Katie, you should be twelve

1 Mar

Katie McCarron, you were beautiful and wonderful and loved by your father and grandparents and I’m sure so many more. Here’s what your grandfather had to say shortly after your passing:

I would like to say something about Katie. Some newspapers have reported that this was done to end Katie’s pain; let me assure you that Katie was not in pain. She was a beautiful, precious and happy little girl. Each day she was showered with love and returned that love with hugs, kisses and laughter. Katie loved music; she would fill in some of the words in children’s songs as my wife would sing along with the CD that would be playing, their own version of karaoke. She liked to dance, she loved to do the hooky poky. She loved being in among flowers and tall grass. She would say “I like grass”. She enjoyed the zoo and because of all of the drills and flashcards she could identify the animals. Which I thought was pretty amazing for such a young child. She was also the only little child in her non-autistic play group that could identify an octagon. My wife and son had a party for her the day they heard that from the teacher.

I am writing about you today because it is a day of mourning in our community. A day when we remember those we failed to defend. For each of us there may be one out of the many murdered who touches us most deeply. I write about you today because it is a day of mourning. I think about you often.

If I recall correctly you should be turning thirteen later this year. I wonder how that wonderful smile would have matured. I know that there were people in your life who would be cherishing you and loving you. You deserved that.


By Matt Carey

Why vaccination uptake matters to the autism community

27 Feb

With the recent outbreak of measles in California (and spreading elsewhere), we are seeing a lot of new coverage of vaccine related questions. We are also seeing a number of vaccine antagonistic individuals and groups showing that they are, well, antagonistic towards vaccines. There is no surprise that much of the antagonism towards vaccines is coming from a segment of the autism parent community. Besides being highly irresponsible in general, these groups are putting our own communities at risk.

In an outbreak people with developmental disabilities are at heightened risk of becoming infected. Autistic children are nearly twice as likely to see a doctor for an infectious disease visit than a non autistic child. (click to enlarge)

lewin

And multiple studies have shown an increased risk of complications or death from infectious diseases. In a recent influenza outbreak, the CDC reported on the deaths in people with underlying medical conditions. This was discussed here at Left Brain/Right Brain as Children with neurologic disorders at high risk of death from flu. From the CDC press release:

Of the 336 children (defined as people younger than 18 years) with information available on underlying medical conditions who were reported to have died from 2009 H1N1 flu-associated causes, 227 had one or more underlying health conditions. One hundred forty-six children (64 percent) had a neurologic disorder such as cerebral palsy, intellectual disability, or epilepsy. Of the children with neurologic disorders for whom information on vaccination status was available, only 21 (23 percent) had received the seasonal influenza vaccine and 2 (3 percent) were fully vaccinated for 2009 H1N1.

Another CDC study, and again discussed here, Severe Influenza Among Children and Young Adults with Neurologic and Neurodevelopmental Conditions — Ohio, 2011.

In one facility with 130 residents total 76 residents had acute onset of respiratory illness. 13 were severely ill. 10 were hospitalized, and 7 died. 7 out of 130 dead in one outbreak.

Here’s a 1988 study, Causes of death of patients in an institution for the developmentally disabled.

Respiratory disease, predominantly pneumonia and aspiration, accounted for 72% of deaths

Pneumonia is relatively common following diseases including measles and influenza.

A study from 1996 Large sequential outbreaks caused by influenza A (H3N2) and B viruses in an institution for the mentally handicapped tells us that residents of the facility were about twice as likely to get sick (59% became ill) as staff. Residents were about 5 times as likely to be sickened twice as were staff.

These are just a few studies I’ve collected. Not a thorough search at all. But the point is clear: the developmentally disabled are more likely to be sickened and more likely to be injured or killed by disease.

What is the infection rate and the rate of injury or death from other infectious diseases, say measles, in the developmentally disabled population? We are lucky enough in the U.S. to not have those data. But if we take the approach proposed by those who are opposed to vaccination, we may find out soon.


By Matt Carey

Comment on: Examination of the Safety of Pediatric Vaccine Schedules in a Non-Human Primate Model: Assessments of Neurodevelopment, Learning, and Social Behavior.

21 Feb

There is a common myth one hears from one group of autism parents: there is no research on autism and vaccines being performed. Usually this is combined with the insinuation that the government is scared of vaccine/autism research. The claims are often made by people who should (and likely do) know better.

One of the few places one can find a discussion of the ongoing vaccine/autism work is here at Left Brain/Right Brain. In a post last year I address the question of Why won’t the government fund vaccine/autism research?, which was really a post about how there is work being funded. In case the title was unclear, I also wrote More of that vaccine/autism research that doesn’t exist. Other articles include What projects are being funded in autism research? Part 1: vaccines and GI issues.

In one of those articles I wrote:

There’s a study by Gene Sackett’s group, A PRIMATE MODEL OF GUT, IMMUNE, AND CNS RESPONSE TO CHILDHOOD VACCINES. This appears to be a follow on project to the Laura Hewitson studies that were discussed a great deal online a few years ago.

And, guess what? A study by Gene Sackett, together with Laura Hewitson and others, has just been published: Examination of the Safety of Pediatric Vaccine Schedules in a Non-Human Primate Model: Assessments of Neurodevelopment, Learning, and Social Behavior. It may not be the study referenced above as that study was government funded, but this new study addresses some of the concerns raised by previous studies published by Laura Hewitson’s team. If you wonder what I mean by “addressed”, here’s the last phrase of the abstract: the study “…provided no consistent evidence of neurodevelopmental deficits or aberrant behavior in vaccinated animals.”

No evidence of harm.

Gene Sackett was a collaborator on one of those previous studies by Laura Hewitson: Delayed acquisition of neonatal reflexes in newborn primates receiving a thimerosal-containing hepatitis B vaccine: influence of gestational age and birth weight. This study was discussed a great deal by those promoting the vaccine/autism link (say here, here, here and elsewhere. It was called a “blockbuster” study by Mark Blaxill (then of SafeMinds, now of the Canary Party, both groups who promote the failed idea that the rise in autism diagnoses was caused by thimerosal in vaccines) on the Age of Autism blog. Dan Olmsted (of the same blog) called the results “explosive”. They both downplayed the preliminary nature of the study and the small sample size and way overplayed the importance of the results.

And as this new study clarifies, both were wrong. Both spread guilt and fear: one can still find parents talking online about how their child was delayed in one of the reflexes discussed in the study and, thus, was harmed by thimerosal in vaccines. Just an example of the harm the people pushing the idea that vaccines and autism are linked have caused.

As noted above, this new study clears up the concerns raised by the earlier studies. If history is any guide, Mr. Olmsted and Mr. Blaxill will not demonstrate the courage needed to admit their mistakes nor try to correct the damage they have caused. I would love to be wrong and have to write an apology to them.

Here is the abstract to Examination of the Safety of Pediatric Vaccine Schedules in a Non-Human Primate Model: Assessments of Neurodevelopment, Learning, and Social Behavior.

Abstract
BACKGROUND:
In the 1990s, the mercury-based preservative, thimerosal, was used in most pediatric vaccines. While there are currently only two thimerosal-containing vaccines (TCVs) recommended for pediatric use, parental perceptions that vaccines pose safety concerns are affecting vaccination rates, particularly in light of the much expanded and more complex schedule in place today.
OBJECTIVES:
The objective of this study was to examine the safety of pediatric vaccine schedules in a non-human primate model.
METHODS:
We administered vaccines to 6 groups of infant male rhesus macaques (n=12-16/group) using a standardized thimerosal dose where appropriate. Study groups included the recommended 1990s pediatric vaccine schedule, an accelerated 1990s primate schedule with or without the measles-mumps-rubella (MMR) vaccine, the MMR vaccine only, and the expanded 2008 schedule. We administered saline injections to age-matched control animals (n=16). Infant development was assessed from birth-12 months of age by examining the acquisition of neonatal reflexes, the development of object concept permanence (OCP), computerized tests of discrimination learning, and infant social behavior. Data were analyzed using ANOVAs, multi-level modeling, and survival analyses, where appropriate.
RESULTS:
There were no group differences in the acquisition of OCP. During discrimination learning animals receiving TCVs had improved performance on reversal testing, although some of these same animals performed poorer in subsequent learning set testing. Analysis of social and non-social behaviors identified few instances of negative behaviors across the entire infancy period. While some group differences in specific behaviors were reported at 2 months of age, by 12 months all infants, irrespective of vaccination status, had developed the typical repertoire of macaque behaviors.
CONCLUSIONS:
This comprehensive five-year, case-control study, which closely examined the effects of pediatric vaccines on early primate development, provided no consistent evidence of neurodevelopmental deficits or aberrant behavior in vaccinated animals.

Let’s repeat that conclusion for emphasis: This comprehensive five-year, case-control study, which closely examined the effects of pediatric vaccines on early primate development, provided no consistent evidence of neurodevelopmental deficits or aberrant behavior in vaccinated animals.

The full paper is available online. In it you can read this:

This data is in contrast to our previous pilot study in which a delay in the acquisition of the root, suck, and snout survival reflexes were reported for primate infants following exposure to the birth dose of the thimerosal containing Hep B vaccine (Hewitson et al. 2010a). This discrepancy is most likely due to the larger number of animals in the present study providing more accurate estimates. Furthermore, in the present study reflexes were examined from birth to 21 days of age, during which some animals received multiple TCVs (not just a single Hep B vaccine as was used in the previous 23 study), and yet no detrimental effects on the acquisition of survival reflexes were reported for these animals.

Hewitson 2010a is Delayed acquisition of neonatal reflexes in newborn primates receiving a thimerosal-containing hepatitis B vaccine: Influence of gestational age and birth weight. This is the “blockbuster” study according to Mark Blaxill. Ironically, Mr. Blaxill’s article links to the first publication of the “blockbuster”, the version that was retracted.

The first thing that people who promote the vaccine/autism link would do with a study like this, one that doesn’t find a link between vaccines and harm, is claim that it isn’t “independent” and the authors and/or funding agencies are too biased. So, let’s look at the authors

Britni Curtis,1 Noelle Liberato,1 Megan Rulien,1 Kelly Morrisroe,1 Caroline Kenney,1 Vernon Yutuc,1 Clayton Ferrier,1 C. Nathan Marti,2 Dorothy Mandell,3 Thomas M. Burbacher,1,4 Gene P. Sackett,1,5 and Laura Hewitson1,6,7

1Infant Primate Research Laboratory (IPRL), Washington National Primate Research Center, and Center on Human Development and Disability (CHDD), Seattle, Washington, USA; 2Abacist Analytics, LLC, Austin, Texas, USA; 3Independent Consultant, Austin, Texas, USA; 4Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA; 5Department of Psychology, University of Washington, Seattle, Washington, USA; 6The Johnson Center for Child Health and Development, Austin, Texas, USA; 7Department of Psychiatry, University of Texas Southwestern, Dallas, Texas, USA

Laura Hewitson was the lead researcher in the previous macaque studies, the ones often quoted as providing evidence of a link between thimerosal and autism. Her organization (The Johnson Center for Child Health and Development) was formerly referred to as Thoughtful House and was directed in that time by Andrew Wakefield. Thomas Burbacher and Gene Sackett have also been involved with previous animal studies on thimerosal, including this one often cited again as evidence of a link between vaccines and autism.

The funding?

This work was supported by The Ted Lindsay Foundation, SafeMinds, National Autism Association, the Vernick family, and the Johnson family. This work was also supported by WaNPRC Core Grant RR0166 and CHDD Core Grant HD02274.

Both SafeMinds and the National Autism Association are strong proponents of the idea that vaccines cause autism.

Under competing financial interests we read:

Competing financial interests: Drs. Marti and Mandell provided consulting services as independent contractors in regards to the data analyses. Neither person has provided services to pharmaceutical companies that manufacture vaccines or their representatives, nor have they been an expert witness in thimerosal, or similar suits. The other authors declare they have no actual or potential competing financial interests.

I will leave you with the final paragraph of the new study

In summary, we did not find evidence of an adverse impact of vaccination status on early neurodevelopmental measures, including the acquisition of neonatal reflexes and the development of object permanence. This was true for animals receiving TCVs, as well as animals in the 2008 group, which received the expanded pediatric vaccine schedule that remains very similar to the currently recommended schedule. Although some animals receiving TCVs performed better in the reversal phase of discrimination learning compared to controls, this association was not consistent across all study groups with thimerosal exposure. Furthermore, learning set performance appeared to be poorest for animals in the TCV group but this observation was not mirrored in the 1990s Primate group. Finally, all infants, irrespective of vaccine status, developed the typical social behaviors for this age of animal, with very few instances of negative behaviors reported. While the data as a whole does not support a consistent adverse effect of TCVs on primate development, factors that may modulate the toxicokinetics and toxicodynamics of thimerosal, such as genetics, gender, birth weight, gestational age, maternal health, and chemical co-exposures, should be thoroughly investigated.


By Matt Carey

Andrew Wakefield discusses “his war with vaccines”

20 Feb

For many years Andrew Wakefield put forth the image of the reasonable scientist who has been persecuted for merely asking questions about vaccines. Over the past year, that image has been fading as Mr. Wakefield has taken a more direct approach to criticizing vaccines and those involved with vaccines. His video claiming the CDC were involved in a “Tuskegee” like experiment and were worse than Hitler, Stalin and Pol Pot was an epic departure from his previous restraint.

His latest interview, while not quite in the epic stature of the “Hitler et al.” video comments, is another example of Mr. Wakefield’s evolving rhetoric. He was interviewed by Alex Jones. Just being on the Alex Jones show is a poor choice for anyone who values accuracy over meager publicity.

The title of the video is “Dr. Unloads On Safe Vaccines”. And beneath that we can read this line:

Published on Feb 13, 2015
Alex Jones welcomes Dr. Andrew Wakefield to the studio to talk about his war with vaccines.

Here’s a screenshot of the YouTube page (click to enlarge):

alex jones on Wakefield

So, we get Mr. Wakefield’s “war on vaccines”. We of course get the obligatory, “We aren’t anti-vaccine”. OK. We also get comparisons of the vaccine program to Nazi Germany. More than once.

Mr. Wakefield seems to be saying that the MMR vaccine does not protect against measles, only the single measles vaccine does. Right. Amazing how we’ve gone so long without major outbreaks of measles with the MMR in use.

Readers may recall that last year Mr. Wakefield bungled the PR campaign for a paper by Brian Hooker. Mr. Hooker’s paper (since retracted) presented a reanalysis of an old CDC dataset on autism and claimed:

Additional research is required to better understand the relationship between MMR exposure and autism in African American males.

It was at best not a strong result in a not strong paper. But even in that paper the assertion that a causal connection was not made. But, how is this work being described now? From Mr. Wakefield on the Alex Jones show:

“And now that Dr. William Thompson, senior CDC scientist, has come forward and said that they have known for 13 years that MMR vaccine is causally associated with autism and they have hidden it from the public, from doctors from public health officials, from everybody.”

The “reanalysis” doesn’t say there’s a causal connection. Mr. Thompson’s public statement doesn’t say “causal” at all. But, hey, Alex Jones and his listeners are not the types to actually fact check Mr. Wakefield.

One could go on and on analyzing the misinformation in that interview. But statements like these make the point: Mr. Wakefield is moving away from his “reasonable guy just asking questions” mode. But we knew that when he put out his race baiting YouTube video last year.

I would be very interested in how Mr. Thompson feels about how he is represented by Mr. Wakefield. Mr. Thompson has made only the one public statement and it does not say what Mr. Wakefield claims.


By Matt Carey

National Geographic, “The War on Science”, includes discussion of vaccines and autism

19 Feb natgeo

I just got my copy of the March 2015 issue of National Geographic a couple of days ago. Imagine my reaction when I saw this cover (click to enlarge):

natgeo

In case you are having trouble imagining my reaction–it includes a big THANK YOU to National Geographic.

Yes, they put “vaccinations can lead to autism” up there with “evolution never happened” and “the moon landing was fake”.

This paragraph includes references to Jenny McCarthy (anti-vaccine activist and actress Jenny McCarthy) and Andrew Wakefield’s Lancet article.

Doubting science also has consequences. The people who believe vaccines cause autism—often well educated and affluent, by the way—are undermining “herd immunity” to such diseases as whooping cough and measles. The anti-vaccine movement has been going strong since the prestigious British medical journal the Lancet published a study in 1998 linking a common vaccine to autism. The journal later retracted the study, which was thoroughly discredited. But the notion of a vaccine-autism connection has been endorsed by celebrities and reinforced through the usual Internet filters. (Anti-vaccine activist and actress Jenny McCarthy famously said on the Oprah Winfrey Show, “The University of Google is where I got my degree from.”)


By Matt Carey

Yes, the video “who killed Alex Spourdalakis” video whitewashes a murder

17 Feb

Consider this review of Who Killed Alex Spourdalakis on Examiner.com. The review is bad. Really bad. But it shows that at least some of the people watching this video are coming away with the idea that the primary fault for the murder does not lie with those who committed the act. In fact, even the murder itself is downplayed.

Don’t believe me? Check out this paragraph:

Alex Spourdalakis had two extremely devoted caregivers who would literally do anything to relieve the problems that he dealt with. He was a normal, happy baby until 18 months. Dorothy, Alex’s mother, and Yolanda Agata Skrodzka, Alex’s godmother, doted on him every moment when he started to show problems, often never leaving his bedside when he wound up in various hospitals. The story that movie tells is a heartbreaking tragedy of an arrogant and misguided healthcare system, not able to accept the changing state of autism in America. Dorothy and Yolanda trusted the doctors as Alex went through numerous changes, assuming the doctors knew best. Over time, it became clear that the doctors mostly didn’t know what they were doing. Eventually, at age 14, Alex died.

Eventually he died? That’s how you describe a death that involved poisoning, having one’s wrist slit and multiple stab wounds to the chest? “Eventually died”? Alex’s life is put in the context of his mother and godmother. He has a supporting role in his own life’s story.

Consider another paragraph:

It becomes obvious looking at the film that there is no coherent method of dealing with this growing problem, and it is the families who are being punished to unimaginable degrees. Hospitals don’t want to deal with this problem, which has led to an epidemic of stress-induced homicides. In Alex’s case, after he was at his very worst he was discharged by Lutheran Hospital in Parkridge, Illinois after a long line of hospitals had passed him along. It was shortly after that, that Dorothy and Yolanda were arrested for the death of Alex. The film shows very clearly that the two women were saints who obviously eventually succumbed to despair. This story is also shown to be a common problem.

So much wrong in that paragraph. So much. But let’s consider the worst: “The film shows very clearly that the two women were saints who obviously eventually succumbed to despair.”

Seriously? They stabbed him. Murdered him. But they are “saints”?!?

One could go sentence by sentence and point out the many flaws in this review, but I think the point is clear: Alex’s death is important in so far as it condemns the medical establishment. His life is important in so far as it shows that his caregivers, and murderers, are “saints”.

Alex deserved better in life. He deserves better now than to have his story told in this way.

By Matt Carey

Movie review: Who Killed Alex Spourdalakis

12 Feb

Alex Spourdalakis was an autistic youth. An autistic youth who faced the sort of crisis we all hope never happens. And that is even before he was killed by his mother and godmother. Much of the last year of his life was spent in a search for a way to treat his sleep disturbance and aggression, with his mother concluding at one point that these stemmed from gastrointestinal disease (she would later decide that lyme disease was at play), a conclusion which apparently put her and her advocates at odds with some of Alex’s doctors some of whom proposed a psychiatric approach. His hospital stays included four point restraints for days and weeks. As a recent study has shown, restraints are not unheard of for autistic patients. This is a topic that deserves attention to limit or end the practice. It is impossible to do justice here to just how serious this crisis was. And that’s leaving out the fact that in the end he faced murder by those closest to him.

He was murdered by his mother and godmother who poisoned him with an overdose of prescription medication and, when that failed, killed him using a kitchen knife to slit his wrist and inflict multiple stab wounds.

We now have a video showing some of the story. A one-sided view of the story. A video by Andrew Wakefield. Mr. Wakefield has a long history with the autism communities and, quite frankly, that history is marked by many less than accurate accounts of fact by Mr. Wakefield. I’ve watched his “Who Killed Alex Spourdalakis” a few times now and tried to put my thoughts into words.

“Who Killed Alex Spourdalakis” is not a true documentary in that the film makers were a part of the story. It appears to have started out as part of their “Autism Team” reality TV show project. Mr. Wakefield’s “Autism Team” was not just standing back and documenting events, they were acting as advocates and advisers to Alex’s mother. For example, they put Alex’s mother in contact with Arthur Krigsman (pediatric gastroenterologist and former colleague of Andrew Wakefield) and arranged transporation for Alex to be seen by Dr. Krigsman. Roughly a week before his death, Alex was in the hospital again, where he was visited by the “Autism Team” in the person of Polly Tommy and it sounds like Andrew Wakefield. Alex’s mother discusses how they’ve been offered a placement in a psychiatric facility, but this would involve Alex being separated from his mother and godmother. A separation we now know was necessary to save his life. In this screenshot we see subtitles for Alex’s mother stating “not in a psych unit. Once a week” (referring to the chances to visit Alex). The godmother is stating, “it’s a psychiatric facility”. And the closed captioned words belong to Polly Tommy who is stating, “No, we can’t do that”. We? The Autism Team are documenting themselves as part of the story.

Before “Who Killed Alex Spourdalakis” was produced many questioned how much did Mr. Wakefield’s “Autism Team” contribute to the horrific outcome. Not directly, of course, but in terms of whether a different group of advocates or different advice from Wakefield’s team would have averted the murder. Alex’s mother was offered help from other groups, and declined it. This is a question that can not be independently explored given this team’s dual role of advocate/advisers and documentary videographers. We are also talking about Andrew Wakefield, who in the introduction to one of his books glorified a murder-suicide involving an autistic and his mother.

But I am now falling into the same trap as Mr. Wakefield: losing sight of the actual story. Because the story isn’t “who killed Alex Spoudalakis”. The story is Alex Spourdalakis. A young man, 14 years old when he was murdered, who was a valuable and often happy person who had reached a point in his life when he needed support: medical and other support. He was a person worthy of respect. Disability did not diminish that. His extraordinary needs did not diminish that. In fact, his extraordinary needs were a big part of the story that needed to be told clearly. While one can pick some of his story out of the video, it gets obscured as the video uses Alex and his story to promote the Wakefield message that vaccines cause autism and a harsh criticism for psychiatry and mainstream medicine in general. And the video argues that Alex’s mother is not responsible for the murder due to alleged use of antidepressants.

Alex needed help. A great deal of help. He couldn’t sleep. He had episodes of aggression. He was in the emergency room for weeks in restraints. Much of the video centers around a division between one side, his mother and the “Autism Team”, who felt that these were signs of an underlying gastrointestinal problem and another side, many of the medical staff, who were often pursuing a psychiatric explanation. It would have been valuable to see an honest account of the question of what was behind Alex’s crisis. But we don’t get that in this video. We get an antagonistic approach to psychiatric care and statements that instead “autism is medical”.

Mr. Wakefield and others would do well to recall that psychiatric care is medical care. For some it can be life saving.

Psychiatric and other medications can also result in extreme reactions. And this is a point Mr. Wakefield makes time and again, to the point of actually weakening the point. For example, we are told about how Alex had a serious allergic reaction to one set of medications, complete with a frame showing this event highlighted in his medical record. Not hightlighted but visible is the statement that this reaction cleared up with two doses of Benadryl. Making a big deal out of a reaction that cleared up with Benadryl, an over the counter medicine, struck me as overplaying this point.

Even with the possibility of adverse reactions to psychiatric medication, Mr. Wakefield would do well to recall that autistics can have psychiatric conditions. Mr. Wakefield is in the community that is quick to tell us that autistics often have comorbid conditions. But rarely does this community point out that a large fraction of comorbid conditions are psychiatric. This was explored by the Lewin Group for children. And by Lisa Croen’s team for adults.

Where GI complaints are 1.3 times more common in autistics, anxiety is 3.7 times more common and schizophrenia 22 times more common (just to name a few psychiatric conditions).

Autistics do have a difficult time obtaining appropriate medical care. One doctor told me that 75% of the information they use to make a diagnosis comes from listening to what the patient tells them. But what if a patient is nonverbal and doesn’t have effective alternative communication? Add to this the fact that autistics often have sensory issues. What happens when, as one friend of mine relates, a person can tell you “I’m in pain” but can’t say where that pain is? And this is before we consider issues such as poor insurance coverage for the disabled and other social factors that limit access to care. This is a story that needs telling. Psychiatric medications are prescribed more often to autistics in poor families than in wealthy families. And this video doesn’t do these points justice.

In the video one does get to see Alex. Yes, the images of Alex in restraints in the hospital that were common online shortly before his death. But also Alex before the hospital stay. Alex Happy. Alex Outside. Alex as a human, not a pawn. It’s telling that Alex’s father and sister do not appear in these videos. According to the video, Alex’s father declined to be interviewed. One does see a great deal of Alex with his mother. She is shown giving him a great deal of affection. I don’t doubt her love for her son. The intention, I suspect, is to portray her in a sympathetic light: the loving mother. She’s so loving that something else must have driven her to the brutal murder of Alex, right? At least that is the message I suspect the director was trying to get across. Well, except downplays the brutal nature of the murder. In the end, though, the scenes of affection between Alex and his mother are more jarring than sympathetic. Knowing that this woman would shortly be poisoning Alex and knowing that she is the one reported to have stabbed him repeatedly, well, the affection does not come across as endearing nor sympathetic. Knowing that Alex loved his mother makes the betrayal all the more painful.

One does have to address that horrific outcome, the question posed by the title of the film: who killed Alex Spourdalakis. Interestingly the first sentence of narration tells us: “what turned Dorothy Spourdalakis, a loving mother, and Jolanta Agatha Skordzka, a loving godmother, into killers?” While it is not contested that these are the killers, the video tries to make the case that it’s more complicated than just who actually committed the physical acts of killing. A critic’s statement, quoted on the facebook page for the group who produced the video tells us one interpretation:

The story of Alex is an indictment of our healthcare system’s ability to treat autism as a disease rather than a psychiatric disorder

In this interpretation, “the story of Alex” isn’t about him or how he lived. And we need to reject the possibility that autistics can have psychiatric needs, because autism is a disease.

The video argues that Alex would have had a happy outcome, similar to that of another “Autism Team” subject, had he followed a “medical” approach of treating GI disease rather than a psychiatric one. One sad irony is that Alex’s mother abandoned the GI approach to follow a different disease approach to his care: lyme disease.

The video downplays the events of the actual murder. Instead of giving the full details, the murder is used as one last critique of psychiatry. In Mr Wakefield’s telling of the murder presents it with a recreation of Alex’s father and uncle discovering the crime scene. The scene is merely described initially as Alex was found “dead in his bed”. This for a scene where a young man was stabbed multiple times and had his wrist slit to the point of nearly severing his hand. He had been dead long enough for rigor mortis to set in. The scene that Alex’s father and uncle found would have been grisly, to say the least. Alex had been bleeding and the blood had time to congeal. But we don’t hear those details. By the time the narration gets to the knife wounds, we hear only that he died of a knife wound to the heart. No mention of the slit wrist nor the other 3 stab wounds.

Instead the emphasis is given to the poisoning attempt. We are told how ironic it is that drugs which Alex is alleged to have had adverse reactions to did not kill him. Psychiatric drugs, alleged to have failed him in life, failed in killing him. This point is give far more emphasis than the actual act of killing Alex.

We are told how Alex’s mother and godmother were found near him, unconscious from a drug overdose. Alex’s mother and godmother had just failed to kill Alex with an overdose and yet chose this same method for their attempted suicide.

His mother and godmother were reported to be “semi conscious” when found. And one document, apparently a police report, shown in the video indicates that the mother and godmother were able to answer questions while still in the apartment. Which begs the question, how many pills did they take in their apparent suicide attempt? Were they really in danger of death?

We need to face the grisly nature of Alex’s murder because glossing over the brutal nature of the murder does not do the victim service. It does help paint the killers in a more sympathetic light. We also must face questions raised by these actions. It is stated that when Alex did not die from the overdose, his mother and godmother took to using the kitchen knife. Why? Was he taking too long to die? Did they fear being discovered? Was Alex waking up? How long did they wait for the overdose to kill him? Why didn’t they call for help in that time?

Mr. Wakefield argues in the video that it was once again psychiatry that failed Alex, and at the same time builds an argument that his mother wasn’t really at fault. The video alleges that his mother was taking antidepressants and the side effects include suicidal thoughts and violence, setting the stage for an insanity defense. There are a few problems with making that argument stick, starting with the argument made by the district attorney that the murder was planned in advance. This argument is supported by the fact that Alex’s mother and godmother made his father and sister leave the apartment a week before the murder. This could be a sign of premeditation: that they wanted to the apartment free to commit the murder. This avenue of reasoning is not explored by Mr. Wakefield in his video. Next, this murder was committed by two people, and Alex’s godmother is not alleged to have been taking antidepressants. In this insanity defense scenario, why didn’t the godmother stop the murder? Report the plans? Next, this isn’t a violent murder–or wasn’t intended to be. It started out as a poisoning attempt. We do not know how long they waited for the overdose to kill Alex, but certainly long enough for either of the killers to have second thoughts and call for help, especially the godmother who is not alleged to have been taking the antidepressants. Lastly, the video tells us that there’s no physical evidence of the antidepressants. They allegedly brought from Greece by Alex’s father, who is further alleged to have removed the drugs from the apartment.

At this point in the narrative Alex is dead. We’ve heard heard an argument as to why his mother isn’t guilty of the crime. But Alex isn’t the story of this video. Even “who killed Alex” apparently isn’t the story. The video next presents us with “one vital piece of this puzzle”. This is the segue into claiming that Alex was a victim of vaccine injury. Mr. Wakefield wasn’t content with telling us this at the beginning of the video, he had to bring it up again at the end. We are told that Aex was a child “…whose life was over in so many ways from the age of 18 months.” In one sentence he negates all the video he invested in showing us Alex as a happy, complete human. Being autistic is being a person “whose life is over.”

Recall that Mr. Wakefield has stated that he makes videos target people who are agnostic on the question of whether vaccines cause autism.

We also get a pitch for the idea that what Alex needed in order to avoid his death was more support from Wakefield’s team. That they are going to start the “Alex Spourdalakis Recovery Center”, a place for autistics and their families after seeing Arthur Krigsman. I am at a loss for words other than to say this is absolutely not the solution that comes to mind to avoid another murder like Alex’s.

In the credits we get snippets of video of Alex. Starting with Alex near the end of his life, naked and rocking. While Alex does appear to be happy in these clips, showing him naked without his permission is inappropriate (note that while Mr. Wakefield does not show Alex’s full body, I have further blurred this image). Then, after showing Alex as a baby and flowers for Alex (complete with business card for Wakefield’s Autism Media Channel), the credits end.

But, apparently just in case we didn’t get the message of the video, we need to be shown two more short scenes appear after the credits. Niether shows or mentions Alex. The last message Mr. Wakefield wanted those watching this film to take away. Nothing about Alex, just a simple screen stating “Merck face legal action for alleged MMR vaccine fraud”. The additional sad irony in this is that even if you accept the claims that Alex was vaccine injured and the claims in the lawsuit, the Merck case is unrelated to Alex’s story. It doesn’t involve Mr. Wakefield’s hypothesis of the measles component of MMR being linked to autism. It doesn’t involve allegations of vaccine injury at all but, rather, the effectiveness of the mumps component.

Alex deserved better in life. He deserved medical care, be it psychiatric, standard medical or both, to bring him back to the happy person he was before his crisis. But Alex also deserves better in death. He deserves that his life and death not be used as a tool to promote Andrew Wakefield’s poorly supported one-size-fits-all approach to autism. He deserves to be the story, not have his story framed as “who killed Alex Spourdalakis”.

Alex deserves better.


By Matt Carey

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