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Caring for David Vetter

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Four year old David with water bottle and other sterilized items, 1975 Caring for any infant or child has its challenges without having to handle him with rubber gloves through a plastic bubble. Nurses practiced diapering and holding a doll for two weeks before David Vetter was born. He never wore anything but lightweight clothing in his life, but as an infant, the small buttons were difficult to maneuver and his mother, Carol Ann Vetter, sometimes resorted to using the adhesive tabs from a disposable diaper to keep his shirt closed.

Weaning and Potty Training
Feeding David was complicated for physical as well as medical reasons. Even when David had turned two, nurses were spoon-feeding him. His caretakers felt he would make too much of a mess inside the bubble if he were to feed himself. He was resistant to being weaned from his bottle when he was two and a half and regressed in his potty training.

Canned Food
All of his food had to be sterilized, so it was all jarred or canned. Carol Ann recalls that the one time they tried warming his meal with a heating pad, "he quickly spewed it out when he tasted it." The labels on the cans were removed because they might contain germs, but David eventually could determine by weight which cans held his favorites: spaghetti and lasagna.

Celebrating Birthdays
On his birthday, his mother would bake a cake and David would watch his family blow out the candles for him. For his fifth birthday, a vacuum-packed, canned cake was found for him to eat.

Dietary No-Nos
Carol Ann notes that there were two foods David wanted to try but were not available to him: "Coca-Cola and ice cream. He couldn't have ice cream because of the high fat content and because it couldn't be sterilized. The doctors also found they couldn't sterilize the Coca-Cola without the heat breaking down the carbonation and ruining the taste. David had heard the word Coke so often on TV and from other children that he always yearned to try one. It was one of the first things he asked for when he was taken out of his bubble before he died. But the doctors decided he shouldn't have one in his frail condition."

The Toothpaste Problem
Dr. Jack Montgomery recalled another issue they had never considered: brushing his teeth. "We didn't know, as he got teeth, what are we going to do to brush his teeth? We need to sterilize his toothpaste." Sterilization could be achieved a few different ways, but none that worked well for toothpaste. "If you put toothpaste in an autoclave it turns to concrete. You can't get it out. We could have bubbled gas through it, but you can't bubble anything through toothpaste, it just makes one giant bubble and explodes the tube. We couldn't irradiate it because it was in a metal tube." And then Dr. Montgomery remembered what he used to use before commercial toothpaste: salt and baking soda. "You can sterilize those, so we can brush his teeth with salt and soda."

Background Hum
David at age 3 standing in the supply isolator Along with the bubble itself, another constant in David's life was the low hum of the motors that kept the bubble inflated with filtered air. His mother remembers the first time she saw him, "The sound of the motors annoyed me somewhat, but he looked so peaceful that I wondered if perhaps the hum of the motors was melodious to him. Later, when he was at home, the noise was comforting to me, too, because it told me that all was well with him. When the motors were turned off during his visits to the hospital, I was unable to sleep soundly."

The blower motors were jarring to every new visitor. The first time Mary Murphy met David, she asked to turn the sound off because she could barely hear him speak. "He said I was dumb," she remembers, "and didn't I know that the bubble would deflate if the motors were turned off?"

Speaker System
Dr. Montgomery worried about David's hearing before they realized how noisy it was inside the bubble. Installing amplifiers inside the bubble so he could better hear his visitors solved this problem and improved his language development.

Supported by Grant Money
All of the equipment and special care for the twelve years of David's life is conservatively estimated to have cost about $1.3 million, the first million spent in the first half of his life. The funds were raised from research grants from the National Institutes of Health and other sources. The 40-odd scientific papers written about David in major medical journals would become the legacy that justified the major grants that funded that care.

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