Dr. Rahul K. Parikh, I Am Becoming Embarrassed For You

By David Kirby

Some Pediatricians are thoughtful. Others are just plain, (well, let's be polite) "belatedly informed."

To wit: The recent book review by Rahul K. Parikh, M.D, in Salon: (HERE)

In his overly simplistic way, this pediatrician from Northern California, who has repeatedly ignored third-party invitations to debate me in an open forum, praises Dr. Paul Offit for his attacks on groups like DAN! and Generation Rescue, while holding up Autism Speaks as a bastion of rational scientific thinking, one that does not succumb to what this doctor calls the "slanted science" of thimerosal research:

"While Offit focuses on those groups (like Defeat Autism Now! and Generation Rescue) that have been very confrontational and that support slanted science, there are many … groups (like Autism Speaks) that have been broader in their search for autism's causes and cure."

Dr.  Parikh published those comments on September 22, 2008. One has to wonder why he did not first check the website of the ("non-slanted") Autism Speaks, just four days earlier, on September 18, before he composed his review.

I did, and this is what I found:

"Three projects will focus on the potential role of vaccines, specifically the role of ethylmercury or other vaccine components. These include a project by Dr. Flavio Keller at the University Bio-Medica in Rome, who will study the behavioral and pathological effects of ethyl and methyl mercury on a strain of mice that possess a certain mutation in order to examine gene and environment interactions. Dr. Mark Noble from the University of Rochester will use a genetically modified cell line to study the effects of ethylmercury and aluminum hydroxide on oxidative potential. Finally, Dr. David Baskin from Methodist Hospital in Houston will study cell proliferation in response to thimerosal exposure. http://www.autismspeaks.org/press/environmental_grants_2008.php

Dr. Parikh – Please get your rhetorical ducks in a row, or refrain from participating in this discussion altogether. Misinformation is a dangerous thing. If Autism Speaks is not "slanted," then how do you explain their support for thimerosal-autism research?

And, if you ever change your mind about a live debate, I know several universities that might want to sponsor it.

David Kirby is a journalist, author of Evidence of Harm and a contributor to Age of Autism.

Comments

[John Stone]

Huh?

Yes, indeed. I am sure that the Alan Rees's challenge to the vaccinators to accept the infant vaccination load adjusted to adult weight still stands:

http://www.bmj.com/cgi/eletters/330/7483/112-d#93670

But I will let you into a secret. Even you placed before them the challenge of accepting the infant vaccine load at the an adjusted weight (ie a fraction of what our children get), they would remain equally silent, or make their excuses and run.

[huh?]

Dr. Parikh wrote : "In pediatrics, we dose drugs and therapies by weight, so kids who are heavier get more."
oh really? why not the same approach to vaccines?

[ObjectiveAutismDad]

To Dan Roy and Dr. Parikh,

Oh, where to begin...

Regarding debating: Mr. Kirby invited any and all comers to debate in several different forums of which Dr. Parikh participates. So he was invited albeit not individually (at least AFAIK). And you could have brought friends -- so the "one bullet believer" comment is a total cop-out. And, if you have the truth behind you then you shouldn't need any help.

Twice in this response he points out what "others" in the community do that Mr. Kirby didn't. What's the point of that???

Dr. Parikh repeated his "disclosure" where he specifically states that he doesn't get any money from the pharmaceutical companies. But he still hasn't answered the other 5 questions that were originally asked of him by "thebossthetruth" on Huffington Post (which I reposted below -- see the 2nd message in this thread -- near the bottom). IS ANYONE ELSE PAYING YOU TO DO THIS?

Regarding: "Cite studies that have very little relevance...". Did you read what you wrote here? In what way are these studies not relevant???

Regarding the dosing levels in animal studies of thimerosal: Most of the studies that I've looked at in this regard specifically state that they've dosed relative to the weight of the animal. So which one(s) are you referring to specifically?

The recent MMR study did an absolutely horrendous job of attempting to recreate Wakefield's study as has been reported on this site and many other. 20%, only FIVE children, in this study met the same criteria as Wakefield's study. This is good science???

Despite what you think Age of Autism and Generation Rescue don't exist "solely to try to prove a vaccine-autism link." We have much bigger problems than trying to prevent this from happening to other children -- but we're going to keep trying to do that as well, because we know what it's like.

"vaccines are safe and effective" -- where is your scientific proof of this (i.e., vaccines, plural, in combination)? (It's a rhetorical question, because we know you don't have any.)

Autism isn't one of the risks of vaccines you say? How do you know? Epidemiological studies? None of these studies, as you should well know, prove that vaccines do not cause autism; and it's not good science to say they do. You DON'T KNOW what causes autism. So you can't prove that it's not the vaccines.

If you care so much about children why don't you advocate for a wide scale vaccinated vs not-vaccinated study that would provide a better understanding of the risks of vaccines? Until you and the rest of the entrenched medical community do then you'll continue to see a decline in vaccination rates. Ivory tower versus reality: Your words and Dr. Offit's are falling on deaf ears -- because the kid down the street has autism, and that scares the hell out of people (as it should).

[Stagmom - Geneticist]

Oh yes, the concerned neuro says, "I recommend you see a geneticist." Finally a scrap of hope! You go. You do the blood draws from hell. You learn your girls are perfectly genetically intact. You hang the results next to your perfect MRI, your perfect CATs and your perfect EEG's...... And you still a child who no longer speaks, is clumsy, can't poop and on and on and on. And this after millions have been poured into the genetics holy grail. Also know as the commode as far as it helps today's real, live children.

[Dan Roy]

This is Dr. Parikh's reply in Salon of Sep, 23 to Kirby's rebuttal above.

David Kirby wrote a rebuttal to my book review in Salon of Dr. Paul Offit’s new book, Autism’s False Prophets.

Here’s a link to his post:

“Dr. Parikh, I am Becoming Embarrassed for You.”

Far be it for me to change Mr. Kirby’s mind. On the other hand, I didn’t write the review to persuade him or those like him who religiously believe in this autism-vaccine link. I write about autism and vaccines to make sure that parents understand that their child’s doctors care deeply about them and that vaccines are safe and effective. Like anything else in medicine, they have risks. But autism isn’t one of them, and the benefits of vaccines clearly outweigh the risks for both a single child and our society as a whole.

But since he makes some claims, I’d like to clarify a few points:

He’s never invited me to “debate” him. The only invitation I’ve ever received to debate anybody about this came earlier this morning via my email, where the manager of autism one radio asked me to debate Andrew Wakefield. I declined that invitation because, as one person said, I don’t want to be the one bullet believer amongst a bunch of grassy knoll conspiracy theorists. But neither Mr. Kirby, nor anybody representing him, has ever contacted me. But I did email him through his website today to ask him if he’s been emailing the wrong person and to let him know about this rebuttal.

He’s right that Autism Speaks does sponsor some anti-vaccine research, but as opposed to Mr. Kirby and the organization that pays him (Age of autism) or Jenny McCarthy’s group (Generation Rescue), they don’t exist solely to try to prove a vaccine-autism link.

Mr. Kirby’s response is also a pretty clear case study of the usual methods anti-vaccine folks use to defend their point of view

· Attack the messenger: “Some Pediatricians are thoughtful. Others are just plain, (well, let's be polite) "belatedly informed."

A more typical example of this is when anti-vaccine folks say that doctors who speak to the safety of vaccines are all paid speakers for vaccine makers or are somehow doing it on their behalf. Mr. Kirby didn’t do that here, but that’s because I added my disclosure to the end of my article:
“Dr. Parikh does not have, nor has he ever had, any relationship, financial or otherwise, with vaccine makers or other other pharmaceutical companies.”
· Demand we stop speaking up: “Dr. Parikh – Please get your rhetorical ducks in a row, or refrain from participating in this discussion altogether.”

Letters and emails that I’ve received from past articles I’ve written about autism and vaccines have demanded that I (or my editors) retract what I’ve written. Mr. Kirby is a lot more restrained here than others, but his point seems to be the same: View different than theirs should not be allowed.

· Cite studies that have very little relevance: “Three projects will focus on the potential role of vaccines, specifically the role of ethylmercury or other vaccine components. These include a project by Dr. Flavio Keller at the University Bio-Medica in Rome, who will study the behavioral and pathological effects of ethyl and methyl mercury on a strain of mice that possess a certain mutation in order to examine gene and environment interactions. Dr. Mark Noble from the University of Rochester will use a genetically modified cell line to study the effects of ethylmercury and aluminum hydroxide on oxidative potential. Finally, Dr. David Baskin from Methodist Hospital in Houston will study cell proliferation in response to thimerosal exposure.”

Lately, anti-vaccine folks have been funding and citing a series of animal studies demonstrating thimerasol is toxic. But none really furthers the case that thimerasol causes autism (I’ll get to aluminum below). For one thing, the relative concentration of thimerasol animals are exposed to in these experiments is very different than in kids. Here’s why: In pediatrics, we dose drugs and therapies by weight, so kids who are heavier get more. This ensures medicine is effective and safe. If you give, as has happened in many of thee animal experiments, the same amount of thimerasol to a rat or monkey as to a child, you’re giving much greater relative amount because these animals weigh much less than a child. Just about anything given in high enough amounts can be toxic. An example of this is the Ames cancer test, in which you can place any suspect chemical onto a testing medium that reacts if that suspect chemical is carcinogenic. The thing is, the Ames test reacts to just about everything you put on it if you add enough of it. Think of these animal thimerasol experiments like placing infinite amounts of mercury onto the Ames test—it will cause a reaction and then every anti-vaccine advocate will declare that they’re right.

On the other hand, the latest MMR study looking at people (the link is in my review) that came out showing (once again) that there is no link between it and autism was very relevant for many reasons—first, it essentially reproduced what Wakefield did and contradicted his findings. Second, the study was designed with the input and participation of groups who are against vaccines. A unique and interesting collaboration. Mr. Kirby hasn’t commented on this study anywhere—he knows about it, since sources tell me he was part of a conference call with the media when the study was released.

A couple of other methods Kirby did not use here, but others he supports do use:

· Move the target: First it was MMR, then it was thimerasol. Now that studies have shown they’re both safe, anti-vaccine folks are moving on the aluminum, “antifreeze” (there’s no antifreeze in vaccines), to anything else that helps make the safe and effective. I’ve even seen studies that blame Tylenol for causing autism coming from this camp. In short, the whenever scientific research debunks the latest culprit in vaccines, they move the target.

· Good P.R: One page ads in newspapers to scare parents, celebrity endorsements, political hearings—all of these are tools that anti-vaccine folks have used to make their case. Psychologists call this the “principle of social proof” or "social authority." Advertisers use it a lot to sell products. Have someone with stature stand next to you and endorse you or what you’re trying to sell. It’s a quick way to get credibility and publicity for your agenda. Anti-vaccine folks have been very effective at doing this. Offit makes this point when he reveals that Generation Rescue (the ones who placed those one page ads) hired the same P.R. agency that those who sued the maker of silicone breast implants used a couple of decades ago. Lately, that P.R. campaign has taken on the slogan "Green Our Vaccines." But what, exactly and specificially, does that mean? Removing everything from vaccines that anti-vaccine folks think are poisonous would, well, be eliminating vaccines. After all, it's some these components that keeps them safe and effective. Before thimerasol, for example, some children would die from infection because they were given a vaccine from a contaminated vial.

Again, the question we need to ask of Mr. Kirby’s response (or any other argument coming from anti-vaccine advocates or groups) is the following: Does anything he said show that vaccines cause autism? Isn't that the question he seems to keep posing?

I don’t believe so. So instead of attacking the messenger, citing irrelevant science, moving the target, demanding that alternative views to theirs be squelched, or relying on slick slogans and celebrity endorsements, I would ask Mr. Kirby to clarify why he still believes vaccines cause autism, especially after we see his rationale explained in Dr. Offit’s book.

______________________________________________-
Addendum 9/24/08: Mr. Kirby has not responded to my email yet. On the other hand, he's busy briefing a NY congresswoman and 130 other members or staff of other other politicians on the autism issue. The hearing is run by a congresswoman who is, by her record, is anti-vaccine. In other words, it will be like Dan Burton's hearing as described in Offit's book. To make a more modern day comparison, as critical an interview as Sean Hannity interviewing Sarah Palin. To my knowledge, there are no opposing views being aired.

[doctorsknowbest]

"If you have not seen a geneticist, I would highly recommend a consultation."

That's a good one. Once fragile-X is ruled out, mainstream doctors just throw up their hands and say it is some "magically" genetic cause.

Ya know, if it were so easy that a simple genetic profile would give the answer, nobody would be asking these pesky questions about regressive autism.

[Sue M.]

"Posted by: nhokkanen
Dr. Parikh misspells Thimerosal 17 times.

Um - no nhokkan. "thimerasol" is considered correct spelling. How do you spell colour, flavour or aluminium vs aluminum. Oh and my son calls me mum".

Nope. Try again. Dr. Parikh misspelled the word thimerosal. Whether or not you can find some reference to a spelling of "thimerasol" somewhere is not important to me. The standard most well-known spellings are thimerosal or thiomersal. End of story. I guarantee you that Dr. Parikh's heart sank when he realized that he spelled the word wrong :)

It doesn't look good for him at all... being a doctor and someone who supposedly is so up on the vaccine/autism connection... He should be able to spell thimerosal. The average "Joe citizen" can get away with misspelling that word... but not Dr. Parikh.

So sorry.

[Solomon]

Aha! another doctor(Doc Bruin) that needs further education! I suggest DAN!Conference on Oct 23-27 for starters. Maybe you can get Big Pharma to sponsor you.

[belinda]

Posted by: nhokkanen
Dr. Parikh misspells Thimerosal 17 times.

Um - no nhokkan. "thimerasol" is considered correct spelling. How do you spell colour, flavour or aluminium vs aluminum. Oh and my son calls me mum.

[Steve]

Dr Bruin: "Since I have never encountered a patient situation such as yours, nor have I met a doctor who has managed a similar case, so it is difficult for me to answer your question as to why?"

Have you looked? I can introduce you personally to dozens families with similar stories. Have you looked at a kid with regressive autism and said "I am going to look until I find out what happened here"? Since you have "never encountered a case", the answer is no, and as such why are you commenting on the causes of regressive autism?

"There are known causes of developmental regression that are not related to vaccine administration and I trust that you have been seen by many physicians, including a medical geneticist to evaluate some of these known causes."

Name one that causes the lapse I described. Name one.

"Many causes of autism are yet unknown, but I feel that we are making progress."

Who is "we"? What are you doing to prevent or treat autism in your practice?

"I definitely do not want to return to the days of polio, HIB meningitis and rampant whooping cough and it is my job to protect my patients and my community in the best way that I can."

Nor any other lists of diseases of the past that have left on their own or with the help of vaccines. I noticed you didn’t say “the days of hepatitis or chicken pox or flu”. Can we start with an honest debate on turning the clock back some on the vaccine schedule?

"While I emphathize with your situation, I cannot give you an answer as to why your child regressed, nor do I think it is reason for me to stop vaccinating the children in my community. I also I do not think that gives you the right to scare other families from preventing their children and our communities from vaccine preventable diseases such as HIB, measles and pertussis."

Now tell me Doc Bruin how did I "scare families"? I simply told the truth. Are you asking me to withhold the truth? Are you saying that my kid gets this sick after vaccination and I don’t have "the right" to talk about it? Do you hear yourself? Again I ask have you put your "empathy" in action?

"If you have not seen a geneticist, I would highly recommend a consultation."

Actually Doc Bruin I had thousands of dollars of genetic testing done at one of the top genetic research hospitals in the country. Guess what the results are… I bet you can… the results were a completely normal genetic profile.

Thanks Doc Bruin for once again documenting how completely out-of-touch the average physician is with what is really going on with regressive autism.