Unbelievable, and Inevitable
This one turned into a bit of a sermon. It’s part of Faith in Medicine week.
I’ve watched this documentary sixteen times since it was released on 5/26/2021, less than a week ago. It has completely absorbed me. It tells a tale at once unbelievable, and inevitable.
It’s the story of how a handful of media-savvy medical fraudsters started the modern anti-vaxx movement for money.
I urge you to watch it. It’s two hours long, so don’t worry, I’ll summarize key findings. Now, let’s think about vaccines and money and medicine, using some of the facts presented in Hbomberguy’s documentary as a spring board.
We know that money dictates medical science. To conduct science at scale, there is no alternative. Someone needs to buy all those stethoscopes, bat catching kits, semiconductors, insurance contracts, printer paper, MRIs. And while certainly there are truthseekers in medicine, there are also hucksters looking for a payday, a grift.
This contention drives Hbomberguy’s documentary. “Vaccines: A Measured Response” details the 1990s vaccines-autism panic, and the hucksters and truthseekers who respectively fought to perpetrate and to unravel the hoax. What Hbomberguy does, which is something I have never seen before, is identify exactly how people came to believe erroneously that vaccines caused autism. It is a precise accounting of that idea: Hbomberguy accounts for the idea of vaccines causing autism, identifying how this idea was, in his words, “laundered” from a fringe theory into accepted medical fact, and he accounts for the large sums of money that changed hands to make it happen. Hbomberguy proves that this belief became widespread through the following gilded, baffling chain of events:
- A mother believed that her son developed signs of autism shortly after taking the MMR (mumps, measles, rubella) vaccine.
- She then hired a lawyer to initiate a class action lawsuit against MMR manufacturers in hopes of winning damages based on this alleged link.
- But since there was no medical evidence of such a connection, the lawyer hired a gut doctor, Dr. Andrew Wakefield, a man with no background in either autism or vaccines, to prove a link between MMR and autism.
- Since vaccines don’t cause autism, Wakefield faked medical data to suggest that vaccines caused a bowel disease (remember, he is a gut doctor) that also somehow affected neurological development and caused autism.
- Wakefield’s faked medical data was so convincing that his study was published in a top medical journal; now, the lawsuit can move forward, since there is medical proof that MMR causes autism. The anti-vaccine lie is born, and a litigious ableist mother, a lawyer, and Dr. Wakefield are about to make a lot of money.
That’s the horrifying truth behind vaccine hesitancy: Sometimes, scientific facts are a mother’s ableism prompting her to hire a lawyer to hire a doctor to fake data in a study of bowel disease to make it look like vaccines caused autism so that the mother, lawyer, and doctor could make millions. Sometimes, that’s what scientific research looks like. Sometimes, our health depends on a bunch of people lying for money.
And that is, to say the least, absolutely terrifying. For all of the wonders of modern medicine, the objective good of many medical breakthroughs, evil and greedy people can high-jack the system if they put their minds to it.
Hbomberguy does end on a positive note: through investigative reporting and the work of a diligent hospital ethics board, Andrew Wakefield lost his medical license, his fraud was exposed, the paper was retracted, and neither Wakefield nor his employer made any money from litigation. And, Hbomberguy argues, the UK learned its lesson. While vaccine hesitancy remains high in the United States, the UK has very low vaccine skepticism, and the public dismantling of Wakefield’s fraud is likely one reason for this faith in medicine.
But, I don’t know. I’m not a very positive guy. Certainly, it’s good to see that there are reporters, hospital administrators, and medical researchers who live to make medicine effective, ethical, true and trustworthy. But unraveling Wakefield’s hoax took nearly a decade. Wakefield shows that the medical establishment is easily exploited for money. Any doctor could, if they were smart enough and persistent enough and paid the right price, do this again.
There’s truth, and then there’s market truth, the truth accepted by people looking to make money. While our bodies respond to biological truths, the biological facts of asbestos, leukemia, morning sickness, unipolar depression, it is the market truth that supplies us our medicine and dictates our compensation were someone to harm us.
Wakefield could not change the biological reality that the MMR vaccine does not cause autism, but he was able to convince the market, briefly, that there was a potential risk. He convinced parents to seek expensive alternatives to the MMR vaccine, and I can only imagine the amount of money spent on PR campaigns to try and restore faith in vaccines. Markets moved for Wakefield.
Our lives are made of money; our lives are made of biology. While it’s much nicer to assume good, kind, intelligent scientists are working daily to make us all a more enriched species, sometimes there’s Doctor Wakefield and sometimes there’s benzene in our sunscreen.
Hell, even these examples are peccadillos compared to some of the fraud and negligence perpetrated for money. Doctors first posited a link between cancer and smoking in the 1800s, with persuasive evidence of this link available in the 1940s. The US Surgeon General only declared them a hazard in 1964, and Wigand’s whistleblowing on the tobacco industry’s deceptions happened only in 1996.
Then, there is the entire genre of medical fictions that exist only to justify the exploitation of Black people (a fitting topic sentence; and a content warning). Doctors, in general, underestimate the pain of Black patients, believing that Black patients have specific biological resistances to pain such as thicker skin, or that their “nerve endings are less sensitive than white” nerves. These are the same beliefs that plantation owners used to argue that Black people were uniquely designed for labor, and profit; The 1619 Project provides an excellent account–thorough in detail, following the money–of the origins of these myths, and the “medical researchers,” mainly Southern doctors and plantation owners, who codified them into legitimate medical science.
Money poisons medicine through many vectors. Neutrogena put benzene in its sunscreen because it’s a cheap solvent, and they saw the FDA’s lack of guidance on sunscreen composition a potential shield from litigation. Fear of litigation, and fear of losing out on potential customers, lead the tobacco industry to combat claims of addictiveness and carcinogenicity. And though medical fictions about Black people stemmed in part from simple racial animus, the enslavers who proposed these fictions found it personally lucrative: slave-for-sale postings often advertised the industriousness of the enslaved person, and medical proof of industriousness would surely boost an enslaver’s pocketbook.
That’s why Wakefield and vaccine fearmongering was both unbelievable and inevitable. In our modern world, powered by pursuit of profit and prestige, evil people will make money by lying to us about medicine. Yet, the immense tangible benefits of modern medicine, its ability to eradicate smallpox, to end this intolerable pandemic, to track the movement of a disease in real time, make it so that we cannot ignore the truths that come out of medicine. We have to believe medicine because we have literally seen its results, and because we know that distrusting medicine or trusting the wrong medicine will kill you.
This is one of those problems that either requires serious reform, or mass movements in the streets, or a Blockchain seasteading utopia, or worse, it’s a problem literally unsolvable, because human beings have been pursuing prestige, power and money for millennia. It’s one of those problems where we won’t know if it’s solvable until we’ve solved it. It likely requires the collaboration of many smart people, and I am but a single smart person. But whoever solves it, or whoever can best assuage it, will have human lives to their name, souls that they saved.