Sabtu, 07 Mei 2011

Autism


You have to believe in cosmic justice when you hear about the case of Mark Geier, the doctor whose license to practice was suspended recently after the Maryland Board of Physicians ruled that his bizarre treatment regimen "endangers autistic children and exploits their parents."
If, like me, you don't know much about autism, let me explain where the cosmic justice comes in: One form of the wide-ranging developmental disorder, on the high-functioning, high-verbal end of it, is Asperger's syndrome, which among other things is characterized by a tendency to obsess on a single subject.
Geier happened to become that subject for Kathleen Seidel.
"I'm the kind of person once my brain kicks in, I just go hog wild," says Seidel, a blogger who lives in New Hampshire. "For me, it's like putting together a big puzzle."
Seidel has a college-aged child who was diagnosed with Asperger's and says she shares some traits with those on the spectrum. With a master's in library science, she tends to meticulously research her obsessions and, after seeing references to Geier's work on some autism-related websites, started to investigate him about five years ago.
"I just went down the rabbit hole and I did not come back up for months," Seidel says.
Rabbit hole, indeed. This is no doubt true of other fraught subjects, but autism has become drawn into a particularly high-pitched, emotional battlefield, particularly on the subject of whethervaccines cause the disorder.
While the medical establishment has repeatedly rejected the vaccine-autism connection, it persists. Geier is one of the biggest names among those who have long argued that vaccines with the mercury-containing thimerosol cause autism. But he and his son, David, go even beyond this disputed link, and say thattestosterone "potentiates" (or makes more powerful) the toxicity of the mercury, and that people with autism have higher levels of thehormone.
Their solution: to inject children with autism with Lupron, a potent drug that reduces the body's production of testosterone. Yup, that's why Lupron is sometimes used on sex offenders — to chemically castrate them.
Seidel's investigation resulted in a 16-part takedown of the Geiers on her blog, neurodiversity.com, that was widely circulated and drew renewed attention this week when the news hit that Maryland suspended his medical license.
While Seidel didn't contact the physicians' board — she did write the Attorney General's Office, but I wasn't able to determine this week whether that led to anything — others did, as far back as 2006. As the board investigated, others filed complaints as well, parents of autistic kids and a physician who had referred one of his patients to Geier.
The 48-page order that the physicians' board issued to document its reasons for the suspension is quite simply heartbreaking.
Despite its dispassionate retelling of the specifics of the cases, you sense between the lines the utter desperation of parents seeking help for children who have a disease with no known cure. And ultimately, you have to be outraged at how, repeatedly, according to the findings, Geier diagnosed these kids with "precocious puberty" even though they didn't fit the established standards for that.
The diagnosis, of course, allowed him to prescribe Lupron, which is used on children who enter puberty prematurely.
It's hard to know how many children he and his son, who is not a doctor, have treated, but they have been outspoken in wanting to franchise their protocol. Alarmingly, the Geiers told The Chicago Tribune two years ago that they had injected 300 children and a few adults with Lupron and were testing 200 others for possible treatment. Geier is licensed to practice in 10 other states.
(Geier has not commented publicly since his license was suspended. "I'm not free to speak about it," he told me when I phoned this week, referring me to his attorney, who did not return a call to his office.)
For Seidel, the suspension of Geier's license — he has the right to an appeals process, starting with a hearing before the board on Wednesday — offers some vindication. She's tangled, at least through the media, with Geier and others who have dismissed her work, saying she's not a doctor.
No, she's simply the parent of an "Aspie." And indeed, even by phone, you see why interacting with them can be both engaging and somewhat tiring. Seidel speaks in whole paragraphs — footnotes even, if you can imagine that in an entirely verbal exchange — and calls back a couple of times to make what were already good points better.
"I'm grateful," she says of the Maryland board's action. "It's not just me out there saying this is awful. It's not just me, a blogger. The professionals have paid attention, a whole table-full of doctors putting their intellect to work."

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