Last Thursday, I expressed dismay about an upcoming NBC news special, A Dose of Controversy, which is about a man who arguably caused more damage to public health than just about anyone in the last decade, namely Andrew Wakefield. Anyone who’s a regular reader of this blog knows just what I think of Andrew Wakefield. I’ve made no secret of it; I have little but contempt for the man, whom I view as incompetent, dishonest, and a quack. Andrew Wakefield, as you may recall, is the British gastroenterologist who in 1998 published a study in The Lancet that claimed to find a link between the MMR vaccine and “autistic enterocolitis.” This study, aided and abetted by truly irresponsible journalism, launched a panic in the U.K. that is only now starting to abate. In the interim, measles, once thought conquered, has become endemic again in the British Isles. In any case, it matters not to the anti-vaccine movement that (1) his study was poorly designed and utterly refuted by later studies; (2) it was revealed that Wakefield received £435,643 in fees, plus £3,910 expenses from lawyers trying to show that the MMR was unsafe; (3) the PCR laboratory that Wakefield used was so poorly run that it apparently had no knowledge of the concept of a negative control; and (4) strong evidence has been revealed that Wakefield falsified data.

If there’s one thing that causes my teeth to grind almost as much as the thought of Andrew Wakefield on national TV, free to spew his pseudoscience, self-aggrandizement, and comparisons of his plight to that of Galileo, it’s the convention of “balance” in news stories. I’ve written extensively about this bogus false equivalence between pseudoscience and science, particularly regarding the vaccine/autism manufactroversy. One extreme example was a particularly execrable episode of an execrable TV show, The Doctors, in which the “tell both sides” mantra led to an infuriatingly inaccurate picture, in which the beliefs of anti-vaccine apologists like Dr. jay Gordon were treated as equivalent to those of scientists.

As I expected, the NBC special is cut from exactly the same cloth; it’s just that the seams don’t show as badly.

I don’t know what possessed me, but I considered it more or less my duty to subject myself to this nonsense. So I did just that yesterday evening, as NBC aired A Dose of Controversy. It was torture, but I do it all for you (and because it’s a quick blog post). I did it even though the site, much less the voice, of Andrew Wakefield, as Pink Floyd sang in The Wall, fills me with the urge to defecate.

Of course, I knew right away from the title of the broadcast that this broadcast was going to be a “tell both sides” crapfest right from the start. The reason, of course, is that politics is not medicine. In politics and many other controversies, there often are two sides with cases of similar validity. In such cases, it is critical to report both sides fairly and accurately. However, in science and medicine, the “tell both sides” mantra often grossly exaggerates the validity of pseudoscience when it’s a conflict between pseudoscience and science. That’s exactly what’s going on with the vaccines/autism “controversy,” because there is no medical controversy over whether the MMR vaccine causes autism or whether vaccines in general cause autism. Rather, it’s what we call a “manufactroversy,” or a manufactured controversy. It’s pseudoscience versus versus science, but Lauer et al starts out painting the story as that of the proverbial “brave maverick doctor” (Andrew Wakefield), who thinks he’s found a horrible result that the medical establishment does not want to acknowledge, which is why it tries to shut him down. Meanwhile, it has a horrible graphic between each segment that shows a vaccine being drawn up, with newspaper headlines and pictures of Wakefield flashing behind it.

The First half of the show is constructed as mainly “dueling interviews,” one with Andrew Wakefield and the other with Brian Deer, interspersed with brief clips that provide background and serve as exposition, right from the start setting up the false equivalence. It also sets up the “brave maverick doctor” against the dogged journalist. Who couldn’t love a story like that? In this case, I can’t. The broadcast did hit all the low points of Andrew Wakefield’s career, such as his conflict of interest, in which he was paid large sums of money for two years before his 1998 Lancet paper by lawyers preparing a class action suit against vaccine manufacturers; his being investigated by the General Medical Council; the infamous incident in which Wakefield got blood samples from healthy children at a birthday party and then later joked about two children fainting and one passing out; and the fact that several of the children in his study were plaintiffs in the class action lawsuit. However, it assiduously avoided the F-word (scientific fraud), and, worse, it set up the allegations in a he said/she said structure, in which Wakefield makes claims, which are then refuted; or Brian Deer describes the findings of his investigation, each of which Wakefield always has a glib explanation for.

Actually, if you want to get a feel for how this whole episode was done, there was the infuriating manner in which Lauer interviewed Deer. For example, he asked Deer, “In your opinion how much was Wakefield paid?” as though the number Deer came up with was, as Asimov so famously said about a “theory,” something Deer had “dreamt up after being out drunk all night.” Come to think of it, the word “theory” is bandied about referring to the hypothesis that vaccines cause autism; it always irritates the crap out of me how that word is misused because in science it is a term with a lot of certainty behind it whereas in colloquial usage it does often mean a “hunch” or an “idea.” Then Lauer repeats the offense by saying to Deer, “It’s your opinion that Wakefield was involved in the development of another vaccine,” again, as though Deer’s conclusions about Wakefield’s conflicts of interest were nothing more than mere opinion, no more or less likely to be valid than Wakefield’s assertions. It is a fact that Wakefield received £435,643 in fees, plus £3,910 expenses from lawyers trying to show that the MMR was unsafe, a matter of public record. Deer’s “opinion” has nothing to do with it. It is a fact that Wakefield had a patent application for a single dose measles vaccine filed before he published his Lancet paper. These are not matters of “opinion.”

Despite this, Brian Deer did get in some good zingers, for example:

  • “This thing stank from the day it appeared.”
  • “Wakefield was greedy, and that’s how I caught him.”

Best of all, after Lauer asked Deer, “Do you ever worry that Andrew Wakefield is right?” his response was an unquivocal “no.” Nor should he. Again, as Pink Floyd sang, the evidence is “incontrovertible.” At another point, when Lauer says:

LAUER: This back and forth between you and Andrew Wakefield has been going on a long time. It seems that Dr. Wakefield has an answer for everything you allege.

DEER: And the dog ate his homework. He’s always got a story…This guy sued me. I could have lost my home; I could have lost everything apart from what I’m wearing.

And about Wakefield’s suit having gone nowhere, Deer quipped, “I’ve got the check” (for Deer’s legal fees).

Paul Offit was also interviewed. He got in some good licks, too, describing how he had been threatened, how an anonymous caller had mentioned his children’s names, a clear threat that he knew who they were and where they went to school. He even admitted that there was one time when he considered giving it all up, and that was it. Still, when he wondered why parents listen to celebrities like Jenny McCarthy instead of scientists and physicians, he encapsulated every frustration those of us on the side of science have felt. That was the power and the problem. At times Dr. Offit came across as testy and angry. Now, far be it from me to criticize a man like Dr. Offit for being angry at what anti-vaccinationists have done to public health in this country, and I very much liked how uncompromising he was when he pointed out that the anti-vaccine movement has caused considerable harm. Unfortunately, the comparison with the unctuously calm demeanor of Andrew Wakefield does not work to Dr. Offit’s advantage. He was right about each and every canard of the anti-vaccine movement he shot down, but his passion came across a bit too angry.

Then, of course, there was Bernadine Healy. I’ve written about her having aligned herself with the anti-vaccine movement before. Here she does it again, big time, providing quotes that only J.B. Handley or Andrew Wakefield himself could love: “Scientists have to be listened to. I don’t think it’s terribly humble to say stop, we have all the answers, shut down the research”:

Visit msnbc.com for Breaking News, World News, and News about the Economy

Straw men that big are usually seen in the Burning Man every year, and Healy could be just the guy who sets it ablaze. No one has ever said that we “have all the answers.” What science says is that the evidence against the contention that vaccines cause autism is such that by any reasonable stretch of the imagination the hypothesis has been refuted.

Perhaps the most disturbing part of the show occurs near the end, when NBC went into Thoughtful House and followed parents of an autistic child through an endoscopy by Dr. Arthur Krigsman. Tim Kasemodel is interviewed about his son Thomas, who is shown being sedated so Krigsman can do both an upper and lower endoscopy on him. The cost is reported to be $4,500 out of pocket, not to mention the pain, fear, and distress to which Tom Kasemodel is subjected being subjected to a medical procedure that is almost certainly unnecessary. It’s very striking how all the trappings of scientific medicine are there, but none of the methodology. Indeed, Lauer inadvertently stumbled on just the issue:

LAUER: Based on your experience, have you made children better? Anecdotally do you have evidence?” Do they get better?

Wakefield, of course, responds in the affirmative. What Lauer should have asked Wakefield is whether he has randomized controlled clinical trials to support his belief that autistic children “get better” at Thoughtful House. He doesn’t, but pretty much every child they scope (85%, according to Dr. Krigsman) has “autistic enterocolitis,” even though, as in the case of Tom Kasemodal, Dr. Krigsman was hard-pressed to find abnormalities. (“Mild or softer findings,” he said about Tom.) Of course, on pathology, Thoughtful House pathologists apparently found “mild inflammation.” What did Krigsman prescribe? Lots of supplements, daily laxatives, and periodic colon cleansing. Can you imagine subjecting an autistic child to laxatives and colon cleanses? As far as I’m concerned, that’s child abuse, particularly given that there’s no scientific justification for it.

Sadly, A Dose of Controversy falls into the same trap that so many media examinations of pseudoscience fall into. It applied the journalistic convention designed for stories about politics, legal matters, and other human conflict to something it’s not well-suited for, the battle between pseudoscience and science. In doing so, it gives the impression that there is actually far more to the pseudoscience than there in fact is. Even worse, it dollops onto that convention another cliche, namely the iconoclast, the rebel, the “brave maverick doctor bucking the system against who the system stands united. Pile it all together, and it was a huge missed opportunity. Two statements illustrate this well, both occuring near the end of the report. First Lauer describes Wakefield as a man who will listen to these parents, respond to them, and stand up for them, while Wakefield says, “I don’t know if vaccines cause autism. I know it’s a question that needs to be asked and I’m not going to walk away from it.”

I predict that the phones at Thoughtful House will be ringing off the hook this week. I guess I should be grateful that, for whatever reason, Jenny McCarthy wasn’t interviewed for this report.

Comments

  1. #1 Jay Gordon, MD, FAAP
    September 7, 2009

    The thread winds down. OK, I’m sure there’ll be another equally interesting discussion about this soon.

    Trrll, Todd W and many of the rest of you speak with absolutely no experience or compassion. As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

    The connection between vaccines and benefit to children is not questioned by me or by most of my colleagues who are ambivalent about the current vaccine schedule.

    The connection between vaccines and harm to children is also supported sufficiently to merit a lot more lightand a lot less heat. Think harder about what it’s like to be a doctor with this much experience.

    Best,

    Jay

  2. #2 Dedj
    September 7, 2009

    I’m amused by Dr Jays post, but not as much as I will be by the ass-handing that’s about to commence at his expense.

    Lay it on, I say, lay it on.

  3. #3 flim flam
    September 7, 2009

    Yet again for dr’r Jay and e, where is the evidence?.

    if all these children are dramatically regressing within hours of their vax’s you’d really think someone other than anti vax propagandists would have noticed.
    Confirmation bias anyone?.

    Am i the only one getting a bit tired of the “i’m not anti vaccine but… ( insert- too many too soon..dr bobs selective schedule..green our vax etc)” schtick?
    and jay, you go on about your “experience”, but where the hell is your knowledge?. “i feel” and “i believe” don’t cut it here.
    Perhaps you could explain to the parents of the little boy in the UK who died of complications caused by chickenpox how dangerous vaccines are?.

    http://www.dailymail.co.uk/health/article-1210300/chicken-pox-killed-son-How-little-boy-died-just-weeks-spots-appeared.html

    9 chidren died in the UK from chickenpox in 2007.

    (you know, harmless chickenpox that the nutters at MDC all want their kids to get) Too many too soon?. not enough , soon enough for the poor little boy. A fair few dead babies over here in Oz due to the drop in whooping cough vax take up too, but again, the vax is worse right?.
    better a dead kid than an autistic one….right dr jay?

    best..
    best you actually start looking at the evidence rather than making decisions based on your “feelings”.
    This is real life Dr jay, kids are dying because of the anti vax propaganda shills like yourself.

  4. #4 Joseph C.
    September 7, 2009

    As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

    That argument makes little sense. Assuming this was such a common phenomenon, science would have no trouble finding the connection.

    Think harder about what it’s like to be a doctor with this much experience.

    It’s funny you mention this since it’s well-established that older docs (aka “this much experience”) are massively prone to bias.

  5. #5 Todd W.
    September 8, 2009

    @Jay Gordon

    Since you didn’t bother answering my question, here it is again:

    What evidence do you have that brings you to the belief that vaccines “trigger” autism? Further, at what rate do you believe this happens?

    Still waiting. And I’ll ignore the “lack of compassion” BS.

  6. #6 Jen
    September 8, 2009

    @flimflam:
    “Perhaps you could explain to the parents of the little boy in the UK who died of complications caused by chickenpox how dangerous vaccines are?.”

    ‘But the receptionist told me a home visit wasn’t necessary and that I should give him a cool bath and some Calpol.

    “But the doctor simply prescribed antibiotics and said I should carry on giving him Nurofen

    What parents need explained to them is how dangerous it is to administer antipyretics to an already immune-suppressed child, or even a healthy child, for that matter. (My goodness, how our species managed to evolve without the use of antipyretics is beyond my comprehension.)

    Fever is not the enemy!

  7. #7 Phoenix Woman
    September 8, 2009

    Flim-Flam’s talking about deaths from chicken pox and you respond by nattering away about Don’t Fear The Fever (hey, wasn’t that a Blue Oyster Cult hit?). Nice goalpost-shifting, Jen.

  8. #8 the bug guy
    September 8, 2009

    Dr. Gordon,
    Compassion is exactly the reason so many here stand up in support of vaccination and against those that oppose it.

  9. #9 Scientizzle
    September 8, 2009

    Dr. Jay @ #201: …there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence.

    Quick exercise in basic math and the null hypothesis, Dr. Jay:
    1. Null hypothesis: no temporal link exists between vaccination and onset of autism symptoms because no causative link exists between vaccination and the etiology of autism.
    2. How many vaccination visits does an average child have between 18 and 36 months of age? We’ll call this variable NV.
    3. What proportion of children have diagnosable autism spectrum symptoms by the age of 36 months? We’ll call this variable P.
    4. What is a sufficiently close temporal association (expressed in months) of “regression” symptomology following vaccination make it most plausible that a vaccination event was a likely “trigger” event for the regression? We’ll call this variable T.

    If the vast majority of autism diagnoses are made between 18-36 months of age (correct me if I’m wrong), then chance alone would predict that in this 18 month period of development, approximately P*[NV*(T/18)] percent of children would have a temporal association that meet the defined criteria.

    Put in numbers that are reasonable, say NV=2, T=1 mo. Therefore P*(1/9) of all children would be hypothesized to have a temporal association between ASD diagnosis and vaccination within that time frame. If NV and/or T increases, that associated fraction increases: e.g., if NV=2.5, T=1.5 mo., a full quarter of all diagnoses appear temporally associated. Even if T is decreased to 1 week or one day, NV=2 predicts approximately 1/40 to 1/270 — a small but significant fraction — of all regressions will appear in very close proximity to a vaccination event by chance alone.

    That gives us a general idea of what would need to be studied. If the null hypothesis is to be discarded, one would need convincing evidence that the onset of regression symptomology is significantly higher in the defined period following vaccination than prior to vaccination or sufficiently after vaccination. The first level of evidence–the low-quality anecdotal evidence–is only sufficient to identify that this may be worth studying…it is only sufficient this far because of the natural, very often mistaken, human tendency to interpret causation with only correlation; the additional confound of confirmation bias no doubt reinforces this notion as self-selected populations commiserate in various fora.

    What would produce more compelling evidence? Retrospective analyses and case-control studies can be performed to evaluate the onset of diagnosable symptoms (e.g., PMID 14754936 & 15364187, which found no temporal link between MMR vaccination and ASD diagnosis). The most convincing evidence would come from a prospective study, but that would necessitate comprehensive monitoring over the entire test period and a very large number of children (due to the small proportion of children that would be expected to be diagnosable within a reasonable time-frame), so it’s probably not feasible from a time, money, or workload standpoint nor currently justified from a foundational science perspective.

    So…tell me Dr. Jay, what evidence beyond anecdotes (yours and others) suggests that there is a real incidence of vaccine-induced regression? I don’t discount the possibility that there is a causative relationship; however no reliable dataset yet supports such a hypothesis. It’s entirely reasonable, in my opinion, to consider “coincidence” as a probable explanation for a large fraction of ASD diagnoses said to be temporally associated with a vaccine event.

    I see no reason to reject the null hypothesis, yet, in this case. On the other hand, with the increases in morbidity and mortality associated with vaccine-preventable illnesses, I do see a reason to reject what appears to be bad advice regarding the delay or avoidance of vaccination based upon the current data.

  10. #10 Jen
    September 8, 2009

    “Flim-Flam’s talking about deaths from chicken pox and you respond by nattering away about Don’t Fear The Fever (hey, wasn’t that a Blue Oyster Cult hit?). Nice goalpost-shifting, Jen.”

    Excuse me? No goal-post shift here. I propose that this child might not have died had his body not been bombarded with pharmaceuticals, antipyretics in particular. (I assume you’ve read some of the studies linking use of NSAIDS during varicella infections to an increased risk of developing secondary bacterial infections?)

    Where’s the evidence that shows that the benefits of fever suppression outweigh the risks?

  11. #11 Scientizzle
    September 8, 2009

    Dr. Jay @ #201: [many of you] speak with absolutely no experience or compassion.

    Regarding “compassion and experience,” Dr. Jay is making a fool of himself. A significant portion of the posters in this forum have ASD children and/or are themselves on the spectrum; I doubt Dr. Jay knows the relevant details of more than a few of those he might paint as without passion or experience. (This is similar to the recent thread in which Dr. Jay tried to broadly tar the posters here as corporate shills, paid to post on RI by Big Pharma.) This assertion is presumptuous, factually inaccurate, and dripping with condescension.

    Dr. Jay, for the sake of argument, let’s presume that you are quite possibly the most compassionate man in the world on the subject of vaccines and autism. Does that compassion mean in any way that you are more likely to be “right” about the medical question discussed here? No. In fact, the scientific method you seem to readily dismiss over and over is decidedly dis-passionate out of necessity. Those too emotionally attached to a particular outcome are the ones that too-often into pseudoscientific crankery when they refuse to let go of their un-supported beliefs. Compassion may be great for the bedside, but it doesn’t help understand scientific facts.

    Your experience (Think harder about what it’s like to be a doctor with this much experience) has been covered many times in these pages, and appears to be your greatest strength and a glaring weakness. You have seen a lot of patients first-hand, but you actually seem to lack a big-picture view; that is, you can’t zoom out from your clinical practical experience to truly assess whether your “gut feelings” extend to the population at large. You see an increasingly self-selected population (as your fame grows in the anti-vax crowd, they come to you), rely primarily on evidence in the form of anecdotal experience (which is the lowest quality evidence), and are repeatedly dismissive of the scientific method in general and those who promote it (Pound your keyboards about science as much as like).

    Dr. Jay, think harder about what it’s like to be a doctor with your experience and how entirely likely it is that you’re falling prey to the cognitive biases that affect every one of us, biases that are only reliably countered by systematic scientific analyses. Then, think harder about how understanding objective reality requires some careful and dis-passionate analysis of the facts at hand. Finally, think harder about how your smarmy, self-righteous statements undermine your constant pleas ’round these parts for people to be nicer to you and for greater civility in discourse.

  12. #12 Jay Gordon, MD, FAAP
    September 8, 2009

    Scientizzle, excellent posts. The first is a great refresher course for me and I appreciate it.

    The second is offensively worded but reminds me that I have to keep an open mind to the possibility that I am prone to selection bias, as you point out.

    The most interesting part of your posts posits that many people writing here are on the autism spectrum. I have thought about that, too. What do you think the implications might be?

    Best,

    Jay

  13. #13 trrll
    September 8, 2009

    Trrll, Todd W and many of the rest of you speak with absolutely no experience or compassion. As EJB has pointed out, there are many, many children who regress after being vaccinated and the number long ago rose beyond anything a scientist–or a smart compassionate layperson–could possibly call coincidence. Pound your keyboards about science as much as like.

    I guess I don’t understand the meaning of the word “compassion.” I thought that it meant empathy for the suffering of others. Like the way I feel for parents who are led by doctors such as Jay Gordon to believe that their child’s autism is their fault for allowing their child to be vaccinated and exposed to “toxins,” such as the formaldehyde that Dr. Gordon so foolishly believed to be a dangerous contaminant of vaccines (apparently, his experience does not include recollection of basic biochemistry).

    But based upon Dr. Gordon’s comment, I guess that “compassion” must really mean “absence of skepticism regarding unsupported post hoc ergo propter hoc arguments.”

  14. #14 Dedj
    September 8, 2009

    The first is NOT ‘a refresher course’ for you Dr Jay, if you truly were competantly aware of the concept it would not have required explaining to you.

    The second is offensively worded……and totally unaddressed by Dr Jay. Dr Jay needs to be reminded at this point that you need to address the substance of a persons post.

    “I see you made a post – well done” is NOT a sufficient rebuttal of the numerous errors of logic pointed out by Scientizzle.

    In short, it was a “”smarmy and self-righteous” dodge, and a insultingly obvious one too.

    Have the decency to address the numerous concerns raised Dr Jay or don’t bother to waste our time. If you want more civility then you might want to start by being a lot less blithely condescending in your replies.

  15. #15 Todd W.
    September 8, 2009

    Jay Gordon appears to have difficulty answering questions. He still hasn’t answered mine, either.

    What evidence do you have that brings you to the belief that vaccines “trigger” autism? Further, at what rate do you believe this happens?

    And, in terms of the NBC special, what evidence do you feel was presented to support Wakefield’s contention that vaccines are involved.

  16. #16 MI Dawn
    September 8, 2009

    Jen: just one small argument. People have been using antipyretics for hundreds of years. The first documented use by a physician was in 1763. Although Aspirin was first patented in the late 1800’s, if you read any of the old herbals, they will discuss the use of willow and other plants in the Spirea family. The active ingredient of a tea made from the Spireas is salicylic acid. Aspirin is simply a buffered, purified version (leading to more uniform dosage and fewer problems with toxicity).

    So, antipyretics have been used for many generations, and we humans evolved quite well with their use.

    That being said, I agree partially with you. I think parents are too prone to using antipyretics when they are not needed (although I don’t agree with you regarding their part in autism).

    Many parents are afraid of fevers (one friend of mine – who actually is, like me, a nurse – verbalized she was afraid of her child’s brain melting…and yes, she was serious). I usually based my usage on how the child was acting. Normal behavior and a fever: leave alone, encourage fluids, monitor. Abnormal behavior (lethergy, unusual crankiness, fluid refusal) I would give antipyretics for.

  17. #17 Scientizzle
    September 8, 2009

    The most interesting part of your posts posits that many people writing here are on the autism spectrum. I have thought about that, too. What do you think the implications might be?

    I have seen several of the “regulars” around here mention that they are on the spectrum. I cannot presume to speak for anyone’s opinions but my own, but I have heard enough comments from many in the autism community to feel confident that a significant portion of them would agree with a statement along these lines:

    Research into the etiology of autism is very important. Vaccination, specifically the MMR vaccine and the preservative thiomersal, was hypothesized to play a role in the development of autism by some hypothetical concerns and preliminary data. These were not unreasonable hypotheses to test. Extensive studies were performed regarding MMR & thiomersal, which in toto do not support the hypotheses of either as a causative agent. Furthermore, much of the earlier work appearing to support these hypotheses has also been found to be terribly flawed and/or likely fraudulent. In the mean time, genetic studies have progressed and there is greater confidence in the hypothesis that genetics plays a substantial role in the etiology of autism.

    Unfortunately, many have refused to accept the best science rejecting the MMR & thiomersal hypotheses, are ignorant of those findings and/or deliberately misinformed. The goalposts have also been shifted to far less-tractable claims (too many, too soon; generic “toxicity”), and demands continue for further studies, absent substantive increases in the veracity of the evidence supporting a vaccine-ASD link. This is fueled by irresponsible practitioners, within medicine and within CAM, that continue to promote these fears…

    This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortality. ASD children are still subjected to treatments, some dangerous, with insufficient evidence of efficacy or prior plausibility (e.g., chelation, anti-fungals). Research efforts and funding, not to mention public relations and education man-hours, are diverted away from avenues more likely to bear fruit in the efforts to continue a wild goose chase seeking some vaccine-related effect.

    Thus, many in the autism community are frustrated that autism research and awareness have been co-opted by a distinctly anti-science crowd, at the expense of public health, on the basis of low-quality evidence. They also dislike the hyperbolic message purveyed by many anti-vaccinationists that ASD patients are (vaccine-) damaged goods.

    Those are the implications, in my opinion.

  18. #18 Chris
    September 8, 2009

    You all should really not feed the “Sid Offit” troll. Even though s/he/it has finally written about a child, I am still convinced that in trying to that s/he/it is a better parent than the rest of us by announcing that there has never been food on her/his/its floor s/he/it admitted to never having any children. S/he/it is immune to logic, and will never provide the real evidence that is demanded.

    The same goes for Sue (who posts the fact free insults with various names like “The Hypocrisy!! It Burns!!!”), who does have children. Though her children do not have autism but diabetes and celiac (“celiacdaughter” is a hint), she has been posting the same kind of nonsense for years.

    The same for for Dr. Jay.

    By the way, “Dr.” EJB you should really start documenting all those kids in your practice that come down with autism after vaccination. Actually use your very well written notes on their development and put it into a paper, even if it takes you five years to come up with a sufficient amount of data. Something along the line of An office-based prospective study of deafness in mumps.

    Now remember: The science has been done, the link between vaccines and autism does not exist. It is a dead link… “It’s not pinin’! ‘It’s passed on! This link is no more! It has ceased to be! It’s expired and gone to meet its maker! It’s a stiff! Bereft of life, it rests in peace! If you hadn’t nailed it to the perch it’d be pushing up the daisies! Its metabolic processes are now ‘istory! It’s off the twig! It’s kicked the bucket, it’s shuffled off its mortal coil, run down the curtain and joined the bleedin’ choir invisible!! THIS IS AN EX-LINK!! ” (hat-tip to Monty Python and the dead parrot sketch)

    Here is some reading for “givemethetruth” (perhaps “Sid Offit” and the two pediatricians could produce equivalent data), take note the author of the first paper had written a paper about “autistic mice”:
    Lack of Association between Measles Virus Vaccine and Autism with Enteropathy: A Case-Control Study.
    Hornig M et al.
    PLoS ONE 2008; 3(9): e3140 doi:10.1371/journal.pone.0003140
    *Subjects: 25 children with autism and GI disturbances and 13 children with GI disturbances alone (controls)

    Measles Vaccination and Antibody Response in Autism Spectrum Disorders.
    Baird G et al.
    Arch Dis Child 2008; 93(10):832-7.
    Subjects: 98 vaccinated children aged 10-12 years in the UK with autism spectrum disorder (ASD); two control groups of similar age: 52 children with special educational needs but no ASD and 90 children in the typically developing group

    MMR-Vaccine and Regression in Autism Spectrum Disorders: Negative Results Presented from Japan.
    Uchiyama T et al.
    J Autism Dev Disord 2007; 37(2):210-7
    *Subjects: 904 children with autism spectrum disorder
    (Note: MMR was used in Japan only between 1989 and 1993.)

    No Evidence of Persisting Measles Virus in Peripheral Blood Mononuclear Cells from Children with Autism Spectrum Disorder.
    D’Souza Y et al.
    Pediatrics 2006; 118(4):1664-75
    *Subjects: 54 children with autism spectrum disorder and 34 developmentally normal children

    Immunizations and Autism: A Review of the Literature.
    Doja A, Roberts W.
    Can J Neurol Sci. 2006; 33(4):341-6
    *Literature review

    Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links with Immunizations.
    Fombonne E et al.
    Pediatrics. 2006;118(1):e139-50
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  19. #19 Jen
    September 8, 2009

    “Many parents are afraid of fevers (one friend of mine – who actually is, like me, a nurse – verbalized she was afraid of her child’s brain melting…and yes, she was serious).”

    Your anecdote about your friend illustrates just how pervasive “fever phobia” really is, even among us nurses who should know better!

    Fevers can indeed be very scary, especially if your child is prone to febrile seizures. My younger son had his first one only a couple of weeks ago, and even though it lasted just a few seconds, and I knew it would cause him no lasting harm, it was still scary as hell to watch, nonetheless. An hour later, though, the fever was completely gone and he was up and playing like nothing had happened.

    Most of the time, I think parents use antipyretics to make themselves feel better; to feel like they are doing something, when in reality, it would be better to do more nothing.

  20. #20 Jay Gordon, MD, FAAP
    September 8, 2009

    Thank you, Scientizzle.

    Trrll, formaldehyde was never in vaccines in an amount proven to hurt children and I was uninformed whenever I said it was.

    Todd, you’ve been here a while and so have I. I have no proof of the connection between vaccines and autism and I’ll say that as often and in as many ways as you need. I rely my experience and observations. Create any hierarchy of science that appeals to you but in mine, this counts for a lot.

    Dr. Wakefield’s study was not sufficient to prove anything either. I think he could be criticized but not vilified for conflict of interest.

    Jay

  21. #21 Todd W.
    September 8, 2009

    @Jay Gordon

    I have no proof of the connection between vaccines and autism and I’ll say that as often and in as many ways as you need. I rely my experience and observations. Create any hierarchy of science that appeals to you but in mine, this counts for a lot.

    I haven’t been a regular reader for all that long, actually. I was interested in whether you actually had actual evidence that suggested to you that vaccines cause autism. I take this statement to mean that, despite lacking any actual evidence, you choose to believe that vaccines might still play a role.

    So, a followup question: what efforts have you made to determine whether or not you are correct in your anecdote-based hunch?

    As to Wakefield, the conflict of interest issue, I feel, is one of the least of the problems with his study and his conduct.

  22. #22 trrll
    September 8, 2009

    Trrll, formaldehyde was never in vaccines in an amount proven to hurt children and I was uninformed whenever I said it was.

    “Uninformed” is putting it mildly. That’s like saying that somebody who thinks that babies are brought by the stork is “uninformed.”

    More accurately, you were lacking very basic biochemical knowledge–knowledge that anybody who presumes to put “MD” after his name should have acquired in medical school, if not before. I knew instantly that it was bullshit, and I expect most of the people who frequent this blog knew it. How did we know? Because we knew that formaldehyde is a product of intermediary metabolism, and we knew that the volume of a vaccine injection is very small compared to the volume of the body. Basic reasoning.

    I am frankly amazed that somebody who would make an error this elementary–and as the result of this error contribute to spreading fear, anxiety, and guilt to parents of autistic children–would still have the incredible hubris to pontificate about how his “compassion” and “experience” enables him to magically distinguish between a causal relationship and the mere coincidental relationship of two things that are known to independently occur at about the same time. Compassion and experience are all very fine, but they are no substitute for good sense and critical thinking.

  23. #23 Sid Offit
    September 9, 2009

    @trrll
    Offit’s vaccine saves millions? Are you serious?

    @Chris
    Thanks for all the MMR and mercury studies. The economic analysis studies were also quite informative – although entirely irrelevant to the discussion. To bad you couldn’t find anything on vaccines in general.

    @Scientizzle

    [This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortaliy

    What are you talking about? Vaccination rates are at all time highs.

  24. #24 Todd W.
    September 9, 2009

    @Sid Offit

    [This has produced an unfortunate situation in which vaccine uptake has fallen, leading to a corresponding rise in vaccine-preventable morbidity and mortaliy

    What are you talking about? Vaccination rates are at all time highs.

    Antivax fear-mongering leads to pockets of reduced vaccine uptake. For example, in the U.K., after Wakefield published his study and gave press releases suggesting a link between MMR and autism, vaccination rates for the MMR plummeted, leading to a surge of measles cases. A disease that was once on the decline, there, is, sadly, now endemic once again.

    Similarly, California has seen pockets of measles outbreaks due to decreases in vaccination rates. In the Midwest, there were a couple small outbreaks of HiB, resulting in at least one death. In Australia, there have been outbreaks of pertussis, again due to antivax fear-mongering.

    Those are the types of things to which Scientizzle was referring.

  25. #25 Chris
    September 9, 2009

    Sid Troll:

    To bad you couldn’t find anything on vaccines in general.

    That is because you refuse to read the epidemiological studies, and you are always moving the goalposts. Just like Sallie Redwood who participated in the design of a study, but decided to denigrate it because it did not come out with the results she wanted. Like her you have blinders that prevent you from seeing what you do not want to see.

    You are intellectually dishonest, and cannot engage in honest debate. Especially when you chose to ignore that vaccination rates have declined in certain populations that have resulted in outbreaks in those groups. These are usually include schools with like thinking families (like the charter school in San Diego, CA and the parochial school in Grant Co., WA).

    Again, this is a dead debate. Vaccines have been studied, and the limited funds available for real research needs to move on to other areas. Go find another hobby.

  26. #26 Prometheus
    September 9, 2009

    A correction for Chris’ comment above (#225) – it was Sallie Bernard who bitterly denounced the NIH study of thimerosal and neurological disorders after having been a part of the group designing the study.

    As Chris states, Ms. Bernard waited until the results were in (and didn’t support her beliefs) to criticise the study design. To be credible, she should have protested the study design before she knew the results.

    Like Ms. Bernard, “Sid Offit” has fixed beliefs about the subject of medicine in general and vaccines in specific. As a result, “he” cannot accept data that is contrary to “his” immutable dogma.

    They should both be more pitied than scorned, although it is hard not to scorn them. The “arrogance of ignorance” is strong with them both.

    Prometheus

  27. #27 EJB
    September 9, 2009

    Chris: “Dr.” EJB you should really start documenting all those kids in your practice that come down with autism after vaccination. Actually use your very well written notes on their development and put it…”

    I thought I had no other comments, but your interpretations are off. I never said I had ‘many many’ cases (that was Dr Jay’s misquote). To the contrary, I said we had less than the average total cases and very few immediately after vaccination. I was referring to the cases over a 21yr span that showed profound regression and which did not, in my medical opinion (experience answered below), warrant the explanation of ‘just a mere coincidence’ to the parents. There are the few bodies that don’t follow the list of side effects and research, and they react to all kinds of medications for whatever underlying reason they may have. I was reviewing through each year, case after case, but did not say ‘many’. Actually, I went out of my way to say that compared to the national average, we have seen less autism cases and have not seen the rise in the last 10-20yrs even with strong recommendations for vaccination. The risk for a preventable disease in that same sensitive individual is higher, so vaccine is definitely recommended. Also, the ‘notes’ to which you refer, were just my constantly updated information about research and safety of vaccines that I share with parents (2 links which I recently received from trll and Todd). Please get your quotes correct.

    hi Todd: “Again, I’ll ask: have you been trained specifically in the diagnosis of autism?”

    Sorry you had to ask twice…I seldom have my husband’s laptop(problems with mine), and I knew my answer would be long. I didn’t think you would be content with a simple “yes”. I specialized in Developmental Pediatrics, trained in neurodevelopmental disabilites, continue to attend and teach inservices and workshops to teachers, military healthcare providers at the base nearby, early intervention, and parents. I am part of a team for final diagnosis in all children screened with autism which consists of but not limited to; a second devel pediatrician, neurologist, clinical psychologist, speech eval, and structured observation. We are able to rule out several other conditions and disorders and not just diagnose all neurodevel disabilities as autism. The decrease in false + is probably why we have less than the avg cases, and we haven’t seen a dramatic rise in new cases because we have been diagnosing the lower spectrum cases for years. In addition, I have probably learned more from my life experience with child behavior and development than from my medical training. By the time I was 10, I was helping raise 8 younger siblings. 4 of which were adopted and had varying levels of developmental delays. Later, 2 were diagnosed with autism, 1 had hydrocephalus and 1 was diagnosed with hemi-paresis due to stroke.(fyi to the anti-vax, they were not vaccinated before adoption and they still had delays due to autism even 28 yrs ago, with or without the name). I was my mom’s sole help for playmate, teacher, daily therapist (followed orders) sport coordinator, feeder, bather, and observer for all my siblings. I worked at a preschool/daycare for typical and devel delayed children in high school and undergrad. I continued working and volunteering in children centers through my residency. Finally, as I mentioned before, I have 7 of my own children plus 2 grandchildren. I have a well trained eye for typical and non-typical developing children that goes way beyond what you just learn in school and ped practice. I am sorry I did not give more history on the singing 2yo whose mother is the high school drama teacher and has siblings that are performing singers… and the car playing boy who always used to kiss the receptionist after she gave him paper and crayons to draw a picture for our waiting room. I used them as an example because they specifically did not have any ‘red flags’. As I mentioned, even the interviews, observations, evaluations and reviewed videos did not invoke suspicion from our panel. However, these particular children did have a cousin and uncle, respectively, with autism. The relatives are very low on the spectrum compared to these children, and they are both over 35. Currently, they both have typical siblings and one autistic sibling as well as relatives further removed diagnosed with autism. I have had discussions with their providers since they moved out of state to share information of ongoing studies that are trying to isolate genes and the different influences on gene expression.

  28. #28 Todd W.
    September 9, 2009

    @EJB

    Thanks for answering my question about your training and experience.

  29. #29 Jay Gordon, MD, FAAP
    September 9, 2009

    @trrll

    ‘ “Uninformed” is putting it mildly. That’s like saying that somebody who thinks that babies are brought by the stork is “uninformed.” ‘

    Formaldehyde is present in vaccines. As you well know, it’s part of the manufacturing process. The trace amounts found in an individual vaccine are probably harmless.

    I have a scientific question for you, a propos your response to my innocuous post: Why do you feel the need to respond like someone completely lacking in civility? Please take your time in formulating an answer. My guesses will come later.

    Jay

  30. #30 Chris
    September 9, 2009

    Prometheus:

    A correction for Chris’ comment above (#225) – it was Sallie Bernard who bitterly denounced the NIH study of thimerosal and neurological disorders after having been a part of the group designing the study

    Oops, thanks for the correction. I am always getting them mixed up.

    Dr. EJB, I also apologize for misunderstanding how many chldren seemed to change after vaccination. But you should understand that the plural of anecdote is anecdotes, not data. It read like it was enough to catch your attention, because you said:

    Even if I only counted the children who were developing normally until 1 to 7 days after vaccination, there are too many cases to simply call it a coincidence.

    …. but if the numbers are very small and the children were actually susceptible to any medication, then there really is no real correlation to claim that vaccines are associated with the development of autism (you can see that there is data in more than one country, and there was no real association between vaccines and autism: Safety of Thimerosal-Containing Vaccines: A Two-Phased Study of
    Computerized Health Maintenance Organization Databases
    … and one can be certain these children also received the MMR, but there are also studies for MMR that have been done in the UK, Denmark, Japan and Finland).

  31. #31 trrll
    September 9, 2009

    I have a scientific question for you, a propos your response to my innocuous post: Why do you feel the need to respond like someone completely lacking in civility? Please take your time in formulating an answer. My guesses will come later.

    Oh, now we have the “ooh, you’re mean” defense. Sorry that I don’t have a great deal of sympathy or respect for somebody whose ignorance of elementary biochemistry has led him to participate in the “toxin” fear-mongoring that not only puts children at risk of death and disability from vaccine-preventable diseases, but also encourages parents of autistic children to feel guilty for having vaccinated their children.

    I don’t think there is really any excuse for a physician to be this ignorant of basic biology, but in any case, it would have taken a reasonable person no more than a few minutes of internet research to determine that it is absurd to worry about formaldehyde in vaccines. That you would presume to speak with the authority of a physician (as you sign your posts with MD) without bothering to do this basic due diligence strikes me as gross irresponsibility, for which “I was uninformed” is a wholly inadequate apology.

  32. #32 Justice
    September 11, 2009

    EJB “yes, as I mentioned, I have seen cases of regression that did not occur around the time of vaccination, but not one of those cases regressed that drastically within hours. Yes, that is the usual age, but that is not the usua”

    How convenient for your conscience that only the children with drastic autistic regression close to the time of vaccination bothers you. Since you obviously recommend vaccination and most of your patients are vaccinated, then I assume that most of your autistic patients have in actuality been vaccinated since birth. I guess the fact that they have received several vaccines before their diagnosis of autism doesnt matter to you as long as the neuro-inflammation doesnt show right away?? As you said, some specific cases are sensitive to medications and vaccines. Maybe we are ALL sensitive, but in some it shows right away, some later, and some never. It doesnt mean the vaccine damage isnt there just because it wasnt seen. I hope you sleep well at night.

  33. #33 Ramel
    September 11, 2009

    Does justice have a coherrant point, or am I just really tired?

  34. #34 Chris
    September 11, 2009

    Justice, EJB later said “Actually, I went out of my way to say that compared to the national average, we have seen less autism cases and have not seen the rise in the last 10-20yrs even with strong recommendations for vaccination.”

  35. #35 Justice
    September 12, 2009

    233 234 My point was that since almost every patient of Dr EJB’s is vaccinated, and they have seen cases of autism, maybe the vaccines had something to do with ALL of them. Why only be concerned with the ones that react within minutes? The vaccines could have triggered the autism in all of them whether it took longer to show or not. The studies you continue to link to, cannot isolate who is sensitive or not. NONE of your studies check for when children were given all the vaccines, while also being exposed to possible environmental neuro triggers, and all the possible prenatal triggers etc all in those first years of life. Apparently, several children on this earth might have genetic tendencies for autism, so we need to find all possible triggers. That is why even children that have not been vaccinated can still have autism, because it is the total amount of triggers which can influence the genes for autism. Vaccines are just part of the big picture for some. But, given that they do cause neuro inflammation, they are definitely a trigger in those cases of autism.

  36. #36 Chris
    September 12, 2009

    Justice, you still make no sense. Most of the large epidemiological studies included children who were fully vaccinated according to the schedule of that time.

  37. #37 Ramel
    September 12, 2009

    Right, so you were just talking out of your arse then. Good to know, thought it was me failing to understand you for a bit there.

  38. #38 Justice
    September 12, 2009

    You are a bunch of idiots living in complete denial. You will still be in denial the day you die, and they will autopsy your brain and find the measles virus from your vaccine 30-40yrs ago, and all the aluminum plaques that caused your alzheimers, and all the evidence of a life of inlammation. Maybe that is why you are so obviously stupid now. You probably have stupid kids too. That is also genetic. Nothing but a bunch of stupid people passing on their damaged dna from a lifetime of exposure. May all you liars rot in hell.

  39. #39 Dedj
    September 12, 2009

    If any of what Justice said was true, they’d be able to provide undeniable real world evidence of people that it has happened to now.

    Nothing speaks louder than the absence of evidence where evidence should be abundant.

    Have a nice life raging at everyone that disagrees with you.

  40. #40 Justice
    September 12, 2009

    Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that. You can disagree on your demented way to the grave. Actually, maybe this memory will come back to you as you go. bye bye

  41. #41 Chris
    September 12, 2009

    Justine:

    Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that.

    Evidence works better than argument by assertion. Evidence also works better than a string of insults.

  42. #42 Dedj
    September 12, 2009

    “Those are some actual findings in pathology reports of people’s brains. You cant get any more real than that”

    You’ll have no problem referencing them then.

    Toodle off and don’t come back until you have a peer-reviewed journal article or two that expressly link public vaccination caused aluminium plaques to alzheimers.

    Not, high-alu exposure linked to a minority of alzheimers.

    Actual vaccination induced aluminium plaques causing alzheimers.

    My guess is we won’t be seeing you again.

    No major loss there. Enjoy hating everyone that disagrees with you. I’m sure you’ve made lots of friends doing that.

  43. #43 Ramel
    September 12, 2009

    There’s something about the crazy ones that never fails to entertain.

  44. #44 Justice
    September 12, 2009

    Those medical records are not available to the public. I see the damage first hand at my job. So you go ahead and make yourself feel better by continuing to deny. Those little links to research have nothing to do with you and they wont help you. The only crazy thing is how some people continue to live in denial. No matter how many arguments you come up with, it wont save you. I never disagreed with anybody, I told you what I see and know first hand, you have the problem with it.

  45. #45 Chris
    September 12, 2009

    The measles vaccine has been available since the early 1960s. The mumps and rubella came out in the late 1960s. All three were combined in a vaccine which was approved for use in 1971. If you have evidence that the MMR causes more problems than those three diseases, please present your evidence (secret knowledge not allowed, limit yourself to stuff on PubMed, but not Medical Hypotheses).

  46. #46 Dedj
    September 12, 2009

    Nobody asked for the medical records.

    Researchers can ask to look at anonymised medical records and then produce work based upon thier observations. This can be checked by other researchers at other centres, who can look at similar medical records locally.

    All of this can be done without releasing any medical record to the public, can be done respecting confidentiality to the deceased and family, and can be done without breaching ethics.

    So, your assertion that you ‘see it first hand’ is pretty much worthless unless you can provide some substance to it.

    You were told not to come back until you had done so. Deny your complete failure as much as you want, you have still failed to provide any reason to believe that you hold the position you allude to, much less that you see what you claim.

    Pony it up and stop pretending that your say-so matters.

  47. #47 Ramel
    September 13, 2009

    Exactly what part of show your evidence is hard to understand?

    I see the damage first hand at my job.

    You don’t even say what your job is, why would you expect us to take you seriously when all you do is make vague references to the source of your ‘knowlege’ without any detail or supporting evidence?

  48. #48 Cooler
    September 13, 2009

    @jaygordon
    Don’t worry about anything TTRL says, the guy is a deranged loser. He’s just a nut that can’t think and so are his pals. We debated HIV and I Kept asking him to describe the papers he read that proved HIV was a fatal disease that Justified AZT’s release in 1987, all he could do is spam a website, something that would him laughed out of a classroom or courtroom.

    Now the moron Ttrl is complaining about how anecdotal correlations were parents and doctors swear their kids got autistic right after the shots are irrelevent, but uncontrolled half assed correlations where the cause and effect are seperated by 10-30 years (HIV and Hepatitis c) prove causality. Guy is a whackjob.

  49. #49 Diane
    September 13, 2009

    Is Jay Gordon an AIDS denier as well? Or is it a variant of crank magnetism (one holds a crank idea, and other cranks are attracted to you)?

  50. #50 Chris
    September 13, 2009

    Diane, Jay Gordon is one of the doctors Christine Maggiore took her daughter to prior to the child death from HIV/AIDS.

    (ignore the troll that posted before Diane)

  51. #51 Orac
    September 13, 2009

    True, but in all fairness to Dr. Jay, he’s expressed great remorse about missing the boat on that one and not correctly assessing the seriousness of the condition of that child. He has also said since then that he accepts that HIV causes AIDS.

  52. #52 Justice
    September 13, 2009

    @245-247 Pub Med has nothing to do with my job. Actually, the limited skewed research listed at pub med proves nothing that is going to help you either. Let’s just say I handle all the paper work of all autopsies of every dead person at 7 different facilities. It isnt some stupid study, it is the real world. In the real world, there are alot of ‘contaminants’ affecting your brain right now. I am stating what is there in the records, black and white, you are arguing with yourself. Sleep well.

  53. #53 Chris
    September 13, 2009

    We ask for evidence, and all you can do is give excuses.

  54. #54 Joseph C.
    September 13, 2009

    Pub Med has nothing to do with my job. Actually, the limited skewed research listed at pub med proves nothing that is going to help you either. Let’s just say I handle all the paper work of all autopsies of every dead person at 7 different facilities. It isnt some stupid study, it is the real world. In the real world, there are alot of ‘contaminants’ affecting your brain right now. I am stating what is there in the records, black and white, you are arguing with yourself. Sleep well.

    Let’s play count the fallacies:

    1) Argument from authority even though you don’t even claim to be a pathologist.

    2) Appeal to special or secret knowledge.

    3) Bashing, misunderstanding, and downplaying science.

    4) Fear mongering.

  55. #55 Dedj
    September 13, 2009

    We know there are lots of contaminents that can affect the brain.

    7 different centres all seeing the same thing? Something so obvious even a clerk has spotted it? And no study in sight? Not even on the numerous alternative to pub-med?

    That story is so fishy it’s got scales on.

  56. #56 MI Dawn
    September 13, 2009

    Dedj, maybe she is telling at least a form of the truth. Since the number of autopsies actually performed these days is quite low (I believe the last statistic I read on it was that only about 10% of all deaths have autopsies performed), maybe she can handle “all autopsies of every dead person for 7 facilities.”

    (Of course, being a smart ass I would say that ONLY dead people get autopsies.)

    Autopsies are not required on most deaths, even in a hospital. Legally, autopsies are usually required on sudden deaths for persons not under a physician’s care. They are usually done on homicides, etc. They will be done if the family requests one, or the physician requests one and the family approves.

    But 7 facilities? The only way I can see that being true is if she works for a medical transcriptionist service that has contracts with 7 facilities. Most hospitals have the services in-house. However, I suppose 7 rural hospitals might band together and hire a transcriptionist service for dictations. And, given the average number of autopsies a small facility does in a month, it is manageable for one person. (I’ve worked in several small hospitals, and a friend of mine was a pathologist. On average, he would do 1-3 autopsies a month. Other work made up the bulk of his time)

    Oh, and don’t you know that Big Pharma is preventing the studies that the centers are seeing? They are EVERYWHERE!!

  57. #57 Chris
    September 13, 2009

    Dawn, that actually makes sense. Being a medical transcriptionist would explain why she does not know about the PubMed index.

  58. #58 Ramel
    September 13, 2009

    @Dawn, an interesting possibility but my first thought was that justice is in fact a fax machine…

  59. #59 Dale
    March 20, 2010

    “Here, at Brian Deer’s website, is the issued patent document for Dr Wakefield’s vaccine.

    http://briandeer.com/mmr/1998-vaccine-patent.pdf

    You may notice that the patent BEGINS:

    “The present invention relates to a new vaccine/immunisation for the prevention and/or prophylaxis against measles virus infection…” ”

    Nooooo! Dr Roo say it ain’t so….

  60. #60 Tim Kasemodel
    February 4, 2011

    Thought I would follow up on this issue after nearly 18 months. I have a few comments regarding some posts above.

    First of all Orac,

    You point out:
    “Perhaps the most disturbing part of the show occurs near the end, when NBC went into Thoughtful House and followed parents of an autistic child through an endoscopy by Dr. Arthur Krigsman. Tim Kasemodel is interviewed about his son Thomas,…”

    An endoscopy DISTURBS you? Are you a doctor or a what? I did think that the producer went overboard showing Thomas in distress getting his anethsesia.. we actually wanted Dateline to show what happened before that, when his gut pain was unbearable… that is what America needed to see.

    And this on comment by Pablo:
    “I don’t know if you caught Mrs. Kasemodal’s comment about why they brought their son to the place. “We think he has a hidden intestinal problem.”
    The beauty is that, now, after nothing was found, they can still claim it is a HIDDEN problem. Oh, he has an intestinal problem, and we’ll find it, darn it! A win for Wakefield!”

    You are one sick puppy. Do you really believe my son did not have any G.I. issues? We did a pill cam and it did indeed show exactly what Dr. Wakefield described 15 damn years ago. You are so blinded by your hatred for Dr Wakefield you forget about the children like mine who suffer every day – you must be one heartless …….

    And this by Just a mom:
    “The story about the family who traveled for those GI scopes, as if Wakefield is the oooooooonly doctor in the whole world who can locate this hidden gut problem,…”

    As matter of fact I said “we thought we could get help in Minnesota, burt we were wrong”.

    The pediatrician we worked with was with the University of Minnesota and she knew by his medical history that we would find bowel disease in our son. She also knew that her career with the University was threatened if she referred our son to a G. I. doc in Minnesota for what Wakefield described. She has since left the University position and is with a private clinic.

    Yes, we still go out of state for our G.I. services. We simply do not trust anyone else.

    BTW, our son’s bowel issues are not 100% resolved but he is nearly pain free after years on suffering thanks to Dr. Krigsman. You don’t cure a lifetime of bowel disease overnight, especially when we spent the last 15 years pretending it does not exist.

    Not that any of you or even Orac cares.

    Tim Kasemodel

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