Wakefield Essay Three

February 1996 was a portentous month for Andrew Wakefield. The previous month he had been approached by Solicitor Richard Barr, an attorney in the small Dawbarns firm in Norfolk, England, who asked him to be an expert for Barr in a planned class action lawsuit against vaccine-makers. The proposed suit, at this early stage, was concerned with the safety of certain vaccines (the MR and then the MMR) and would be brought by parents, who claimed that their children experienced a variety of disabilities as a result of adverse reactions to vaccines. Wakefield was only vaguely aware of the possible implications for his career and life of accepting Barr's offer. He knew that there were powerful medical, pharmaceutical and political forces "out there" which had huge domains to protect, and he suspected that if he waded into the issue of vaccine safety he might get caught in some of the riptides of reaction that would almost certainly ensue. On the other hand, he also knew from his medical training and sense of identity as a doctor that concerns of parents about vaccine safety, which had increasingly been his interest in the previous few years, ought not to be ignored. Or, to put it differently, parental concerns about vaccine safety needed to be honored. He talked with his wife and another member on the medical faculty of the Royal Free Hospital in London, where Wakefield was then a Senior Lecturer in Medicine and Histopathology, about becoming an expert witness. He was undecided.

Then, in February, came the decisive phone call. It wasn't from Solicitor Barr asking him to hurry up and make up his mind or from his medical colleague giving further advice. It was from a woman in the North of England whose child was severely autistic and who had, according to her, become so after the administration of a vaccine. Her husband was infirm. She was, literally, at her wits end, and felt that there was no one in government or the medical community that was willing to provide either answers to her or help for her son. Her words over the phone were chilling: "When I go (and she was an older mother to begin with), I will be taking my son with me."

Upon hearing her words, Dr. Wakefield was gripped with a mingled sense of helplessness and responsibility. He would do whatever he could, even in a small way, to make sure not only that the woman's cries were heard, but that she might have good information and, if possible, treatment for her son's condition. Yet he had, at that time, little knowledge of autism. In fact he was first introduced to the possible connection of a vaccine and autism through a May 1995 phone call (see below). But his training was as a gastroenterologist, and the focus of his career, before getting into academic medicine in the late 1980s (he was born in 1956), was in surgery on the gastrointestinal tract, popularly known as "the gut." But he knew a lot about vaccines, for a reason I will state below, and thought that there was a way that he could provide help, however little, in the woman's situation. He would, then, sign up to be an expert for Richard Barr. He called Barr soon thereafter and said that he was on board for the case. That decision, in all its simplicity, was the decision that has led ultimately to the countless articles written about him and, most recently, to the drama unfolding before the General Medical Council.

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