By Dan Olmsted and Mark Blaxill
RALEIGH, N.C. -- Our search ends here, not far from where it began.
No, says Brook Blanton, listed as the "informant" on the death certificate, she can't give us any information. Politely professional, she can't even say what seems obvious -- that as an employee of Wake County Family Services, she served as guardian ad litem for the deceased, representing the interests of a disabled adult.
So we are left with not much more than "decedent's name: William Ritchey Miller."
We do know his parents called him Ritchey. And that Leo Kanner called him "Richard M."
And we know that by whatever name, he was Case 3 in Kanner's landmark 1943 report, "Autistic Disturbances of Affective Contact."
But beyond Kanner's writing we know only what William Ritchey Miller didn't do. Under marital status on the death certificate: Never Married. Under usual occupation: Never worked. Under decedent's education: 0.
The death certificate, which we'd picked up the day before at Wake County Vital Records, gives his date of birth -- November 17, 1937. The certificate says he died on July 8, 2011, cites "multiple myeloma" as the cause, and reports he had been sick for a year. He was 73 years old.
Given the bureaucracy into which disabled children with no one to advocate for them can fall, it is frustrating but fitting that this is where the trail goes cold -- in a public agency where no one is allowed to even acknowledge his existence, surrounded by a virtual megalopolis of hospitals (Wake Med), rehab centers, nursing homes and assisted living, perhaps the nation's true growth industry. Raleigh has the fastest-growing proportion of 65 and older adults in the United States.
And autism, as the fastest growing developmental disorder in children, will eventually comprise a significant portion of such adults, many with no one to depend on at the end but a state-appointed guardian, and the kindness of strangers.
Pieced together from multiple sources culled over the past decade, here are the contours, if not the depth, of a life that deserves to be recognized, both for its own intrinsic value and for what it may tell us about the origins of the Age of Autism, and the future of the thousands now "aging out" into a life for which no one has prepared.
Kanner referred to those 11 children only by a first name and last initial, some accurate, some pseudonyms, some, like Richard M., amalgams. "Richard" arrived at the Johns Hopkins Hospital where Kanner practiced on February 5, 1941, age 3 years 3 months. His lack of ordinary responsiveness led his parents to believe he was deaf. He wasn't.
An intern made these notes: "The child seems quite intelligent, playing with the toys in his bed and being adequately curious about toys used in the examination. He seems quite self-sufficient in his play. ... He does not pay attention to conversation going on around him, and although he does make noises, he pays no attention to conversations going on around him."
Ritchey thus fit the emerging pattern Kanner was seeing for the first time -- children of at least ordinary intelligence and no visible physical abnormality who nevertheless were oblivious to the outside world, pursuing strange fixations, rigid routines and nonsense speech patterns, if they spoke at all. Most especially, they failed to form the ordinary bonds of infancy -- the "affective contact" -- that was universal to human development.
Baffled, Kanner wrote up his findings on the 11 children in 1943. By then, he had seen Richard M. twice more, with no improvement evident. "He did not communicate his wishes but went into a rage until his mother guessed and procured what he wanted. He had no contact with people, whom he definitely regarded as an interference when they talked to him or otherwise tried to gain his attention.
"The mother felt she was no longer capable of handling him, and he was placed in a foster home near Annapolis with a woman who had shown a remarkable talent for dealing with difficult children. Recently, this woman clearly heard him say his first intelligible words. They were, ‘Good night.’”
The next and last time we hear about Ritchey Miller, it is 1971, in a follow-up report on those first 11 children.
"After two changes of foster homes, he was placed at a State School for Exceptional Children in his home State [North Carolina] in May 1946," Kanner wrote about “Richard M.” "A report, dated June 23,1954, said: 'The institution accepted him as essentially a custodial problem; therefore, he was placed with a group of similar charges.’"
"Richard is now 33 years old. In 1965, he was transferred to another institution in the same State. The Superintendent wrote on September 29, 1970: 'At the time of admission, tranquilizers were pushed to the point of toxicity. After about 3 months, he showed some awareness of his environment and began feeding himself and going to the toilet. He is now being maintained on Compazine, 45 milligrams t.i.d.... He now resides in a cottage for older residents who can meet their own personal needs. He responds to his name and to simple commands and there is some non-verbal communication with the cottage staff. He continues to be withdrawn and cannot be involved in any structured activities.'"
Our search for Richard M. began in 2005, when we decided to try to identify the 11 children in Kanner's report. Using clues from the original paper and follow-up report, we have been able to identify eight of the 11 so far. As it happened, the first three we identified were cases one, two, and three, in that order.
The identity of Case 1, "Donald T.," yielded to a comment Kanner made in the 1970s that Donald was from Forest, Miss. A simple Internet search turned him up -- Donald Triplett in Forest, complete with street address and phone number. We subsequently visited him there, in the childhood home where he still resides. The fact that he was living happily on his own turned out to be quite a story.
Case 2, "Frederick W.," was identified because in his follow-up paper, Kanner said the child was known as "Creighton." That yielded reams of information on a distinguished family whose patriarch, Frederick Creighton Wellman, was the namesake of the child who became Case 2. The child's father, Frederick Lovejoy Wellman, was a prominent plant pathologist with the U.S. government.
Case 3, "Richard M.," was more difficult (as the rest have proved to be). We knew from Kanner's article that the father was "a forestry professor in a southern university," and that most of the 11 families were represented in Who's Who, American Men of Science, or both. We purchased a contemporary volume of the latter and scanned every entry until we came to a "William Dykstra Miller," a forestry professor at North Carolina State in Raleigh.
Several other southern forestry professors were also in the book, but using Kanner's clues we eliminated all but Miller. Still, because we couldn't locate Ritchey, the publisher of our 2010 book -- The Age of Autism -- Mercury, Medicine, and a Man-made Epidemic -- had us refrain from giving his actual name even though we identified the parents.
Ironically, it took his death to confirm his identity.
In our book, we described the Millers -- William Dykstra Miller and his wife, Catherine Ritchey Miller -- as a young and gifted couple full of energy and promise. William Miller grew up in the Northwest, attended tiny but prestigious Reed College in Portland, Oregon (Steve Jobs went there for a year and named his son Reed), then got a Ph.D. in forestry from Yale. He spoke multiple languages and later, on the side, translated scientific papers.
He landed his first job out of Yale in 1932 as an assistant forestry professor at the University of Idaho, just as the department was beginning a study of lumber preservatives. The results would be published by the forestry school in 1934.
The next year, the couple pulled up stakes for the last time and moved cross-country to Raleigh, perhaps drawn by the school's recent acquisition of 80,000 acres of land known as the Hofmann Forest to conduct studies, train future foresters, and earn revenue from timber sales. (In later years, Miller wrote the official history of the forest.) NC State already had a thriving program -- it was the first forestry school in the country, having emerged from work pioneered on the Biltmore Estate near Asheville.
Ritchey, as they called him, was the Millers' first child, born two years after they arrived in North Carolina. A younger brother, Alden Dykstra Miller, was born a year and a half later. William Miller spent the rest of his career at NC State; his wife was an accomplished musician who gave piano lessons and played the organ at her church. When one of us visited the church while researching our book, a woman who had known her was surprised to learn she had two children -- Catherine had only spoken of Alden; Ritchey had been institutionalized not long after Alden was born.
Her reticence is understandable, given the terrible conjecture that emerged in that very first paper -- blaming the parents. Kanner wrote, "Richard's father was a professor of forestry, very much immersed in his work, almost to the exclusion of social contacts. The mother was a college graduate," unusual for its time. "The family, in both branches, consisted of professional people."
That might seem like a positive environment for a child. But when Kanner saw this pattern repeated in the first 11 families -- just for starters, Case 1's father was a Yale-educated lawyer; Case 2's a Ph.D. plant pathologist working for the Agriculture Department; and Case 3's a Yale Ph.D. in forestry and college professor -- he wondered whether it might point to oddities in the parents' approach to child-rearing.
"There is one other very interesting common denominator in the backgrounds of these children," he wrote. "They all come of highly intelligent families." He went on to claim, "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. ... The question arises whether or to what extent this fact has contributed to the condition of the children."
This pernicious logic can be seen in the Miller's case -- the father a scientist "very much immersed in his work, almost to the exclusion of social contacts," the mother -- horrors! -- a college graduate. (Kind of like today's computer and tech experts getting blamed for blending gene pools and causing Asperger's in their kids.)
We think Kanner missed the forest for the trees here, almost literally: Yes, the parents were educated and had scientific abilities. Yes, that’s a clue. But it’s a clue to this: As researchers in allied professions like plant pathology and forestry, they came in contact with a new neurotoxin sooner and in greater quantity than other families, unknowingly putting their children at risk first and worst. It wasn't who they were, as we have put it before. It's what they did.
That leads us to a brief description of Ritchey's younger brother, Alden Dykstra Miller, whom we're also identifying for the first time in this article.
Alden, like his father, grew up to pursue an academic career. (As Kanner later acknowledged, the fact that one child of the same parents was successful and the other had to be institutionalized militated against the parent-blaming idea.) Alden graduated from North Carolina's Davidson College in 1962 and earned a PhD in sociology from the University of North Carolina, according to an account in an American Sociological Association newsletter.
He was on the faculty at Indiana and Boston universities. At the latter, "There were rumors among the faculty about his exceptional abilities as a methodologist. His reputation and quietness made him seem austere and unapproachable," but "those of us who got to know him found Alden to be not only approachable but extremely patient."
Alden joined the Harvard Center for Criminal Justice, rising to associate director, and then a similar institute at the University of Maryland. But his health began failing and he was unable to drive. He died in Hyattsville, Md., in 1984.
He was only 44 years old. The cause of death, according to the ASA account, was lupus erythermatosis, an autoimmune disease in which the body attacks its own healthy tissue.
According to his death certificate, as mentioned above, his brother, Ritchey, died of multiple myeloma -- a cancer of the immune system, formed by malignant plasma cells in the bone marrow.
As we've reported before, Donald Triplett, autism's case one, came down with a nearly fatal case of an autoimmune disease, juvenile rheumatoid arthritis ,as a young teen. Gold salts treatment cleared up that illness -- and, his brother told us in 2005 when we visited Forest, led to a remarkable decrease in his autistic behaviors. Donald went on to a career at the local, family-owned Bank of Forest and, now retired, travels the world and follows his golf hero Ernie Els. He turns 80 on September 8.
Problems related to the immune system, then, look like a clue from early days to the nature of autism. Something may have been triggering both. But what?
Leo Kanner later backed completely off his suspicions about the parents -- claiming somewhat disingenuously that he had never voiced them -- but arch-Freudians like Bruno Bettleheim raised parent-blaming to a malignant art before Bernard Rimland demolished the whole construct in the 1960s. That gave way to gene theories -- if it wasn't psychogenic, it had to be genetic -- and now, as gene-based theories come up empty -- to vague "gene-environment" interactions.
Lost along the way is what we believe is the truth about the rise of autism -- those first 11 cases, and especially the first three, point to the new toxic exposure that triggered them. That exposure was ethylmercury, a new organic mercury compound developed in the 1920s and commercially licensed around 1930 as a fungicide for three specific uses -- to preserve lumber, disinfect seeds, and allow multi-dose vials for mass vaccination.
The first two uses, we've argued, are evident in those first three cases. We first laid out this idea in 2005 , and amplified it in our 2010 book, The Age of Autism. In a nutshell, here it is:
-- In 1930, Donald Triplett's parents built the house he was born in three years later. The comfortable, unpretentious residence set in a large, leafy yard is not far from the lumber mills where the first tests of the ethylmercury wood preservative Lignasan were done at the same time. We suspect off-gassing of ethylmercury from the wood -- a known risk that eventually led to Lignasan's decline -- affected the mother and her infant.
-- In 1936, the year Case 2, Frederick Wellman, was born, his father was experimenting with the ethylmercury dust Ceresan at the Beltsville Agricultural Research Center just outside Washington in suburban Maryland, according to records in his archive.
-- In 1937, when Ritchey Miller was born, his father had already been exposed to Lignasan at the University of Idaho during its wood-preservation experiments; the report of those experiments lists Lignasan as one of the substances tested and shows its effect in protecting a window frame.
Forest, Mississippi. A plant pathologist. A forestry professor at the same southern university. A new toxic exposure that links all three and triggered the rise of autism. As autism research wandered far afield, the truth was evident in the first three cases -- confirming Occam's Razor, the axiom that the simplest explanation is usually correct.
We believe that in all three cases this exposure extended to the mother and her infant. Second-hand risks from occupational exposure to mercury – especially in excessive quantities as might arise in a laboratory setting -- are well-documented in the medical literature. Other cases in the first 11 point to risks to the mother and the child from the new diphtheria toxoid vaccination; one mother was a public health pediatrician who was part of the first well-baby clinic project at Harvard and actively promoted the shots.
So the life of Ritchey Miller helps form a pattern that might otherwise have remained obscured. Yet even now, more than a decade after the similarities between mercury poisoning and autism were pointed out in a peer-reviewed journal article by Bernard et al. -- and despite the evidence we've assembled of a link in the very first cases -- health officials continue to insist ethylmercury is safe to inject in children. And they fail to recognize the significance of associated immune problems also evident from the beginning.
While removed from some infant vaccines, thimerosal is now used in flu shots recommended for millions of pregnant women and children in the United States. Worldwide, 87 million children every year receive mercury-containing shots. Meanwhile, the autism rate has soared from 1 in 10,000 in the 1960s to 1 in 88 today, according to the Centers for Disease Control.
Over the past several years, we have traveled a great deal in Raleigh. It is also the home of Case 2, Frederick Wellman, whose father, the plant pathogist, retired from the U.S. Agriculture Department to become a visiting professor at North Carolina State. The fact that the fathers of Case 2 and Case 3 were professors at the same school here in allied fields -- forestry and plant pathology -- is, we believe, no coincidence.
We first came here in 2006, after identifying Frederick Wellman as Case 2. We also looked for Case 3, Richard M., then in the nearby town of New Hill, which is where his parents' obituaries said he resided. We checked nursing homes, group residences, the post office. No luck.
And not much now. The death certificate for William Ritchey Miller gives a "facility name" for "the decedent" that turns out to be a suburban house. The woman who answered the door had never heard of him. The funeral home listed on the certificate did not have any records available. His body was cremated.
That led us to the department of family services and the politely unhelpful presumed guardian. Dead end.
Before leaving town, there was one more thing we wanted to do. We drove just under 10 miles to a nicely wooded well-maintained garden apartment that must be mainly for senior citizens. There's an assisted living/nursing home next door.
This garden apartment is where Frederick C. Wellman, Case 2, lives. We know a lot about him, because, along with Donald T., he was a success story amid the institutionalized and disabled Kanner kids from 1943. A former professor in the plant pathology department who knew his father, Frederick L. Wellman, gave us a moving vignette for our book about how his parents lived with him in this same building (they had retrieved him from an institution when they moved to Raleigh in 1964).
The parents doted on him, included him in conversations and gatherings, and along with members of their nearby church, made provisions for him after their deaths.
But what was his life like now, as an elderly adult, on his own?
In 2006, one of us (Dan) rang the buzzer and made introductions. "Wrong number," the voice said abruptly over the intercom before hanging up. We dialed again, carefully, and got the same answer.
This time we dialed carefully once again and announced ourselves. "Wrong number," he said. We didn't try again.
"I guess he doesn't want to talk to us," we said to an apartment worker standing nearby. "Well," she said, "there's nothing I can do about that."
"How's he doing?" we asked.
"He's doing well," she said.
One can only hope.
Dan Olmsted and Mark Blaxill are Editors at AgeOfAutism.com and co-authors of The Age of Autism -- Mercury, Medicine, and a Man-made Epidemic, published in 2010 by Thomas Dunne Books.