August 30th, 2010

August 30th 2010,
Dear Jeremy,
We live in a time where information is a ubiquitous fact of life. There is not a moment at present, and certainly barring any technological apocalypse in the time when you will read this, that information on anything is not waiting at your fingertips eagerly for your edification. The problem with this ease of access to information is the equal, or arguably larger, access to misinformation. Anyone with gumption to employ media and internet might have a YouTube page or a blog and present their point of view, whether it is educated or otherwise, and present it to world at large as truth. With that in mind, and before I go further, I feel it behooves me to say these letters are my opinion. They have always been and will always be my opinion. I implore you to fact-check; do your own research, understand everything you can, and determine your own opinion. (Note: My opinion happens to be fact)
This misinformation or, even being supremely fair, lack of well rounded information leads to a lot of controversy in quite possibly every aspect of life from low-brow and trivial affairs such as Paris Hilton’s cocaine arrest to important and underplayed issues such as the benefits of childhood vaccinations. Today, we will speak of the latter, suggesting only of the former and those deeply engrossed with it: “You are a waste of space”.
We live in a time previously unheard of in the realm of medicine and medical treatment/prevention. There are cures, treatments, and preventative vaccinations for a great many diseases that in that time of my parents were incredibly dangerous, in the time of their parents potentially fatal, and in the time of their parents a veritable death sentence. For example polio, at one time, would cripple and could kill children and adults with the effectiveness of a sledgehammer to the spine. It was once in the forefront nightmares of parents. A vaccination for it was developed, employed, and successful within the life span of your grandparents. It was successful in preventing the contraction of polio to such a large degree that the last wild case of it was recorded in the United States before the decade I was born in.
The way vaccinations work is that they inject into the system a small and weakened amount of the sickness being inoculated against into the body. This small amount of virus or other pathogen begins to affect the body and symptoms of the illness may develop (for example a common side effect of a flu vaccination might be “flu-like symptoms). The body fights this small infection and creates its own in-born cure to the illness. Many times the cure cannot be synthesized or mass produced in a fashion that would allow for it to be a mass produced “cure” so in lieu of that vaccinations were developed. An individual’s body creates a cure or resistance to the convalescence in question which is tailor made for that person’s biochemistry (or whatever).
There is something to the effect of 30 different shots that a child must receive within the first six years of their life to prevent upwards of 16 different diseases that are actually life threatening or life altering. Proponents of receiving the vaccinations include: pediatricians, pathologists, and the Center for Disease Control (CDC). The argument that they put forth is rather convincing for most: the discomfort of a shot, or the short time side effect of a vaccine (soreness, overnight fever, a day or two of mild illness) are more preferable to the discomfort of the disease (paralysis, incapacitation, severe long-term illness, disability, or death). This, to your mother and me at least, seems to make for a pretty good argument for having a child vaccinated (also we enjoy poking you with needles—so everybody wins). You are, at almost six months old, in the middle of that process now.
Before I go further I have to make a point of stating some things that people in our times of fancy-pants doctors and medicine forget:
1) Medicine is an evolving science. The bleeding edge thoughts on diseases, health, and medicine today could be debunked and viewed as medieval tomorrow. You can only go with the information and research of the day and balance it with the critical thought that your conscience, morality, intelligence, and education can reconcile. While the science is exacting it is not exact.
2) Medicine is a business that is run by pharmaceutical conglomerates; and business is good. While the researchers themselves may be very altruistic people (altruistic mercenaries of science) the companies themselves are looking to make a profit. The research that goes into developing pharmaceutical drugs is unbelievably expensive; but not solely for profit. The price that you pay for expensive medicine today directly funds the uncovered overhead cost and the upfront direct cost of that medicine, and the next medicine in development. While the companies still make a substantial and sizable profit (arguably an excessive profit, but that’s for another time).
3) Many of these treatments and medicines have side effects—often the more serious the ailment the more serious the side effect from its corresponding medication. The pharmaceutical companies must inform the public about the side effects but may downplay them. Being informed about what a medication will do and might do is as much your responsibility as it is the company’s to publish the information.
4) At the end of the day medical treatment is in your power. You can refuse or accept whatever it is that the doctors want to give you. Read the “Patient’s Bill of Rights” and know exactly what it is that they can and cannot do. Everything requires consent—and consent requires thought.
There is a growing contingent of parents that are convinced that childhood vaccinations are a leading proponent in rising numbers of diagnosis in children with autism. The claim is that the bombardment of illnesses into the young body in the fashion of vaccination and inoculation somehow sets off a chemical reaction in the body that can cause autism in the child. Some argue it is the level of mercury introduced into the system via vaccinations. Mercury has a long history of being involved in various psychological and physical disorders the most prevalent of which is insanity (as demonstrated by Alice in Wonderland’s and Batman’s “Mad Hatter” characters respectively). Others believe it has something to do with the number of ailments introduced at a time shocking the system. Still more do not claim to know what causes it scientifically but site empirical evidence of a phenomenon.
Now Jeremy, I can’t argue: there is some truth in what is said in a blatantly “cause and effect” observation. Many parents claim that directly after vaccination (within several days or weeks) their children had severe regression of development or seizures which were followed by diagnosis of autism. Famously, Jenny McCarthy’s son, Evan, had such an experience and her highly publicized plight and lobby for Autism research has done much to fuel the media frenzy surrounding the disability. She is a proponent of the vaccination theory.
Recently, I spoke with my friend Jon Weiss, a student of Immunology (whom I will refer to as a scientist) about the topic. When I asked this scientist about the idea that vaccinations were causing the statistical rise of cases of autism he dismissed it as easily as I dismiss the notion that Quicksilver is faster than The Flash. He did agree, as a scientist, that there is a possibility that there might be, very well, a likening between genetic predilections towards Pervasive Developmental Delays (PDDs) such as Autism and these vaccinations—but there would have to be the genetic precursor of this occurring anyway. In essence what he said was that while vaccinations may, at times, be the straw that brake the camel’s back in the onset of diagnosis but it is certainly not a contributing factor in the same sense that cigarettes cause cancer.
He further suggested that there might be a confluence of unrelated events in play. Often times, children diagnosed with autism will seem to develop normally and then have a regression that leads to the search for a diagnosis in the first place. This might happen regardless of vaccination status. It is part of the horrifying part of having a child—a diagnosis like autism might strike out of nowhere when you thought you were “in the clear”. It is the perception of a regression within days or weeks of a vaccination (which occur quite often in children under the age of six, especially under the age of one) is merely a coincidental occurrence. For example, I may have my first dirty-water hotdog in Manhattan tomorrow and go to the dentist the following day and find that my wisdom teeth need to be pulled. There is a cause and effect perception that the dirty-water hotdog I ate may have very well caused the malady with my wisdom teeth—but popular understandings would deem it coincidental. Conversely, if many people started to make similar claims the phenomenon (or supposed phenomenon) would require close inspection and study.
In the early 1990’s with the renewal and title change of Education for All Handicapped Children Act in to the Individuals with Disabilities Education Act (IDEA), autism became its own category of disability. Previous to this it was considered at times to be a component of schizophrenia, being diagnosed in children as “childhood schizophrenia”, or being a form of mental retardation. With IDEA autism was recognized as being fundamentally different than any of the other developmental, physical, or mental disabilities. This was done, in my opinion, as a matter of prudence and not in respect to some statistical surge. Around this time, with people with autism receiving services for autism as a category of diagnosis as opposed to a subheading or other explanation of a “larger” disorder it began receiving notoriety in the public arena.
To the layman it was a “new” disability—and as such was (and still is) an intriguing one because of its describing characteristics. People living with autism generally look quite typical; especially when one considers the physical appearance of a person with Down’s syndrome or multiple sclerosis which are respectively visually identifiable—almost readily. Like many disabilities, autism exists on a spectrum from profound to mild to moderate and the person carrying any of these levels of the diagnosis will display a scattering of abilities. They might be verbal, or non-verbal. They may or may not have issues with gross or fine motor development and implementation. They might excel and any one or many of these areas. I am wont to refer to the term “savant” but many times those with autism indeed fit that bill of being a person with an “above average or normal” knowledge on a specific subject or ability with a specific skill. Also a person with autism will generally have “no affect” which is most easily (though certainly not most accurately) described as being a lack of perceivable emotions.
The experience of autism is often described as being overwhelmed by the senses (or sometimes by one sense) to such a degree that the person becomes engrossed in it. There is a lack of social awareness, or a lack of social skills, or a lack of ability to be social because of the withdrawn and inward nature of being overwhelmed by the senses. Certain sensations can be more or less desirable or intense at given times which lead to “self-stimulatory behaviors” and other neurological stimulatory behaviors. These stimulations may or may not lead to seizures, or bouts of screaming, and other manifestations of being overwhelmed. It is important to note though that people with autism (and disabilities in general) can live very fruitful, meaningful, purposeful, and depending on the severity of their condition—normal lives. Due to these characteristics, and in my opinion most heavily the lack of physical disfiguration and “savant” like scattering of abilities there has been somewhat of a “popularity” in the media towards autism.
There is still the statistical evidence that incidences of autism are on the rise. There may be more misinformation in that regard than information. At this point in time I am pursing a Master’s Degree in Elementary Education and Special Education and preceding that I spent 5 years working in special education primarily with children diagnosed with autism. Due to the rise in public interest in autism and its history of being lumped with other development disabilities it is easy to diagnosis, for example, a child with moderate Down’s syndrome with autism. One might wonder why a parent might want this to be done—there are many reasons. First and foremost is stigma. Many people, families, and cultures still have a negative view of mental retardation as being a lost cause or as something shameful for the family. Considering the du-jour status of autism it is socially more acceptable in many circles for that diagnosis as opposed to Down’s or M.R.
Though autism “enjoys” this “du-jour” status it is also important to note that autism is statistically one of the less common forms of disabilities—far overshadowed by Down’s syndrome and mental retardation in general. Regardless of this fact it is much easier to get services for autism than it is for many other developmental disabilities. This causes an error in statistical book keeping which would undeniably change the statistics of autism. This is actually a hidden benefit for the child “supposedly” or even “falsely” carrying an autistic diagnosis because the child will receive services that they may not have received otherwise. While this doesn’t do much for the social acceptability of many disabilities it might service the individual in an exponentially beneficial manner. In this way the practice becomes morally complicated; but the complication is resolved by a little mantra that has been effectively jack-hammered into our thought process at NYU: the diagnosis is a means to getting services; it has little meaning after the services are granted. Coupled with the fact that autism is a fairly new and admittedly fluid diagnosis it opens the statistical possibility and logistical argument for a wide gamut of topics in the social/political discussion of autism.
In the end I can’t in good conscience subscribe to the school of thought that says vaccines are directly related to the development of autism. I might suggest that it leads to the growing number of diagnosis of autism, but that is a different statement altogether. The argument also opens up a very different discussion. Supposing that vaccines do cause autism, then autism is no longer its own category for disability. There are 13 educational categories for disability where autism resides apart as its own area; if vaccines are linked to be a true cause then it then becomes a part of the “Traumatic Brain Injury” category or is split between its own category and brain injury. This doesn’t really help the situation at all because now you’ve essentially castrated your own cause by redistributing it into another category that has its own set of protocols. Nor has a strong case been made to discontinue vaccinations because of the high incidence of children getting their vaccination and not “contracting” or developing autism or symptoms remotely related.
I was watching an episode of Frontline when I was prompted to write this particular letter to you, Jeremy. There was a woman in the episode who was a writer and a PhD who questioned why vaccinations were given for rotavirus or polio when you would be hard pressed to find incidents of them in the United States at this date and I was shocked. She was from a community in Oregon with one of the highest community percentages of “opt-out” from the federal vaccination program. Her argument was that because children no longer contracted these illnesses that they should be phased out of program. Did it not occur to this highly educated individual that these illnesses were not occurring because of the success and continued practice of vaccination? It’s almost like suggesting the discontinuation of seat belt laws because of all the lives they’ve saved.
Maybe by the time you read this in the year 2035 (when I’m 50 at you’re 25) this will be a moot issue. The cause will have either been discovered or disregarded as ultimately irrelevant. Maybe there will be one vaccination that makes immortals and negates all disability and illness. Science is crazy like that, and I don’t discount anything as impossible. Until then I just have to hope that whatever meds I get put on are worth the anal leakage and impotence—though I’m not sure what that kind of life would be worth.
Love,
Your Father
P.S. This week you went to a barbeque and a birthday party. The birthday party was for your cousin Raziah and you slept right through most of the loud music. It was a joy. In the past week you’ve launched yourself off of the couch with your powerful calves and did a lot of rolling around on the carpet. I am starting to question the movies I show you because you made a very…interesting face…during Terminator 2: Judgment Day…but I probably won’t change. Remember I hold the remote in this house!