Doctors Who Go the Extra Mile

Defeating death's sting

Claude A. Frazier, MD

For three decades, allergist Claude A. Frazier has been on a lonely crusade. It's taken him to state legislatures and elementary school classrooms throughout the United States and on visits to much of Europe as well. Frazier's mission is straightforward but elusive: to eradicate deaths caused by anaphylactic reactions to insect stings.

The impetus came in 1970. "A woman called me about her son, one of my patients. He'd been treated in the ER for anaphylaxis and was brought back in when he was stung again. The doctors gave him an antihistamine, but he died. It was such a heartbreak."

Frazier was dismayed that the physicians gave the child antihistamines when only epinephrine could have saved him. And he was certain the problem of fatal bee stings was greater than reported. "When a football player dies suddenly, the cause of death is often listed as a heart attack," he says. "But sometimes another player reports hearing the youth say, 'I've been stung,' just before he collapsed."

To prevent such tragedies, Frazier launched a two-pronged attack: to educate doctors, teachers, coaches, and others who are around young people about the life-saving properties of epinephrine; and to legalize programs to prepare more people to inject the drug in life-threatening situations.

Seeking AMA support for a model bill, he told the organization's Board of Trustees, "I have bad news and good news. The bad news is that any one of you can walk out of this hotel, be stung, and die in five minutes—even if you've never had a previous reaction. The good news is that if a trained layman, such as a policeman, were allowed to give epinephrine, you'd be saved."

His words were convincing, and not just to the AMA. Approximately 40 states have now adopted the model bill—sometimes over the objection that such loose application of the powerful drug will lead to needless casualties. Frazier scoffs at that notion: "I checked with every medical journal I could think of to see if there'd been any reported negative reactions to epinephrine, even among people with hypertension and heart problems. There have been no reactions—none."

Frazier's relentless campaign has included reams of letters to the editor and articles in medical journals, newspapers, and magazines, as well as hundreds of training programs and guest lectures. In the process, he's spent about $100,000 of his own money, says Geraldine Gosnell, his office manager. "He's had no backing, so he absorbs all the costs. And he's trained thousands of people—school nurses, firefighters, emergency personnel. Children's camps would send counselors to our waiting room for training."

The deeply religious Frazier feels this crusade is his purpose in life. (His middle name, he notes puckishly, is Albee.) Despite all the progress he's already made, Frazier, who retired recently, continues his campaign, because there are still needless deaths from insect stings. He can't help thinking about all the children who'd be alive, he says, if only someone nearby had had an epinephrine kit.

—Anne L. Finger, Senior Editor

. Doctors Who Go the Extra Mile.

Medical Economics

2000;5:91.