What makes a physician become an antivaxer? (Part 2) [Respectful Insolence]

Yesterday, I discussed a topic that has vexed me ever since long before I started this blog, namely the topic of how physicians are seduced by pseudoscience and ultimately embrace it whole-heartedly. The kinds of pseudoscience I’ve seen physicians embracing are many, including climate science denialism and creationism, but the ones that most interest me are ones that physicians should know better than to embrace. I’m referring, of course, to pseudoscience related to the medical profession, such as various forms of medical quackery (which, alas, have found all too cozy a home in medicine to the point of even becoming part of a specialty called integrative medicine) and antivaccine beliefs. Yesterday’s post addressed the question of antivaccine beliefs, but much of my discussion could have applied to many forms of pseudoscience that doctors all too frequently embrace.

The discussion after yesterday’s post was more voluminous and involved than I had expected. I love it when that happens, and, especially when such discussions are not invaded by our resident troll sockpuppet Travis Schwochert impersonating old commenters. It got to the point where I realized that I had left out one very powerful motivating factor for physicians. Well, there are actually two that I didn’t discuss that much. Money is one, but that one tends to apply only to physicians who have discovered that quackery can be lucrative. The second one is related, but not the same, as one that I discussed yesterday. Both flow from ego gratification.

You’ll remember that yesterday I discussed the case of Dr. Douglas Mackenzie, a plastic surgeon who has become very antivacccine, so much so that he’s now doing promotional work for the antivaccine propaganda movie VAXXED. I have no evidence that he makes any money off of antivaccine views, and from his interview I concluded that much of his motivation for “going antivax” flows from his self-image as a “maverick,” as someone who can “think for himself” and “do his own research,” and the sense of superiority that comes from viewing himself that way. In Dr. Mackenzie’s world, he is a free thinker, someone who doesn’t follow the rest of his sheeple colleagues, whom he contemptuously describes as having been “brainwashed” about vaccines. He brags about having read not just books by antivaccine “thought leaders” (if you can call it thinking) Andrew Wakefield or Suzanne Humphries but also having the “other side” in the form of books by Paul Offit. Of course, the very fact that he thought that Wakefield and Humphries trump Offit tells you all you need to know about his critical thinking skills (i.e., that they are very weak indeed), but there’s another reason he was drawn to people like Wakefield and Humphries. They speak his language. They view themselves as being apart from the “herd,” and therefore better than the herd, as well. Mackenzie saw that and it resonated with him. Against that shared arrogance, Dr. Offit’s low-key defense of the scientific consensus never had a chance right from the very beginning. It doesn’t matter whether Dr. Mackenzie makes any money off of antivaccine views,

But there’s another reward of bucking the scientific consensus besides feeding one’s egotistical view of oneself as being a better, freer thinker than one’s colleagues and the rest of the scientific community, and that’s adulation. Before I return to antivaccine physicians, let’s take a look at a cancer quack, Dr. Stanislaw Burzynski. He’s a trifecta of reasons for embracing pseudoscience in not only does he make a lot of money selling his antineoplastons, but he also clearly shares Dr. Mackenzie’s self-image of being better, more innovative, and more of a free thinker than the rest of the medical profession. It’s a character trait that he’s clearly had since he was very young. Then there’s the adulation. Burzynski’s patients (at least the few who survive) adore him. They believe that he’s curing cancer that can’t be cured, and their worship of him is such that they immediately react to any perceived threat to him. They did it in the 1990s when the FDA was prosecuting Burzynski, and they recently did it again when the Texas Medical Board brought action against him to strip him of his medical license. In the process, Burzynski has rubbed elbows with admiring celebrities and politicians. One fan, Eric Merola, became so enamored of Burzynski that he made not just one but two propaganda films about him. Clearly, Burzynski loves the attention and thrives on it, viewing criticism and legal actions taken against him as “persecution” that geniuses suffer as a result of their genius.

Then there’s Andrew Wakefield. In the small, loony world of the antivaccine movement, he is the equivalent of a rock star. (Better to rule in hell than to serve in heaven, I guess.) Parents (particularly mothers) who believe that vaccines caused their child’s autism basically worship the ground he walks on. Whenever he attends a rally, an antivaccine meeting disguised as a medical meeting, or any antivaccine event, he is surrounded by sycophants, toadies, and lackeys, as well as adoring fans. Like Burzynski, Wakefield views himself as superior to the rest of the medical profession, as someone who doesn’t “follow the herd” and listens to parental concerns that the medical profession is ignoring. Never mind that the medical profession isn’t ignoring the concerns of parents who believe in the antivaccine pseudoscience that concludes that vaccines cause autism; it’s just that the message it is telling parents is not one they want to hear. Responsible physicians have to base their treatment and utterances in science, and science has come to a conclusion that these parents reject utterly. Wakefield, in contrast, panders to these parents’ views, and, because they view him as having suffered for his “apostasy” with respect to vaccines, they admire him. To show you how much antivaxers love Andy, I like to cite this article from over five years ago:

“To our community, Andrew Wakefield is Nelson Mandela and Jesus Christ rolled up into one,” says J. B. Handley, co-founder of Generation Rescue, a group that disputes vaccine safety. “He’s a symbol of how all of us feel.”

Since losing his medical license, Wakefield has depended on his followers for financing and for the emotional scaffolding that allows him to believe himself a truth-teller when the majority of his peers consider him a menace to medicine. The fact that his fans have stood by him through his denunciation may seem surprising, but they may find it easier to ignore his critics than to reject their faith in him. After all, his is a rare voice of certainty in the face of a disease that is, at its core, mysterious.

Note that Handley was being utterly unironic when he said that, nor was he exaggerating. Many antivaxers view Andrew Wakefield just that highly, and over the last 19 years since he first burst onto the international scene with his case series linking autism with the MMR vaccine (which is now known to be fraudulent) Wakefield’s ego has grown in proportion to that worship.

Looking at cases like Wakefield and Burzynski (and several others not listed here), it can’t be overemphasized how much of a factor ego is in motivating physicians to become antivaccine (or quacks). Physicians in particular are prone to the Dunning-Kruger effect, in which they have far more confidence in their knowledge and mastery of a topic than is justified, and many physicians like to view themselves as superintelligent and able to master virtually any topic on their own if they just put their mind to it; e.g., Dr. Mackenzie. Alternatively, they discover something and can’t let it go when it becomes clear that it isn’t the breakthrough that they thought it was. Either way, embracing pseudoscience feeds not only the physician’s self-image as being open-minded and “apart from the herd,” but it can also bolster the physician’s self-image as a “healer” who takes his patient’s concerns more seriously than other doctors or who can do things for their patients that other doctors can’t. Add to that the fact that, in some cases, there’s a lot of money to be made, and it’s not surprising that physicians, particularly those with personality traits possessed by Wakefield and Burzynski (and many others) are attracted to quackery like moths to the flame.