Cold Open

It’s October 21st, 1983, at Texas Children’s Hospital in Houston.

In a side room off the immunology ward, 46-year-old Dr. William Shearer watches closely as nurses and orderlies cover every inch of the room in antiseptic spray. The cleaning is painstaking as Dr. Shearer only lets the orderlies move on when he's convinced that no germs remain.

While every hospital room must be sterilized to prevent infection, the reason for today’s especially rigorous cleaning sits on a bed in the corner of the room. Inside a plastic-sheeted isolation chamber is 12-year-old David Vetter. David was born with an immune system so weak that exposure to any rogue pathogens could prove fatal. His entire life so far has been spent cut off from the world, separated from friends and family in airtight, sterile conditions. But Dr. Shearer hopes that a bone marrow transplant will eventually allow David to step outside his isolation bubble for the first time in his life.

Satisfied that every surface has been disinfected, Dr. Shearer signals for the procedure to begin.

He inserts his hands into thick rubber gloves set into the wall of David’s bubble.

Dr. Shearer taps a needle, clearing it of any air. Then, he inserts an IV line into David’s arm. Over the next hour or two, stem cells will slowly drip through the line and into David’s body. Hopefully, this will allow David to live a normal life—but only if the experimental procedure goes according to plan.

Dr. William Shearer’s decision to risk an experimental procedure on his young patient has been one of the toughest of his medical career. David Vetter could have been left inside his sterile bubble for years. But the ethical debate over imprisoning David in isolation has raged since his birth. But now that they’ve chosen to act, those close to David hope that his life as the “boy in the bubble” will come to an end after the bone marrow transplant on October 21st, 1983.

Introduction

From Noiser and Airship, I’m Lindsay Graham, and this is History Daily.

History is made every day. On this podcast—every day—we tell the true stories of the people and events that shaped our world.

Today is October 21st, 1983: The “Bubble Boy’s” Experimental Transplant.

Act One: Isolation

It’s September 21st, 1971, at St. Luke’s Episcopal Hospital in Houston, Texas, twelve years before David Vetter's bone marrow transplant.

Heavily pregnant Carol Ann Vetter rubs her aching back as she walks through the hospital, trailing a team of doctors giving Carol and her husband a final tour of the facility. Carol listens intently as doctors review what will happen over the next few hours. It’s information that she and her husband have been told before, but Carol understands how important it is for the rest of the day to go according to plan.

So far, they’ve visited the midwives who’ll care for their baby and the surgeons who will perform her C-section. But this isn’t an ordinary pregnancy, and Carol still has another group of specialists to see.

Carol and her husband follow the doctors into the delivery room. Waiting patiently, there are several immunologists. They’re standing next to the sterile, plastic isolator where Carol’s baby will be placed as soon as he enters the world.

The sight of the tiny isolator is overwhelming. Carol asks for a moment alone with her husband. And after the doctors leave, Carol looks deep into her husband’s eyes, seeking his reassurance that everything is gonna be okay. But Carol knows he can’t promise that—because they’ve already suffered the loss of one child.

Fifteen months ago, Carol gave birth to her second child. But the joyful moment quickly turned to tragedy. Doctors discovered that the baby boy had a rare genetic disorder: Severe Combined Immune Deficiency Syndrome, or SCID. It was a devastating diagnosis. The baby’s immune system was so compromised that his body couldn’t fight everyday germs and viruses, and even the mildest infection could prove fatal. The life expectancy for most babies born with SCID was just two years—but Carol’s son didn’t even make that. Only six months after his birth, his frail body succumbed to a routine illness.

And after this loss, the Vetters were informed that there was a 50 percent chance that any other male children they had would also develop SCID. Despite these odds, they decided to have another child after meeting biologist Raphael Wilson. In Germany, Wilson had successfully raised twin boys with SCID inside specially built isolators. After three years, their immune systems had developed to the point where they could fight off infections, and they were released to live a relatively normal life. With Dr. Wilson’s example reassuring her, Carol decided to risk another pregnancy. And later today, her second son is going to be born.

Satisfied that everything is ready, Carol is prepped for surgery. And then, seconds after the C-section, doctors place the baby in an enclosed isolator. For the first part of his life, David will live in a chamber that’s only two feet long and a foot wide.

Knowing that her son is suffering from a life-threatening condition, Carol and her husband arrange for him to be baptized using sterilized holy water. The priest daubs the water onto the baby’s tiny forehead using thick plastic gloves built into the wall of David’s isolator. The same method is used to feed David and to change his diapers. All food and clothing is checked for contaminants and sterilized before goes inside the protective bubble.

Then, as David grows, so too does his world. His isolator is expanded, then eventually replaced by a plastic-lined hospital room. But even there, Carol can't touch her son, and David never feels the warmth of another person’s skin. He interacts with the world only through the layers of plastic.

News of David’s unusual life spreads quickly. The press dubs him “The Boy in the Bubble.” Photographers and TV crews capture his daily existence, and when David is just four years old, he even inspires a movie starring John Travolta.

Away from the cameras, David undergoes regular testing. Specialists track his development closely. David takes his first steps in total isolation. And thanks to the individual attention he receives from countless adults, David’s vocabulary is far better than the average child’s—but since the hospital is his only home, many of the advanced words that he uses are medical terms.

But one area of David’s development always lags behind. Dr. Wilson’s hopes that David’s immune system will repair itself come to nothing, and his life-threatening condition remains unchanged. Which means the longer he remains in his bubble, the moral dilemma of whether or not a child should be kept in indefinite isolation will grow, until David’s family and medical team will have to face an almost impossible choice.

Act Two: Sterilized

It’s November 9th, 1977, in Texas Children’s Hospital in Houston, six years after David Vetter was born.

51-year-old child psychologist Mary Murphy fixes a smile and gestures at David to crawl into the plastic tunnel ahead of him. She kneels down, pressing her face close to the isolation bubble that David’s spent his entire life inside, pleading with him to listen. But David stamps his feet and shakes his head.

Behind her, Mary hears a cluster of reporters shift restlessly. The news media has gathered to witness an important milestone in David’s life. He’s been given a “bubble suit,” an innovation designed with help from experts at NASA. It will allow David to leave his sterile bubble and move freely around the world. But not for the first time, six-year-old David isn’t cooperating.

Two years ago, David found a syringe that had been accidentally left inside his bubble and used it to pierce holes in the plastic. After that incident, David’s parents and doctors explained to him for the first time about his rare illness. And from that moment, David’s mental health began to decline.

As David’s psychologist, Mary closely monitored the toll that his isolation was taking. His mood ricocheted from pensive withdrawal to eruptions of rage. And as David got older, Mary noticed that he developed a fear of abandonment. And one of his primary doctors was taken off the case after a heart attack, David tried to rip his bubble apart and smeared excrement on the plastic walls.

Recognizing that a hospital was no place for a child to grow up, doctors agreed that a second isolation bubble should be built at David’s home. After careful preparation, he was allowed to leave the hospital. David even enrolled in school, listening in to classes via telephone. But although new technology aimed to make David’s life as normal as possible, he couldn’t help noticing how different his experience was from other children. So now, Mary hopes that the bubble suit will eventually bridge that gap, perhaps even letting him attend school and sit in class with other children. But David won’t go anywhere if he won’t get inside it.

Sensing that the presence of the reporters is worsening David’s mood, Mary asks the newsmen to step out. And once they’re alone in the room, Mary softly asks David again. She breathes a sigh of relief as he tentatively steps inside the bubble suit.

At first, David is scared by his new surroundings. The oversized helmet encloses his head. And the plastic material sticks to his skin. But after a few minutes, he grows used to it. Eventually, the reporters watch as David emerges from his room in a bright yellow suit. A long tube carrying sterilized air from the isolation chamber means that there’s a limit on how far he can go. But even so, he walks up and down the hallway—the first time he’s been able to go anywhere under his own power.

Although the press heralds the bubble suit as a triumph, Mary knows the truth. It’s just a stopgap, not the true freedom that a six-year-old boy wants or needs. Mary is soon proven correct. David wears the bubble suit just six times—and on each occasion, David is reluctant. When he grows out of the original suit, a new, larger version is made. But David refuses to wear the replacement even once. And over the next few years, David’s outbursts become more frequent and hostile. He confides in Mary that he’s too scared to leave his bubble. He feels comfortable and safe behind the plastic barrier. It’s all he’s ever known.

But then, a miraculous cure finally emerges, one that may give David true freedom.

Ever since he was born, doctors have suspected that David’s best hope of getting better is to receive a bone marrow transplant, but lengthy searches for a donor who matched his bone marrow type have proved fruitless. That changes when a breakthrough in medical science makes it possible for unmatched bone marrow to be used in a transplant.

But all medical procedures carry a risk—and no one knows whether the bone marrow transplant will actually cure a patient suffering from SCID. But given David’s quality of life, it’s a gamble that his parents and medical team decide they must take—because the alternative is a life sentence in a plastic bubble.

David’s older sister volunteers to be the donor. But the decision to undergo the experimental transplant will not save David. Instead, it will make things much worse.

Act Three: Hope

It’s October 21st, 1983, at Texas Children’s Hospital in Houston, several hours after David Vetter's bone marrow transplant.

Dr. William Shearer sits outside David’s isolation bubble, waiting for him to wake. As far as Dr. Shearer can tell, the transplant has gone well. The painless procedure lasted for a few hours, and David drifted off to sleep during it. But throughout, Dr. Shearer sat by his side, keeping a sharp eye on his patient.

Then, as David stirs, Dr. Shearer straightens in his chair. When he’s fully awake, David places his hand on the plastic wall still separating him from the outside world. Dr. Shearer presses his own hand on the other side. Then he smiles and tells David that the transplant went as well as they could have hoped for.

But Dr. Shearer doesn’t know that the procedure has already sealed David’s fate. Over the next few weeks, David’s condition deteriorates. Eventually, doctors realize that his sister’s bone marrow contained a dormant virus—and it’s too much for David’s fragile immune system to cope with.

As his health worsens and his condition becomes terminal, doctors decide to finally free David from the bubble. For the first time, he will feel the touch of his family, the sensation of walking barefoot on grass, and feeling the wind on his face. The world that David longed to experience is finally his—but only briefly. David dies on February 22nd, 1984, at the age of 12.

But the young boy’s death will not be in vain. After analyzing David’s blood, doctors will identify the specific genes that caused his immune deficiency. And further advances will allow newborns to be tested for SCID. Improvements in preventive measures will mean that those with similar conditions will no longer be forced to endure a life of isolation. And although David Vetter's life was cut short, many more will be saved by the lessons learned from the experimental transplant performed on October 21st, 1983.

Outro

Next on History Daily. October 22nd, 1934. Federal agents track down notorious outlaw Charles “Pretty Boy” Floyd and kill him in a gunfight.

From Noiser and Airship, this is History Daily, hosted, edited, and executive produced by me, Lindsay Graham.

Audio editing by Muhammad Shahzaib.

Sound design by Mollie Baack.

Music by Thrumm.

This episode is written and researched by Owen Paul Nicholls.

Edited by Scott Reeves.

Managing producer Emily Burke.

Executive Producers are William Simpson for Airship and Pascal Hughes for Noiser.