Editor’s note: Contributing Editor Joe Gabriel’s fantastic “ripped-from-the-headlines” post appeared earlier this week, only to be buried by even more timely content on “The Stoned Ages.” We’ve put it at the top of the page again so it can enjoy the adulation it deserves.
I’ve been following the recent controversy over Gardasil with quite a bit of interest. As you probably know by now, the Gardasil vaccine was developed by the pharmaceutical firm Merck & Company to prevent human papillomavirus (HPV), one of the most commonly spread sexually trasmitted diseases in the United States. In 2007, after it had been on the market for about a year, Rick Perry issued an executive order requiring that all sixth-grade girls in Texas receive the vaccine. (He can do that – he’s the governor of the state.) Everyone flipped out, for various reasons, and the Texas legislature passed a law revoking the order.
The whole episode was filled with drama and theatrics, but the hoopla seemed to have died down until Perry entered the presidential race. Michelle Bachman, bless her twisted heart, latched onto the issue and accused Perry of pushing the vaccine at the behest of Merck–which, as it turns out, doesn’t seem that implausible, given that his former chief of staff was once a lobbyist for the company. It looks like there may have been a lot of money involved in the decision after all, though of course it is difficult to know about such things from the outside.
[Editor’s Note: We had a cool clip of Bachman and Perry going at it embedded right here, but the embedding has been disabled “by the owner of the clip.” Go figure. You can still watch it on You Tube.]
Anyway, following the debate, Bachman went even further, claiming that the vaccine can cause “mental retardation.” The comment prompted a storm of criticism. Bachman was widely derided for, well, just being crazy and making stuff up. To put it mildly. As the International Business Times politely noted, “Bachmann did not offer any scientific evidence to suggest there is actually a viable link between Gardasil and mental retardation.”
Anti-vaccinationism, of course, has a long history in this country, and for anyone who studies the history of medicine Bachman’s comments are probably not all that surprising. Populists have long resisted mandatory vaccinations as a type of medical tyranny, and as Robert Johnston reminds us, in a brilliant chapter in his wonderful book The Radical Middle Class: Populist Democracy and the Question of Capitalism in Progressive Era Portland, Oregon, they have sometimes done so for very good reason. Vaccinations in the past at times casued terrible damage to those who received them, and anti-vaccinationism was – at least in the progressive era – a reasonable position to take. How it transmuted into its current form is an important issue, though one beyond the scope of this post.
Still, the echoes of this damage can be seen living on in the types of claims Bachman makes. No, there is no scientific evidence that Gardasil causes developmental damage, and I am certainly not arguing that Bachman is correct in her claims. Far from it. But there is a longstanding assumption in our culture that vaccines are dangerous, that medical authority is not to be trusted, and that the pharmaceutical industry frequently places its own profit over the public’s health. This suspicion cuts across political lines – it animates both the populist left and the populist right – and in this context Bachman’s claims make a lot more sense than most pundits are giving her credit for.
Indeed, Bachman’s arguments draw on a very long history of prioritizing personal experience as a source of medical knowledge over the elite opinion of expert authority. This tradition dates back to the Thomsonian movement of the early nineteenth century, if not earlier. Part of what I find interesting about the whole episode is not just the types of claims that Bachman made about the supposed dangers of Gardasil but what is, in my view, the fundamental misunderstanding of the potency of her claims on the part of her critics. Most observers seem to think that her inability to support her claims with scientific facts somehow weakens them. Quite the contrary. Her arguments are based on the utter rejection of science as a way of knowing, and the dismissal of her claims by scientists, academic physicians, media pundits, and other elites probably only reinforces them among her target audience. Bachman suggests that individual experience is the proper source of knowledge, that everyone has the ability – and obligation – to discover for themselves the truth of the matter. “It can have very dangerous side effects,” Bachman said following the debate. “This is the very real concern, and people have to draw their own conclusions.”
This is powerful stuff. There is a strong implication here that science is fundamentally corrupt, and outside of Rush Limbaugh’s criticisms, I doubt that her supporters blinked an eye one way or the other at the torrent of dismissive commentary thrown her way. Indeed, all the huffing and puffing by shocked elites probably just reinforced her message. Sure, she quickly backed off the claim – but her supporters aren’t fooled. They know who is on their side of this potent issue.
So, here we have Michelle Bachman channeling Samuel Thomson. In 1813 Thomson formulated a health system based on individual self-care and the rejection of elite medical opinion. Thomson wanted to make “every man his own physician,” and his system became immensey popular during the 1820s and 1830s. “We have many examples of some of the greatest philosophers, physicians, and divines the world ever knew,” he wrote in his 1822 text New Guide to Health; or, Botanic Family Physician, Containing a Complete System of Practice, “who were entirely self-taught; and who have more honor…than a million of those who have nothing to recommend them but having their heads crammed with learning, without sense enough to apply it to any great or useful purpose.” Not surprisingly, Thomson was roundly dismissed as making unscientific claims, as deluding the public for personal gain, and as an ignorant fool. He didn’t care. He just went on doing it, and became wildly successful as a result. Combine all this with the more recent critique of corporate profit corrupting the political process, and Thomson sounds quite a bit like Bachman attacking Perry over Gardasil. We all know that the stuff is dangerous, goes the argument. After all, its being pushed by the evil drug companies – and we don’t need some fancy doctor telling us otherwise. You can’t trust them, either. Right?
Bachman, in her rejection of scientific orthodoxy, speaks to those among us who do not always trust the information we are told to believe. And while I find her beliefs and policy positions repulsive on many levels, I must admit a certain sympathy for her as she flails wildly at Perry on this issue. No, I don’t think Gardasil causes mental retardation. But I don’t always trust what my doctor tells me, either, as he recommends that I take this drug or that. Thomson’s voice is still powerful, even when refracted through the broken prism of Michelle Bachman.
That pharmaceutical companies developed high stakes with the institutionalization of the medical profession in the politics of public health cannot be denied. Embedded in concerns for public health and safety, such propagandist overtures do incorporate powerful political connotation along with economics of gain.
Nice piece, Joe. I think it deserves to be more widely read. I’m not sure how closely linked the critiques of science and corporate behavior are. I certainly understand how they might be subsumed under more general forms of populist resistance to elite influence and opinion. On the other hand, there are times when science and corporate behavior don’t share the same villain’s role. Of course, one might (thinking out loud here) argue that science is beginning to move closer to corporate America in populist perception. For my part, I think that that populist/consumerist distrust of corporations deserves a lot more time and attention than it currently receives. As you say, it cuts a crazy path across conventional political categories, and has done far more to perpetuate the drug war than most scholars are willing to acknowledge.
Thanks. I don’t really see distrust in science and the populist critique of corporations as the same thing, but there is a very significant overlap between the two. So, yes, sometimes they go in opposite directions – populists sometimes embrace scientific claims as a way of constraining corporate behavior, for example. In the case of the pharmaceutical industry, though, I think the two are closely linked, and I think this has been the case from very early on. I’ve found some great stuff about suspicion of the American Medical Association as being in cahoots with the drug companies from the first decade of the century, for example, and I’m pretty sure the critique goes back to at least the 1880s when Parke, Davis & Company and some of the other companies really started taking off. Anyway, thanks for the comment. I’ll try to do a follow up post that’s more historical in nature soon.
You know, consumer skepticism of drug products–historically, I mean–really needs more work. The patent medicine consumer has either been treated as a total dupe or, as I have more often done, as a wholly willing partner with the patent medicine makers. That’s the cocaine story, right? Either poor victims tricked into taking cocaine, or rational actors looking for the highest percentage of cocaine. There’s not much room in either version for the consumer who suspects the whole thing’s a bunch of crap.
I couldn’t agree more. A lot of it, I think, actually comes from the patent medicine manufacturers as they got shut out of the alliance between orthodox medicine and the new ‘scientific’ drug companies, c. 1880-1920. Companies like Abbott Alkaloidal, before they switched over and went legit. But consumer suspicion also comes from somewhere else – partially a general skepticism of medical authority, a la Thomonism, but there was something deeper going on as well. I don’t quite have it figured out yet, but I’m working on it.
Excellent analysis. Besides the usual reasons for distrust of vaccines, giving Gardisil to girls (still theoretically in latency) involves thinking of them as potentially sexual. I wouldn’t expect Bachman to be OK with that. However, I do see some rational basis for suspicion, as cervical cancer is almost entirely preventable with Pap tests and low-risk treatment of early cellular changes. Could the scientific consensus in favor of HPV vaccine have been influenced by sexual-contagion phobia? Maybe I should mention that I give that vaccine to patients and it is not only more expensive but more painful than most shots. The length of immunity is also uncertain, so the long-term benefit may be less than predicted.
Thanks for the comment, Laura. I think you are correct that the vaccine involves thinking of girls as potentially sexual, and that this is almost certainly at the heart of a lot of the controversy. It cuts a lot of ways though – for example, it may also involve thinking about both girls and their future male partners as not only potentially sexual but also potentially dishonest – so girls need it, “just in case” in order to protect themselves, even if they claim to be chaste and are planning on marrying their boyfriend, who also claims to be chaste and waiting until marriage. So, the vaccine not only involves thinking about girls (and boys) as potentially sexual, it involves thinking about them as potentially dishonest and untrustworthy. And then there is the issue of giving the vaccine to boys, under the presumption that they might engage in anal sex. Am I correct in thinking that this is getting more common? Needless to say, that will be probably raise concerns for some people as well.
Bachman’s conspiratorial skepticism shows the complicated politics of collapsing the question of scientific legitimacy with the problem of corporate power. It is one of the paradoxical legacies of Foucault et al. that the power/knowledge nexus, originally intended as a vehicle to posit intelligent reform, has become so close in people’s minds that the question of epistemology or epidemiology often becomes a determined subcategory of governmental (from the right) or corporate (from the left) hegemony. And Bachman shows nicely how even these dichtomies no long hold, as the term “crony capitalism” is now bantered about in the Tea Party. But this is because we are no longer talking about coherent political ideology in the 19th century sense, but 21st century conspiracy theory, which ravenously consumes everything in the hopes of explaining everything. But since this is impossible, this deluge of facts ends up simply affirming the one thing that people know for sure–their uncritical impulses and “intuitions.” Which are precisely the things that scientific method is supposed to question.
Would anyone like to return to drugs and alcohol?
Go ahead. Although I’m not sure why you think a post on Gardasil doesn’t qualify as discussing ‘drugs.’
As you can see, the Points blog continues to focus a great deal on “drugs and alcohol” as most people would define them. That said, I think Joe’s post really adds to an important conversation. To begin with, even if you want to define Gardasil out of the “drugs” category, the larger issue of popular response to medical authority and corporate promotion is really critical. In truth, I don’t think you can write the modern history of pharmaceutical drugs without working through this issue (I’d argue that even cocaine in the nineteenth century raises aspects of this same question), and that too few historians have really begun to do so.