Violent metaphors

Colin here, taking over the job Jennifer’s graciously been doing by editing and posting my own writing. I’m no longer on the ConspiraSea Cruise doing research for a book on irrational beliefs. Now I’m home (briefly) and writing up my experiences. This is a fuller explanation of what happened on the fifth day. You can read Day 1 here, Day 2 here , Day 3 here, Day 4 here, Day 5 Part 1 here, and an explanation for what I was doing here. 

I have just one more full day to go, then a very personal post about the very last morning of the cruise. I want to move forward quickly because we aren’t done after that. In the future I’ll write in more detail about individual presentations and my thoughts about what the conference has to teach us about irrational ideologies and the debates around those beliefs.

In the last post, I explained how I wound up as the primary audience of a long, angry lecture by Andy Wakefield. Here’s a much more detailed explanation of what happened, and some thoughts on why it happened and why it matters.

And I apologize in advance for the fishing puns. Honestly, I tried to stop.

Setting the hook

On Friday, the second-to-last day of the cruise, Wakefield was scheduled to repeat a presentation he gave on the first day of the conference called “Whistleblowing in the Public Interest.” There was a blowup just before the presentation, in the hallway outside the conference room, as two other guest speakers tried to confront the professional reporters on the scene. Once that blew over, the reporters had to choose between sitting through another round of a Wakefield presentation they’d already seen, or heading next door to (I think) “How to Control the World with Mind Machines” by Joshua Warren. They made a pretty obvious choice between déjà vu and learning how to control the world.

As we were filtering into our various presentations, though, Wakefield made an odd appeal—he wanted the journalists to see his presentation. He indicated, through an intermediary, first that they were welcome to attend and then that they were specifically invited. This was a little strange because all week long the reaction to us had bobbled between “confront at full volume” and “cautiously welcome.” I don’t recall any of the media being specifically invited to any other presentations.

Nevertheless the reporters did their duty and went to see the other session—they were there to report on everything, after all. But I’m relatively focused on vaccine issues, given our past writing about vaccines and the vaccine debate.

Wakefield made it clear he’d really hoped for the journalists to attend, and asked for any other media to identify themselves. I did, and explained that I’m writing a book and writing for Violent Metaphors—and mentioned that Jennifer is a scientist. That would probably have clued him off to our approach to vaccines if he wasn’t already aware. He asked for our perspective, and I explained that we’re firmly pro-vaccine. So far you’ve read this much in my last update.

Catch of the day

The ambush wasn’t all that dramatic, but it was very awkward and a little alarming until I realized what was happening. Wakefield had a copy of an article published years ago by one of the publications with reporters on board, and used it as a launching pad for a speech defending himself and his work. I don’t know what he planned on asking the journalists, especially since none of them were involved with that piece, but it was probably more or less what he asked me: had I read the Lancet article myself? (I’ve uploaded this part of the recording up so you can hear for yourself.)

No, I haven’t—I’m a lawyer, as one audience member helpfully informed the room at the beginning of the talk. I’m not qualified to follow a technical medical article. I was expecting to watch a presentation, not be a witness on the stand. Being grilled in front of an audience that we can charitably say was hostile to me was an uncomfortable experience. (On another day, an attendee who heard that I intend to vaccinate my children demanded loudly to know if I was “for real.” Yes.) Wakefield then asked if I had a position on the article I hadn’t read. I said that I had a position on the sources I’d read about the paper, and that I had read and trusted Brian Deer’s reporting on the debacle.

Brian Deer, if you’re not aware, was the investigative reporter who essentially blew the whistle on Wakefield. Deer’s responsible in large part for the destruction of Wakefield’s reputation. He reported that even before the Lancet paper was released, Wakefield took hundreds of thousands of dollars in “secret payments” from a lawyer who was trying to build a case around the idea that the MMR vaccine was unsafe. Deer also reported that Wakefield applied for a patent for a vaccine that would have competed with the MMR vaccine he was attacking as unsafe.

Saying that I am persuaded by Deer’s reporting was a true answer, but probably not a diplomatic one. Wakefield hates Deer. In multiple presentations Wakefield excoriated him as a journalistic hit man and someone with an organic brain defect, possibly caused by something that “went wrong very early in life,” who “takes pleasure in the suffering of these families” with autistic children. Oh, and he criticized Deer for getting personal.

So it’s probably not surprising that Wakefield got a bit worked up, but he tried to set the stage a little further first. He asked if I believed that the Lancet paper “made a claim that the MMR vaccine causes autism.” Now, I haven’t practiced law in a courtroom in years, but I’ve been there. I know a trick question when I hear one. The correct answer to that question, in that tone of voice, is obviously “no” – even if you’ve never heard of MMR or autism. I gave a true answer and then answered the question he didn’t ask.  I said I knew the paper didn’t make such a claim, but that Wakefield had subsequently taken that position. In other words, why were we quibbling about what the Lancet article said when he’d spent hours on that very boat blaming the MMR vaccine for autism?

I don’t think Wakefield liked that I pointed out that “subsequently [to the Lancet article], you’ve taken the position very aggressively that there is such a link.” He simply said, “Right.” And then launched into an intense and mildly accusatory defense of his career. He began by saying that he was going to explain things “for those non-scientists here but who have a strong position on this, based on Brian Deer amongst others.” Meaning me. And my recollection is that he delivered the following speech almost entirely to me—I was sitting in the front row, right next to the podium, and was very much the target of the speech.

Unfortunately I can’t prove this. I was eager to see the video of the speech, to see if my memory was accurate. Turns out the videographer left the camera pointed at the screen showing Wakefield’s slide deck, rather than on the exchange happening between the two of us. But here’s what I was emailing to the reporters: “Wakefield reading statement about you.” “Grilling me now.” “backup pls” “This lecture is NOT a repeat. Angry martyr speech. Delivered to me personally.” (I take notes on a tablet, so I was tapping emails in at the same time.) Unfortunately by the time they got my messages, Wakefield had wrapped up the new part of his presentation—when a couple of the reporters came around to see what was happening, he’d already transitioned back into the original “Whistleblowing in the Public Interest” presentation.

Autohagiography, and a Two Minutes Hate for Brian Deer

The bulk of Wakefield’s presentation was a recitation of the facts as he sees them. But I think the meat of it, the part that was truly designed to make a lasting impact on his audience, was emotional and manipulative. Wakefield showed pictures of autistic children he said were in so much pain due to gastrointestinal distress that they were acting out, even harming themselves or attempting suicide. They were very hard to take. He specifically blamed Deer for those kids’ suffering:

Brian Deer, and [to me] please, you can write this, is a psychopath. I say that not in a pejorative way, I say that is what Brian Deer is. He’s a psychopath. He manifests all the characteristics of a psychopath. And that is a perfect foil for the industry, because he will go where no others will go, he will say things that no others will say. Unfortunately, when he is supported by the system he will get away with those things, and I wish with all my heart that we’d been able to bring him to trial. This, on the other hand, is the child, one of the children that we were investigating back in the day. In the intervening twenty years, this kind of child has gone to the wall because of the BULLSHIT, because of the lies told by Brian Deer, the British Medical Journal, and the Lancet.

He used pictures of several suffering children to deepen the impact of his speech. I wrote in my notes, “emotionally brutalizing audience.” So was he using these disturbing images to make a purely emotional case, or were his accusations warranted? I’m not an expert on vaccine safety, so here are the two things I found most persuasive in deciding that they weren’t.

Wakefield complained that he hadn’t been able to bring Deer to trial, but a British court concluded that was Wakefield’s strategy. Wakefield sued Deer for defamation in England. According to the court’s ruling, Deer said Wakefield had “gravely abused the children under his care by unethically carrying out extensive invasive procedures (on occasions requiring three people to hold a child down), thereby driving nurses to leave and causing his medical colleagues serious concern and unhappiness.” He also alleged that Wakefield had a conflict of interest, as “his research on autistic children had begun with a contract with solicitors which were trying to sue the manufacturers of the MMR vaccine.”

The court ruled that rather than aggressively trying to disprove those allegations, Wakefield parked his lawsuit and left it in stasis while he used it to suppress criticism. “I am quite satisfied, therefore, that [Wakefield] wished to extract whatever advantage he could from the existence of the proceedings while not wishing to progress them or to give the Defendants an opportunity of meeting the claims.” It also found that Wakefield used the lawsuit “as a weapon in his attempts to close down discussion and debate over an important public issue.” For example, the court wrote that Wakefield or someone acting on his behalf tried to use the lawsuit as an implicit threat, “to restrict the Department of Health from supplying the public with such information as it thought appropriate.” Wakefield eventually dropped his lawsuit. (He later sued Deer again in the United States, but the Texas court decided it lacked jurisdiction.)

So if Wakefield didn’t or couldn’t prove his claims in the courts, what about in the scientific community? What about the epidemiologists, immunologists, neuroscientists, developmental specialists, autism researchers, pediatricians, and infectious disease specialists? That’s the venue that really matters when it comes to scientific questions, after all. But the community of experts in relevant fields overwhelmingly rejects the claim that the MMR vaccine causes autism. (And no, that’s not exactly the claim Wakefield made in the Lancet article—it’s the claim he makes today.) That’s why there were no immunologists or epidemiologists on the ConspiraSea cruise with Wakefield. Just fellow conspiracy theorists like the guy who claimed to be the third-dimensional delegate to the “Galactic Round Table” or the woman who thought chemtrails might have something to do with it or the ones who blamed GMOs. That’s why I, as a non-expert, believe that Wakefield is wrong about vaccines. I look to the opinions of people who are experts, and they overwhelmingly–virtually unanimously–disagree with him.

Wakefield threw children’s suffering in his audience’s face. But Brian Deer didn’t cause it. Nor did the BMJ or the Lancet or the MMR vaccine. Maybe no one did. Children suffered before vaccines, and they suffer—although much less—today. Of course we all want to find someone or something to blame, but there won’t always be an easily-identifiable culprit. That just makes it easier to identify a scapegoat.

Why it matters

You’ve heard the saying, “If you have the facts, pound the facts. If you don’t have the facts, pound the table.” Wakefield hasn’t been able to persuade the community of experts that he’s right. That’s going to keep him from ever redeeming himself in the eyes of the scientific and medical community. But what if that’s not the goal anymore? After all, he headlined a conference for conspiracy theorists that also featured experts on crop circles, GMO paranoia, and astrology. That’s not the game plan of a man trying to win back scientific credibility.

Rather, Wakefield suggested more than once that he’s rebranding himself as a documentarian and activist. He’s a film maker now, not a scientist—and he has a movie coming out soon that focuses on the “CDC Whistleblower.” (You’ll be hearing a lot more about that in the coming days.) If scientists need facts to pound, film makers don’t. They can rely on images of suffering children and sticky, hard-to-rebut emotional appeals rather than hard data.

Which brings me back to where we started, with Wakefield trying to lure the reporters into his presentation so that he could ambush them. I was a consolation prize; he wanted them in the room so that he could wave an article around and nitpick it to characterize it as an attack. An attack on him, an attack on the anti-vax community, an attack on the conspiracy theorist community. He wanted to deepen the “us vs. them” sentiment that had already resulted in reporters being stalked and ambushed. I don’t think that he wanted them to be harassed like that—he told me later, in a personal conversation, that he regretted the fact that they felt like they were under attack, and I believe him. But I also think he wanted his own audience to feel like they’re under attack. By media, by medicine, by science, and by skepticism. It’s a dangerously false idea. There’s no conspiracy to poison kids. Brian Deer, whatever his faults, doesn’t enjoy the suffering of children. And to connect it with the other scare stories circulating around the community of conspiracy theorists, the government isn’t dulling our brains with fluoride or staging fake attacks on elementary schools.

To those people who were on the boat with us, and those who fall within that culture of anti-vaccine conspiracy theories: it’s not us vs. them. It’s just us. We all want to protect kids’ health as much as you do; we in the mainstream trust scientific medicine to do it, just like we trust science when it comes to antibiotics and surgery and prenatal vitamins.

To those of us in the mainstream, who are far more likely to have read this post: it’s not us vs. them. It’s just us. They want to protect kids’ health as much as we do; they don’t trust science to do it, partly (but only partly) because of gurus selling fear like a product.

It doesn’t help to hate or fear or ridicule the people who follow these gurus. Nick Begich, another conspiracy theorist presenting at the conference, said something I really admire: when you confront an adversary, pull back far enough to recognize their humanity.

If you read this account and you want to do something about it, you can. Talk to your friends and family about immunizations. Tell them that you vaccinate, and why. If they don’t, ask them why. Do more listening than talking. Sympathize, and be sincere and respectful. Because it’s not us vs. them. It’s all us.

 

 

Update: Bronwen Dickey, who was on the ship writing for Popular Mechanics, reminded me that Seth Mnookin had a great take on this. While Deer might be Wakefield’s most prominent critic, the case against Wakefield’s research doesn’t rest on Deer’s shoulders. There has been an enormous amount of scrutiny of that research independent of Deer, so even if one didn’t trust his reporting it would be difficult to have faith in Wakefield’s conclusions.

Mnookin also made a point that I think is very important, even if anti-vaxers will find it extraordinarily difficult to accept: “From the day it was published, one of the major problems with Wakefield’s original work that researchers pointed to was that it relied on parents’ post-facto recollections to determine what had or had not actually happened. Those memories weren’t a suitable substitution for actual data then…and they’re not now, either.” An emotional case feels like a good substitute for a factual case, but it’s not.