The Doctor Who Fooled the World Page 11

  That February, Chadwick began testing the samples, as the legal board submission—of which he knew nothing—had prescribed the previous June. He looked for measles (as well as mumps and rubella) in biological materials from twenty-two kids, including Child Eleven, plus an additional six control patients for comparison.

  “And are these children,” I ask him in a television interview, “the same children that went on to be published in The Lancet, leading to the MMR scare?”

  “Yeah, that’s right,” he replies.

  “Did you find measles virus in those children?”

  “No. No single case did I find any measles virus in those children.”

  “You looked at some cerebrospinal fluid, by lumbar puncture?”

  “That’s right.”

  “Did you find any measles virus in those?”

  “No.”

  “So you found no measles virus in the children who were presented to the public, at the very foundation of the MMR scare—where Dr. Wakefield’s theory was that it was measles virus itself that was responsible for a bowel disease, and then leading on to some kinds of autism—and you found no measles virus?”

  “That’s correct.”

  Unlike the material in Mr. Eleven’s pot—fixed in formalin for hospital pathology—the bowel tissues Chadwick tested were frozen in nitrogen within five minutes of being taken from the patient. But, despite this advantage, and his status in the protocol as the “coordinating investigator,” his data wouldn’t be published, or supplied to the legal board in Wakefield’s report on the study.

  I only learned of these data from Chadwick’s other supervisor: a respected molecular biologist, Ian Bruce. At the time, he was a professor at the University of Greenwich, southeast London, and he vouched for the power of the young scientist’s methods. “Nick had developed the best test that could ever be carried out at that time for testing for measles virus in those samples.”

  Wakefield didn’t think so. He believed that Chadwick’s PCR wasn’t sufficiently “sensitive.” The methods had “major limitations,” he’d argue. The results were “false negatives,” he said.

  But, what people couldn’t understand was how Wakefield could find a virus with microscopic-level stains, and yet molecular methods—surely vastly more sensitive—so consistently drew a blank. Indeed, when I’ve presented his proposition, talking to biology undergraduates, they laugh. They think it’s a joke.

  Mr. Eleven didn’t know about the conflict with Chadwick. But he knew that Wakefield wasn’t happy about an external cross-check on the virology. After delivering the pot to the Chelsea lab—into the care of a senior virologist named Robin Weiss—and returning with his wife and son to California, the father waited on the findings. And waited.

  “They wouldn’t release the results to me,” he tells me, still baffled. “In all honesty, I don’t know why.”

  He waited and waited. He wrote letters. No luck. And as 1997 rolled through summer and fall, Wakefield always seemed busy. Behind the scenes, that June, he filed a first version of the Lancet paper, with the second, scientific, study claiming to find measles virus. In August, he stoked the media through statements to Pulse. In September, he met with managers to discuss the press conference. Then, two weeks later, he flew to Virginia, to speak at an anti-vaccine convention.

  At home in California, Mr. Eleven struggled. He took advice from London lawyers. He warned he might sue. Then, long after the information could have made any difference—because a storm of provoked media was off and running—the Chester Beatty virologist issued a report giving his findings on the tissue from the boy.

  This time yet another technology was employed—to see if the virus could be grown in human cells. And, no, it couldn’t be grown. The “most likely reason,” said the report, which the father shows me, “is that the child’s biopsies do not contain measles.”

  ELEVEN

  Spartanburg Science

  The medical school’s command center nestled in the basement, accessed via a slope at the side of the concrete castle, then through glass doors, and down a wide, shiny corridor that ran east–west through the building. To the right was a suite, shared by the dean and the school secretary. Then deeper inside, past Student Planning, lay the office of the man in charge of money.

  Just five days after the event in the Atrium, Wakefield arrived here for a meeting. This was Tuesday, March 3, 1998, and in the country beyond Hampstead, his profile now loomed like a white-coat leper messiah. Should anyone have missed his Thursday performance, the school had issued a statement on Saturday morning, recirculating data on the twelve Lancet kids, citing apparent backing from America.

  Parents reported the onset of behavioural symptoms in their children following either MMR vaccination (8 cases) or a likely measles infection (1 child previously vaccinated with MMR). Behavioural changes included repetitive behaviour, disinterest in play or head banging. This same temporal association with MMR has been observed by workers in the United States.

  Through the weekend, the nation’s local press joined the fray: the South Wales Evening Post, the Belfast News Letter, the Northern Echo, The Herald (Glasgow) . . . and London titles hadn’t yet quit. The Evening Standard revealed a shortage of single vaccines. The Independent showcased the man. “If I am wrong I will be a bad person,” it quoted him saying. “But I have to address the questions my patients put to me.”

  The Tuesday meeting had been scheduled before the press conference, and followed months of planning. Behind Wakefield’s public image as a dispassionate researcher lay not only his deal with the lawyer Richard Barr but yet greater ambitions for a more personal success, which that day he would discuss with management. Forget Burrill B. Crohn, or Warren and Marshall. He’d be the greatest gastroenterologist who ever lived.

  In his own mind, in those early months of 1998, he’d not only solved the riddle of Crohn’s disease but had found in the children a new inflammatory bowel disorder, unrecognized by medicine. For now. It was part of the new syndrome with regressive autism: just like he’d told the Legal Aid Board about before any of the children were scoped. No matter his lab and its molecular tests, he was confident that the villain was measles virus, especially the strains in vaccines. Now, from this meeting, he hoped to scramble even higher: to barely imaginable peaks of achievement.

  Two business associates came with him that day. Both were venture capital entrepreneurs. One was a professional investor named Alex Korda, who’d spent two decades in biotech start-ups. The other: Robert Sleat, with a similar background, and a PhD in environmental microbiology. Sleat was also father of one of the twelve Lancet children and had first met Wakefield at an autism meeting with the sentinel case’s mother, Ms. Two.

  They descended to the basement to meet with the finance officer and deputy secretary: Cengiz Tarhan, aged thirty-nine. Turkish by origin, with a wry sense of humor, he had a passion for classic rock and fast cars. The previous Thursday, he’d gone upstairs with the school secretary, Bryan Blatch, and heard Wakefield’s call for MMR to be suspended in favor of single shots.

  Tarhan (who later declines to speak to me) knew all about the Research Assessment Exercise and the money the Lancet paper might bring. But he was also responsible for a school company, Freemedic, which aimed to exploit any inventions or discoveries by staff that might be spun off to make a profit. That Tuesday’s meeting was to explore one such venture that Wakefield had been touting for months.

  This wouldn’t be the first time that Tarhan engaged with the protégé of the powerful Roy Pounder. For all Wakefield’s public image as an idealistic scientist, he’d long craved commercial success. Indeed, practically since the time he returned to Britain from Canada, he’d been filing for patents, launching business schemes, and shooting his cuffs over deals.

  Tarhan didn’t need to pull cardboard files from his cabinets. Wakefield’s record as an entrepreneur was memo
rable. First came a company called Endogen Research, with the postal address of a store in Bath, Somerset, two and a half miles from Heathfield. Through this, for three years from August 1991, he’d negotiated with the school to develop monoclonal antibodies. Then came Inceltec, in September 1993, and Histogene, in December 1994. Nothing of any remained.

  What lingered, however, was an impression of ambition going somewhat beyond expertise. One patent application was for PCR “primers”: short strings of nucleic acid used to frame genetic sequences targeted for molecular amplification. My favorite is what I call “Wakefield’s Box,” an “apparatus and process for performing a chemical reaction,” with a microwave element, turntable, and fan—like a well-known kitchen appliance.

  Bold, certainly. Innovative, perhaps. But the objective never appeared selfless. After one venture, Tarhan warned him that “individual interests” must be secondary to the school’s. In another, Wakefield talked of being “suitably incentivized by the allocation of Equity.” And in a third, managers were stunned to learn of a £24 million “appeal” intended to fundraise from the question-marked paper, and elevate Wakefield to the rank of professor.

  Tarhan’s bosses balked at that. Such an appeal would clash with the school’s own plans. And the intended self-promotion was intolerable. “It is not for you to determine whether or not a professorial title is conferred upon you,” the secretary, Blatch, slapped him down.

  Then came ideas about Crohn’s and autism, producing flurries of business paperwork. Just two days after Child Two was scoped (and while the eight-year-old and his mother were still on Malcolm Ward), Wakefield broached a breathtaking scheme. Aimed at diagnosing measles virus in inflammatory bowel disease, he estimated an annual cash flow of up to £385 million (about £710 million or US $880 million at the time I write this)—from Britain and the United States alone.

  “In view of the unique services offered by the Company and its technology,” he wrote in an eleven-page “Inventor/School/Investor Meeting” document that I obtain (replete with bold emphases) “the assay can command premium prices.”

  No wonder the excitement when he thought Child Two had Crohn’s. Wakefield had already filed a patent. Lodged in his own name, from his home address, his claims were frankly astonishing. Not only did he profess to have discovered a means of diagnosing the disease (as well as ulcerative colitis) by detecting measles virus in bowel tissue and blood, he also registered a “medicament for treating these diseases” and, even more remarkably, “a measles vaccine comprising a system which expresses part or all of the measles virus genome.”

  So that was Crohn’s. Then came autism: with a patent so secret that even John Walker-Smith later said he knew nothing about it.

  Almost nine months before the twelve-child paper was unveiled, with parents urged to shun the three-in-one, Wakefield had registered an even more ambitious moneymaker, claiming to have discovered a miracle drug, with a sensational three-in-one action.

  It could be adapted as a “vaccine for the elimination of MMR and measles virus,” as a “therapy” for Crohn’s and other inflammatory bowel diseases (IBD), and as a treatment for what he called “regressive behavioural disease” (in other words, a remedy for autism). It could be administered by injection, pills, or suppositories. It was “remarkably free” of side effects.

  “I have now discovered a combined vaccine/therapeutic agent which is not only probably safer to administer to neonates and others by way of vaccination,” he claimed in a document I later reveal on page 1 of the Sunday Times, “but which also can be used to treat IBD whether as a complete cure or to alleviate symptoms.”

  It was this venture that he brought, with Korda and Sleat, to discuss with Tarhan that Tuesday. With Freemedic money they wanted to start a company, to be called Immunospecifics Biotechnologies. With the Royal Free’s backing, they hoped to raise £2.1 million to develop diagnostic tests, therapies, and vaccines.

  Tarhan listened and, three days later, received a draft prospectus. Notwithstanding the negative results from Wakefield’s lab, it claimed that a Japanese collaborator, Hisashi Kawashima at Tokyo Children’s Hospital, had found measles where Nick Chadwick failed.

  Nine “objectives” were listed in the sixteen-page prospectus. Three were process issues, such as raising cash and finding partners. One was to commercialize “immunotherapeutics and vaccines,” while the others were measles, measles, measles. There was a “measles specific” treatment for inflammatory bowel disease; the same breakthrough for “developmental disorders”; plans to “purify” the products for regulatory approval; likewise for a “measles specific clinical diagnostic”; and plans to “establish the potential” for a vaccine.

  Big ideas? Could there be many bigger? Just five days before, as Wakefield gazed into the glare of television lights, and voiced his torment over the “moral issue” of vaccine safety, he’d not only his secret deal with Barr in the background—to attack the triple MMR, but not single measles shots—but he’d also dreamt of his own product (including his own single vaccine), which, if credible at all, could only succeed if public confidence in the three-in-one was damaged.

  Tarhan couldn’t judge the science in front of him. The technology was something called “transfer factor”: an extract of lymphocytes (a type of white blood cell) first raised by a few scientists in the 1950s as a would-be game changer in medicine. Drawing on an ancient bright idea—that you can take stuff from one person’s body and stick it in another’s—it aimed to pass clinical benefits from donors to recipients for everything from Alzheimer’s to AIDS.

  Even to the accountant, this seemed a tall order. Still, the project appeared reputable enough. His visitors were pitching a three-sided pact: firstly themselves, then Freemedic, and finally an entity in Spartanburg, South Carolina, called the NeuroImmuno Therapeutics Research Foundation.

  It sounded tempting. Wakefield was nothing if not plausible. But, when Tarhan’s secretary sent the proposal down the corridor, the dean’s response was blunt and negative. “I have considerable research experience with transfer factor and viral infection,” he’d told Tarhan, in a previous letter. “I would not support the investment.”

  Wise move. The impressively named therapeutics foundation was the vehicle of the pipe-smoking immunologist, Hugh Fudenberg, who advised Mr. Eleven. His résumé was, to say the least, colorful. Before relocating to Spartanburg, he’d been a professor at the University of California, San Francisco, where he succumbed to funding from the tobacco industry to probe the genetics of emphysema. He’d been sued by the Food and Drug Administration for prescribing hazardous treatments, suspended by his medical board for controlled-drug misconduct, and now ran a consultancy, charging eye-watering fees, to parents of autistic children.

  He was also the first to report a proposed link between the MMR vaccine and autism. Although Wakefield would seize the crown as the “father of the anti-vaccine movement,” and people talked of his twelve-child study as the first of its kind, Fudenberg had beat him to it. Indeed, it was this man’s paper that the Royal Free’s Saturday press release meant by “workers in the United States” who made the “same temporal association.”

  First presented in June 1995 at a conference in Bologna, Italy, Fudenberg’s paper was published nine months later on five pages of a fringe journal called Biotherapy, which was soon to be discontinued by its publishers. He reported on forty autistic kids, fifteen of whom, he wrote, developed their “symptoms” within a week of MMR vaccination. Three had high fevers and convulsions within a day, he said, while the rest experienced a gradual onset of issues (the most common natural history of autism) at between fifteen and eighteen months of age.

  He called his paper a “pilot study” and named as the source of his forty children a New York neurologist named Mary Coleman, a specialist in developmental issues. But when I phone her, she calls him “dangerous and crazy,” says she thought that “something has hap
pened to him mentally,” and that “there’s something about this field that attracts quacks.”

  But, quack or not, Fudenberg attracted Wakefield. So I drive to South Carolina to meet him. He was old and infirm by the time I get there, grinning from a wheelchair in a denim beanie hat, thick brown jacket, and dark glasses. He calls Wakefield a “gentleman,” says he’d stayed at his London home, and that he, Fudenberg, had turned him down.

  “He wanted to go into business with me,” he says, as we talk on his upstairs deck on a humid afternoon, eighty miles southwest of Charlotte.

  “And what would that have done, that business?”

  “Make a lot of money for him.”

  “But apart from making money, what would it have done?”

  “Maybe gave him some fame perhaps. I don’t know. If you’re a big businessman, you get famous.”

  He says he refused to go along with Immunospecifics, because he didn’t like Wakefield’s values. “He wanted to prove he was right,” he says. “That was his main motive. To prove he was right. He kept at it through thick and thin. He was also just money too much.”

  We talk about transfer factor, where documents I obtain showed that the immunologist had experienced regulatory difficulties. “Now, using this technology,” I ask, “do you believe that autism can be cured?”

  This was a leading question, to test his reaction. I’d assumed that his answer would be the stock-in-trade of pioneers, whether quacks or Nobel laureates. The smart response was, “We’re getting good results.”

  Fudenberg’s reply was, “Yes.”

  I didn’t see that coming. But these were early days. “Cured?”

  “Yes,” he repeats his claim.