Managing Editor's Note: To learn more about Dr. Grinker, click HERE to read JB Handley's piece called, "Grinker's Stinker: His Wife runs the IACC."
By Dan Olmsted
In some parts of the far-flung autism universe Roy Richard Grinker is a big deal -- professor of anthropology and director of the George Washington University Institute for Ethnographic Research and the author of five books including Unstrange Minds, which makes the case that autism is not new, just better identified. His credentials and credibility help “mainstream” this malignant notion: Time magazine says his book “persuasively argues” that there’s no autism epidemic at all.
Big deal. You’ve still got to get your facts right.
Lately, I’ve been reading the autobiography of Leo Kanner, the child psychiatrist who first described autism in 1943, which is unpublished but available at the American Psychiatric Association. I remembered that Grinker had cited the autobiography in Unstrange Minds and, out of curiosity, decided to review those references.
Oh, dear. I’m afraid Grinker’s gotten some things quite thoroughly wrong. And because the facts matter so much to solving the autism puzzle, that IS a big deal. Some mistakes don’t bear directly on the debate, but they make you wonder how many do.
the fate of Leo Kanner’s family after he emigrated from Berlin to South Dakota in the 1920s. Grinker writes: “His father died just before the start of World War II, and it was to be the only natural death in the family. The Nazis shot his mother while she was napping in a rocking chair, his three sisters and their families were murdered in concentration camps, and his brother, Klias, committed suicide as the Nazis approached the small town in which he lived. The only survivors were Leo’s sister, Dora, born while Kanner was in South Dakota. … and a brother, Wolf, who fled to Shanghai, where he worked as a pharmacist for seven years before returning to Austria to become a violinist with the Viennese Philharmonic Orchestra.”
Except for the part about his father, that’s dead wrong. On page 347 of his own autobiography, the one Grinker is citing, Kanner says: “Of course, I kept in touch with my relatives. I received word of my father’s death. … My sister … moved to Belgium. My brother, Max, whom I had brought over to these shores, married a Sioux City, Iowa girl and worked as a furrier for a department store. My brother Josef, using the money which I sent him, migrated to Palestine … my brothers Willy and Emil were engaged in business in Berlin.”
Who ya gonna believe, Roy Grinker or Leo Kanner? Grinker is misreading a letter written TO Kanner by an old friend, describing what happened to HIS OWN family. And Grinker appears to have read right over (or not read at all) Kanner’s personal account. Kanner makes no mention of his mother in that passage, but unless she also was shot while napping in her rocker, that’s not right, either.
It’s an unfortunate and pretty careless mix-up, but not on the critical path, so to speak, to Grinker’s fundamental argument. The next two are.
First, Grinker makes hash of a study Kanner did while a psychiatrist at the state mental hospital in South Dakota. Here’s what Grinker says: “After four years in South Dakota, Kanner had earned his stripes, and more. Indeed, his brilliance and clinical skills were easy to see. His first publication was a paper on the American Indians he had treated at Yankton. … Kanner argued that Indians didn’t have as much insanity as the rest of the population, probably because the incidence of syphilis, one of the main causes of insanity in those days, was inexplicably low in Indian communities.
“His observation seemed so simple in retrospect, but no one had thought of it before. That was the first sign of his clinical genius. Kanner received so much attention that the German physician Emil Kraepelin, the founder of modern psychiatry … decided to visit Yankton during his trip to America.”
Oh, no. No, no, no, no, no. Let’s start with Kanner’s study, which he describes in the autobiography and published in 1926; the study is also listed in Grinker’s bibliography, which means he read it. Here’s what Kanner says in the ’26 study:
“Syphilis among the Indians is VERY COMMON [emphasis added], according to the statements of a great number of authors, and it is frequently, almost proverbially, said by people very near Indian reservations that the great majority of the red race have syphilis.” It is clear from the context of the study, co-authored by G.S. Adams, that they agree with this statement. What Kanner and Adams are actually talking about is the rarity of a particular kind of neurosyphilis -- syphilis of the brain and nervous system -- called general paralysis of the insane, or GPI. Kanner’s question was why, given how COMMON syphilis was among Indians, there wasn’t more GPI.
The study is titled “Paresis [general paralysis of the insane] among North American Indians,” for heaven’s sake. As far as I know Kanner never said anything about the overall rate of insanity among Indians.
Then there is the slight matter of the father of modern psychiatry, Emil Kraepelin, supposedly beating a path to Kanner’s out-of-the-way door in Yankton, South Dakota, to pay homage to the 30-year-old genius. Except, well, Kanner hadn’t yet written the paper about Indians that supposedly caught Kraepelin’s eye. What actually happened was that Kanner found out Kraepelin happened to be coming to a nearby asylum for Native Americans, and he wangled himself an invitation to meet him.
“I learned from a notice in the Sioux City newspaper that Emil Kraepelin, the famous German psychiatrist, was visiting this country with the purpose of studying the occurrence of general paresis among North American Negroes and Indians,” Leo Kanner wrote. “He was accompanied by the serologist Felix Plaut ... They were to spend four days at the Federal Government Asylum for Insane Indians at Canton, South Dakota.”
Kanner persuaded Adams, the Yankton superintendent, to get them and their wives invited to meet the great man. When they did, Kanner told Kraepelin he was treating a Native American with GPI, and Kraepelin urged him to write it up for publication.
So, contrary to Unstrange Minds, syphilis was not rare among Native Americans and Kanner never said it was; Kraepelin did not come to see Kanner, of whom he had almost certainly never heard, to discuss a study Kanner hadn’t written; and Kraepelin never set foot in Yankton.
Of course, this goof is not deliberate on Grinker’s part, but it’s getting into tendentious territory. Once made, it serves a useful purpose -- Kanner is such a blinding genius that the old order bows before him; only he notices the obvious that in retrospect has been ever thus. You can see how this paradigm comes in handy when Kanner, in 1943, writes Autistic Disturbances of Affective Contact about 11 children born in the 1930s. Kanner describes them as “markedly and uniquely different from anything described so far;” but if you accept that, you’ve got to accept the idea that autism was a new disorder and that something triggered it. Better that Kanner be sui generis, a genius of observation and insight.
I’ve written lots about those early cases, of which I’ve found several despite Kanner’s first-name-and-last-initial-only identification. Based on that intensive investigation, my theory (co-developed with Mark Blaxill) has nothing to do with the simplicity of clinical genius. But it does happen to be backed by some actual facts, and it goes like this: Autism was triggered by the commercialization of ethyl mercury in vaccines and fungicides in the 1930s.
The reason Leo Kanner was the first to describe it can be explained by the “alert clinician” phenomenon -- cases of a new disorder (AIDS, for instance) start popping up, and someone of reasonable skill and experience, in the right place at the right time, is the first to spot them and write them up.
In Kanner’s case, the fact that by then he was at Johns Hopkins in Baltimore was serendipitous, to use one of his favorite words, because several of the parents of those first kids were cutting-edge researchers in medicine and agriculture, a number of them working nearby and for the federal government. A classic instance is Case 2, Frederick L. Wellman, who when his son was born was a plant pathologist investigating ethyl mercury fungicides for the U.S. Department of Agriculture in Beltsville, Md., in suburban Washington. The agriculture center was right on the Baltimore-Washington Road, and it led straight to Johns Hopkins and Leo Kanner.
That leads me to one more mistake in Unstrange Minds. I’ve written about it before, in a column in which I reviewed the book. I found it “beautifully written” and useful for the way it laid out the argument against an autism epidemic. But I said I fundamentally disagreed with it.
And I pointed out that Grinker had messed up the math in a reference to Case 3: Richard M., in Leo Kanner’s landmark 1943 paper on autism. At about age one, Richard got a smallpox shot that was followed by a fever and illness that lasted a week, and later his mother told Kanner she recalled him losing skills he had started to develop. If you carefully track the chronology contained within that case study, you realize this regression started about the time of the smallpox shot and subsequent reaction. But Grinker gets the chronology wrong -- he puts the regression at age TWO, not age one. At that later age, the regression obviously could have had nothing to do with the shot at age one.
To my mind, this association between shot, illness and autistic regression in Case 3 is not a minor matter -- it is a clue, a warning from the very beginning of the Age of Autism. But Grinker misreads his way right past it. Here’s what Grinker writes: Richard “showed signs of normal cognitive development -- or at least this is what the parents retrospectively argued -- until he was about two. Then, as his mother wrote to Kanner, ‘It seems that he has gone backward mentally gradually …”
No, not at age two. At age one. When he got the shot and got sick. And regressed. Wrong again.
I’m going to venture a guess that at least the first two screw-ups I cited came by way of research assistants. But if you’re going to stake your professional reputation on the idea there’s no autism increase and no epidemic -- no worries, mate! -- you’ve got to get in there and read the early literature for yourself, and read it carefully, and get it right. I’ve spent so much time in archives over the past four years that I feel like I have a permanent coating of dust on me and haven’t seen the sun since 2005. Right now I’m flipping through my library cards for the D.C. public library, the University of Maryland, the Maryland State Archives, North Carolina State, John Hopkins Medical Archives, the New York Public Library, the Library of Congress, the National Agricultural Library, the Arlington Public Library, the Falls Church City Library and the National Archives. It’s slow and tedious work but my motto, apologies to The X-Files, has become “The Truth Is IN There.” And it is, believe me.
Of course, all this seems like quibbling, not anything consequential, to the medical mainstream, those who already know autism didn’t start in the 1930s, who already know it doesn’t have anything to do with vaccines or mercury, who already know it isn’t increasing. They rather pity us poor misguided purveyors of Internet inaccuracies.
“The debate about whether thimerosal [vaccine mercury] is linked to autism has been fueled by a recent book on the subject, … high-profile articles by Robert F. Kennedy Jr., and stories by Dan Olmsted of United Press International [now of Age of Autism],” Grinker writes in Unstrange Minds.
“The widespread dissemination of information via the World Wide Web sometimes makes us ordinary parents believe we are experts, or at least paraprofessionals. …” So, fellow ordinary folk, and especially you out-of-your depth parents out there, let’s back off and let the “experts,” the ones who have the professorships and the degrees and who write the books and publish the papers, handle these things. We can trust them to get this right.
On second thought, I’m starting to wonder whether that is such a good idea.
Dan Olmsted is Editor of Age of Autism