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Logo of brjgenpracThe British Journal of General Practice
Br J Gen Pract. 2006 November 1; 56(532): 898.
PMCID: PMC1927116


It is autumn. It has rained, torrentially. My grandmother though, is as tough as they come. Sitting, aged 92, in the remains of her once pristine sitting room, she merely points out that, before the days of central heating, floods were even more of a problem. It could take weeks before it was possible to light a fire and you just had to struggle on till then without any heating at all. No, she won't grumble and she won't move out. She has known worse than this.

‘It'll all get sorted eventually’, she says.

She even remembers the flu epidemic of 1919. Bodies being loaded onto the undertaker's cart on a daily basis. She was the only one in the house who didn't catch the bug. She has always been tough.

Nowadays she has made a few concessions to her advanced years. She allows someone else to do her decorating for her and she makes sure she gets the flu vaccine each year.

‘Doctors are supposed to get it now too, aren't they?’ she asks me.

‘Probably’ I respond casually.

‘Do you?’

‘No’. The conversation moves on and she never gets the explanation she was about to seek.

The next day I develop flu. With a fever and rigors in evening surgery, I feel I ought to go to bed. I do so as soon as I get home and am unable to emerge for 3 days. I feel I might die, although in retrospect I am probably being a bit melodramatic in this self-assessment — luckily. During this acute phase of the illness I am capable of no useful thought or interaction. But in the few days afterwards, being physically still too addled to be useful, yet capable of rational thought again, I find myself reflecting on that short segment of conversation with my grandmother.

Like everyone else, it is only at times like this that it occurs to me how much my pattern of existence depends on health. Prior to developing flu I felt so confident of my good health I didn't even notice it as an issue. I thought of myself as an all-conquering Greek hero, capable of thriving in any circumstances thrown my way by the Fates. Metaphorically anyway.

That is why I didn't have a flu jab at work: I just felt so immune already. I was bursting with immunity to anything I needed it for. So, being quite logical, I did not need a flu jab.

Besides, I have always been a bit troubled by the consequences of everyone having these things so that we all eventually become dependent on having them, and then what happens if the factory burns down or something and we suddenly can't get them? 1919 all over again, or worse. Not having the jab now helps to ensure I'll have natural immunity when that time comes so I can survive Noimmunogeddon.

On the other hand, I admit I am a little troubled by the ethical aspect of not having a flu jab. The potential for infecting others who have come to me for advice about other problems entirely. I do not lose much sleep over this however, since presumably it was one of these innocents who gave me the flu in the first place, perhaps while I was showing due concern over the state of his corns.

Ultimately, it proves to be the combination of that conversation with my grandmother and my subsequent near-death experience that decides matters. I have been left with a nagging sense of unease like I have been found out. Blushingly, I resolve to make sure I have a flu jab next year. Then I know I will be able to look my grandmother in the eye next time she tackles me on the subject.

But that was 4 years ago now. She is no longer so tough: she has mislaid her thoughts and only her old memories still have coherence. 1919 remains. Spared that further questioning by her, nevertheless I do feel guilt: I have still not had a flu jab. The trouble is, I am scared of needles.

Sometimes, the path between intention and action is just too fraught.

Articles from The British Journal of General Practice are provided here courtesy of Royal College of General Practitioners