Facts, not Fantasy

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Sunday, February 28, 2010

The Shimmering Cloak

"I have never argued with a reasonable man and did not defeat him, but I never have argued with an ignorant man who did not defeat me."

-Ali bin Abi Talib from Nahgul-Balaghah

It is hard to refute the anti-vaccination movement. It is hard the way shoveling snow is hard, the way running errands on a tight schedule is hard. It hard because work is hard. To thoroughly and completely address anti-vaccinationist rhetoric you must be a polymath, you must pore over numerous journals, look up statistics, be somewhat familiar with the basics of toxicology, chemistry, and biology. On the other hand, in order to generate anti-vaccination rhetoric, you don't need to know anything whatsoever, or prove your statements with facts in any way. It cannot be taken for granted: Attacking a non-facts-based movement with facts alone is not enough.

Arguments with people from the anti-vaccination crowd always run the same way: First the allegation is that thiomersal causes autism. Then it is revealed that thiomersal has been removed from vaccines. Suddenly all kinds of new accusations emerge, that vaccines do not cure disease, or that they cause many other adverse reactions too numerous to list. One can only imagine how the vaccinated must function from day to day- poor delicate things that they apparently are.

Suddenly we find ourselves dealing with a dancing, shimmering cloak, concealing the simple fact that the anti-vaccination movement has no case. We address thiomersal, a shimmer and shift later, and thiomersal is no longer the concern. You can address the basis vaccines have in germ theory, the studies that failed to find a link, the fact that the people who design vaccines believe in vaccination, and generate two mountains of answers for every question raised by the anti-vaccination movement. All of this effort goes to waste. There will always be something else.

For parents trying to make the decision to vaccinate, it can be daunting to see a list of reasons not to vaccinate as long as their arms, but see comparatively little in rebuttal. Rebuttals must be well researched, made carefully, qualified adequately, and are by their nature limited and single-subject. Meanwhile the anti-vaccinationists can cite any number of highly questionable sources. Sources that parents cannot divine the value of for themselves. Scientists and doctors take it for granted that parents can distinguish facts, from fantasy. To a doctor- certain statements can be untrue in obvious and clear ways, but that doesn't mean that a layperson will appreciate the physician's promise that the claimants are "talking moonshine". A knowledgeable person is always hedging, always uncertain. The argument from ignorance is strident and sure.

Take for example: the recent retraction by the Lancet of Andrew Wakefield's paper- which in many respects allowed the anti-vaccination movement to catch fire. This retraction has done little to discourage the proponents of the idea that vaccines are a net harm to society. It has also failed to slake the thirst of many a parent who is out for the blood of the pharmaceutical industry. Of course, a parent who truly believes in the existence of a tangible villain that caused their child's illness can hardly be blamed for falling for the very persuasive narrative put forth by the anti-vaccination community.

So a flash, a glimmer, and a shimmer later we're right back where we started, and claims of censorship abound. This is why I do not feel that the anti-anti-vaccination movement can in fact win a battle of facts and evidence. What brought so many into the folds of the anti-vaccination movement was so much more than evidence and so much less at the same time. Less, in that it will never be sufficient to sway the dispassionate currents of reality as they buffet us about the world. More in that they now believe that every wave carries malice and intent, and they know in their hearts they are being borne off to some deserted island to endure the cruel machinations of some sinister force. Reality is not compelling, it's not a story, and human beings think in stories.

I'm not saying that evidence is unimportant and should never be brought into the discussion. Rather that not every one is appropriately primed to receive it, to incorporate it into the narrative that they have so elaborately woven. We've all seen the courtroom drama. The brilliant young lawyer receives a message pointing to some evidence absolving his innocent client of any guilt. He quickly proceeds to get the case thrown out by interrogating the right witness, or demonstrating conclusively in a single swift Cochranesque bit of elegant logic that his client cannot possibly be the perpetrator. However if we watch enough such dramas, we see there is also a completely different archetype:

Sometimes, there is no further investigation necessary by the inquisitive lawyer, and the evidence is lying in plain sight for all to see. The lawyer's task is not to find new ways of showing the jury the evidence, the reason his or her client is on trial has nothing to do with the evidence. It's the system that put them on trial, and it's the prejudices of the jury that will convict. The task of the usually young, usually spunky, lawyer is in fact much more herculean than a simple cold assembling together of the evidence before the jury: The counselor must instead present his or her case in a way that will shatter the illusions of the jury, obstruct the clear line of sight that they have between their world-view and the matter at hand. Our hero must change their thinking about the case from top to bottom as he destroys the persuasiveness of their precious narrative- so that when they finally move to the quiet of the deliberation room, they finally look to the evidence. In this scenario, the evidence is not the means, but the irrevocable end. The jury must now construct the only narrative that now makes sense, having shed their biases, and the verdict can only be a product of the clues gathered before them.

You cannot do battle with the shimmering cloak. It is, after all- an illusion and an obstruction. Yet every illusion presents an edge to grasp and every act of chicanery has stray thread to be pulled at. We long ago established that we have the answers, it is the questions that must fly fast and furious:

Who payed Andrew Wakefield?
How can an anti-vaccination doctor patent a measles vaccine in good conscience?
What did Jonas Salk charge for his polio vaccine patent?
If it's not thiomersal- what is it?
Why are genetic markers turning up for autism?
How many children die as a result of not vaccinating?
Considering this: On the balance, even if vaccines do cause autism, are the inevitable deaths from infectious disease an acceptable price to pay?
What's in a vaccine?

This last one is asked by our opponents, but only as a hollow point of rhetoric. I think it's a legitimate question, as evidenced by the fact that one anti-vaccinationist I talked to truly believed that vaccines contain animal brain matter. Not only is this untrue, but if it were- we would see the evidence of it in the form of an intense increase of neurological symptoms resembling mad cow disease. Brain matter is a very strange thing to pack into a vaccine anyway. I think that vaccines deserve to be demystified, and the story must be told of how they are made.

Each of the questions above, when answered, raise a set of new and more provocative questions, and each of the answers to those form a brief indelible impression on the person's mind. This series of answers comes at the seeker in a flurry of pictures. The mind, being what is, tries to put the pictures together to tell a story. There, suddenly, a zoetrope unfolds and in that flickering motion our thinker spies a courtroom and a jury that is slowly coming to its senses.


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