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Doctors at Texas Children's Hospital told David and Carol Ann Vetter that their second son had a 50/50 chance of being born with the same immunodeficiency that had killed their first son. Consulting with a team of Texas doctors including experimental biologist Raphael Wilson and pediatric immunologists Mary Ann South and John "Jack" Montgomery, the family decided that the best way to improve their child's chances of survival was to ensure his birth occurred in a totally germ-free environment.
To attain a germ-free birth required that the boy be delivered by cesarean section, both so that the child would not pick up any germs from the mother as he passed through the birth canal and so that the birth could be scheduled for controlled conditions. A cesarean section was planned for September 21, 1971.
Although creating a germ-free delivery room was unusual, in academic papers on the subject the doctors stressed that the sterilization procedure was neither dangerous nor expensive, and required no extraordinary equipment. It did require much preparation. Three connecting operating rooms were booked for the procedure days in advance. The rooms were sealed off, all non-essential equipment was removed, and the cabinets taped shut. Each room was scrubbed down daily, from floor to ceiling, for three days. The afternoon before the surgery, foot traffic was directed away from the hallways outside the rooms.
Testing the Team
Every member of the surgical team had cultures taken to make sure they were not carrying any germs; replacements stepped in for those who were potentially infectious. The staff prepared various subtle nods and eye signals for the delivery so that there would be no talking or extraneous movements that might disturb the air in the room.
On September 20, Carol Ann Vetter showered, shampooed and scrubbed down with Phisohex, a bacterial disinfectant used by surgeons when they prepare for surgery. And then she washed again. "She sleeps on sterile sheets and wears a sterile mask and gown," Wilson explained. "She is given sterile food and a hot plate so that she can prepare her own germ-free meals." All communications were conducted by telephone. The next day, Carol Ann was wrapped in sterile sheets -- "like a mummy," she recalled -- and her belly scrubbed with disinfectant for ten minutes.
Meanwhile, the surgical team began in the first operating room. As they proceeded through each room to the main operating room, they donned perfectly sterilized clothing: scrubs, two gowns, two masks, sterile booties and tennis shoes. Once inside the delivery room with the mother, no one moved or spoke, allowing the air to settle. Carol Ann described that quarter hour of silent anticipation as the longest 15 minutes of her life.
Diapered and Baptized
When her son David was delivered, the doctors continued to move slowly but efficiently. The boy was aspirated and then placed in an isolator, a plastic bubble kept inflated by filtered air. The isolator had been equipped with sterilized diapers, bottles and emergency medical equipment in case of possible problems. Wilson, a lay brother of the Roman Catholic Church, baptized the child with sterilized holy water, also placed inside the bubble.
The extraordinary preparations paid off. David Phillip Vetter had been exposed to the world for less than 20 seconds -- in a medical journal the surgeon estimated the exposure to be five seconds. He did not become infected with any germs during that exposure. David's growth and development would all take place in germ-free isolation. The next time he would leave his protective bubble was 12 years later, just fifteen days before he succumbed to cancer.