Friday, January 7, 2011

Dr. Wakefield controversy

Some very disturbing information came out today.  There have been accusations that Dr. Wakefield falsified his data in his ground breaking 1998 paper.  I have to admit that I am more confused than ever about what to believe.  As I was reading articles on both sides of this issue, I was reminded of the story of Dr. Semmelweis.  

Dr. Semmelweis was a Hungarian physician practicing in Vienna who proved a link between doctors not washing their hands after performing autopsies and then assisting with births and mothers dying soon after childbirth.  At this time facilities that used midwives to perform childbirth had about a 2% rate of “childbed fever” (a disease that caused women who had just given birth to die unexpectedly).  Hospitals had a 10-20 times greater rate.  Mothers would refuse medical attention by doctors in the hospital because of fear of dying from childbed fever. 

Through vigorous observation and data collection, Dr. Semmelweis concluded that if physicians would simply wash their hands before assisting with childbirth, the rates of childbed fever went down to almost zero.  What he did not realize was that he discovered germ theory.  He didn't have all the answers, but he definitively showed through empirical data that when doctors washed their hands before treating expectant mothers, the rates of childbed fever were nearly eradicated.   

In his time, Dr. Semmelweis was vilified and mocked by his peers because of hospital politics.  Just a few years after his death, Louis Pasteur and Joseph Lister published research explaining how germs caused diseases.  Even though Dr. Semmelweis had successfully prevented disease, because he could not explain why his methods worked, he was discounted. 

We should learn from history.  NO ONE knows what causes autism.  At this time, we shouldn’t be throwing out any theories as to what causes Autism or what treatments could be helpful.  It is an uncomfortable and confusing place to be.  Especially for most doctors practicing western medicine who feel they should have all the answers.  It is so sad to see politics and money get in the way of pure science.

It should be very concerning that a physician (Wakefield) who seems to be trying to unravel the mystery of autism is so vocally attacked by the media.  Are they making him a straw man to beat up and distract from the real issue?  The real issue is that rates of autism are skyrocketing and no one knows why. 

Inevitably, these same journalists tout the theory that autism is a genetic disorder.  Most governmental research dollars are given to scientists studying the genetics of autism.  I believe this is a fool’s errand.  It is a good way to get grant money and to continue your research, but I don’t think it is going to yield any real help for families.  Multiple genes have already been implicated for causing autism.  If Autism were a purely genetic disorder, then the numbers of cases wouldn’t be going up exponentially.  There MUST be some environmental factors at work.  That is the only way that we could see rates increase so dramatically.

We should learn from history that when things are not easily explained, caution and safety should be paramount.  How many hundreds or thousands of women died in those hospitals in Vienna wanting to do what they thought was best for their children by giving birth in a hospital?  How many million more children have to be diagnosed with autism before we get serious and do the necessary studies to find the real cause?  It seems as though journalists, politicians, and doctors can remain detached and only purport “scientific” treatments until they are personally affected by autism.  Then they start to look into alternatives and find treatments that work for their child.  Because when it is your child, you do what ever you can to make them better.

The best physicians and scientists listen to their patients.  They do not dismiss their concerns saying that it is all just a coincidence.  Wake up America and listen to the parents of children that cannot speak for themselves.  If we do not learn from history we are bound to repeat it.