In 1976 or so, only a few years after we moved to North Carolina for my first faculty appointment at the School of Public Health at the University of North Carolina at Chapel Hill, I encountered one of the most dramatic and even beautiful examples of public health in practice. Our master's program (like many other graduate master's programs in public health required each graduate to spent three summer months on a field training assignment under the guidance of a field training site health official, in this case a small public health clinic in New Mexico.
My student, Doris M., a graduate of a fine small undergraduate program in Ohio, chose for her summer training a clinic in a small New Mexico village, Embudo. Embudo is Spanish for “funnel”, and the village is named after the funnel-shaped mountain that looms above it in the Sangre de Cristo mountains of New Mexico and Colorado.
We faculty members in at the School of Public Health were required to visit our field-training sites to see how the student was doing, and to thank the field site staff for the three month work experience. And so, after flying to Albuquerque, I was driven up to Embudo by a University of New Mexico public health faculty member, who served as my student's faculty field preceptor. When we arrived the director of the clinic, a physician, greeted us along with several staff members, including my student Doris, and a young man wearing red cowboy boots.
After the introductions an learning from the director the history of the clinic, originally sponsored by the Presbyterian church, the physician took me aside saying, “I’m excited. I think that young man has plague!" He nodded his head toward the young man with the beautiful boots.
I couldn't stop myself from looking at the teenager and his red cowboy boots, hopefully without alarm spreading over my face. I knew a little about how plague was transmitted and a handshake was not a danger, but still...
The physician had informed me that a blood sample had been sent to the state health department in Albuquerque and we would learn the results the next morning. The test in Albuquerque confirmed the diagnosis, and the next morning, the physician and I drove up the mountain to visit the the young man's home, a sheep ranch.
As we drove up to the ranch house, an older man, his father, came out on the porch with a beautiful dog, a shepherd.
After polite introductions, the physician broke the news, telling the father that his son had contracted “la plaga” and that he probably contracted the disease from a flea carried by the dog.
The father looked at the dog sharply. The dog's ears shot up to the top of its head, on high alert.
“No hay vergüenza en que la plaga." "There is no shame in la plaga," the physician hastened to say. Your son probably was infected from a flea carrying the bacterium, and the dog killed a prairie dog which in this country sometimes carry flea-borne plague.”
The physician explained that dogs often kill prairie dogs, and sometimes the prairie dogs carry the infected flea in that small part of northern New Mexico where a few cases of the plague turn up some years. He said to me later that we are fortunate that region is so isolated. If the outbreak were near a metropolitan area, the result could be far more dangerous to the citizenry.
"Por favor, Senor, no mata al perro." "Please do not shoot the dog. Spread this powder on the dog and the bedding." He went on to say that the man's son would receive antibiotic treatment and would return home soon. When treated early enough the antibiotics were completely effective. The physician said the young man would be fine.
On the way back to the clinic, the physician told me the family was descended from Spaniards who early came to the New World and who were sheepherders. They were not Mexican emigrants.
Later the physician, my student and I drove over to Santa Fe and we had supper and even had a short tour of Taos Pueblo, at dusk. There were no lights and I found it kind of spooky. The next day, I was driven back to Albuquerque.
Years later in my public health career, as a New York State health official, I encountered reports of plague again in reports from state health officials who found cases on planes from South Asia where plague outbreaks had occurred.