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Autism Ideas - Part 2: Offit, Come Off It
By Mary W Maxwell, PhD
Even-handedness has its place, but for me, today, it's not going to be a priority. I have read from cover to cover Dr Paul Offit's book, "Autism's False Prophets" and Andrew Wakefield's "Callous Disregard." While Offit does reveal, in his book, one astonishing misdeed committed by Wakefield, the Wakefield book wins hands down. In fact it is an eye-opening and very touching report on what many autism parents have gone through, being constantly dismissed and being given the run-around.
The Offit book contains loads of helpful data. Nevertheless, I feel sure it was written by public relations professionals, as it is so slanted. What doctor would write in a smug tone of voice about this extremely serious issue? The 'false prophets' referred to in Offit's title are the quacks who try to sell a cure for autism. If you were a pediatrician writing about that, wouldn't you stake some territory for non-quacks? I mean, given the huge numbers of new autism cases, shouldn't Offit (who recently was head of the American Pediatrics Association) scream out "Hey, let's get some action going here!"?
As for "Callous Disregard," it was written by Wakefield who was struck off the register by Britain's General Medical Council in 2010 -- one of his alleged sins being that he showed 'callous disregard' for patients. He now works at Thoughtful House in Austin, Texas, with his physician wife, Carmel. (It's a wonder they didn't revoke her license too, on grounds of association with the sinner!) This all has to do with a long-running investigation of an article he wrote for Britain's leading medical journal, The Lancet.
Wakefield states ­ and I believe him ­ that the article, dated 28 February 1998, was not intended as a research paper. It was a 'series-of-cases' report, regarding 12 patients. That is a legitimate and well-established method by which doctors make available to other doctors their observations of something new or interesting. It doesn't require the paraphernalia that a research article does -- such as a control group and permission from an Ethics Board. The cases speak for themselves, as it were. Take 'em or leave 'em.
The Lancet has said that it publishes only 5% of the thousands of submissions it receives.
We can assume that while an article is undergoing peer review, it will be tossed into the bin if it fails to include such standard formalities as a brief summary of the literature, and an explanation as to why the author makes the deductions that she makes. Andrew Wakefield and his two co-authors, Simon Murch and John Walker-Smith (all pediatric gastroenterologists) handled those formalities properly.
Let me paraphrase their message: "We have twelve children presenting with symptoms of bowel disease who also are autistic. This is very interesting and makes us wonder if the bowel disease somehow travelled to the brain and caused the autism. This could be a biggie!" Naturally these physicians-researchers were eager to get into print with their scoop. Nevertheless, they state their findings in The Lancet in a very restrained way, as follows:
"If there is a causal link between measles, mumps, and rubella vaccine and this [bowel] syndrome, a rising incidence might be anticipated after the introduction of this vaccine in the UK in 1988. Published evidence is inadequate to show whether there is a change in incidence or a link with measles, mumps, and rubella vaccine. A genetic predisposition to autistic-spectrum disorders is suggested by over-representation in boys and a greater concordance rate in monozygotic than in dizygotic twins. Urinary methylmalonic-acid concentrations were raised in most of the children, a finding indicative of a functional vitamin B12 deficiency. B12 deficiency may, therefore, be a contributory factor in the developmental regression." Well, I'll be a monkey's aunt! Vitamin deficiency is one of the possible culprits in autism.
The concluding paragraph states: "We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after measles, mumps, and rubella immunisation. Further investigations are needed to examine this syndrome and its possible relation to this vaccine."
Nowhere do you see "MMR jab (measles/mumps/rubella jab) causes autism," right?
But on page 186 of his "False Prophets" book, Paul Offit says, "After Andrew Wakefield published his paper in the Lancet claiming that MMR caused autism" Wait. Did I read it wrong? Am I having trouble understanding English? What are we to think of all this?
It needs to be said that Wakefield has affirmatively told everyone that children should continue to get the measles shot -- just not in combo with mumps and rubella vaccine. He reports, in his "Callous" book, that six months after he gave that advice, the British government made the single shot unavailable! (Pause. Read that last statement again.)
One of Offit's criticisms of The Lancet article is that it deceives readers -- I agree -- by its implication that the 12 patients merely popped up in the population, when in fact some of them were recruited via the activist grapevine. The authors could have simply said "We heard that mothers all over England were complaining about their babies getting autism a few days after a vaccination, and we sought the chance to investigate them medically."
In any case, it doesn't matter where Wakefield et al got the children. Their Lancet conclusion didn't claim that the percent of vaccine-complainers among this small set (eight of the twelve) should be extrapolated to the whole population. The general value of the article has to do with reporting a new syndrome, the presence in autistic children of bowel disease; it's not about the role of any vaccine in bringing about that syndrome. Until now no one caringly asked, "Why do autistic children have bright yellow diarrhea?"
I should also mention that, since 1996, Wakefield had been acting as scientific consultant for a lawyer, Richard Barr. This lawyer had received a $20 million grant from the Legal Aid Board of the UK to deal with potential litigation about the MMR vaccine. Conflict of interest? Well, we typically do not like to see a scholar poring over a problem when the outcome in one direction rather than another could benefit that scholar, do we? In academic medicine these situations are now commonplace but it sure does spoil the atmosphere.
I suspect Wakefield's main indiscretion lay in his not informing his co-authors that he was working for Barr. This has apparently miffed them no end. Not because they considered that connection unethical -- it is not unethical for doctors to be expert witnesses in lawsuits -- but because it gave scope later for the opposing camp to have a field day. (You can see the full field day, if you like that sort of thing, at briandeer.com.)
Offit's book points out that the very day the Lancet article was published, Wakefield called a press conference to announce the findings, which 'led to' scare headlines in the March 1, 1998 Guardian and Daily Mail. Hmm. (That's a loud 'Hmm.') Why would media create hype against drug companies? They never do that. And later, one of the autism moms, Jenny McCarthy, got to tell her anti-vaccine story on the Oprah program and on CNN's Larry King Live. Sorry, but that tells me something peculiar is going on.
Back around 1995 I attended a political science meeting in Canada. The men were discussing the fact that the New York Times had carried a human-interest story, for the first time, about a Cuban family being reunited with relatives in the United States. Since no one could figure out how it got published, I said, "Maybe a reporter simply learned of it and decided to write it up." My Canadian colleagues looked at me like I was the jerk of the century. They said, "Nothing ever happens by chance at the New York Times. Every editorial decision is controlled at the top."
Here's my take: the whole government and media hype about a doctor causing a vaccine scare is itself a well-planned project with two intended goals. One is to get everybody worried about health issues, and to start distrusting their doctors. The other is to let every doctor and every scientist know that Normal Science has ended. If they wish to keep their jobs, they must now denounce any scientist who is identified as a dissident.
So what was the dissidence here? I reckon it may be the discovery that there is a way into the brain through the gut. "You are not supposed to have figured that out, guys. It's classified." I will have more to say on that later in this little series of Autism Ideas. (Remember, I'm a dab hand at conspiracy theory!) But for now I can only be certain that the way this whole thing is being conducted indicates a concerted effort to stir people up and create enmities. The well-worn routine of divide-and-rule.
That said, I discovered in Offit's book an accusation about Andrew Wakefield that I had not previously heard and which, if true, is really sad news. Offit says that a pathology company in Ireland told Wakefield that the results were not positive regarding specimens he had sent to them, yet he went ahead and published that they were. Yu-uck. Sorry, I won't be able to resolve the details of that, but it does need to be aired.
To the older member of the team, Walker-Smith, I proffer my consolation for what he says was the devastating experience of having his medical license revoked. I have read his memoirs (on the Internet) which suggest that he fell in love with the small intestine when he was 26. He wrote: "I applied to work for Professor Chris Booth, who was an inspirational teacher of gastroenterology, and I was lucky enough to be appointed. This changed my life. I realized that gastroenterology, and the small intestine in particular, was my life's vocation."
You can't beat that. Born, 1936; graduated Sydney Church of England Grammar School, 1953; fell in love with small intestine, 1962. Men of that type don't cheat on research. I know because I lived with 'that type' in a blissful marriage for 20 years. (Not that my George gave a hoot about intestines, but he was in love with Medicine generally and pediatrics in particular.) Is it unscientific of me to generalize about such men? Pardon me, but 'science' is what is done in the lab. In real life we make judgments about people all the time by applying past experience and common sense. Based on gut feeling, no pun intended, I support Walker-Smith.
One more item: Professor Offit provides what looks to me to be a good refutation of the theory that it was the mercury in the vaccines preservative (known as thimerosal) that caused damage to babies. He repeatedly says that there were careful studies done and the result was a finding that babies whose vaccines had thimerosal were less likely to become autistic than the ones without thimerosal. Holy Moley! Does that mean we should run out and buy thimerosal? And if it's so salubrious shouldn't researchers be made to investigate it further "for public health"?
Or is somebody totally and utterly having a joke on us?
Mary W Maxwell, PhD, can be reached at her website www.ProsecutionForTreason.com. Note: this article is part of a series. The first one was called "The Brainy Ms Grandin,"
which can of course be googled for.
POSTSCRIPT. For anyone who wants to see how flimsy the GMC's (General Medical Council's) disciplinary proceedings actually were, here is an excerpt from the document that put Walker-Smith out of business:
"The reporting in [The Lancet article] of a temporal link between gastrointestinal disease, developmental regression and the MMR vaccination had major public health implications. Professor Walker-Smith did not admit that he knew or ought to have known the paper had these implications or would attract intense public and media interest when it was published in February 1998. However the Panel noted that he wrote a letter to Professor Brent Taylor on 4 August 1997, following the publication of an article in the medical press in which Dr Wakefield had referred to the research results. In that letter, Professor Walker-Smith indicated his concerns about any weakening of the MMR uptake and expressed awareness of what he described as the 'rapacious' press and media." (Mary says: Does this mean that doctors who find a 'temporal link' are obliged to keep it a secret??? GMC to the Tower then!!!)
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