By Dan Olmsted
One of the most interesting – not to mention important – figures in the current controversy over autism is the head of the National Institute of Mental Health, Dr. Thomas Insel. Considering his central role in finding the cause, some of his recent comments should make those who say vaccines have been exonerated just a bit nervous.
I've met Dr. Insel once – at the Institute of Medicine's Workshop on Autism and the Environment last April in Washington – and he left a strong impression on me. Energetic and formidably well-spoken, his very presence at the conference (along with Dr. David Schwartz, who then headed the National Institute of Environmental Health Sciences) was a cause for optimism in the biomedical/environmental community. Despite what I'm sure is a full plate of responsibilities, he sat there for the full two days, engaged in the discussions and seemingly open-minded.
I approached him during a break because I wanted to hand him the Baltimore City Paper in which I had recently written about "Frederick W.," the second child in the landmark study of autism published in 1943. I had uncovered Frederick's identity (see Mercury Link to Case 2 on our home page); traced his father's career as a plant pathologist; and discovered he was working with a new ethyl mercury fungicide when his child was born in 1936. Ethyl mercury is also the active ingredient in vaccines, where it's called thimerosal. This seemed an unlikely coincidence, and an ominous sign that vaccine mercury might also have triggered the huge rise in autism starting in the 1990s. Call me quixotic, but I wanted to hand-deliver a copy to Dr. Insel, along with Dr. William Raub, science adviser to HHS Secretary Michael Leavitt, and the NIEHS's Schwartz. -- all of whom were at the workshop. I just didn't want to hear in 10 years that key officials charged with figuring out the cause of autism never knew about this very early association with vaccine-type mercury.
Anyway, I introduced myself to Dr. Insel and briefly explained the focus of the story. He was polite, but dismissive of the mercury hypothesis. I wasn't taking notes, but his comment was that the mercury idea didn't pan out, or the thimerosal theory didn't hold up – that kind of remark.
Then he said something that floored me – again, this is not verbatim but pretty close: He said it (the cause of autism) still could be the vaccines themselves. I remember the words "still could" – the idea that while mercury had been ruled out as far as he was concerned, vaccines were by no means off the hook.
Whoa. After the 2004 IOM report that said funding for research into a vaccine-autism link should be shut down; after the withering criticism by pediatricians and public health officials of parents claiming they saw their child regress after vaccinations; after the ostracism and expulsion of scientists who dared raise the same question (Andy Wakefield, phone home), here was a key player saying, It still could be vaccines.
I didn't write about Dr. Insel's comment at the time, in part because I wasn't taking notes and it was such a brief and informal conversation, but I did tell several colleagues about it.
I also recalled a couple of other comments attributed to Dr. Insel that took on heightened significance. The director had attended a meeting at NIMH with advocates of the epidemic-environment-vaccine theory who were pressing for more reseach. They say he looked around the meeting room, which included key administrators and scientists from the federal agency, and said, There are no epidemic deniers here.
That's another "Whoa." The CDC says it doesn't know whether autism has actually increased but is working so very, very hard to find out. Lots of mainstream journalists, pediatricians and public health experts casually repeat the supposed "fact" that better diagnosis, greater awareness and broader definition are behind the rise in cases. And here's Dr. Insel saying it really is rising – the way an environmentally triggered illness rises, not a genetic one.
That comment fit with one he made in a Newsweek cover story last year. He said that as a psychiatrist in the 1970s he never saw a single person with autism. "In 1985, curiosity sent him searching; it took several phone calls to find a single patient," Newsweek reported. The article goes on to say that NIMH is "newly interested in environmental factors that might set off the disorder in patients who are already genetically prone to it."
I'll bet they're newly interested if their own director believes autism is an epidemic and vaccines could be causing it!
All this reached a tipping point -- "boiling point" might be a better description -- last month in Atlanta, at the National Autism Association conference. Dr. Insel had agreed to speak – again, surprising and encouraging in itself.
The buzz after Dr. Insel's speech was not positive, though; way too much talk about genes, many felt, far too little understanding of the sophistication of the audience. But what really had the audience buzzing came in the question-and-answer session, when a mom asked: "Dr. Insel, with a simple yes or no, do you believe vaccinations – after everything you've read and heard -- caused autism in our children?"
He backed away smiling from the podium as soon as he heard "with a simple yes or no." When he returned to the mike he was no longer smiling. "I think that's a trick question," he said.
"No, I'm sorry," the mother persisted as their voices overlapped. "I'm just looking for a simple yes or no answer. From everything you've read or heard, do you believe that vaccines can cause autism in our children?"
"I'm not going to answer that question," Dr. Insel responded, "because my belief is not what's at stake here. I'm talking about the need to bring science to every one of the questions that we both have, and until we do that well we're not going to have the data we need on any of these issues that I'm here today about. Listen to what we're saying, most of it is future, most of it is, 'those are things we need.' Again I go back to my central point – we don't know. The answer is let's do the research to find out the answers not just for this question but for a lot of others that are really pressing."
"Whoa" no longer suffices. "We don't know" whether vaccines cause autism? And despite what the IOM says, we need better science and more research to find out? And there's definitely an epidemic? And even if it's not the mercury, it still could be the vaccines?
One last question: Isn't this what we've been saying all along? Now the head of the NIMH is saying it, too -- and it's his job to get us the answers. When you stop and think about it, that's absolutely freaking incredible.
Dan Olmsted is editor of Age of Autism.