Saturday, September 6, 2008

Brief Respite

This blog will be on break for about a month. Posts will resume around the first or second week of October.

Tuesday, September 2, 2008

The Blind Fighting the Blind

I have little to say about vaccines: this blog is about the subject of autism, and vaccines have nothing to do with the subject of autism. But unfortunately, the society around me cannot seem to stop talking about vaccines and autism, so perhaps from my distress at the level of noise, I am going to make a candid observation about the two main parties to this so-called debate.

The current focal point of the autism-vaccine wars is the Autism Omnibus Proceeding, a set of hearings in which a rabid mob of charlatans, shrews, shriekers and legal bottom feeders have engaged themselves in an everything-but-the-kitchen-sink effort to extract a large sum of settlement money from the United States Treasury, and in which a team of respondent attorneys representing the Department of Health and Human Services—and by extension much of the established scientific community—has taken on the unenviable task of fending off this mob. But as it is, I can find almost no one to cheer for in this battle royal, although if pressed I might be willing to express a little sympathy for the government lawyers. Faced with an onslaught of crackpot theories, off-the-cuff evidence and emotional appeals to everything except the facts, the government legal team finds itself forced into adopting a strategy that at first glance might seem to be the most prudent, the most promising, and indeed, in a practical sense, is most likely the best. They counter this torrent of irrationality by responding with the established tenets and practices arising out of the autism research and medical community—they call on that community’s experts to offer a reasoned defense.

Ah, but there is the rub.

If this were a question of calling on scientific experts with an established track record of aid and understanding for the autistic individuals in their care, then indeed a reasoned defense would have a most salutary effect. But the established track record of the autism research and medical community—more than sixty years in its making—is now one of the most abysmal in the land. Indeed, the very concepts of aid and understanding for autistic individuals seem to have barely scratched the surface for this community, except perhaps as occasional lip service, for on its juggernaut path to becoming the medical profession’s preeminent growth industry, the autism research and medical community has shown little patience for anything, or anyone, hampering the course of its rapid expansion. Thus it is we see that community amassing positions, grants, chairs, journals, expensive equipment and massive hospital wings, while for the autistic individuals in its care we see it amassing overpowering drugs, invasive therapies, haphazard genetic testing, and a relentless confirmation of the words illness, defect and burden. In this age of heightened awareness of autism, in this era of expanding diagnoses stoking the growth industry’s flames, we see the autism research and medical community reaping all the rewards of the added attention and additional resources, while the autistic individuals themselves are reaping the back of that community’s hand.

To employ an example from the omnibus hearings themselves, we have the case of Dr. Bennett Leventhal, an expert witness brought forth by the government to counter the now stale argument that thimerosal in vaccines has spawned an epidemic of regressive autism (whatever that may be). To his credit, Dr. Leventhal manages to swat away the thimerosal hypothesis with the greatest of ease—for after all, a six year old child can swat away a fantasy. But before passing out handshakes, cigars and pats on the back all around, let us consider what else Dr. Leventhal manages to accomplish during his self-assured time upon the stand. He manages to accomplish a good deal of myth promulgation (mental retardation is co-morbid with autism 70-80% of the time; parents with autistic children have unusually high divorce rates). He manages to accomplish the all-too-common disparagement of autistic children as burdens to bear and a gigantic stress upon the family. He manages to accomplish the promotion of his profession’s superior “gold standard” tools and brand new centers of excellence—despite his profession’s dreadful history in exactly these areas—and he manages to accomplish a subtle plug for the use of risperidone in treatment. Perhaps it is just me, but more than anything during his brief and authoritative time upon the stand, Dr. Leventhal manages to accomplish—do you get this whiff too?—an air of arrogance for himself and a massive dose of condescension for all his patients. And of course it goes without saying that in the autism research and medical community, there are literally thousands and thousands of Dr. Leventhals.

The question must be asked: how are the subtly malignant efforts of such so-called experts any the less harmful to autistic individuals than the more obvious quackery of, say, Messieurs Geier and Geier?

In this battle of the vaccine-hating militia versus the scientific establishment, we have a perfect example of the blind fighting the blind. If we must insist upon supplying uniforms to tell the two sides apart, then I suppose we can characterize the vaccine haters as the willfully blind, and the autism research and medical community as the ignorantly blind, but the added distinction does little to make the battle any the more compelling.