By Teresa Conrick, Dan Olmsted and Mark Blaxill
We found her.
Eight years after setting out to identify the 11 children in the first medical report of autism, we have found “Virginia S.”, the eldest child in that landmark paper -- and thus the first-born child of the Age of Autism.
Her real name: Vivian Ann Murdock. Born in 1931, Vivian was placed in a Maryland institution at age 6 and died in a state-run home in 1987, age 56. She was the daughter of a prominent Baltimore psychiatrist, Harry M. Murdock, and his wife, Margaret.
The key to finding her real name was the recent online publication of the 1940 U.S. Census – allowing one of us (Teresa) to test her hunch about the institution to which"Virginia" had been committed as a child: The Rosewood School in Owings Mills. The hunch was correct; the Census listed an "Inmate" there named Vivian Murdock, age 8 in 1940, who we conclusively identified as "Virginia S."
In Dan and Mark's The Age of Autism – Mercury, Medicine, and a Man-made Epidemic, published in 2010, we described the seven children we'd identified to that point, and wrote of “Virginia”: “We continue to search for this eldest child of the Age of Autism and whatever clues her identity may hold.”
Now, having spoken with family members, and pored over countless records and archives, we believe her identity does offer important clues, ones remarkably consistent with the other cases in that first report -- exposure to new mercury compounds in their families.
Vivian was directly in the path of at least three mercury vectors:
-- the first use of mercury-preserved vaccines in Baltimore -- a drive to vaccinate every infant with those shots began the month she was born;
-- her parents' avocation of orchid growing and breeding, which required intensive application of chemicals including mercury;
-- and her father’s psychiatric career, which brought him – and probably his family through second-hand exposure – in contact with mercury treatments for a common form of insanity.
Mercury is no longer used in agriculture or mental health treatment. But each year, 100 million children worldwide get vaccines containing thimerosal, the ethylmercury preservative first used in those shots in Baltimore. In the United States, flu shots, most of which contain mercury, are recommended for pregnant women and for infants beginning at 6 months of age.
Our research on Vivian and the other first cases of autism suggests that is a very bad idea.
Vivian’s identity also offers insight into how the damaging idea of “refrigerator parents” – supposedly cold and neglectful mothers and fathers responsible for causing their children's disorder -- got its start. We will explain these clues and conclusions in detail, but first the basics about the discovery of Vivian Murdock.
Seventy years ago this month, in April 1943, a psychiatry journal called The Nervous Child published an article titled “Autistic Disturbances of Affective Contact.” Written by Leo Kanner, a Johns Hopkins child psychiatrist who is widely considered the founder of the field, it begins:
“SINCE 1938, there have come to our attention a number of children whose condition differs so markedly and uniquely from anything reported so far, that each case merits -- and, I hope, will eventually receive -- a detailed consideration of its fascinating peculiarities.” Elsewhere, he called it "a behavior pattern not known to me or anyone else theretofore."
The three of us have always found those words remarkable, coming as they did from an acknowledged authority who eight years earlier had catalogued every known childhood mental disability in his landmark 500-page book “Child Psychiatry.” Those pages contained not a whisper of autism, or anything that in retrospect looks similar.
Our own research convinced us the autism rate before 1930 was effectively zero (it is now 1 in 50). A handful of cases over several centuries might conceivably qualify, but there was nothing approaching the cluster of children whose worried parents brought them to see Leo Kanner in the years between 1938 and 1943.
Curious whether the family backgrounds of those first 11 cases might point to common environmental exposures, we began trying to identify them in 2005. The eight boys and three girls were described in the paper only by a first name and last initial. But because Kanner gave birth years for each child, we knew that “Virginia S.” was the oldest; her birthday was listed as September 13, 1931. Even as the number of autistic children seen by Kanner rose in later years, none appears to have been born earlier. (In a 1955 update, Kanner revisited his first 42 cases. The oldest autistic person at that point was 24 -- born in 1931 and presumably Virginia S.)
We began our hunt with Kanner’s original 1943 "Autistic Disturbances" report and a follow-up paper he wrote in 1971. (In the latter paper, he slipped once and referred to “Virginia S.” by what we now know is her real first name, Vivian.) In “Autistic Disturbances,” he quoted a psychologist noting that Virginia “could respond to sounds, the calling of her name, and the command, ‘Look!’
“She pays no attention to what is said to her,” the psychologist said, “but quickly comprehends whatever is expected. Her performance reflects discrimination, care, and precision. … She is quiet, solemn, composed. Not once have I seen her smile. She retires within herself, segregating herself from others. She seems to be in a world of her own …”
Of his wife, the father said: “She is not by any means the mother type. Her attitude [toward a child] is more like toward a doll or pet than anything else.” When Vivian’s older brother, "Philip," was interviewed at Hopkins, he burst into tears. “The only time my father has ever had anything to do with me was when he scolded me for doing something wrong.”
“His mother,” Kanner reported, “did not contribute even that much. He felt that all his life he had lived in a ‘frosty’ atmosphere with two inapproachable strangers.” Philip had a stutter that in the circumstances must have been viewed as psychological as well. That emotionally “frosty” image would haunt autism parents for decades; to the extent that it placed responsibility for autism within the family unit, rather than outside in toxic exposures, it arguably still does.
At the end of his 1943 report, and with Vivian’s parents no doubt top of mind, Kanner wrote: “One other fact stands out prominently. In the whole group, there are very few really warmhearted fathers and mothers. For the most part, the parents, grandparents and collaterals are persons strongly preoccupied with abstractions of a scientific, literary, or artistic nature, and limited in genuine interest in people.”
Within a few short years, Kanner was calling the mothers and fathers of autistic children “refrigerator parents,” claiming that must have something to do with the genesis of the baffling disorder. Time magazine wrote in 1960 that “Kanner has sometimes written of the 'refrigerator' type of parent...highly intelligent, organized, professional parents, cold and rational...who just happened to defrost long enough to produce a child.”
Kanner later abandoned that idea entirely, as has the medical community, but not before Bruno Bettelheim ruled autism orthodoxy, and ruined untold lives, with his claim that infants retreated into “the empty fortress” of autism in fear of their mother’s homicidal feelings.
Vivian did not marry or have children. But we located and spoke with her three nieces and nephews – Tim, Laurie, and James -- all of whom were surprised to learn of her role in the history of autism. Their father, Vivian's brother “Philip” in the 1943 study, is Bruce P. Murdock, who now lives in a Baltimore retirement home and was not able to be interviewed.
“Do you know who my grandfather was?” Tim asked, describing Harry Murdock’s long tenure as medical director of the Sheppard Pratt mental hospital, which still occupies a sprawling, manicured campus just north of Baltimore, adjoining Towson State. A behavioral health non-profit, it has 2,500 employees and 33 programs in 11 counties.
When Harry Murdock died in 1982 at the age of 79, the Baltimore Sun obituary quoted Sheppard Pratt’s director at that time on his “extraordinary human kindness and understanding” along with “outstanding clinical competence and administrative skill.” Survivors were listed as his son, Bruce, and Bruce's three children. His daughter, Vivian, though living, was not mentioned. His wife, Margaret, died in 1977.
When we read Tim Murdock the description of his grandparents from Leo Kanner's 1943 study, he told us: "That’s point-blank accurate. My father has always made reference to the fact that there was zero connection with his parents. They didn't have time for him, to the point of my father apologizing for not being a father because he didn't have a father."
Tim’s sister, Laurie, had similar memories when we spoke with her. She said when she was born, her parents felt uncomfortable bringing her around the grandparents, apparently because of their sadness over their own daughter, Vivian. The third grandchild, James, recalled Harry and Margaret as “aristocratic" -- even Christmas was a rather formal affair, as if handing out presents was “scheduled,” rather than the free-for-all in many families with young children.
The Murdock grandchildren knew of Vivian’s existence, but few details. Tim Murdock said he knew she had been institutionalized from an early age; he believed she was mentally handicapped; his father seldom spoke of her, and he did not know she had died until we told him. James says he learned of her in the 1980s, when he and his wife were about to have their first child; his father was worried about a family predisposition to having a mentally handicapped child.
After we contacted Tim, he went online to look at our reporting. When he called back, he said he was struck by our description of a plant pathologist who also lived in Maryland.
“Is that my family?” he asked. It wasn’t, we explained. It was another of the first 11 cases, whose father, Frederick L. Wellman (below), was a scientist at the Beltsville Agricultural Research Center in the Washington suburbs of Maryland. Wellman’s archive showed him experimenting with plants, seeds and mercury compounds – including the new ethylmercury seed disinfectant Ceresan -- over a long career. (The brochure below is in his papers at North Carolina State. We gave a detailed look at the agricultural connection to mercury in the early cases.)
Then it was our turn to be surprised: Tim told us why he focused on the Wellmans. His own grandfather, while a psychiatrist by profession, was an avid orchidist. (“Outside his fields of medicine and psychiatry, he was a founder and early president of the Orchid Society of Maryland,” his obituary said.) Harry Murdock was, in essence, an amateur plant pathologist.
“The strong connection in my mind is the connection between plant pathology,” Tim Murdock told us, speaking of the Murdocks and the Wellmans. “I know for a fact my grandfather developed a strain for a particular orchid. My father was always saying how my grandfather and his mother galloped in the greenhouse nude developing all this orchid stuff. There's all kinds of mercury connections" in the chemicals used to breed and raise orchids, he said. Sister Laurie also remembered the orchids, and the chemicals.
Harry Murdock and his wife spent hours in the large greenhouse in the back yard of their residence, a stately home called Auburn House on the Sheppard Pratt grounds. (It is now the Towson State athletic director's office.) According to James, the greenhouse was around 20 by 40 feet, about 80 feet from the house. He remembers “a rain forest” atmosphere inside, and recalls putting his nose close to smell the flowers. When his grandparents moved to a private home off the Sheppard Pratt grounds, they had another orchid house, this one above the garage, accessible from the kitchen through a foyer.
Orchids are the ultimate hothouse flower, gorgeous, difficult, demanding attention – and heat (which might explain wearing little or nothing to tend them). They thrive in 70 to 80 degrees, all the way into the 90s. The movie of the detective classic The Big Sleep starts with Humphrey Bogart meeting a frail elderly client in a wheelchair, wrapped in a shawl in the sweltering orchid house inside his mansion. Bogart takes off his jacket, sweats through his shirt, mops his brow, gulps his drink. “The orchids,” the old man laughs, “are an excuse for the heat.”
But heat is not enough. Under the heading “Harvesting the Seeds,” the American Orchid Society Bulletin for March 1937 prescribes this treatment for the seeds of new hybrids like the Murdocks worked on:
“Take some test tubes of different sizes, stop them up with cotton treated with bichloride of mercury. Sterilize them by baking in an oven at 180C for thirty minutes. The cotton should be slightly yellowed when it comes out of the oven. Next, place the test tubes with the stoppers in a tin box, the bottom of which has been covered with cotton to avoid breaking, and store in a dry place.”
That kind of chemical connection is why Tim Murdock identified with Frederick Wellman’s background; the first paper in Wellman’s archive was an experiment with the same chemical, mercuric chloride (also known as mercury bichloride), to disinfect cabbage seeds. Wellman's son was born in Beltsville in 1936, about 40 miles west and five years later than Vivian Murdock, as Wellman experimented with the new ethlymercury dust Ceresan on all kinds of seeds. (Another of the first 11 fathers was a forestry professor who worked around a new lumber preservative, Lignasan, made with ethylmercury.)
But seed treatments aren't the only plausible connection to mercury in the Murdock family background.
Harry Murdock was born in Omaha in 1903, Margaret Shaw in Des Moines in 1904. Harry got his bachelor’s of science degree in 1925 from the University of Nebraska; Margaret was a student at the University of Iowa. They met and married. Bruce, their elder child, was born in 1927 in Nebraska.
That same year, Harry got his M.D. from the University of Nebraska, and he taught at the Colorado School of Medicine while a Commonwealth Fellow at Colorado Psychopathic Hospital. In 1930, he took a job at Sheppard Pratt in Maryland. Vivian was born there on August 29, 1931. (Kanner reported the date incorrectly as September 13, perhaps in error, perhaps to disguise the family of a local colleague.)
That move east in 1930 may have shaped the way the Age of Autism was about to unfold. The ethylmercury vaccine preservative thimerosal was first introduced that year in multidose vials of the new diphtheria toxoid vaccine. Baltimore – home of Johns Hopkins, a leading medical school with a major public health outreach to the community – was an early adopter.
This chart from the 1931 Baltimore City Health Department Annual Report shows the first use of diphtheria toxoid -- the 30 c.c. packages at the far right are multi-dose containers of the new toxoid vaccine that would have been preserved with ethylmercury. The older and less effective antitoxin and toxin-antitoxin compounds, at left in the chart, were being phased out in favor of the new toxoid formulation.
"During the year the Department began the distribution of diphtheria toxoid on a large scale," the 1931 report said. "In May, we began the distribution of this product in individual packages to physicians. On October 1 the Bureau of Child Welfare began the use of diphtheria toxoid exclusively in all their clinics."
That means the bureau abandoned the older formulations completely in favor of the new mercury-preserved diphtheria toxoid shots, right when Vivian was born.
At the same time, the Health Department began an annual drive to inoculate all infants against diphtheria at six months of age. The Director of Health wrote, ""Diphtheria is one of the most preventable of diseases. If each child in the city could receive two doses of toxoid a month apart, shortly after the age of six months, this scourge of childhood would rapidly disappear. It is the hope of the Health Department, with the assistance of the medical profession and cooperating civic groups, to eradicate diphtheria from Baltimore."
So in 1931, "During the months of August and September [Vivian was born August 29], the Health Department conducted a diphtheria immunization campaign in which a large number of pre-school children were immunized against diphtheria."
That means the first child with autism was born the same month a campaign to inject all infants with mercury-containing shots was launched, and local physicians were called on to help.
Vivian, daughter of a doctor, turned six months old in February 1932, the right age for the new shot. By the end of that year, about a quarter of Baltimore children had gotten the injections, and "by the end of the year 1933 it is estimated that 31.3 per cent of children under five years of age have received the required inoculations of toxoid." Vivian Murdock likely was among them.
As we wrote in The Age of Autism, speculating on where we might eventually find “Virginia S.”: “She was born just in time to be caught up in the early wave of diphtheria vaccination in Baltimore or New York or Boston or another early-adopter location.” Indeed she was. (Another of the first 11 cases we've identified was the daughter of a public health pediatrician who actively campaigned for early childhood vaccinations -- "in the case of diphtheria, booster shots are extremely important," she told the Annapolis PTA. Three more of the 11 children were infants in Baltimore in the early 1930s as the mercury-containing shots became universal.)
A third possible vector: Psychiatrists in the 1930s often encountered a mental illness in syphilis patients called general paralysis of the insane. One of the main treatments was mercury, both in the form of rubs and mercuric chloride injections. Records show the Colorado Psychopathic Hospital had a practice in neurosyphilis back in the period from 1928-30 when Harry Murdock was a Fellow there. Such patients would have occupied a number of beds there and at a large, long-term facility like Sheppard Pratt. For Murdock, exposure to mercury would have been an inevitable occupational hazard.
Four of the first 11 fathers were psychiatrists. While some have said this points to "selection bias" -- meaning psychiatrists would have been likelier to get help for a child with a strange new affliction than typical parents -- that is just speculation. One thing is certain: It had nothing to do with the way Virginia was discovered.
Though she was the oldest child in birth order, Vivian Murdock was not the first to come to Leo Kanner’s attention at Johns Hopkins. That child was Donald Triplett, from Forest, Mississippi, who became “Case 1 – Donald T.” (We identified him first, in 2005.) After that, the order in which Kanner wrote about the children seems random, perhaps designed to create a coherent narrative. Vivian Murdock was “Case 6 – Virginia S.”
In order of referral to Hopkins, Vivian was next to last, seen in November 1942, just six months before publication of “Autistic Disturbances.” By then, we know Kanner already had formulated his observations on the “markedly and uniquely” different syndrome that came to be known as autism. So Vivian's arrival helped him fill out the profile, rather than creating it.
She was first spotted not by Kanner but by Esther Richards, a colleague at Hopkins who was on the board of visitors at the nearby Rosewood School, the institution for the mentally handicapped where Vivian, then age 11, was living. No doubt Richards was familiar with Kanner’s developing research on the strange condition he would call “autism,” and brought the girl to his attention.
"Virginia stands out from other children," Richards wrote, "because she is absolutely different from any of the others." She did not talk. She did not play with other children. She did picture puzzles by the hour. "All findings seem to be in the nature of a congenital abnormality which looks as if it were more of a personality abnormality than an organic defect."
No wonder she seemed absolutely different. She was the earliest known case of a brand-new disorder.
It is not hard to see how the “refrigerator parents” image got its start with Vivian's family: the parents by the father’s own account were less than attentive to their children; the brother had his own grievances and disability; the father was a leading psychiatrist at a posh private mental hospital who "dumped" -- Kanner's word -- his 6-year-old daughter into a public institution for the mentally handicapped.
And Rosewood was, even by the standards of seven decades ago, a hellhole. "About one-fourth of the patient body at Rosewood consists of custodial cases," according to a 1946 report; Vivian would have been one of them. "Most of these are individuals with mentality of infant level or lower. All any institution could do for them is to provide adequate care and reasonably pleasant surroundings.
"However, Rosewood fails even in this respect. Instead these unfortunates are herded together into huge basement 'playrooms'; the total effect of the smell, sight and sounds of Rosewood's Hill Cottage can be guaranteed to produce revulsion and often nausea into anyone viewing it for the first time."
That was bad enough. But there is another, more personal reason Kanner might have loathed anyone who committed a relative to Rosewood. In 1937 – just a year before he saw his first autism case – Kanner delivered a paper at the annual meeting of the American Psychiatric Association in Pittsburgh. Titled “Habeas Corpus Releases of Feebleminded Persons and Their Consequences,” it recounted his own investigation into the scandalous treatment of patients at the Maryland State Training School for the Feebleminded – Rosewood.
Ksnner discovered that many of them, especially young women, had been sent over a period of two decades to live with families that treated them as little better than indentured servants. (And probably worse.) The school, with judges’ consent, released 166 such patients between 1911 and 1933, all but 15 of them females. “The Maryland Courts,” Kanner wrote with contempt, “were allowed to function as employment agencies for domestic servants."
Kanner’s expose made headlines in the local papers and quickly brought an end to the practice. So when he came upon Vivian there just five years later, that could have strengthened his dislike for the parents. Not for the last time, it may have led him to overlook a much more dangerous “environmental” risk in the child's early life – toxic substances.
What we’ve learned about “Virginia S.” raises a final, and unexpected, question for us: Did mercury affect more of the Murdock clan than just Vivian? Could it explain any of the anti-social strangeness in the parents that Kanner remarked on to such unfortunate effect?
That’s impossible to say, of course. But we do know mercury can cause a condition called erethism, characterized by behavior changes such as irritability and excessive shyness; it was known to afflict people who worked too long around mercury vapor. This might explain Kanner's observations of others among the original families as well. The father of “Alfred L.”, he wrote, “does not get along well with people, is suspicious, easily hurt, easily roused to anger, has to be dragged out to visit friends, spends his spare time reading, gardening, fishing.” That father was a lawyer at the U.S. Patent Office in Washington – and a chemist by training.
If mercury played a role in parental behavior as well as the children’s disorder, and led to a misunderstanding of its cause, that would be a sad echo. We proposed for the first time in The Age of Autism that many of Freud’s early hysteria cases were mercury poisoned – by mercury rubs for syphilis and mercuric chloride antiseptics. Families of the first autistic children suffering similar effects, and psychiatrists once again missing them, would not surprise us.
What became of Vivian? In Leo Kanner’s 1971 follow-up paper on the first cases of autism, he wrote: “Virginia will be 40 years old next September. She has been transferred to the Henryton State Hospital. ‘She is,’ the report from there, dated November 2, 1970, says, ‘in a program for adult retardates, with her primary rehabilitation center being the Home Economics Section. She can hear and is able to follow instructions and directions. She can identify colors and can tell time.
“She can care for her basic needs, but has to be told to do so. Virginia likes to work jigsaw puzzles and does so very well, preferring to do this alone. She can iron clothes. She does not talk, uses noises and gestures, but seems to understand when related to. She desires to keep to herself rather than associate with other residents.”
Nothing but her location had changed in three decades, in short, including the fact that she was still surrounded by people who were nothing like her. Nothing at all.
After that, Vivian the person disappears from history. She died seventeen years later, and was cremated. Her simple marker at Wicomico Memorial Park in Salisbury, Maryland:
So what might this new, if still unfinished, portrait of “Virginia S.” as Vivian Ann Murdock tell us about autism?
Set side by side with the other seven cases we’ve identified, we believe it strengthens the case that autism is an environmental illness, not a genetic one; that the “markedly and uniquely” different behavioral syndrome called autism, strikingly evident from infancy, had a beginning with the commercialization of ethylmercury compounds in agriculture and medicine; that those like Vivian with the earliest and greatest mercury exposures faced the first and worst risk.
This risk has now spread worldwide and probably includes other sources of mercury and other vaccine ingredients, such as aluminum, another toxic metal used as an immune stimulant in vaccines.
That is a tragedy of historic proportions. The good news is that because the Age of Autism had a beginning, it can have an end. But first these clues need to be taken seriously, along with the eyewitness accounts of thousands of parents whose children have regressed immediately after mercury-containing vaccinations; the growing body of research that shows ethylmercury is exquisitely toxic at infinitesimal, parts-per-billion levels; and the unconvincing denials by public health officials and drug company spokesmen who, we suspect, are in too deep to ever face the truth.
Early in 2013, the United Nations, backed by the American Academy of Pediatrics, exempted vaccine mercury from its treaty banning mercury compounds. A World Health Organization panel said it was “gravely concerned" the debate could harm vaccination efforts “without scientific justification.” It called mercury a “safe, essential and irreplaceable” component of vaccination programs, “especially in developing countries.”
But from the very first, we believe, the link between mercury and autism has been there to see, hidden in plain sight in those first 11 cases. Public health officials in the United States and around the world need to look at the evidence again, this time with open eyes and a healthy respect for the precautionary principle. That should be the real legacy of Vivian Murdock, the first child of the Age of Autism.
Teresa Conrick, Dan Olmsted and Mark Blaxill are Contributing Editor, Editor, and Editor at Large of AgeOfAutism.com. Olmsted and Blaxill are co-authors of The Age of Autism – Mercury, Medicine, and a Man-made Epdemic, published in 2010 by Thomas Dunne Books. Thank you to Stuart Dahne Photopraphy for the use of the photograph of Rosewood.