Managing Editor's Note: We thought this piece deserved a second run - Mark wrote it after the Hannah Poling decision last year when the press referred to Miss Poling as having "autism like symptoms."
By Mark Blaxill
Some people get a little squeamish when others use the word bullshit to describe a certain kind of bureaucratic doublespeak. Not me. I like to remind the squeamish among us that bullshit is a precise term in the philosophy of science and it’s entirely respectable to use the word in polite company. To support my case, I point friends to Harry Frankfurt, emeritus Professor of Philosophy at my alma mater, Princeton University, who elaborated on the relevant philosophical concepts at some length in his wildly popular essay, On Bullshit, in which he famously distinguished bullshit from lying.
Bullshitting is not exactly lying, and bullshit remains bullshit whether it's true or false. The difference lies in the bullshitter's complete disregard for whether what he's saying corresponds to facts in the physical world: he does not reject the authority of the truth, as the liar does, and oppose himself to it. He pays no attention to it at all. By virtue of this, bullshit is a greater enemy of the truth than lies are.
I’ve been reminded again about Frankfurt’s wisdom in observing the public health apparatchiks’ transparent attempts to spin the recently disclosed concession that vaccines caused Hannah Poling’s autism. There are three aspects of the spin that are just so egregious it’s impossible to let them stand without some kind of rebuttal.
1. Hannah Poling was not really autistic. She just had “autism-like symptoms” or “features of autism.”
Sorry boys, but that’s just bullshit. In case you hadn’t noticed, there is nothing else that defines autism except a collection of features and symptoms. If you have enough features from the official checklist, then you have autism. It’s that simple. It’s not as though we actually have an agreed biological definition of autism—biomarkers, genes, tissue characteristics—that specifies a biomedical condition. Quite the opposite, the entire concept of autism is just a hypothesis of its own: that there are kids who share some kind of underlying disease process that one day we’ll understand well enough that we can redefine in biological terms.
Don’t believe me? Then believe Michael Rutter, the man who developed the formal diagnostic concept of the triad of features (“impaired social relationships”, “language and prelanguage skills” and “insistence on sameness”) that has guided the diagnostic instruments used in autism for the last three decades. In his landmark 1978 essay that set out the modern criteria for autism, Rutter made this point pretty clearly as he described his attempt to both support and update the original criteria set forth by Leo Kanner in 1943:
The question is not “What is autism?” but rather “To what set of phenomena [can you say “features”?] shall we apply the term autism?” There is no point in starting with the word autism and then defining it. It is merely a word and like any other word it means just what we want it to mean—no more and no less…This may seem like a mere semantic quibble but in fact the distinction has important practical consequences. The word autism could be used to describe children who merely avert eye-to-eye gaze or for that matter to describe wooden tables…But Kanner’s use of the term was more than a simple label, and that is where the trouble really increases. It was also a hypothesis—a suggestion that behind the behavioral description lay a disease entity. In short, he suggested (quite properly) that the particular grouping of behaviors he chose to call autism had a validity in the sense that the children with these behaviors differed from children with other psychiatric disorders in some important sense.
It’s not complicated folks. For anyone who just watched Hannah Poling (what a beautiful little girl!) on Larry King Live, is there any doubt that she's autistic? Let's get real. “Autistic-like symptoms”, if you have enough of them, are autism. By definition.
2. Vaccines aggravated a rare undiagnosed mitochondrial disorder. They didn’t cause autism. It would be completely wrong to say that this case has bearing to the vast majority of children with autism.
Oops, gotta stop you there. More bullshit! Hannah Poling’s doctors tested her blood after she had a clear vaccine reaction. They found “subtle abnormalities in the serum creatine kinase level, aspartate aminotransferase, and serum bicarbonate”, all markers for mitochondrial metabolism problems. Then they took a muscle biopsy and found some more markers that pointed in the same direction. But more importantly, they turned around and looked for the same blood markers in a sample of banked autism blood samples. In close to half of these samples they found elevations in the same plasma markers (aspartate aminotransferase and serum creatine kinase) that they found in Hannah. A rare condition? Not exactly.
More to the point, mitochondrial dysfunction is a common feature of autism. Several studies of autistic children have found biomarkers consistent with abnormalities in mitochondrial metabolism. These abnormalities are typically observed in blood tests as either elevated levels of lactate or elevated levels of the lactate/pyruvate ratio in plasma (both signs of “hyperlactidemia”, plasma is the liquid component of the blood). Lot’s of people have been worried about mitochondrial problems in autism for a long time. Two of the smartest DAN! doctors around (Dan Rossignol and Jeff Bradstreet) just published a paper on it.
So let’s be clear here. Hannah’s pattern of mitochondrial dysfunction is not rare. It’s quite common in autistic children. If vaccines caused Hannah’s illness and mitochondrial problems, it’s quite possible, indeed likely, that they could cause the same effect in other autistic children. Large numbers of them. Hannah’s case is not just a trivial, obscure, one-of-a-kind anomaly. It may very well prove to be a big deal and a model for the injuries that affected large numbers of children after they were vaccinated and then became autistic.
3. Hannah Poling’s health problems come from a well known genetic defect in mitochondrial metabolism. Her genetic defect produced an “encephalopathy.” It’s not really autism.
The genetic bullshit is always the most creative. Let me take these points one by one. First of all, “encephalopathy” is one of those fancy sounding medical words that mean absolutely nothing. According to the Oxford English Dictionary (my go-to resource when the linguistic bullshit starts flying), encephalopathy is “a disease of the brain.” Literally speaking, it means “sick in the head.” That’s not a precise description and not the least bit useful. Just sound and fury signifying nothing.
Second, the genetic issues are about as far from well understood as you can get. Lots of scientists have speculated about defects in the genes surrounding mitochondrial function in autistic children, but none of their theories have gotten very far. The most prominent genetic theory regarding mitochondrial metabolism in autism is that there is an increased inheritance of a form of the “mitochondrial aspartate/glutamate carrier gene” (it goes by the catchy name of SLC25A12) that increases the risk of autism. But despite some tentative findings that suggested that one form of this gene might be passed on more frequently from parent-to-child in autism, the finding has not held up well under repeated testing. Despite misleading comments to the contrary, the direct genetic connection between mitochondrial function and autism remains a mystery. Perhaps it always will be.
Finally, and most importantly in the Poling case, is that the specific genetic mutation that Hannah’s doctors found has never before been connected with a known mitochondrial disorder. The recently published court papers in the Poling case revealed that “a mitochondrial DNA (“mtDNA”) point mutation analysis revealed a single nucleotide change in the 16S ribosomal RNA gene (T2387C).” Search the scientific literature, the internet, any medical database you can find for that matter, for this T2387C gene mutation and see what comes up. Is it a well known, commonly characterized genetic source of mitochondrial dysfunction? To ask the question provides the answer: of course not. Mitochondrial scientists have never before published anything relating to Hannah’s specific mutation and I’d be surprised if anyone ever does. The suggestion that genetic science has the slightest idea what is going on in Hannah Poling’s genes is simply wrong. And more bullshit.
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To some extent I realize that I’m preaching to the choir with our readers at Age of Autism. But there’s one very critical disagreement that I know is out there, because I’ve had this discussion with many fellow parents. There’s an important counter-argument to my model of bureaucratic (the Soviets called bureaucrats apparatchiks) misbehavior here and it has to do with the intent of the public health apparatchiks in denying vaccine damage in the case of Hannah Poling. Quite a number of you will argue that these people aren’t just dealing bullshit. In Frankfurt’s terms, they know what the truth is and they’re taking a position in opposition to it, with full awareness that that’s what they’re doing. In that sense, many would argue, what the CDC is doing has nothing to do with bullshitting. They’re simply lying. And I’m letting them off the hook.
I always prefer to explain error with confusion rather than malice. But since I can’t read the minds of the apparatchiks, I suppose I have to admit that the cynical case is just as plausible as mine.
So on the latest spin that “vaccines have nothing to do with autism” in the Hannah Poling case: is that lying or bullshit? I’ll let you be your own judge.
Mark Blaxill is Editor at Large for Age of Autism.