While doing my Christmas shopping, I found myself in the book isle. Browsing the long shelves, a small white-jacketed book caught my eye. Not only was the cover beautiful, the title spoke right to me.
David and Goliath: Underdogs, Misfits, and The Art of Battling Giants by Malcom Gladwell.
I snickered as I picked it up thinking how I could relate. Any insight on how to do that more successfully was well worth it. Without reading more than the back cover I tossed it in the cart.
A few days later when I finally got to read it, I realized I had seen Malcom Gladwell and this very book profiled on a television show. Gladwell is the author of Outliers, probably his most famous book, and David and Goliath was following in its footsteps.
In short, Gladwell uses psychological research to prove that by changing our perspective and redefining what an advantage or disadvantage actually is, we can navigate and lead the world more successfully.
I devoured the book in less than two days.
Among the interesting arguments he presents, one stands out as most profound to me: that both deficiency and excess have negative consequences, and that although common sense has dictated this for some time, science is now proving it.
For example, most people assume smaller class sizes are better for student achievement. Research says it’s not that simple. Very small and very large classes are both negative for student achievement, although not in the same ways.
Likewise, most people assume parenting is easier the more money you have. Research also says, no. It gets harder. Poverty and affluence are both challenging, although not in the same ways. (Remember the boy who recently had a reduced sentence using affluence as an excuse?)
And physically, we know that drinking a few glasses of wine per week can have a positive effect on health, but just a few more and it becomes a negative. No wine, you miss out on the health benefits. Too much wine, you negate them and make things worse.
The pattern follows with everything of consequence, Gladwell argues. Deficiency, bad. Moderation, good. Excess, bad. In fact, the most famous philosopher to point this out was Aristotle himself.
The concept is called “The Inverted U.” And this is what it looks like. (These graphs are for mere visualization purposes only and are in no way scaled to meet any mathematical exactness.)
What we assume:
What we assume is called a monotonic graph. The more you have the better it gets. In reality what we usually have, however, is a non-monotonic graph. The more you have eventually the worse it gets. In other words, there is a threshold or a margin of diminishing returns.
Per Gladwell, “…Inverted U-Curves are hard to understand. They almost never fail to take us by surprise, and one of the reasons we are so often confused about advantages and disadvantages is that we forget we are operating in a U-shaped world.”
Not surprising perhaps, I immediately thought about vaccines.
The idea of too much of a good thing has been the basis of much of the vaccine controversy for some time. Many wonder, like I do, have we gone too far? Have we reached the margin of diminishing returns? Have there been unintended consequences? Are we using the right information to determine that?
And if we haven’t gone too far yet, when will that time come? Is there anything in life that can increase and increase and increase without eventually resulting in a negative consequence?
Science says, with rare exception, no.
We see this research in a paper Gladwell uses to make his point entitled, “Too Much of a Good Thing: The Challenge and Opportunity of the Inverted U”, which appeared in 2011 in the Journal Perspectives on Psychological Science by Adam Grant and Barry Schwartz. I purchased the study just to read more.
To be sure, the paper focuses specifically on psychological domains, not medical ones. For example, the authors argue that a deficiency of courage is cowardice, but in excess is recklessness. A deficiency of pride is humility, but in excess is vanity. And regarding anger, a deficiency is spinelessness and in excess is irascibility. They then go on to cite dozens and dozens of papers to support it.
And to be fair and very clear, the researchers acknowledge the Inverted U may not be applicable to everything. Interestingly, Vitamin C and E are cited (by different authors) as possible evidence given that you can’t overdose on them.
But I wondered, just for the heck of it, if we were to apply this same concept to medicine, what would we find? Is medicine operating in an Inverted-U world as well?
It most certainly is.
Let’s look at antibiotics as an example. Antibiotics are arguably one of mankind’s most important and incredible medical accomplishments. The amount of lives saved by antibiotics would be impossible to determine.
And yet, scientists are growing increasingly concerned that we have overdone it. Bacteria not killed by regular strength antibiotics have required stronger and stronger versions to do the job. Coupled with the overuse of these antibiotics, the unintended consequence is that the surviving bacteria are now extremely dangerous.
So in the case of antibiotics, yes, they have operated in an Inverted U. No antibiotics, bad. Responsible use of antibiotics, good. Too many and too frequently used antibiotics, bad.
Other medicine could also be put into the same graph. It is the reason dosing is so important. The right amount of any medication for the right person has (ideally) the right affect. But too much for the same person and you have an overdose.
Even the use of medicinal mercury has been based on the assumption of the Inverted U. Organized medicine has believed for centuries that this neurotoxin can be harnessed for good if only dosed in the right amount the right way. They have yet to be proven right; however, that has been their prevailing theory, and thus the reason Thimerosal remains in vaccines to this day.
Does this mean that medicines, antibiotics included, are bad? Or that people who draw attention to their potential misuse or abuse are anti-medicine? Of course not.
What it does mean, however, is that in the right time and place and amount they have positive benefits. Without them, people would suffer and possibly die. But with too much of them, people also suffer and possibly die. And it is our responsibility to monitor the situation carefully and accurately so that we can remain between the two.
The Inverted U.
Which leaves one to wonder why anyone would believe vaccines would be exempt from this phenomenon. Why should they be? Or more important, how could they be?
Food. Exercise. Money. Wine. Medicine. Power. Virtue. Sunshine. Even water.
All are subject to this rule.
And yet, vaccines are not? That’s what many would like to believe, because that’s what they believe applies: the monotonic graph. In their reality, the more vaccines children have received the better overall health they have had, and the more vaccines they receive in the future, the better health they will continue to have.
What is reality, however, is the opposite. Although the original vaccines children received (at the onset of their invention) indeed resulted in better overall health, it is undeniable that the more vaccines children have received over time since then, the worse overall health they have had: the non-monotonic graph.
(It is important to bear in mind that in all Inverted U examples the negative consequence of absence and the negative consequence of excess are usually opposite. In this instance, suffering and death from infectious disease versus suffering and death from chronic disease.)
Now, we all know correlation does not equal causation.
But that doesn’t change the graph that describes reality for America’s population under the age of 25, the most vaccinated generation of children in the history of mankind, and by far, the most chronically ill on record. And as such, I believe, reason enough to merit an honest, immediate, and independent investigation into the unintended consequences of a for-profit-liability-free program that appears to have possibly reached its margin of diminishing returns.
As Gladwell says, we tend to forget we are operating in an Inverted U world. It’s time we start remembering both absence and excess have negative consequences; framing our discussions, debates, and research within that context; and holding ourselves accountable for maintaining a responsible middle ground.
Our children are depending on it.
Julie Obradovic is a Contributing Editor to Age of Autism.