It was a jarring moment when generations of young readers got to the fourth book in the Little House series by Laura Ingalls Wilder and saw that it opened with the simple statement that her sister Mary had gone blind from scarlet fever. Ingalls wrote her remembrances late in life for young readers, and many believe they were heavily edited by Rose Wilder Lane, but what made it into print left a distinct and frightening impression. But it turns out that scarlet fever doesn't cause blindness. Dr. Beth A. Tarini deduced, after a decade of research, that Mary probably went blind in 1879 due to viral meningoencephalitis. But why does it matter so many years later?
“When I’m in clinic,” Dr. Tarini said, “and I tell parents their child has scarlet fever, I see their eyes widen. In my mind, it’s no different than a strep throat with a rash, but the specter of history colors their reaction.” Those emotional words describing Mary’s lost vision still carry weight with the parents who read and remember “By the Shores of Silver Creek” and all the books that came before and after it.
“We’re taught to find out what’s wrong and give a patient a diagnosis,” Dr. Tarini continued, “but that’s only one of the things the patient needs. If I say ‘scarlet fever’ and a mother is thinking, ‘Mary Ingalls’ then if I don’t know to pull that out, I’m not doing my job.” It matters to pediatricians if it matters to their patients.