Soapboxing

A change from the usual today.

On Friday, the Washington Post published an interesting profile of a cardiologist in Arizona named Jack Wolfson. Dr. Wolfson has made a name for himself recently as a physician who encourages his patients to not vaccinate their children. Also, he goes on TV a lot now to talk anti-vaccine stuff, even as children in the southwestern United States have measles.

MEASLES!

In the article, Wolfson is quoted:

“I’m the son of a cardiologist,” he told The Post. “I was trained to believe in the power of vaccines…. And going through school, as a medical student you don’t question anything. You don’t question what’s going on.”

In case you don’t feel like clicking through and are thinking, “well, that doesn’t sound that bad,” here’s what he said later:

“Don’t be mad at me for speaking the truth about vaccines,” Wolfson said in a telephone interview with The Washington Post. “Be mad at yourself, because you’re, frankly, a bad mother. You didn’t ask once about those vaccines. You didn’t ask about the chemicals in them. You didn’t ask about all the harmful things in those vaccines…. People need to learn the facts.”

Now, I’m pretty sure that if you’re a reader of this blog, it’s unlikely that you agree with the Jack Wolfsons of the world. But it’s still worth writing about, if only because this guy’s status as a physician lends an awkward, false veneer of respectability and truthiness to the anti-vaccine argument. And it gives the Great Media Hippo (a glorious term I stole from a Charles Pierce article) an opportunity to create the false sense of balance it dearly loves, when in fact there is no such balance whatsoever.

So first of all, it’s somewhat of a defining characteristic of a medical student that we have lots of questions and that we question pretty much everything we’re told. It bothers us when things don’t make sense, which is why psychiatry (the rotation I just finished) can be so frustrating. What, actually, is depression? What is the disease process in schizophrenia, and why can’t we figure out Alzheimer’s?

Some things, though, are so well-understood and easy to understand that you don’t have to question them. You know what’s a great example? Vaccines. Any first-year medical student can explain the concept of a vaccine to you in about thirty seconds. With measles, you take the virus and modify it so that it is weakened. (With other infections, you use a dead pathogen.) You then give someone this weak-sauce virus, and the body mounts an immune response, developing antibodies. Your immune system fights off the virus easily, and the antibodies stick around for life – conferring immunity.

Boom. Done.

Dr. Wolfson and the lunatic anti-vaccine fringe have said that it is a child’s right to acquire these infections and obtain immunity that way, instead of putting “chemicals” and “toxins” in their body and doing it artificially.

I have sat at my computer for thirty minutes trying to come up with a metaphor that illustrates how psychotically insane and unhinged that statement is, but I just can’t. It’s too crazy.

It also makes no sense in any kind of context. We, as humans, exist by putting chemicals in our bodies. Coffee is essentially caffeine and dirt with water added. Your liver breaks alcohol down into acetaldehyde, a close relative of embalming fluid. Adding iodine (surprise! it’s a chemical!) to salt increased the IQ of Americans by 15 points. Seriously.

If you subscribe to the chemicals-and-toxins argument, I can’t see how you would approve of any medical treatment in any scenario besides a car accident. If you acquire the plague, why would you be okay with getting antibiotics? You might fight it off. Or you might not, but as Dr. Wolfson says, “some people die.”

It’s like the last 200 years never happened. If you ask any physician what the two or three most important, amazing, earth-changing medical advances in the history of humanity are, they will tell you some order of antibiotics, anesthesia, and vaccination. It’s right up there with the discovery of fire and the ability to use tools in terms of human advancement and achievement. And so, unbelievably, there is a cohort of astoundingly ignorant and otherwise reasonable people who would like their kids to take their chances with diseases like polio and the measles. Which can kill you.

It’s BSC. And it’s dangerous as hell, because a) immunity is not always lifelong or perfect, and b) our civilization’s ability to resist a massive epidemic of preventable disease rests largely on herd immunity. Willfully not vaccinating clusters of people against disease does to herd immunity what Manifest Destiny and Westward Expansion did to actual herds of buffalo – wiped out.

So, yeah, we’ve moved from “crazy but harmless” to “crazy and a major public health danger.” Because measles, again, can kill you.

Here’s a fun thing I learned on psychiatry and then got wrong on my shelf exam: the definition of a delusion. A delusion is “a fixed, false belief that is not shared by the person’s culture and is resistant to change.” Having delusions is actually a disorder unto itself (predictably, delusional disorder). It is also a symptom of other things, like being a psychotic insane person who needs to stay in a facility with “HIGH ELOPEMENT RISK TODAY” written on all the doors.

I took care of a patient with a disorder called delusional parasitosis two weeks ago. She thought that she was infested with parasites; she picked at her skin, her clothes, and her bedding, collecting little bits of “evidence” to show to us. She needed high-dose antipsychotic medication just to keep her from tearing off her own skin.

From a diagnostic standpoint there is little difference between Dr. Wolfson and this lady, who collected pieces of her skin as proof in an eyeglasses case. The beliefs are equally insane. The difference is that my patient had stopped taking care of herself and needed treatment; Wolfson and the anti-vaccine people are much worse. Their brand of nuts represents an active and ongoing risk not just to themselves but to anyone they contact. They are at best morally absent ignoramuses who don’t know any better, and at worst a time-bomb danger to civilization.

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13 thoughts on “Soapboxing

  1. Eeerm I slightly disagree with you (if I’m allowed to do that… please dont kill me >.<)

    I have friends whose parents decided not to vaccinate them and they turned out fine, haven't gotten seriously ill or anything. Some people dont feel its right to vaccinate their child because its unlikely they will get that disease anyway and some chemicals are harmful in the long term. E.g. the case with autism and vaccines.

    I dont think its fair to say that just because someone has a different opinion on vaccines , it makes them deluded and we should ridicule them. I'm not saying I'm against vaccines, I'm just saying we shouldn't look down on people who are.

    Obviously I dont know the science behind it all since I'm not a medical student (yet…) but its just something I wanted to point out.

    Other than that I honestly do love your blog and its weird my first comment is a disagreement xD Peace:)

    • Ok “doctor.” The argument for vaccines centers on herd protection. If an unvaccinated kid gets measles and passes it to someone who’s, say, immunosuppressed because they’re being treated for cancer, the cancer patient is dead. It’s part of a societal contract.

      As for the original post, while I agree with you, calling these people idiots will only harden them. I don’t know what the solution is, because hard data showing that there is no harm in vaccines doesn’t seem to work

    • Thanks for the comment. I’m glad someone besides my family reads it!

      I think it’s critically important to make a couple of things crystal clear. Number one, the autism-vaccine link has been so thoroughly discredited that the ex-doctor who published the original paper on it, Andrew Wakefield, has lost his medical license. Furthermore, the findings in his paper were fabricated. Completely made up. Not real.

      Second, every vaccine in use today has been proven safe with the highest-quality studies we know how to perform. There is zero data – actual data, not the made up ridiculousness you see on pseudoscientific websites and news channels – that would indicate that any vaccine or any element in any vaccine is “harmful in the long term,” as you put it.

      I agree with you on one thing. I don’t think we should look down on people who believe nonsense like this. We should feel sorry for them, because they believe something that is not true. This is not an issue of having different opinions, because that implies a gray zone that leaves room for interpretation. There is no such zone here. Vaccines are safe. This is truth. Vaccines save lives. This is truth. Not getting a vaccine is willful child endangerment: not just for your child but for your child’s friends, some of whom may be unable to receive vaccinations for real medical reasons as opposed to invented absurdities.

      So we should feel sorry for people who believe the anti-vaccine stuff, in the same way that we should feel sorry for people who believe that their neighbors have been replaced by humanoid aliens. They are the definition of deluded.

      I reserve my ridicule and my anger for the people spreading this false message who should know better – people like Dr. Wolfson. It is stunning – truly stunning – that this man has a medical license. He must know what he is saying is, to put it mildly, a crock of bullshit. Giving him a platform to spread his absurdist propaganda, where he can influence some people who don’t know better, is practically criminal.

      I’m glad your friends’ kids are healthy. I pray they stay that way.

      • Thanks for the reply!
        So does that mean everything on this website is made up; http://www.mercola.com/article/vaccines/statistics.htm and this http://www.naturalnews.com/037229_vaccinations_children_research.html# (Actual question) Maybe I am wrong but I mean if so many people disagree with vaccination it cant JUST be because they are stupid or uneducated, there must be another reason which has made them feel that vaccination is a bad thing. I mean I hardly think a doctor is gonna encourage people not to vaccinate without a GOOD reason.

        • So a general comment first: If you are going to go into medicine as you mentioned before, kudos. But the very first thing you will learn – before biology, anatomy, physiology, or chemistry – is that you should be extraordinarily wary of nonscientific sources.

          I looked at the Mercola article you posted (the naturalnews one was formatted so strangely I couldn’t read it). I can’t go line by line through it because of space and time, but just at a cursory glance:

          -The 1992 DPT paper that drew a link was later established to be a case of ‘correlation does not imply causation;’ that is, other variables besides DPT caused the increased death rate. Indeed, that paper is a case study in not drawing conclusions based on insufficient data. Furthermore, there is a newer DPT vaccine in use now with no associated increase in death.

          – 80% of children who contracted whooping cough IN A SMALL OUTBREAK IN CINCINNATI were vaccinated (caps added by me). Again, this is part of the DPT vaccine that is now different, with better immunity rates. No vaccine yields 100% immunity; the measles vaccine ranges between 95-97%, for instance. But non-perfect immunity far, far, far outweighs the risk of getting the disease from not being vaccinated at all.

          -“The Sabin oral polio vaccine (OPV) is the only known case of polio in the US today.” This statement is stunning in its idiocy. Why do you think there is no polio in the United States. BECAUSE WE CURED IT WITH A VACCINE. The vaccine, unsurprisingly, IS CALLED THE POLIO VACCINE.

          Sorry for yelling. That one was too remarkably stupid to let slide.

          I can’t continue to go line-by-line, but later in the paper it mentions “toxins” in the vaccines. You can look at your favorite cereal and find about 30 things that, if you ate enough of them, would be toxic. If you ate enough kale, you would die. You can even drink enough water to kill yourself. The point I’m making is that it’s all dose-dependent, and the doses of these “toxins” are infintesimally small.

          The rest of the article is a bunch of nonsense – I mean that literally, I can’t understand what it’s talking about with dirt and mediums – that has no scientific support whatsoever.

          Bill Nye said it best: “The nice thing about science is that it’s true.” The Mercola article, at the very least, is extremely not true. I will end with the following quote from the Mercola article:

          “First, pathogenic (disease-causing) viruses will not grow on healthy “soil” (the medium). If the environment is correct within our body, the virulent viruses and disease-causing germs will not grow. For example, hepatitis virus does not grow on a side-walk, nor in a healthy person.”

          If you believe this, I would simply recommend reconsidering your career in medicine.

          • I was just questioning a few things before I just accepted it completely as a black and white argument.

            Yeah I agree, that was an unreliable source of evidence I didn’t even read it properly. Most of the clinical trials and articles from journals (more reliable evidence) talk about perceived risk vs actual risk of vaccines (http://pediatrics.aappublications.org/content/101/3/453.short) (http://www.sciencedirect.com/science/article/pii/S0264410X99002923) and most of the “risk” with vaccines has been eliminated through time such as this case (http://aje.oxfordjournals.org/content/93/4/238.extract) which dates back to 1960 to 1970 and the examples you gave.

            Thanks for clearing up a couple of things for me and thanks for bringing up the subject, I was able to go and research a topic on my own, ask a few questions and come to an informed conclusion.

            Just not everyone is able to do that so they accept what they are told or accept the information from the first thing they see on google. And yes it does make it worse when doctors promote this because they should know better. I think Dr Wolfson should come up with ACTUAL evidence to show the so called risk of vaccines and the chemicals in them instead of just saying it. And his argument is very silly, saying getting diseases is the “rights of our children”, what the hell is he on about O.o

            Again thank you >.<

  2. Excellent. Take the physicians to task for ignoring the lessons of the past. Sue him, shame him, strip him of his creds. But be nice to parents. Invented absurdities are not entirely invented. Vaccines have risks. We are apprised of those risks with every injection. And, with every signed waiver, we battle a tremor of dread. What if MY child has a reaction, a complication?

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