Appendix 6 – The Other Medicine

HEAR THE SILENCE1
A Review by Michael Fitzpatrick2

A forthcoming drama about the MMR controversy has angered many
doctors. A general practitioner and two child health experts, who have
all seen a preview, explain why Channel 5, 15 December at 9 pm.

Hear the Silence is Channel 5’s dramatisation of the case that the
measles, mumps, and rubella (MMR) vaccine causes autism.
Gastroenterologist Andrew Wakefield, whose 1998 paper (Lancet
1998;351: 637[CrossRef][ISI][Medline]) first led to claims of a link
between MMR and autism, is played by actor Hugh Bonneville. We
see him introduce himself as the caring, listening doctor to Nicky
(Jamie Martin), a little boy with autism, and his mother, Christine
(Juliet Stevenson). “Hello, I’m Andy,” he says. At his positive
response to Christine’s conviction that MMR caused her son’s bowel
problems and his autism, she bursts into tears. “You believe me?” she
says between sobs of joy and incredulity that she has at last found a
doctor who endorses her claims. “Why wouldn’t I believe you?” asks
Dr Wakefield.

This film presents the gospel according to St Andrew that is now
familiar from numerous newspaper and television accounts. In this
crudely propagandist drama, there is little scope for character development.
In her fight for justice, heroic Christine loses her high-flying
banking job and her aloof businessman husband, but not —after all, this
is Channel 5— her sultry good looks. The medical professionals she
encounters (apart from Andy) are unsympathetic, pompous, and patronising.
Dr Wakefield’s critics at the Royal Free Hospital, London, and
the Department of Health are cynical and scheming, concerned about
their own careers or influenced by the vaccine manufacturers. Dr
Wakefield is a crusader for truth, a committed scientist, a conscientious
physician, and a devoted family man.

At the preview earlier this year, writer Tim Prager indicated that
Dr Wakefield had collaborated on the script. It appears that the creators
of this drama have listened exclusively to Dr Wakefield and his
anti-MMR campaign supporters. As the parent of an autistic child, I
wish they would all look at the evidence and listen to the opinions of
numerous serious scientific and medical authorities, and not compound
the burdens of autism parents with the unwarranted fear that by
giving their children MMR they rendered them autistic. As a general
practitioner, I wish they would consider the consequences in death and
disease that is likely to result from the return of measles, mumps, and
rubella if this drama contributes to a further decline in the uptake of
MMR.

Anticipating criticism of the decision to broadcast such a grossly
one-sided account of the MMR controversy, Channel 5 organised a
debate to follow on after Hear the Silence (MMR: The Debate,
Channel 5, 15 December at 11 05 pm). However, in the days leading
up to the debate (pre-recorded on 3 December) it became clear that
viewers, after seeing more than an hour of anti-MMR propaganda,
would then see a discussion giving equal weight to arguments for and
against the MMR-autism link, when the division of medical and scientific
opinion approximates to 99% for and 1% against. Outraged
that the Wakefield campaign was going to get even more publicity, a
number of leading authorities, who had been invited to participate,
decided to boycott the debate.

Although the debate is introduced with the statement that the discussion
included experts in child and public health, not a single paediatrician,
epidemiologist, microbiologist, or autism specialist
appeared. However, I agreed to take part because I believe that the
stakes are too high to allow the anti-MMR campaign to go unchallenged.
The debate was not even-tempered. Dr Wakefield made the same
extravagant claims for his researches that have failed to impress
numerous expert bodies in Europe and North America over the past
five years. We did our best, within the difficult framework imposed by
the organisers, to challenge some of the arguments and to expose
some of the absurdities of the anti-MMR campaign.

16 December 2003

THE HYPOCRISY OF MICHAEL FITZPATRICK
Nigel J Thomas, Graduate

It is amazing to read a review of a film which the reviewer calls a,
‘crudely propagandist drama’ when his own review is so blatantly a
‘crudely propagandist review’ that it is itself more a dramatisation than
the film of which it was attempting a critique.

We’ll skim over the patronising way Michael Fitzpatrick refers to
Andrew Wakefield (who is, incidentally, a scientist more qualified
than the general practitioner himself) as ‘St. Andrew’ and go straight
on to the first mistake in the review in which Fitzpatrick states that
the, ‘heroic Christine loses her high-flying banking job’ when in actual
fact, she resigns. This is, I admit, a small point which I only mention
as it makes me wonder how closely Fitzpatrick has paid attention
to other ‘minor’ details in the rest of the film. He is obviously paying
attention to something, as he notices that Juliet Stevenson does not
lose her ‘sultry good looks,’ and seems to think that perhaps losing
your looks is something necessary in a film portraying a ‘fight for justice.’
Would Fitzpatrick have given the film more credit if the heroine
were played by a less aesthetically pleasing person, or does he feel
that Juliet Stevens is too glamorous to be a ‘real’ parent?

However Fitzpatrick does seems to think it a dramatisation that
‘the medical professionals she encounters (apart from Andy) are
unsympathetic, pompous, and patronising.’ Perhaps if he had actually
spoken to more parents himself, (or watched his own exchanges with
a parent in the later debate) he would be less amazed. As the brother
of two autistic children, I have experienced it first hand.

Fitzpatrick goes on to say that, ‘It appears that the creators of this
drama have listened exclusively to Dr Wakefield and his anti-MMR
campaign supporters.’ Why does he write about what simply ‘appears’
to be the case, when he could have contacted the makers of the show
to ask them? How can he say that the film can ‘compound the burdens
of autism parents with the unwarranted fear’ and then not demand for
the research in to the MMR to be properly, independently funded, so
that the fears of parents may conclusively be found to be unwarranted
or otherwise? He says he wishes that the makers of the film would,
‘consider the consequences in death and disease that is likely to result
from the return of measles, mumps, and rubella if this drama contributes
to a further decline in the uptake of MMR.’ and yet does not
support single vaccines which would not only give parents the choice
they deserve, but prevent the ‘death and disease’ which he fears.

Fitzpatrick then continues his hyperbolic review, claiming that the
film is so ‘grossly one sided’ that ‘a number of leading authorities’
(note that he does not mention which) are not prepared to redress the
imbalance! If these ‘leading authorities’ of which he speaks were so
absolutely confident in the safety of the MMR, surely they would feel
certain enough in their convictions to be able to talk about it on a prerecorded
late night Channel Five debate. Even if they were, as
Fitzpatrick claims ‘outraged that the Wakefield campaign was going
to get even more publicity’ it is laughable to suggest that anyone could
seriously believe that their refusal to take part in a debate reduced the
publicity of so important an issue. Thus on one hand he laments the
lack of, ‘not a single paediatrician, epidemiologist, microbiologist, or
autism specialist’ and yet salutes their not being present for fear of
increasing the publicity of Andrew Wakefield’s research. Even here
Fitzpatrick gets it wrong, as there was an autism specialist present,
whose life’s work had been studying autism.

Following the film, parents in the debate spoke of how much of
the evidence in support of the MMR was based on statistics rather
than scientific evidence. It was therefore rather amusing to see how
Fitzpatrick claims that, ‘the division of medical and scientific opinion
approximates to 99% for and 1% against’ the MMR, and I would be
delighted to see his source for this particular ‘statistic (or should I say
‘evidence’ as Fitzpatrick and his colleagues seems to find the two so
interchangeable). I do agree with Fitzpatrick on one point however,
when he states that the debate was, ‘not even-tempered’ as he himself
seemed unable to listen to what anyone else had to say without interrupting.

Perhaps jealous of the ‘heroic’ status he has placed on Andrew
Wakefield, Fitzpatrick ends his review with an almost apologetic
statement that his team, ‘did our best’ in such a ‘difficult framework
imposed by the organisers‘ against the ‘absurdities of the anti-MMR
campaign.’

If a campaign to seek the truth and justice is called ‘absurd’ by
Fitzpatrick, I wish him well in seeking a suitable term for his own
review.

Competing interests: Brother of two autistic children.

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