September 21, 1971|
Houston, Texas, U.S.
|Died||February 22, 1984
Montgomery County, Texas, U.S.
|Cause of death||Lymphoma; complications from SCID|
David Phillip Vetter (September 21, 1971 – February 22, 1984) was a prominent sufferer of severe combined immunodeficiency (SCID), a hereditary disease which dramatically weakens the immune system. Individuals born with SCID are abnormally susceptible to infections, and exposure to pathogens can be fatal. Vetter was referred to as "David, the bubble boy" by the media. Vetter's surname was not revealed to the general public until 10 years after his death in order to preserve his family's privacy.
In his first years of life he lived mostly at Texas Children's Hospital in Houston, Texas. As he grew older, he lived increasingly at home with his parents and older sister Katherine in Shenandoah, Texas. He died in 1984, at the age of 12.
Vetter's parents were David Joseph Vetter, Jr. and Carol Ann Vetter. Their first son, David Joseph Vetter III, was also born with SCID and died at 7 months of age. Vetter's parents were advised by physicians that any future male children they might conceive would have a 50% chance of inheriting the disease. At the time, the only management available for children born with SCID was isolation in a sterile environment until a successful bone marrow transplant could be performed. The Vetters, who already had a daughter, decided to proceed with another pregnancy. Their third child, David Phillip Vetter, was born September 21, 1971.
A special sterilized cocoon bed was prepared for David at his birth. Immediately after being removed from his mother's womb, David entered the plastic germ-free environment that would be his home for most of his life. David was baptized a Roman Catholic with sterilized holy water once he had entered the bubble. Plans to proceed with a bone marrow transplant came to a halt after it was determined that the prospective donor, David's sister, Katherine, was not a match.
Life in the bubble
Water, air, food, diapers and clothes were sterilized before entering the sterile chamber. Items were placed in a chamber filled with ethylene oxide gas for four hours at 140 degrees Fahrenheit (60˚C), and then aerated for a period of one to seven days before being placed in the sterile chamber.
After being placed in the sterile chamber, David was touched only through special plastic gloves attached to the walls of the chamber. The chamber was kept inflated by air compressors that were very loud, making communications with the boy very difficult. His parents and medical team, which included Dr. John Montgomery, sought to provide him as normal a life as possible, including a formal education, and a television and playroom inside the sterile chamber. About three years after David's birth, the treatment team built an additional sterile chamber in his parents' home in Conroe, Texas, and a transport chamber so that David could spend periods of two-to-three weeks at home. David had his sister and friends for company while at home. A friend arranged for a special showing of Return of the Jedi at a local theater so that David could attend the movie in his transport chamber.
When David was four years old, he discovered that he could poke holes in his bubble using a butterfly syringe that was left inside the chamber by mistake. At this point, the treatment team explained to him what germs were and how they affected his condition. As he grew older, he became aware of the world outside his chamber, and expressed an interest in participating in what he could see outside the windows of the hospital and via television.
In 1977, researchers from NASA used their experience with the fabrication of space suits to develop a special suit that would allow Vetter to get out of his bubble and walk in the outside world. The suit was connected to his bubble via an eight-foot (2.5 m) long cloth tube and although cumbersome, it allowed him to venture outside without serious risk of contamination. David was initially resistant to the suit, and although he later became more comfortable wearing it, he used it only seven times. He outgrew the suit and never used the replacement one provided for him by NASA.
Psychological and ethical aspects
At the time of David's case, once a child was born with SCID, it would either be moved into a sterile environment, or quickly die from infection.
David came to be considered psychologically unstable due to the lack of human contact and his increasing realization of his limited prospects for a normal life. As a young child, he presented a painstakingly polite façade, but as he grew older, he appeared to become increasingly angry and depressed. He was extremely anxious about germs, and would experience repeated nightmares about the "King of Germs".
The chaplain of Texas Children's Hospital at the time, Rev. Raymond Lawrence, said of the situation: "The great scandal of the Bubble Boy was that he was conceived for the bubble. The team that did this didn't think through this very well. They didn't consider what would happen if they didn't find an immediate cure. They operated on the assumption that you could live to be 80 years old in a bubble, and that would be unfortunate but okay." Lawrence said that the original three doctors encouraged David's parents to conceive David so that they could have a test subject for studies, a charge which is denied by the three involved doctors.
The case raised numerous ethical questions, including whether parents with the genetic traits producing a 50% chance of SCID should have children, and whether the knowledge produced by such research justified allowing or encouraging parents to have children subject to this risk.
Approximately $1.3 million was spent on David's care, but scientific study failed to produce a true "cure" and no donor match had been identified. Physicians expressed concern that as a teenager David could become unpredictable and uncontrollable. Those concerns and advances in unmatched bone marrow operations led the medical team to recommend, and the family to decide to attempt, an unmatched bone marrow transplant from his sister Katherine through intravenous lines running into the bubble. The transplant operation went well, and produced hopes that he would be able to leave the chamber. A few months later, however, David became ill, for the first time in his life, with diarrhea, fever, severe vomiting and intestinal bleeding. The symptoms were so severe that he had to be taken out of the chamber for treatment.
He died 15 days later on February 22, 1984, from Burkitt's lymphoma at age 12. The autopsy revealed that the donor (Katherine's) bone marrow contained traces of a dormant virus, Epstein-Barr, which had been undetectable in the pre-transplant screening. Once transplanted, the virus spread and produced hundreds of cancerous tumors.
An elementary school which opened in 1990 in The Woodlands in unincorporated Montgomery County, Texas, was named David Elementary after Vetter. This is believed to be the only school in the United States named after a child.
David's parents later divorced.
His father went on to become the mayor of Shenandoah, Texas. His mother married a People magazine reporter who had written about her son. David's psychologist, Mary Murphy, wrote a book about David's case that was to be published in 1995; however, its publication was blocked by his parents.