Wakefield is probably wrong about MMR, but I am glad he has taken his stand
Rod Liddle says that the opprobrium being heaped upon the the controversial doctor reflects the monomaniacal, fundamentalist face of science Dr Andrew Wakefield, if he is still a doctor by the time you read this, seems to be a baddun. A disciplinary panel heard that when children arrived at his house for a birthday party he grabbed a syringe and extracted blood from each one of them, giving the kids five pounds in exchange. Some fainted or vomited following this unexpected procedure, just before the cake was cut. So, already we have a vampire trope to be going on with. Also, he now works at a clinic in West Texas, the last worldly refuge of all manner of scoundrels. As he arrived at the General Medical Council hearing which was to deliberate his fitness to continue practising in Britain he was surrounded by his usual cabal of autism groupies, all those mums and dads with placards who cannot bring themselves to shed the idea that the terrible illness which afflicts their kids was caused by anything other than some government imposed pathogen, something dark, mysterious and catastrophic lurking within the M MR vaccine. They howled their usual protests, cleaving to the notion that Wakefield is a brave and persecuted man of honour. The medical profession, almost as one, and the government insist that he is a charlatan, a quack — and go about the business of persecuting him It is pointed out, drily, that his animus towards the MMR was not inconsistent with a patent he'd taken out on a single measles vaccine — so, financial greed is the final nail to be hammered into Wakefield's professional coffin.
He is this year's Sir Roy Meadow. In the summer of punk, 1977, Sir Roy concocted a suitably nihilistic illness, Munchausen's Syndrome by Proxy which, once he had invented it and given it a name, existed as an unquestioned scientific fact, like the boiling point of water or the mass of an electron, for the next quarter of a century. Sir Roy's illness was a cunning creature; no symptoms save for mums murdering their kids while they slept. No cure. Sure form of telling if the patient has Munchausen's Syndrome by Proxy is their fervent denial of it. Everything peer reviewed, published data in the most learned of medical journals and all ticketyboo. The courts swallowed it whole and plenty of women were sent to prison or the booby hatch on the basis of this circular theory which, by definition, was impervious to argument — a little like the Anthropic Principle which explains away the existence of the universe by insisting that it is like it is because it couldn't be any different.
Anyway, in the early years of this century a procession of embittered women were suddenly let out of prison or the booby hatch and Sir Roy Meadow was struck off the register by the GMC. Munchausen's Syndrome by Proxy by now didn't exist; it was a fiction; it had never existed. Sir Roy allegedly fiddled some of his statistics and that is what he was done for. But the earliest objections to his illness were not predicated upon his dubious figures. It was the incarcerated women, their husbands and the defence lawyers crying out, repeatedly, 'This cannot be!'
So it is with Wakefield. His linkage of the MMR vaccine and the onset of autism was peer reviewed and published in the Lancet; it existed, for a while, as a contentious fact and led to many parents refusing to give their kids the three-jabs-in-one vaccine. And opposition to Wakefield initially sprung not from the uncovering of dubious diagnostic techniques or his habit of draining young children of blood whenever the opportunity arose, but from a sort of swelling consensus: 'This cannot be!' Allied, of course to another orthodoxy, which is that every child must have its MMR vaccine and those who argue against this are incivistic and plain wrong. And so Wakefield is humiliated as publicly as possible, much as was Meadow. It is not enough that they must be told that they are wrong, it must be shown that there is a punishment for being wrong.
And they probably are both wrong, I would reckon, from my limited medical understanding. I suspect that autism is not triggered by the MMR vaccine but instead is down to that fashionable thing, genetics — and that the large rise in kids diagnosed as being autistic, or suffering from Asperger's, is due to better diagnostic techniques and maybe something to do with assortative mating patterns. I'm about 85 per cent convinced by that — but I'm also quite glad that Andrew Wakefield is around to put forward a different thesis, no matter how damaging the authorities might believe that thesis to be, nor how unlikely it is. Also, I am still unconvinced of the absolute safety of the MMR vaccine — not because of any link with autism, but because I worry about my children's immune system being compromised. Perhaps I am wrong to worry; but the truth is the arrogant and didactic approach of the medical community merely serves to convince me that I'm right to worry about MMR — right, in fact, to be gently sceptical of everything they tell us. One moment Munchausen's Syndrome by Proxy exists and peoples lives are ruined — the next it has gone, vanished. One moment the MMR vaccine will be safe and maybe, a few years down the line, we will discover that it wasn't safe after all.
This is not a whine about the inexact nature of science, which is obviously a given; in a way it is the reverse. It is a whine about scientists not accepting the inexact nature of science — and dragging the rest of us along in their monomaniacal wake. The courts, the government, the campaigning health charities, the schools. They are always convinced, always certain, always ready to point to the system of checks and balances which prove they are incontrovertibly correct. Peer reviews, for example. But Meadow was peer reviewed and so was Wakefield. Maybe Wakefield reviewed Meadow's stuff and vice versa — because peers are, of course, simply other scientists, as fallible as any humans.
In a perfect world science would progress with a slow, gradual, accretion of knowledge, but that is not how it happens. There are instead sudden paradigm shifts when one generation of scientists die off and another takes its place at the top table. Principles which have held true for years are suddenly disproved and then, a few years later, reinstated. Old wives' tales are treated with contempt until the day on which some clever boffin suddenly discovers them to have been true all along (as happened recently with the common cold: going out when it's nippy can make you vulnerable to a cold). Striking Andrew Wakefield off the medical register will not convince me that the MMR is safe.
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