Dr. Greene, my 16-month-old son died of complications of bacterial meningitis on 17 December 1997. Up until 14 Dec he was healthy. He got sick on Sunday, 14 December 1997, we took him to the pediatrician on Monday the 15th, where she said her diagnosis was an intestinal virus. We took him home, he kept throwing up, but the doctor said this was OK. We took him in on Wednesday the 17th with a 104 degree fever in the early AM, and while waiting for a bowel x-ray, my son went into a seizure, we rushed to the ER one floor below, and my son later died in the pediatric intensive care unit. The doctor in the PICU said the cultures later showed pneumococcal bacteria had caused sepsis in his blood, and a CAT scan had shown that his brain was full of a fluid the doctor interpreted as blood or pus. My questions are many, but I have spoken to several doctors who are personal friends... they all say this is basically a crap-shoot kind of situation, where 100 kids can go to the doctor with the same symptoms, and 99 will have a virus in their intestines, and the one will have bacterial sepsis or meningitis. Is there any way we could have known? Everyone says no. Once they realized in the ER what was happening, it was too late to save him, the damage was done. He also died with the purple spots on his arms and torso, which, I am told, indicated advanced sepsis. Is there anything that you can tell me about this situation?

P.S. We bought your book on ear infections a few months ago. Liked it a lot, plan to use it for the next kids.

Neal, even just hearing about the gaping wound of having your precious son so rudely wrenched from your life creates a deep ache in me and in many parents who will read this. How wrong that the exuberance of a 16-month-old toddler, careening joyfully through life, should be extinguished. Promise and dream vanish. The fragility of life, which hides beneath the surface of our awareness, has now put questions to everything.

This week, Neal, I stood next to bed 5 in the Pediatric Intensive Care Unit at Children's Hospital Oakland. Dwarfed by the stacks of monitors and machines, an 11-month-old named Connor lay stretched out on the tiny bed. He too had been perfectly healthy until quite recently.

Connor is a miracle baby. When his parents finally came to understand that they couldn't have a baby, they adopted a beautiful little girl. Three months later, they were pregnant with Connor. With two infants in the house, life was hectic but wonderful.

Then, one night, Connor developed a high fever. When his parents were unable to bring the fever down with medications, they appropriately took him to the ER in the middle of the night. At the ER, the appropriate lab tests were performed, and the initial results indicated a viral infection that didn't look serious. When they went home from the ER that night, they didn't know that it would be their last trip home - at least to the simple joy that they had known.

The next morning when they took Connor back to be checked by the pediatrician, he had become lethargic. The doctor called 911 to have him transported directly to the hospital, where he was diagnosed with bacterial meningitis. Despite swift intervention with the best medicines, he hovered between life and death for days and nights on end. Seizures and strokes complicated his course, and when the pneumococcal meningitis was finally gone, it wasn't clear how much damage had been done to his brain.

He was transported to Children's Hospital Oakland to have a gastrostomy tube placed. This tube was to be surgically inserted through the wall of his stomach so that he could be fed during the many long, slow months of rehabilitation.

Then, this Thursday, without warning he began seizing uncontrollably, a CT scan revealed massive fluid in the brain, and he was rushed to the operating room to have a shunt placed to remove the fluid. I arrived at his bedside as Connor was recovering from the emergency surgery, only to hear a doctor explaining the situation to Connor's mother and grandmother.

"The little boy that you have known and loved is gone," the doctor advised, "it's time to let go of him, and learn to love this new, very different, Connor." My heart ached as I listened.

Truth be told, it is far too early to know the end of Connor's story. When pneumococcal meningitis hits, some children recover (even with as many complications as Connor has had). Some are left with serious brain damage. Many lose their hearing (Ian, another delightful little boy I know, is permanently deaf following his pneumococcal meningitis this fall). And some, like your son, have their lives cut short suddenly. Whatever the outcome, bacterial meningitis rolls through like a juggernaut, smashing health and peace.

Bacterial meningitis can occur at any age, but 95 percent of cases are in children under 5 years old. Boys are more likely to get it than girls.