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.
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.
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.