A Tale of Two Studies

“It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness…”

In March of 2007, two studies on different aspects of autism have been published. These two studies, although they are both published in peer-reviewed journals, could not be more different in quality.

The first study is “Sulfhydryl-reactive metals in autism”, by JK Kern, et al. This study attempts to correct the shortcomings of the dreadful Holmes et al study, which I have discussed in depth some time ago.

My mother used to tell me, “If you can’t say something nice, don’t say anything at all” – so, to follow the letter of that maxim (if not the spirit), I will begin with the positive aspects of this study:

[1] They did do their statistics correctly, using non-parametric statistics when it was clear that their data did not follow a normal distribution. Bully for them!

[2] They explained their reasons for picking the statistical analytical method they did (the Kruskal-Wallis test)

[3] The values they obtained for hair mercury for both subjects and controls were within the range found in the larger NHANES study, unlike the Holmes et al study, which had control values that were completely off the scale.

[4] Their use of the case-control method reduced concerns that the controls might be different from the subjects in some way unrelated to autism.


Now, unfortunately, we come to the major shortcomings of this study - shortcomings that are as fatal to its conclusions as those of the Holmes et al study. In fact, the major shortcoming is the same in both studies:

Hair Doesn’t Excrete Mercury

I’d like you to keep that sentence in mind for the next few paragraphs.

You see, despite their perseveration on the idea that mercury is excreted into the hair – which would, in turn, make a low hair mercury level indicative of “poor excretors” – mercury uptake by hair is completely passive. There is no excretion mechanism that can be “impaired”. Mercury in the blood flowing through the hair follicles is passively bound to the sulfhydryl groups of the amino acid cysteine, which is especially abundant in hair.

It’s as simple as that. No excretion, just passive absorption and binding to the growing hair.

But don’t take my word for it.

[1] Akira Yasutake and Noriyuki Hachiya “Accumulation of Inorganic Mercury in Hair of Rats Exposed to Methylmercury or Mercuric Chloride”. Tohoku J. Exp. Med., Vol. 210, 301-306 (2006) .

“These findings suggest that the inorganic mercury is also taken up by rat hair from the blood circulation, as is the MeHg, irrespective of the consequences of the biotransformation of MeHg or exposure to inorganic mercury itself.”

[2] Shi CY, Lane AT, Clarkson TW. Uptake of mercury by the hair of methylmercury-treated newborn mice. Environ Res. 1990 Apr;51(2):170-81.

“Distribution of mercury in pelt and other tissues was measured. The level of mercury in pelt was found to correlate with hair growth. The amount of mercury in pelt peaked when hair growth was most rapid and the total amount of mercury in pelt was significantly higher than that in other tissues, constituting 40% of the whole body burden. [Note: the hair of mice contains a larger percentage of body mercury than it does in humans. This is because the hair (pelt) of mice is a larger fraction of the mouse body mass than the hair of humans, especially human children]

However, when the hair ceased growing, the amount of mercury in pelt dramatically dropped to 4% of whole body burden and mercury concentrations in other tissues except brain were elevated.

Autoradiographic studies with tritium-labeled methylmercury demonstrated that methylmercury concentrated in hair follicles in the skin. Within hair follicles and hairs, methylmercury accumulated in regions that are rich in high-sulfur proteins.”

[3] Mottet NK, Body RL, Wilkens V, Burbacher TM. Biologic variables in the hair uptake of methylmercury from blood in the macaquemonkey. Environ Res. 1987 Apr;42(2):509-23.

“The total mercury (Hg) in hair and blood of 45 young healthy adult female Macaque fascicularis given 0, 50, 70, or 90 micrograms MeHg/kg body wt orally in apple juice daily revealed a close and constant ratio between blood Hg and hair.

The amount of hair Hg does not increase with time (maximum period of observation 490 days) at a given dose level. Also the ratio was unchanged between background and subtoxic dose levels. Individuals at a given dose level with a higher-than-average blood level had a proportionately higher hair level.”

”This was the most unkindest cut of all…”

The last article, you will notice, was authored by none other than Thomas Burbacher, who is currently on the chelationistas “Most Favored Scientists” list.

Bottom line: hair mercury (and presumably other sulfhydryl-reactive metals) reflects the blood mercury (etc.) at the time that portion of the hair was forming. If the hair mercury (etc.) is low, then the blood mercury (etc.) was low.

And the only way mercury (etc.) can get into the brain is via the blood, unless you inject it directly into the brain.

So, low hair mercury (etc.) equals low blood mercury (etc) equals low brain mercury (etc.).

Any questions?


Now that we have rather thoroughly demolished the idea of mercury being excreted into the hair, what else does the Kern et al study have to say?

The only graph in the entire article (Figure 1) is rather puzzling – it lists the mean ranks of the arsenic, cadmium, lead and mercury levels of the autistic and control groups. For those not familiar with non-parametric statistics (and for many that are), this may seem odd. Frankly, it is odd to show the mean ranks instead of the data themselves. It suggests that the data, seen naked and unadorned, might not be as convincing as the authors would like.

Table 3 gives the mean (average) and standard deviation of the various hair metal levels of the two groups. This, too, is odd, since they went to great lengths to explain that their data did not follow a normal distribution and yet give mean and standard deviation – two measures that imply a normal distribution. Better would have been to give a median (the middle value of the ranking) and range. But they didn’t.

And when you look at the numbers they did give, you begin to understand why they didn’t show a graph of their data.

Zooming in on the mercury levels, the mean (SD) of the autistic subjects was 0.14 mcg/g (0.11) and that of the controls was 0.16 mcg/g (0.10). You’d be right if you thought that these levels were awfully close, although the Kruskal-Wallis test showed them to be statistically different.

Even if there are statistically significant differences between the two groups, the question remains if they were clinically significant.

I might also point out that not only are these values far lower than those measured by Holmes et al, they are also a bit lower than the NHANES levels (mean 0.22 mcg/g). And, curiously enough, they used the same lab as the Holmes et al study.

Curious.

It was especially curious to see them cite Holmes et al as supporting their hypothesis without once mentioning how very different their numbers were.

So, what can we make of their data, then? Clearly, their hypothesis that autistic children are “poor excretors” based on hair metals is unsupportable in the face of data showing (over and over) that mercury and other metals are passively taken up by hair.

Perhaps, the “take home message” from this study is that autistic children absorb less mercury. That wouldn’t sit well with Kern et al, but there is data to support that hypothesis.

[4] Ballatori N, Wang W, Lieberman MW. 1998. Accelerated methylmercury elimination in gamma-glutamyl transpeptidase-deficient mice. Am J Pathol 152:1049-1055.

“There were no differences in methylmercury excretion between the wild-type and heterozygous mice; however, the GGT-deficient mice excreted methylmercury more rapidly at both dose levels. Wild-type and heterozygous mice excreted from 11 to 24% of the dose in the first 48 hours, whereas the GGT-deficient mice excreted 55 to 66% of the dose, with most of the methylmercury being excreted in urine.”

Since gamma-glutamyl transpeptidase also has a profound effect on the redox state of the cell and gluthathione, (both of which have been linked to autism by another of the chelationistas Most Favored Scientists, Jill James) what Kern et al are seeing may be nothing more than the effects of altered gamma-glutamyl transferase activity, which may be related or unrelated to autism.


So, by doggedly perseverating on a hypothesis (autistic children are "poor excretors"), two sets of researchers have missed a possible implication of their findings: that autistic children may actually be "over-excretors" of mercury.

After all, that's what the data seems to be saying.

And it's a lot more likely than hair being a significant excretory organ for mercury.

End of Part One.


Next:

Strong Association of De Novo Copy Number Mutations with Autism.

Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.

Science. 2007 Mar 15; [Epub ahead of print]


Prometheus

Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

A Tale of Two Studies – Part the Second

”…it was the epoch of belief, it was the epoch of incredulity, it was the season of Light, it was the season of Darkness, it was the spring of hope, it was the winter of despair, we had everything before us, we had nothing before us, we were all going direct to Heaven, we were all going direct the other way…”


We now return to our previous story…


Strong Association of De Novo Copy Number Mutations with Autism.

Sebat J, Lakshmi B, Malhotra D, Troge J, Lese-Martin C, Walsh T, Yamrom B, Yamrom B, Yoon S, Krasnitz A, Kendall J, Leotta A, Pai D, Zhang R, Lee YH, Hicks J, Spence SJ, Lee AT, Puura K, Lehtimaki T, Ledbetter D, Gregersen PK, Bregman J, Sutcliffe JS, Jobanputra V, Chung W, Warburton D, King MC, Skuse D, Geschwind DH, Gilliam TC, Ye K, Wigler M.

Science. 2007 Mar 15; [Epub ahead of print]


In this study, the authors used ROMA, a type of comparative genome hybridization, to look for de novo mutations in autistic children. They looked at 195 autistic children and their parents (need to look at the parents’ genome to know if the mutation was inherited or arose spontaneously) and 196 unaffected children and their parents.

What they found was – to put it mildly – very interesting.

The size of the human genome limited the resolution of the technique (in this study) such that they could detect only about 15% of the mutations that cytogenetic techniques indicate to be present. Even with these limitations, they found:

[1] Spontaneous mutations were more frequent in patients with autistic spectrum disorder (14/195) than in unaffected individuals (2/196).

[2] The frequency of spontaneous mutations was higher (12/118) in sporadic cases of autism – children with no affected relatives – than in cases from multiplex families (2/77).

[3] The frequency of spontaneous mutations in unaffected individuals was 1% (2/196).

[4] Most of the mutations in autistic individuals were deletions (12/15 – one child had two mutations), while the two mutations in the controls were duplications.

[5] None of the mutations were seen more than twice and most were seen only once.

[6] The mutations seen in autistic children were on chromosomes 2, 3, 6, 7, 10, 12, 13, 15, 16, 20 and 22.

If, as they suspect, their technique was only able to pick up 15% of mutations, then the actual mutation rate in autistic children may be much higher.

What it means is that there is a statistically significant (p less than 0.0005) association between spontaneous mutations and autism. Now, I've often argued that association is not causation, and so do the authors of this study.

However, the locations of many of the mutations were highly suggestive of a connection. For instance, one mutation - a 1.1 Mb deletion from chromosome 20 - deleted 27 genes, including the oxytocin gene OXT. This is particularly notable, as oxytocin has been shown to regulate social behavior and awareness.

Five of the mutations involved only a single gene, which indicates that these genes are prime candidates for further study.

Now, what does this mean for the people who claim that autism can’t be genetic, that it’s all the result of exposure to (fill in the blank with environmental toxin de jour)?

Well, it means that they need to start thinking up a way to “spin” these results.

Doubtless, they will find that some of the authors have – at one time in their careers – been supported by the pharmaceutical industry (“Big Pharma”) or “the government” or maybe they’ve ridden in black helicopters.

Or they’ll find some other equally ridiculous claim of bias, corruption or conspiracy.

But they won’t be able to stem the tide.

"What tide?", you ask.

There’s a tidal wave of data bearing down on the “reality deniers” in the autism world, and they’d better start heading for higher ground.

Or learning how to swim.


Prometheus


Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

Finding Truffles amongst the Clods

ARI’s Parent Ratings of Behavioral Effects of Biomedical Interventions

For years I have advised people to avoid this site because it presents poor data in a poor fashion. The “data” is gathered (if that is the proper word) from an on-line survey (it started as a paper survey) of parents. The parents, by and large, are people who already have a favorable opinion of “biomedical interventions” (meaning: “non-drug”, or at least, not the FDA-approved use of “drugs”) and – by corollary – an unfavorable opinion of “mainstream” medical therapies for autism.

As a result, the “data” gathered is skewed in favor of “biomedical interventions” – as the results so clearly show.

There is also no attempt made to confirm the reported results or to control for the initiation of other therapies at the same time.

In addition, the arrangement of the categories of interventions – into “drugs”, “biomedical/non-drug/supplement” (with Pepcid and “chelation” listed as non-drugs) and “special diets” – biases the survey, as a PhD psychologist like Dr. Rimland (and his heir-apparent, Dr. Edelson) should know.

Finally, the way the “data” is “analyzed” is … well, unusual. They take a six-point scale (another oddity, with three favorable ratings, two unfavorable and one neutral) and bin the results into “got better” (top two favorable ratings), “no effect” (the “possibly helped” and “no definite effect” responses) and “got worse” (the two unfavorable responses).

They then effectively discard the “no effect” responses to come up with a “better:worse” ratio. This may have some utility, but a better rating would be to lump all the favorable responses together and compare that to the sum of the neutral and unfavorable responses. If you do that, then some of the current favorites start to look a bit less attractive:

Examples:

Antifungals: Diflucan -
ARI better:worse = 11:1 -- better:not better = 1.2:1

Secretin: Intravenous -
ARI better:worse = 6.7:1 - better:not better = 0.9:1

Vitamin A -
ARI better:worse = 23:1 -- better:not better = 0.7:1

Pepcid (non-drug?) -
ARI better:worse = 3.2:1 - better:not better = 0.4:1

Vit B6 and Magnesium -
ARI better:worse = 10:1 -- better:not better = 0.9:1


You might agree, after seeing those numbers, that the ARI “better:worse” rating is a bit misleading.

And what about that all-time autism treatment favorite: chelation? Well, ARI lumps it with “Detox. (Chelation)”:

Detox. (Chelation) -
ARI better:worse = 35:1 -- better:not better = 3.2:1

Still, if you were to believe in the numbers generated by this poorly designed survey, you might think that some of these treatments had something to offer. You might be right – you might also be wrong – there’s no way to tell from this “data” because it was gathered in such a poor way.

But there is something you can glean from the ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (PRBEBI). You can find what the natural progression of autism might be.

You see, buried in the ARI-PRBEBI is a treatment that has been rigorously studied – a treatment that was extensively tested in a multi-center, placebo-controlled, double-blinded study. That treatment is secretin.

Secretin has been exhaustively tested for effectiveness in autism and found to be no better than placebo (i.e. no effect). This is not in question. Even the company that held the patent to make recombinant secretin, which could have earned them a lot of money if it had been an effective treatment for even 10% of children with autism, has admitted that secretin has no effect in autism.

Let me repeat that: Secretin has no effect in the treatment of autism.

But, if we look on the ARI-PRBEBI, we find that the parents who had secretin administered (intravenously) to their children rated it effective (“got better”) 48% of the time, ineffective 44% of the time (“no effect”) and saw their children worsen 7% of the time.

This is pretty much all you need to know about the validity of the ARI-PRBEBI. It rates secretin as an effective treatment for autism despite the fact that large, well-designed and well-funded studies have found secretin no better than placebo.

But wait, there’s more!

Since we now know that secretin is without positive effect (and the studies also found very few negative effects), this is a fair placebo trial for the natural progression of autism without treatment: 48% get better, 44% are unchanged (at least over the short time the parents waited for an effect from secretin) and 7% worsen.

Of course, this result also carries with it the limitations of the ARI survey, namely:

[1] The reported results are not confirmed by anything other than parental impressions.

[2] There is likely to be a confirmation bias, i.e. the parent population taking this survey is more likely to report improvement than worsening.

[3] This is certainly not random or evenly distributed parent or patient population.

[4] It is likely that other “treatments” were instituted at the same time as the secretin, which would confuse the issue.


Still, as a first approximation of what parents might experience as the untreated progression of autism, it isn’t bad. And it rather confirms the clinical impressions of physicians and psychologists who treat autistic children – that most of them show improvement over time.

Given that the time period over which improvement was looked for after secretin injection was probably a matter of weeks to months, the fact that 44% of the children showed “no effect” (i.e. no change) is also confirmation of the periods of stasis (no discernible developmental progression) that autistic children experience.

So, having tried my darnedest to derive something positive and useful from the ARI-PRBEBI, I leave you with the following summary points:

[1] The ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (ARI-PRBEBI) is not a reliable gauge of how effective a treatment really is.

[2] The ARI Parent Ratings of Behavioral Effects of Biomedical Interventions (ARI-PRBEBI) can be used to demonstrate that a significant percentage of untreated autistic children can be expected to show noticeable improvement over a short time course (weeks to months).

This pretty much puts an end to the claim (oft-repeated but never substantiated) that, but for the brave use of “biomedical interventions”, autistic children would be stuck at the same developmental stage they were at the time of diagnosis. It should also help people realize that autistic children do continue to develop – to improve - even without treatment.

I can only hope that some people will take notice.


Prometheus

Note: Prometheus will be attending a conference of minor mythological figures next week and will not be able to moderate comments. Rest assured, when he returns, all pending comments will be dealt with in a firm but fair manner.

Listening to Autism

Periodically (every other day, if not more frequently), some outraged parent will send me a blistering e-mail about how I am "not listening to the parents" or "not listening to the autistic children" or (even more curiously) "not listening to autism".

I assume that these people are not being strictly literal in their complaints, as I listen to anyone who cares to speak to me (and read what people send me).

I suspect that their core complaint is that I listen but don't agree.

Here is the gist of the matter:

Parents have a great deal of observational data about their children - what they do, how they respond etc. - and many of them feel that this translates into understanding their children's emotions and thought processes.

How many of these parents will have cause to question this "understanding" when their children reach puberty?

But, to the matter at hand.

Many parents of autistic children also feel that their wealth of observational data gives them a special insight into their child’s physiology, as well. They feel – and many feel this way because they have been told by well-meaning “experts” – that they know more about autism than the people who study it, simply by the virtue of having “lived with it”.

These parents often lose patience with doctors and scientists who are hesitant to accept at face value the parent’s claims of dramatic improvement with “alternative” treatments or their explanation of what caused their child’s autism. The parents see the doctors’ cautious skepticism as a direct challenge to the parents’ innate knowledge.


Why is it that I don’t “trust” the parents’ stories of how (fill in the blank) improved their child’s autism? Well, at least a part of the reason is the track record of autism “cures”.

As an example, let's review the history of a "breakthrough" treatment for autism: secretin.

Secretin first hit the public scene in 1998, when it was reported that a single secretin injection (done as a routine part of endoscopy) dramatically improved the language and social functions of an autistic child. These initial reports led to a massive run on secretin and a number of studies - good, bad, short-term and long-term - were rapidly started.

The excitement for secretin kept building, even after some initial studies failed to find the dramatic results. In fact, the interest in secretin continues even after a large number of studies, including a focused, multi-center, multi-million dollar study sponsored by a drug company that had the patent for recombinant secretin, have failed to find secretin any better than placebo.

Should I be listening to the parents that believe that secretin improved their child’s autism? Even though well-designed studies sponsored by a company that had every financial reason to want to find an effect failed to find any effect? Would that be wise?

Enlarging the view a bit, a brief survey of parent-focused autism websites and newsletters reveals a dizzying number of “cures” for autism. Special diets, vitamins, minerals, and a growing (and worrying) number of prescription drugs (off-label uses) are being used to good effect, if parental reports are to be taken at face value.

So, if all of these treatments are effective, as the parents claim, then what are we to make of it all? As I see it, there are two overall possibilities:

[1] Autism can be improved by an amazingly broad range of “biomedical” therapies (as distinguished from behavioral therapies).

or

[2] Autism shows a pattern of alternating developmental stasis and progression, which fools parents into believing that the last “treatment” they tried before the improvement was the “cure”.

Interestingly, normal child development shows a pattern of alternating developmental stasis and progression. Most parents are vaguely aware of this, but the parents of children with developmental disabilities are hyper-aware of the developmental progress of their children.

Thus, if a “treatment” is proposed (or promoted) for autism and a large group of parents try it on their autistic children, the possible outcomes, even if the treatment is completely ineffective, are:

[a] If given at the end of a period of progression, the “treatment” will be assessed as having made the child worse.

[b] If given at the end of a period of stasis, the “treatment” will be assessed as having made the child better.

[c] If given in the middle of a period of stasis or a period of progression, the “treatment” will be assessed as being ineffective.

Remember, these are the possible outcomes even if the treatment is utterly without effect (either good or bad).

Hopefully, you are getting an idea of why I don’t put a lot of stock in parental reports of “treatments” for autism.

Let me try to explain the parental fervor for some of these “treatments” with a small fable.

The Tale of the Lucky Stockbroker

Long, long ago, a smart fellow decided that he would try to make a lot of money in the stock market. Having watched the market for some time, he realized that the best way to make money on stocks wasn’t to buy and sell them, but to sell expert advice.

Knowing that most people who invested in stocks were wary of advice, he set out to prove to people that he had a special power for knowing when stocks were about to go up or down. He got a list of a ten thousand people who were avid stock traders and sent each of them an e-mail describing his services (and fees) and giving them a “sample” stock pick.

Half of the prospective customers got an e-mail saying that the stock would go up in the next week, and half of them got an e-mail saying that the stock would go down. At the end of the week, the stock he picked had gone down, so he sent another e-mail to the five thousand people who had received the “correct” stock advice.

Half of the five thousand got an e-mail saying that another stock would go up in the next week; half got an e-mail saying it would go down. At the end of the week, he sent out another e-mail to the remaining 2500 would-be customers.

At the end of six weeks, he was down to a little over 150 potential customers, but those 150 has seen him make six correct stock predictions in a row! The last e-mail he sent them was to tell them that they could continue to get these predictions only if they bought a five-year subscription to his service.

In autism therapy, much the same system is at work, although I don’t claim that anyone is doing it deliberately, unlike the stockbroker in the story. Parents who get results will convince themselves that the “treatment” is working. They may have seen improvements in the past, but without a “treatment” to hang them on, these improvements would have seemed maddeningly random (as, in fact, they are).

The parents who don’t see any improvement will quietly drift away from the “treatment”. If they choose to tell other parents that the “treatment” didn’t work for their child, that is easily explained away by “every child is different – you need to find what works for your child”. And so, they head off into the sunset on a search for the “treatment” that will work on their child.

When you take in a broader view of the autism “treatment” landscape, it seems painfully clear that this is happening. Every therapy has its own group of parents who swear that it has “cured” or “recovered” their children. And each therapy also has a rather pitiful group of people who haven’t seen the “cure” yet, but are hoping that it will happen soon.

And there are dozens (if not hundreds or thousands) of “treatments” out there that are just like secretin – a few anecdotal stories (or even just one), a hint of biological plausibility (which, given that nobody knows what autism is, can be pretty vague) and a cluster of “me too!” stories.

In fact, even though secretin has been very thoroughly shown to be ineffective, there are still large numbers of “alternative” practitioners using it to “treat” autism. Apparently, no amount of good science is going to penetrate the core believers.

Unfortunately, most of the other “treatments” for autism are not going to get as thorough scientific evaluation as secretin did. Many of them have so little “biological plausibility” that no real scientist is going to want to bother submitting a proposal to study them. The rest have so little biological plausibility that they don’t even seem worth debunking for the fun of it.

And, given what happened with secretin, why would anyone bother? If people are going to “listen to autism” and ignore the science, what’s the point?




Prometheus

Fear Pressure

For some time now, I’ve wondered why promoters of the mercury-causes-autism get so hostile when they talk to us skeptics. Time after time, I’ve been accused of:

[1] Preventing parents from treating their children with (insert therapy).

[2] Preventing parents from hearing about (insert therapy).

[3] Keeping kids from getting (insert therapy).

This, of course, is utter nonsense.

I’m not standing in the way of parents who want to “treat” their autistic children with whatever voodoo they want to use. I’m just a single person writing a single ‘blog – I’m not blockading their homes, picketing “supplement” stores or standing in the doorway of even one DAN! doctor.

Parents have a wide variety of woo-based websites, parental support groups, newsletters etc. to inform them of the latest in woo-based autism therapies. I can’t hope to compete with the amount of baloney available to parents. I’m just a single voice shouting (actually, writing) in the wilderness.

I’m not hacking websites (although folks on the “other side” have done that), I’m not buying up web domains with similar names (although folks on the “other side” have done that) and I’m not trying to harass, intimidate or litigate against people who want to tell their side of the story (although folks on the “other side” have done that).

Finally, I’m not doing anything to keep the children from getting whatever therapies – woo or otherwise – their parents see fit to inflict on them. Nothing but quietly telling my side of the story.

Yet, they are offended by my skepticism. More than offended – enraged. People have said things to me and about me that are offensive, accused me of base and dishonorable behaviors and have told me – in no uncertain terms – to SHUT THE F**K UP!

Why does my lack of belief in their viewpoint make them so angry?

To be honest, it’s not just me. They seem to hate anybody who’s not on board with their “program”. And "hate" is the correct word - make no mistake about that.

A few days ago I found myself with a bit of unstructured free time, so I decided to spend the time trying to understand the anger I seem to provoke in the mercury-causes-autism believers.

I started by imagining that I had a child with a poorly-understood disability of unknown origin and uncertain prognosis. That was the easy part.

Then, I pictured what it would be like to have someone – or a group of someones – tell me that they had discovered THE CAUSE and THE CURE of the dread illness that was afflicting my child. So far, so good.

Then I tried to imagine what it would be like to have other people, perhaps people with expertise in medicine and science, disagree with THE CAUSE and THE CURE.

How would that make me feel?

Frankly, I was at a loss to see why I would give two shakes of a lab-rat’s tail what the “experts” might think if I had (or thought I had) a cure for my child’s ailment. As long as they weren’t getting in my way, why should I care they thought?

After all, in the post-modern world, people ignore the experts all the time. In the US, they’ve raised it to a cultural icon. The only thing that “the people” distrust more than “experts” is “the government”.

Indeed.

But then I considered how I would feel if I was doubtful about whether or not THE CURE worked.

That would change things. A lot.

If I was harboring secret doubts, doubts that I scarce could admit to myself, then someone else doubting THE CAUSE and THE CURE would be a big problem.

As long as everyone around me was chanting the party line (“Mercury causes autism and chelation is its cure.”), I could bury my own doubts. After all, if I was the only person with doubts, then it must be true.

Right?

But once I started to hear other people doubting THE CURE or THE CAUSE then my own doubts would start gnawing at me. They’d start keeping me up nights.

And why, you might ask, would I have doubts?

Well, maybe the improvement wasn’t as dramatic as I was making it out to be. Of course, my child was getting better, but he wasn’t CURED, not like all the other kids were being CURED. And the other kids I saw, they weren’t as CURED as they were made out to be.

Of course, I wouldn’t be tactless (or stupid) enough to tell the other parents that their “recovered” kids didn’t look all that “recovered” to me. And I certainly wouldn’t be bold enough to say that I didn’t think that my child’s improvement was as much as I expected, based on their descriptions.

Of course not. That would be like saying…oh, I don’t know…like saying, “The Emperor has no clothes!”

And we wouldn’t want to say that, would we?

So, what are my options? I can’t admit to myself – or my spouse or fellow mercury-causes-autism parents – that I have doubts about THE CURE or THE CAUSE. That would cause unacceptable mental anguish, since I’d not only have to admit that I was wrong (never an easy thing to do, in the best of circumstances), I’d have to admit that I didn’t have a cure for my child’s illness.

That’s not going to happen. Uh-uh. Nope. Never.

And the other option? I can get angry at the doubters. I can accuse them of bias, corruption, ignorance, arrogance, insensitivity, or whatever else comes to mind. I can circle the wagons and excommunicate anyone who admits to doubt.

And why would I do these things?

Because I’m afraid.

Very afraid.

Because without THE CAUSE and THE CURE, I’d have nothing to offer my ailing child.
I would be defeated.
I would have no hope.

Or so I might think.

So, when the mercury-causes-autism proponents take their next poke at me, I’m going to try my very best to remember that, although their actions are hostile and belligerent, they aren’t really angry with me.

They’re just afraid that I might burst their bubble. That I might force them to face their own doubts.

And they’re not ready for that.

Yet.


Prometheus