'll be in the hospital for weeks and weeks. Now you take good care of the youngsters, and we'll let you know if there's any change here. [Jerry Winney:] Well, thank you, doctor. I'll be back in the morning. I know you'll do everything, I mean... [Dr. Simmons:] Of course, we will, Jerry. Everything possible. [Jerry Winney:] Well, what I can't figure, doctor, why Carol wasn't immunized for this thing? [Dr. Simmons:] Jerry, I don't know how many times I've urged her to be immunized. She always put it off. "No time this week." That sort of thing. And now. [Jerry Winney:] Now is the payoff. See you tomorrow, doctor. [Music] [Jerry is seated with his children at home.] You see, the hospital's the best place. Mom will have everything she needs there. Special nurses and all. And we'll make out until she feels better. [Mike Winney:] But, Dad, Mom must feel real sick because she never gives in. [Jerry Winney:] Yes, Mike. She is sick. And you're right, she has courage. That's why I know she'll be home again in a few weeks. Until then, we'll just have to run the house. [Mike Winney:] We'll do all we can to help, Dad, won't we, Jenny. [Jenny Winney:] Sure, Dad. I'll do the dishes every night. You'll see. [Jerry Winney:] I know you will. Well, give me a kiss and get to bed. Tomorrow's a school day, you know. [Music] [Mike Winney:] Dad? Mom will come home, won't she? [Jerry Winney:] She has to, son. She just has to. [Mike Winney:] We'll say our prayers for her tonight, Dad. She'll be all right. [Music] [Jerry Winney:] If she'd just gotten her shots. When I think back on how it happened, it just doesn't seem possible. [Carol is gardening.] [She seems to injure her finger.] [She goes inside and bandages the finger.] How could a little scratch like that cause so much trouble? She didn't even say anything about it that day. Everything went along the same as usual. [Carol Winney:] Jerry, how are the hamburgers coming? The kids will be here any minute. [Jerry Winney:] Coming up. I got the onions, pickle relish, chili sauce, the works. I estimated six for Mike. Do you think that'll hold him? Ah, here come the troops now. [Mike Winney:] Hey, Dad. You should have seen the scrimmage. I completed four passes. The last one was about fifty yards. Well, thirty anyway. [Jerry Winney:] Well, now that's great, champ. I'm sorry I got home too late to be there. Sit down. Dinner's ready. [Mike Winney:] Hey, Mom. Could you wash my uniform so it will be clean for the game tomorrow? [Carol Winney:] Sure, Mike. I'll do it. [Jerry Winney:] I don't know what we'd do without her. She holds the whole family together. You never think about something you have until you don't have it anymore. How long was it before she started feeling bad? It all happened so fast. [Carol Winney:] Jerry? [Jerry Winney:] Hi, Carol. What are you doing? I thought you were playing bridge. [Carol Winney:] Well, I'm not feeling so good. That's why I called. [Jerry Winney:] Well, what's wrong? [Carol Winney:] Oh, I feel kind of feverish and have this stiffness in all my muscles, and then, well, I'm weak all over, and I have a splitting headache. Another thing, I don't exactly know how to explain it, but, well, I'm so restless or something. Well, I bawled the kids out this morning, and they really didn't do anything wrong. [Jerry Winney:] Well, maybe you ought to give the doctor a call. [Carol Winney:] You think so, too? Well, then I'll call Dr. Simmons. It's probably nothing serious, but, well, I'd feel better anyway. [Jerry Winney:] Listen, let me know as soon as you find out something, will you? [Carol Winney:] OK. I'll call and let you know. Bye, sweetie. [Music] [Dr. Simmons:] Carol, you know I'm not disposed to be an alarmist. Quite the contrary. But after what you told me on the phone, I felt it my duty to order you down here on the double. Some things you can't let go. Now, try and remember just when it was that you got this scratch, and how. [Carol Winney:] Let's see. It must have been, yes, Tuesday, in the middle of the morning. I was gardening, and something in the mulch, I don't know what it was, nicked my finger a little, and that's all. [Dr. Simmons:] In the mulch? So your hands were dirty? [Carol Winney:] Well, you can't garden and keep snow-white hands, you know. [Dr. Simmons:] Yes, I know. My wife has a green thumb, too. Carol, you never got those tetanus immunizations we talked about, did you? [Carol Winney:] No, I just never did get around to it. Do you suppose that might be what's wrong? [Dr. Simmons:] Well, I don't say that it is, but it could very well be. We're going to admit you to the hospital for observation and further testing right now. [Music] [Jerry Winney:] What a shock it was when the doctor told me. Tetanus. Lockjaw. Something you never even think about. [Phone rings.] Hello. Oh, yes, Sally. Thanks so much for staying with the kids today. No, I don't know yet. But I'm going over first thing in the morning. Oh, I surely will, and thanks for calling. Bye. [Jerry Winney is at the hospital.] Good morning. Is Dr. Simmons in? [Nurse:] Dr. Simmons is in with your wife now, Mr. Winney. Well, why don't you step down the hall and wait for him? [Jerry Winney:] Thank you. [Nurse:] Oh, here he comes now. [Jerry Winney:] Morning, doctor. How's Carol this morning? [Dr. Simmons:] About as expected. Jerry, I told you it was going to be a long, tough fight. She's going to get worse before she gets better. We have to face that. We've had one good break, though. She's shown no adverse reaction to tetanus anti-toxins. So we've been able to give her large doses of that. It should help. [Jerry Winney:] Can I see her? [Dr. Simmons:] Well, yes, but, Jerry. [Jerry Winney:] Yes? [Dr. Simmons:] It's not pretty, and be very quiet. Any little noise or vibration could cause a spasm. [Jerry Winney:] Oh. Will she know who I am? [Dr. Simmons:] Oh, yes. She's conscious. Sedated, but she'll know you. [Music] [Carol is moaning in her hospital bed.] [She grimaces in pain, her jaw locked.] [Jerry Winney:] Doctor, can't you do anything? [Dr. Simmons:] Jerry, we're doing everything we can. She's trying to get your attention. [Carol tries to speak.] [Music] [Jerry and the doctor leave the room.] [Jerry Winney:] Lockjaw. Why does she have to suffer? [Dr. Simmons:] Well, you have every right to be upset, Jerry, but this can happen to anybody who isn't protected, and the suffering goes with it. Let's find a seat, and I'll give you some background so you'll have a better picture of what's going on. Jerry, tetanus bacteria grow in the intestines of grass-eating animals such as horses or cows. So, as you may guess, they're frequently found around barnyards and fields used for grazing, but this doesn't mean they're just way out in the country far from city life. There are dairies in and around every city in the United States, and that means cows. There are riding stables, park areas, zoos, many different activities involving grass-eating animals wherever you are. Further, and this is even more significant, when the bacteria in the soil dry up, tiny spores are formed, each one as deadly as the bacteria. And they live almost indefinitely. These spores can go anywhere, carried by the wind, and lie in wait for a victim, and they're not just outdoors. They're brought in to homes, churches, schools, everywhere. On shoes, clothing. It's safe to say that tetanus spores may be found in any room you enter. Of course, the spores may be concentrated wherever manure is used to fertilize trees, shrubs, and flowers. That's probably the source of Carol's infection. We fear the spores or bacteria most in dirty wounds, such as punctures from nails, gunshots, wounds from automobile accidents, but they can enter the body through any break in the skin, no matter how superficial. Over fifty percent of all cases come from wounds so trivial that people don't even seek medical attention, and usually involve an abrasion which is contaminated with soil, such as the scratch on Carol's finger. Although everybody's exposed to tetanus because everybody gets a scratch occasionally, certain types of occupations are more frequently exposed. For example, construction workers and field hands, outdoor laborers, industrial workers in plants and factories who work with their hands. And then there are children. You know how active they are. Always falling down, scraping a knee or a hand. Recently, women have become more and more exposed, too. You see, more than ever, they're participating in sports, going camping, working in gardens. They need protection just as much as men do. Once inside the body, the germs produce a powerful nerve toxin or poison that causes painful convulsions or spasms of the voluntary muscles. One of the most frequently affected muscles is the jaw muscle, causing the patient's jaw to close tightly. This characteristic symptom gave rise to the common or slang name for tetanus, lockjaw. Over half the infected people die from the disease unless treated quickly. I hope we've caught Carol's in time. The terrible thing about tetanus is that it's absolutely unnecessary. It should never happen. Yet we have hundreds of cases each year in this country. Remember when you were in the service, and you got your tetanus immunization. Well, tetanus vaccine is, for all practical purposes, one hundred percent effective, and there's virtually no serious reaction. Of course, you should have booster immunizations at regular intervals. There are no documented cases of immunized persons dying from tetanus. Most men get their immunization in the service. So a big problem is with women. They should be immunized, too. For the past thirty years or so, immunizations have been given to infants in combination with diphtheria and whooping cough. But don't worry, Mike and Jenny have had theirs. But there are millions of children under five who have never had this protection. They need immunization. Another thing, tetanus is no respecter of age either. It strikes anytime from birth to old age. There are millions of elderly people in the United States who've never been immunized and should be. There would be no tetanus in the United States at all if everyone would get their immunizations. But that's water over the dam for Carol. If she pulls through this time, we'll make sure she's immunized. [Jerry Winney:] You mean she could get it again? [Dr. Simmons:] Oh, yes. Having this disease does not confer immunity. You must have the toxoid. [Jerry Winney:] You just said over half of the people die. What are Carol's chances? [Dr. Simmons:] That's the truth, Jerry. Carol has a 50/50 chance. Maybe a little better. Her symptoms have progressed rather slowly. That's on the good side. Let's just say she's holding her own right now. So if there's no change tonight, there's no use you sitting around here. Much better you be home with the kids. If you are needed, I'll call you. [Music] [Jerry looks around the house at things that remind him of Carol--a sewing machine, flowers, a photograph.] [He sits down and throws his head back.] [Jerry Winney:] What would I do without her? What would the children do? But she just can't. She just can't. [Jenny Winney:] Dad. Dad. [Jerry Winney:] Oh. Oh, yes. What do you want, honey? [Jenny Winney:] Well, Mom always reads my spelling words to me before a test. Could you do it for me, Dad? [Jerry Winney:] Why certainly. Let me see the book. You ready? Necessary. [Jenny Winney:] N-E-C-E-S-S-A-R-Y. [Jerry Winney:] Right. Habitation. [Jenny Winney:] H-A-B-I-T-A-T-I-O-N. [Phone ringing] [Jerry Winney:] Hello. Yes. Yes, of course. I'll be there right away. Mike, I've got to go to the hospital for a little while. You go next door and tell Mrs. Barnes, will you? She'll come over and stay with you, and I'll see you in the morning. [Mike Winney:] What's the matter, Dad? [Jerry Winney:] They just want to talk to me, son. You mind Mrs. Barnes now. [Mike Winney:] OK, Dad. [Music] [Dr. Simmons:] You got here in a hurry, Jerry. Sit down for a moment, go ahead. [Jerry Winney:] Oh, I'm all right. Well, what's wrong? Is she worse? [Dr. Simmons:] Well, she's had laryngeal spasms. That means closing off her windpipe, which could stop her breathing. We've had to insert a tube in her windpipe. This is one of the hazards of tetanus. [Jerry Winney:] What are her chances now? [Dr. Simmons:] Well, the odds have certainly gotten worse. It's not hopeless, but it's not a good situation. If we can pull her through tonight, I'd say she has a good chance then. [Jerry Winney:] Can I see her? [Dr. Simmons:] If you make it brief. She's heavily sedated. She may not know you this time. [Music] [Carol Winney is unconscious in bed, breathing through a tube.] [Jerry stands next to her bed. Carol's eyes are covered and a tube extends from her throat.] [Labored breathing sounds] [Moments pass, Jerry appearing deeply worried.] [Breathing sounds] [Jerry sits in a chair, considering.] [Jerry Winney:] She'll get through the night. She'll make it all right. Things will be like they always were. [Carol, Mike, and Jenny Winney:] Happy birthday to you, happy birthday to you. Happy birthday, dear Daddy. [Winney family:] Happy birthday to you, me. [Carol puts drops in Mike's nose.] [Carol trims Jenny's hair.] [Carol reads with Mike.] [Carol is shown lying in bed with her eye bandages.] [Jerry Winney:] She's not going to make it. There's no sense in kidding myself. She's not going to make it. [Music] [Jerry is dreaming, seeing filmy images of nurses and brightly lit hospital rooms.] [He imagines nurses and other medical staff, beckoning him down corridors and towards Carol's room.] [Carol's hospital bed is empty, neatly made up.] [Menacing music.] [A hand comes toward Jerry's face.] [Dr. Simmons:] Jerry, come out of it. [Jerry Winney:] She's gone. What's the matter? [Dr. Simmons:] You're exhausted. That's what's the matter. Three days with no sleep finally caught up with you. It's morning. [Jerry Winney:] Morning? How's Carol? [Dr. Simmons:] Good news. Her condition improved during the night. She's going to pull through. We feel sure. Why don't you go call the kids? They're scared, too, and then come on back here. [Jerry Winney:] OK. I'll call. She's going to be all right? Oh, man. What a dream. And she's coming home. [Phone ringing] [Mike Winney:] Hello. Hi, Dad. She is? Sure. Sure. Bye. Mom's going to be all right. Dad just said so. She'll come home. [Dr. Simmons:] Well, what did the kids think about the good news? [Jerry Winney:] I talked to Mike, and he was really pleased. [Dr. Simmons:] Good, good. [Jerry Winney:] Can I see Carol now? [Dr. Simmons:] Well, it would be best if you can wait until this afternoon to see her, Jerry. She's still a mighty sick girl and will be for several days. She'll stay here in the hospital for quite a while. Those stiff, rigid muscles and spasms will persist, but they'll gradually get fewer and further apart until she's completely recovered. I can tell you this. We were lucky, mighty lucky. Tetanus is something doctors dread. As I told you before, even with prompt round-the-clock treatment, we still lose about fifty percent of the cases. And without treatment, death is virtually certain. [Jerry Winney:] I just never knew. If people only realized, this sort of thing wouldn't happen. [Dr. Simmons:] Right. [Jerry Winney:] I won't keep you anymore. Maybe I ought to get some breakfast in me. [Dr. Simmons:] That's a good idea. I'm going back to Carol. I'll see you this afternoon. [The doctor stands over Carol's bed.] So unnecessary. There wouldn't be a case of tetanus in this country ever if people would just get immunized. [Music] [THE END M-1415 MCMLXVII] [Produced for the National Communicable Disease Center]