#158-Brian Deer: A tale of scientific fraud—Andrew Wakefield & the belief that vaccines cause autism

1. 0:00 – 0:10

   Intro;

   1. PAPeter Attia0:00

      [upbeat music] Hey, everyone. Welcome to The Drive Podcast. I'm your host, Peter Attia.

2. 0:10 – 12:35

   How Andrew Wakefield’s flawed approach to scientific research led to the belief that vaccines cause autism;

   1. PAPeter Attia0:11

      Brian, thanks so much for, uh, for staying up somewhat later, I guess, in the afternoon, evening, um, your time. It's, uh, it's really an honor to be able to speak with you here today about such an important topic. Um, I think as I told you when I reached out to you, um, this is certainly a subject matter I've paid very close attention to for a number of years, but I was still somewhat surprised by some of the revelations in your book when I first read it. I actually had to read it a second time to fully assimilate, um, all of it, uh, at which point I reached out to you and said, "Look, I, I'd really love to speak with you," so I, I'm, I'm grateful for the time you've made. I'm sure this is a, a tale you tell often.

   2. BDBrian Deer0:50

      Well, thank you, Peter. Good to be here.

   3. PAPeter Attia0:52

      Let's just, uh, let's just get right to the chase. Um, obviously, uh, you know, surveys of people, um, around the world, certainly I can speak in the United States and the UK, uh, a sizable portion of the population believe that autism is likely or probably caused by vaccines. Is that a, is that a fair statement today?

   4. BDBrian Deer1:15

      Yeah, it's a very, it's a very, um, well-known opinion. I don't know what the precise polling is at the moment, but yes, there's, there's tended to be quite a, a strong, uh, view about that, particularly I think in, uh, North America, not so much in the UK at the moment. But, um, yeah, I think that's true. A lot of people have this idea.

   5. PAPeter Attia1:33

      This is not something that you were paying enormous attention to initially. It, um, you were, I don't wanna say a latecomer to this, but you weren't, uh, I gather, paying close attention to this in the early 1990s or even earlier because the idea itself that a vaccine, um, could cause harm has certainly been around for, uh, probably more than 100 years, uh, correct?

   6. BDBrian Deer1:57

      Sure. Sure, yeah. Different vaccines, yes, but, um, the, the idea that it might, uh, cause autism, uh, arose in the late 1990s.

   7. PAPeter Attia2:05

      Mm-hmm.

   8. BDBrian Deer2:06

      Yeah.

   9. PAPeter Attia2:07

      So let's, let's just talk about the story because I think there is really, um... There's a character that is at the center of this story, a character by the name of Andrew Wakefield, um, a former physician, um, who... I have to be honest with you. I think prior to reading your book, the impression I had was that he was a misguided and not particularly competent physician. Um, but I don't think I was aware of some of the other, um, shall we say, uh, behaviors that, that would, I think, go beyond a lack of con- competence or scientific rigor.

   10. BDBrian Deer2:48

       On that point, it's an interesting point because when I started researching the book, I mean, I've, I'm, I'm reasonably experienced in the, the nature of storytelling for one reason or another. I've gone into it a little bit in my life. And, um, I really wanted to try and have some kind of arc of development in this character. So I was looking to give him the benefit of the doubt in his early years. This is a guy who, as you say, he, he, he's a, he was a physician, or in fact, he, he trained as a surgeon. And, uh, he, he went off from the UK to Canada in the late 1980s, where he studied, uh, at the, um, Toronto General Hospital. And, um, originally, he was observing doctors there who were trying to do the world's first whole bowel transplant, and that was, that was the idea they had at the time. And he was a, a trainee there, but he moved very quickly away from surgery, and we've, we've never entirely found out the reason why he did that. Uh, very unusual thing to do because his mother told me that, um, he'd always wanted to be a surgeon, nothing else but to be a surgeon, and he moved away into research. And when I went back into those years, I really wanted to make him look, uh, believable, credible, almost heroic because it's a better story. If you're trying to, if you're trying to draw people in, uh, they want something to latch onto. They want to get the idea that this was a good guy who, as you say, was misguided, was perhaps incompetent, perhaps moved away from the things that he really understood. But I never really was able to find anything that, that evidenced that. Uh, it seemed that at, at a very early stage, he demonstrated a fanatical obsession with proving that, um, a, a particular infectious agent caused a particular issue. Uh, and nothing would shake him from the idea he latched onto, and the way he latched onto it was so extraordinary and so absurd, uh, that it was really very difficult to give him a, a good, positive, heroic, uh, sympathetic start in the story.

   11. PAPeter Attia5:15

       Let's talk about his eureka moment, which if I recall was, oh, I don't know, it was on Yonge Street or Bathurst Street or something like that. It was in a pub drinking a Guinness. What was the amazing insight that he had, um, in that, in that pub in Toronto in the, in the late '80s?

   12. BDBrian Deer5:34

       Well, what happened was, as you say, he was, he, he... The story which he told to an- another journalist, it's, it's a remarkable piece of history because it, it never surfaced anywhere else other than an interview he did with a, with another journalist, um, was that he was, he was, as I say, working at the Toronto General Hospital where they were, uh- Looking into the possibilities of whole bowel transplants and, and the reason why might, one might wanna do that is in order to deal with Crohn's disease. Most people, I think, have an idea of what Crohn's disease is. An appalling, ulcerating, blistering, burning disease of the bowels. Um, and nobody knows what causes it. Even today, nobody knows what causes it. Uh, people have got ideas, and there's been a lot of epidemiology, but I don't know if you've ever looked at it yourself, but the epidemiology of Crohn's disease is just totally baffling and bizarre. And no matter how many books you stack up on a table to try and understand it, you just realize it's just better to walk away and just believe it. Um, he was in this pub, is the way he, he tells it, and, and he wanted to find out what the cause of Crohn's disease was. And the mythology or the, the, the, the legend that he has sought to create is that he, he didn't want to spend his life chopping out bits of gut, which is normally what happens if you get Crohn's disease. Uh, uh, uh, in addition to heavy duty, very heavy duty drug therapy, usually you end up having pieces of your gut chopped out. So he wanted to find out the cause as being a, a much more credible, um, course in life. And I, and I give him that credit at the start, and I set it up like that. He was trying to discover the cause of Crohn's disease, and he's looking into this pint of Guinness, and he says, "Well," the convent- thinks to himself, "Well, the conventional wisdom is that Crohn's disease was caused by, um, uh, bacteria, food, some kind of allergic reaction inside the gut." And he came to the idea, "Well, maybe it isn't that. Maybe it's, maybe it was a disease of the blood supply to the gut wall, um, and an infectious agent." Now, this was in, in the late 1980s. This was when AIDS was really big in the news and really an intractable problem. And obviously in the case of AIDS, they found an infectious agent. So he thought, "Well, what could the infectious agent be?" And he came back to London and got a job at a, um, uh, really, to be fair, at that time, a third-rate London medical school, the Royal Free in Hampstead, North London. And he was still on the budget of the Wellcome Trust, which at the time, today the Wellcome Trust is a, is a preeminent, uh, medicine and health related charity. Absolutely blue chip, gives out enormous sums of money, and really is i- in many ways the financial engine behind the United Kingdom's extraordinary success with, um, or apparent success with dealing with, uh, the coronavirus outbreak because of the sequencing, uh, which is being carried out here on a massive scale, uh, uh, largely with, uh, funding that was originally given by the Wellcome Trust. But at the time it was the, if you like, the grant giving arm of a pharmaceutical company. And he was on their budget, and he came back to London and he would be on their budget for a couple of years at this hospital and medical school, but he was gonna inevitably be moved off their budget onto the budget of the medical school. So he's, he's there, the clock's ticking. He's got this idea about Crohn's disease and he goes to the library, goes to the hospital library and takes out, or at least reads there, uh, a two-volume encyclopedia of viruses called Fields Virology. Big thing it is, couple of, couple of bricks thick in its two volumes, and starts going through it until he eventually comes to measles virus. And there he sees a paragraph which says that in, in acute measles infection, the measles virus can be found in the, uh, in the gut, in the colon and, and the intestines generally. Um, now, and he thinks, "Ah," and in Crohn's disease, this blistering that you get produces little ulcers and measles, acute measles infection characteristically, in fact it's pathognomonic I think of the, uh, of the, of the, uh, of the disease. In measles you get things called Koplik spots which are little spots, uh, in the, um, in the, in, us- mostly in the mouth. And he came to the conclusion that these Koplik spots were essentially the same thing as was seen in the bowels, um, when, uh, somebody has measles, usually a, usually a child. So he thinks, "Ah, I've found it. This is my eureka moment. Measles virus is the cause of Crohn's disease." Now just as a little aside, the thing about fulminant measles is you can find it everywhere in the body. I mean, you wouldn't just find it in the gut. You wouldn't just find it in the mouth. You find it everywhere. I mean, for the period of acute infection, you can find measles all over. So nothing surprising that, that. But that's where, that's where he started off and he then set about trying to prove that measles virus was the cause of Crohn's disease.

   13. PAPeter Attia11:28

       Now, if the measles virus is in fact the cause of Crohn's disease and the measles virus is waning because of vaccination, is it safe to say then that the next leap is a vaccine that introduces a small amount of vesel, uh, measles could still be causing a problem? Is that the, is that the next step?

   14. BDBrian Deer11:48

       Yeah, because the thing, the thing about, um, about Wakefield was that he, he could never do what, he wasn't, see, 'cause he wasn't a scientist. He wasn't trained in science. He trained as a surgeon, um, which is a, has a particular psychology, I think. Um, and I think as I say in the book, in, in, in science, courage isn't about proving yourself right. It's in your efforts to prove yourself wrong. It's your efforts at a very early stage to try and refute your own hypothesis. So a hypothesis, which is nothing more than a guess. So you start off with a guess, and then you try and prove it wrong rather than try and prove it right. Obviously, you're collecting data that supports it, but yeah, but in order to, to work in a, in a rational way, you try to

3. 12:35 – 27:50

   The importance of following the scientific method, and how Wakefield twisted the science to link measles virus to Crohn’s disease;

   1. BDBrian Deer12:35

      prove yourself wrong. And he never got to that second stage. At any time in his life, he never got to the stage of trying to question his own ideas, to doubt himself. And this, I think many people came to regard as an extraordinary flaw of character, um, possibly for anybody, but certainly for scientists. Um-

   2. PAPeter Attia12:55

      Yeah, I'll, I'll just interject, Brian, with one of my favorite scientists who you can probably see behind me, Richard Feynman. Uh, very famous for having said, and I'm paraphrasing, that, uh, the first principle in science is, um, not to be fooled. Uh, or I'm para- you know, it's not to fool yourself effectively. Uh, and, uh, you're absolutely right. Um, uh, when one comes up with a hypothesis, the goal is to do everything you can to demonstrate it is incorrect. Um, and, and, and even the word proof in science is a loaded word, isn't it? Because unlike mathematics, we really don't have proofs in science. Everything is probabilistic, um, which I wanna get to later. Um, and w- you know, you look at a body of literature, a body of experiments, and you try to ascertain, perhaps just as a court would, what does the mountain of evidence suggest in one direction or another, uh, versus, say, in science relying on an anecdote or something like that. So, uh, yeah, I, I couldn't agree with you more, and I, and I think you're right, by the way. Uh, you know, I trained as a surgeon, and I would go one step further and say, this is not just about surgery. I just don't think medicine, the actual discipline of medicine, does a lot in the way of scientific training. So it is true that many people who train in medicine also go on to receive scientific training. But in speaking for myself, none of the scientific training, uh, I learned came from medical school. Medical school was really geared towards getting as many facts as possible into your head. You certainly learned a bit about the history of science. You, you, you were able, you were fortunate to put in context what other people had done and how we were able to utilize that information. But in terms of the scientific method and, you know, this idea that you generate a hypothesis, you figure out what the right questions are to test it, you design experiments, you critically look for all the ways you could be fooled, that is very difficult to learn unless you spend time in a laboratory and you're well-mentored. Um, so, uh, you know, I, I, I actually never take offense to the idea when people say, you know, doctors don't understand science, which is usually something that, you know, someone with real scientific chops would, uh, would level as a criticism.

   3. BDBrian Deer15:20

      Hmm. Oh, I think that's right. Um, so yes, he, he, um, he, so there he is, um, with this attempt to prove himself right. And I mean, it, it, it, as you say about medicine, medicine I sometimes liken to, like, learning Chinese. Uh, the, the method essentially is that you read books and you sit in lecture halls and you see things, and if you ask a question, why is that so, then the person who's teaching you will essentially say, "Because I say so." That's, that's what it is. You just have to learn this stuff like a, a European learning Chinese. It's this is, this is this symbol, this is this, this is this. Don't question it, just learn it. Um, so but the scientific method obviously is different now, but what Wakefield would do, and it's all over his work. I mean, not, it, it, it's everywhere. You find a particular word. It's almost his favorite word, and his favorite word was consistent. So he would say, uh, this particular finding or this piece of data or whatever is consistent with his hypothesis. But of course, the thing about consistence, I mean, it is consistent, um, that, um, the, uh, orbit of Mercury, uh, is related to, I don't know, inflammatory bowel disease. It's consistent that Mercury rose this morning and, uh, the, uh, you could, you could, you could, you could link any things together and say they're consistent. Um, it's consistent with me talking to you.

   4. PAPeter Attia16:54

      Yeah, it's, it's an even, it's an even sillier word than associated with, which spakes, which means nothing, right?

   5. BDBrian Deer17:00

      It means nothing. It, it, it means it's just, means it's, it's not a refutation. Um, so but he used this word consistent all the time and never stopped, and he never stopped to question at any stage or, or do, carry out any kind of, um, experiment or research or anything that would conflict with that commitment to the idea at this stage that, that measles virus was the cause of Crohn's disease. And when anybody else, uh, came up with contrary information, so for example, he would say, and this is one I, I mean, I, I don't have a background in medicine or science. Um, I had to learn it all from nothing to, to, to, to do this work. Um, and he would, he would use, for example, a, a technology called, um, well, immunohistochemistry. It's, it's a, it's a chemical, essentially a chemical staining, a, a microscopic staining technique. And so you take bits of tissue out the gut, and you, uh, you prepare it and you stain it and with certain things and use certain antibodies and what have you, and you look down a microscope, and if the thing that you're looking for, in this case it would be measles, you'll see a, you'll see a stain, a color, a change in the, a, a color in the stain. It's usually brown. Um, so this is a microscopic technique, but then other centers around the world, uh, other universities in Japan and in the United States and in, in the UK, um- People used what, what is now, uh, uh, probably everybody knows what it is now, PCR, the polymerase chain reaction, which is now big news all over because of the, uh, efforts to tackle the coronavirus. When people used this, um, this, uh, molecular method, they couldn't find the measles virus or where they did and what they ... Well, anyway, I won't go into the whole detail. They couldn't find the measles virus. Now, I once was, was giving a talk. I can't remember where it was. It was somewhere in the States. I can't, I can't remember. It was, it was a lab meeting with biology students, so they were, like, about 18 or something like that. And I said that he'd found measles virus using immunohistochemistry. Other people used, uh, the polymerase chain reaction, and Wakefield's answer to that was that the PCR wasn't sensitive enough. At which point, to my s- initial surprise, my audience laughed. [laughs] And I couldn't, I, I, I, I, I didn't think it, I didn't realize that it was that funny. I mean, I realized it was rather paradoxical to suggest you could find something under a microscope that you cannot find at a molecular level. But that was the lengths that Wakefield would go to to stick with his hypothesis that measles virus was the cause of Crohn's disease.

   6. PAPeter Attia19:50

      A- and let's put that in context, Brian. So in 1993, I believe, is when he first published that paper in the, uh, in the Journal of Virology. Is that correct? Using his immunohistochemistry.

   7. BDBrian Deer20:03

      Journal of Medical Virology, yeah.

   8. PAPeter Attia20:05

      Yeah. J- J Med Vir- Viral, right. And he published in there saying, "We've identified this using immunohistochemistry." And as you said, it was two years later that a Japanese group using PCR said, "We cannot replicate these results under any circumstance." Do you have a sense what the scientific community thought at that time? Um, first of all, it's not impossible for scientific results to conflict, but was it just sort of dismissed as, well, you know, maybe there was an artifact, maybe, um, there was a contamination, maybe this person didn't understand how to do the assay correctly, maybe their controls weren't right. Um, uh, what was, what was the view of how ... 'Cause remember, I'm, I'm not telling you to remember this, I'm saying just for the listener, like, science is about advancing knowledge. It's about being at the edge of what is known and unknown and trying to advance that. And this is a potentially interesting hypothesis, right? Let's, let's acknowledge that if measles is the cause of Crohn's disease, this would be a very important thing to know.

   9. BDBrian Deer21:12

      Yeah.

   10. PAPeter Attia21:12

       Yeah. So, so I'm just sort of curious in hindsight or retrospect, in the mid-'90s when PCR, which at that point was becoming the way that you would do this type of assay, so now the gold standard for the reasons that I think we'll get into later on, 'cause I wanna get into O'Leary's lab and really understand how one can be fooled.

   11. BDBrian Deer21:34

       I think that's the most interesting part of the whole thing for me. But anyway, I, I-

   12. PAPeter Attia21:37

       Yeah, yeah, yeah. So I mean, did, did, did you get a sense of how, how the scientific community viewed Wakefield's work at that time prior to 1998? 'Cause when we get to '98, it's a whole other, you know, it's a whole other ball of wax.

   13. BDBrian Deer21:51

       Well, when you say the scientific community, first you gotta remember that, that this is a fairly specialist field, so there wouldn't be a lot of people watching this thing too carefully.

   14. PAPeter Attia22:00

       Even outside of gastroenterology? I mean, sorry, within-

   15. BDBrian Deer22:03

       Uh, well-

   16. PAPeter Attia22:03

       ... within gastroenterology, I mean. I'm sorry.

   17. BDBrian Deer22:05

       Yeah, within gastroenterology, you know, s- people would, people would pay a little bit of attention to it, but it's a very specialist ... It's, it's probably quite a s- a small community of, of scientists who work in this area, and I should think they mostly all know each other. They all go to the same drug industry sponsored conferences. Um, but, um, but within that, there were people who thought that he was incompetent because it appeared that he'd been using, um, inappropriate controls in his work. Um, because hi- he, his work that, his, his, his microscopic work looking at stains under, under a microscope were, involved controls, involved ... So people were saying, "Well, how is he getting these results with controls?" Because you would, you would expect to see, if he was do- using the technique wrongly, you would expect it to sh- to show up in not only in the, in the specimens, but also the controls if it was contamination or something like that. He was claiming to use controls, and some people thought he was incompetent, but there were other people, and I could name, and I don't think he would mind me naming hi- him, uh, a professor in London called Tom McDonald, who's, uh, uh, now the dean of research at, uh, in fact at, uh, a medical center where, uh, the queen's husband is currently resident as we speak. Um, and, um, and he was of the view even then that Wakefield's work was fraudulent, that he was concocting results even then. And that created a problem for me, as I was saying earlier, because it, it, it, I wanted to, like, paint Wakefield in the best possible light, so I never really in the book went too much into that because I didn't, I suppose, to be authorial about it, I didn't wanna piss on my own bonfire. I mean, I didn't want to, I didn't want to lead people from the get-go to suspect that, uh, he was doing what he came to be shown to be doing elsewhere. Um, so I kind of glossed over that a little bit, but there were people even then who said that his work was fraudulent, and in fact, um, Professor McDonald, uh, declined to go when he, he was part of a team at another London hospital who moved to where Wakefield was going to work or was working in Hampstead, North London, and he refused to go. He took a much less interesting and I don't know whether it was a better paid or worse paid job, way away from 100 miles or so away from London, rather than go and work in a place where Wakefield was. So there was no clear consensus as what explained how it could be that Wakefield would find these things by microscopic techniques. In fact, he said that he'd seen the virus under a microscope.

   18. PAPeter Attia24:57

       Which I think it's important to explain to people that that's not possible.

   19. BDBrian Deer25:02

       Well, he, well, anyway, that was the claim in the paper. That was the claim. He used an-

   20. PAPeter Attia25:10

       Was this an electron? Was this electron?

   21. BDBrian Deer25:11

       An electron microscope.

   22. PAPeter Attia25:12

       Oh, I'm sorry. I thought you meant light microscopy. Okay.

   23. BDBrian Deer25:15

       No, when we get to him seeing it, it was an electron microscope. And ultimately that came apart. The wheels came off that one as well. But that was the idea. But so there was this confusion. And medicine, as I certainly found, I certainly found this as I went on through my inquiries. Doctors, I think, and perhaps professionals generally are very reluctant to come to the conclusion that somebody is dishonest as opposed to wrong. Dishonesty inevitably requires the intent to deceive or intent to mislead. People are very reluctant to come to that conclusion. And that's understandable. You want to give people the benefit of the doubt. So the world just kind of moved on and accepted that there was this doctor with a little team of people he was trying to gather together in London who maintained that measles virus was the cause of Crohn's disease in the face of really very compelling evidence from multiple centers that in Crohn's disease, measles was not a causal factor. Wakefield just dismissed these other centers and said they didn't know what they were doing, but he did. They were looking in the wrong place or the virus was present at levels below the threshold of detection by PCR, but not below the level of detection by microscopic immunohistochemistry techniques, which in itself-

   24. PAPeter Attia26:53

       I'm trying to think of an analogy because obviously I've done both of these techniques personally and there are people listening to this who have spent time in a laboratory that will understand how ridiculous and absurd that statement is. But I appreciate that most people don't and I'm trying to think of an analogy. It's sort of like saying I can see the details on the moon with my naked eye, but I can't see them with the most high-powered telescope because the resolution isn't good enough.

   25. BDBrian Deer27:28

       It's not a good telescope or you don't know how to use it properly.

   26. PAPeter Attia27:31

       Yeah, it's not a good enough telescope lens. So that's why I can't see what's on the moon. That's why you can't see what's there, but I can see it with my naked eye. I mean, that's how absurd that claim is. So-

   27. BDBrian Deer27:42

       Yeah, that's why I say undergraduate biology students laughed when I, I was really, I used it ever since. You know,

4. 27:50 – 49:35

   The backstory behind Andrew Wakefield’s infamous 1998 Lancet paper linking the MMR vaccine and autism;

   1. BDBrian Deer27:50

      they laughed.

   2. PAPeter Attia27:51

      So let's fast forward a few years now into a place where his thesis undergoes a change, right? A new layer is added to this and it becomes effectively the main story that you are writing about, which is a very famous paper that came out in 1998 in a very famous and highly regarded journal called The Lancet, which would probably rank in the top five in the United States, pardon me, in the world scientifically. So let's talk a little bit about that paper, which I have to admit, I don't think at the time I realized how pathetic it was. In other words, you know, it's a very poorly done report on 12 patients not recruited at random. I mean, you're going to go through all of this, but it's almost amazing, not almost, it's outright amazing that The Lancet published it in the first place, let alone took so long to basically pull it. But let's talk about what it is that took Wakefield down this new path to perhaps an even bigger discovery or idea.

   3. BDBrian Deer29:16

      Right. So after he came up with this idea about measles virus causing Crohn's disease, one criticism that was leveled was that, well, you say that measles virus is causing Crohn's disease, but at the time, which is not true now, but at the time, the instance of Crohn's disease was rising and measles was in decline because of the advent of vaccination. So the vaccine itself, he realized, I don't know whether he needed an encyclopedia to tell him this, but he realized contained live measles virus. So he modified his theory, his hypothesis at that stage to encompass vaccines causing Crohn's disease. So there he was saying that vaccines were linked to Crohn's disease. And this drew him to the attention of somebody else, a man named Richard Barr. And Richard Barr was an obscure lawyer, an office working lawyer, which we in the UK call a solicitor, in Eastern England, in a small provincial town in Eastern England doing humdrum work, magistrates courts, petty offenders writing wills, things like that, house conveyancing. And he was in fact a specialist and written a book about it on house conveyancing, this man Richard Barr. And as I explain in the book, so I won't go into now in massive detail, he, he got a contract with the British government agency to try to show that the MMR vaccine, the measles, mumps, and rubella vaccine, was the cause of developmental issues, particularly autism, and how Richard Barr descended on autism, picked autism out of a whole cluster of other things, is a story in itself. Um, and, um, this man, Richard Barr, was looking to find a doctor who would help him, would agree with him that vaccines caused, ultimately, they settled on autism. And his problem was there weren't any in the UK who really took that position at all. It was, it was such a, an, an, an, an out to the left kind of idea that he, he couldn't find anybody of the remotest credibility to advance that hypothesis. And without an, quote, unquote, "expert" to say, "Ah, yes, I say that, uh, there's a probable cause that measles in the MMR causes autism," he ended up going to this man, a bowel surgeon, trained as a bowel surgeon, uh, whose subject was Crohn's disease and whose whole theory was about measles causing Crohn's disease. He hired him. This lawyer hired him. This was in early 1996 after some talks between them beforehand. So there Wakefield was now hired by a lawyer at very generous hourly rates to help make a case that the measles vaccine in MMR caused autism. Now, this was interesting, not least because Wakefield knew nothing about autism, and he knew nothing about vaccines. Uh, neither of these were any part of his training, uh, any part of his, uh, professional expertise, but he was the best that this man, Richard Barr, could get. So together, they set about trying to prove that the MMR vaccine caused autism. Uh, it's a long story as to why they picked autism, but, but they did. This lawyer picked autism. Long, long story about why that was. Very interesting and, uh, and I, many ways I wish I'd gone into it more, but it's-

   4. PAPeter Attia33:20

      Do, do you wanna just give sort of a, a, a short, a short overview of it?

   5. BDBrian Deer33:24

      Well, it was, it was e- it was essentially that, that this man, Richard Barr, latched onto another player in all this, which was a woman called Jackie Fletcher. And Jackie Fletcher had a child who, uh, within a couple of weeks of receiving his MMR shot, started having seizures and went on to show, uh, serious, uh, neurological illness, uh, transformative, lifelong damage or, or, or... Well, it's, damage presupposes that the... Well, anyway, um, and she had seen media coverage of the, uh, of an issue to do with vaccines. And while she was in the hospital, uh, talking, um, to other parents, one of them or some other of them gave her the idea that vaccines could cause this injury to her child. Now, her child didn't have autism. Uh, uh, I hate using the word retarded, but, but, I mean, specialists used it, so I suppose I can. She had a profoundly retarded and handicapped child, um, and she, uh, she came to believe that the cause was the vaccine. Nothing to do with autism. So in order, but in order for her to sue in the United Kingdom, she had to get lots and lots of other people to say the same thing, because the only place you could ever get money to do that was a government scheme where they provided money for people who couldn't afford to sue, and who can afford to sue drug companies or vaccine manufacturers? So, um, they, they kind of, she got together with this lawyer, Richard Barr, and with Wakefield, and together they made music over this idea that the MMR vaccine caused autism. It was, it was generated basically because autism, which, which although the phenomenon, the, the, the, the manifestations of what came to be called autism have been present, you could go back to, like, the Victorian, um, uh, lunatic asylums in the United Kingdom, and you would, you would see autism. And there, I've, I've got video in from television programs long before MMR was even, even licensed, um, which you would say, well, in that period you would say that was autism. Autism had come to be constructed. What a lot of people don't realize about autism is that autism is a construct. There's no, it's not like, um, it's not like, let me think of an example. It's not like Crohn's disease. Uh, autism is a, is a kind of tick box diagnosis of, of different signs and symptoms which are brought together, uh, and clustered together. And it's really been created, a bit like schizophrenia really, and in fact, schizophrenia kind of went into decline with the rise of autism. Um, a bit like childhood schizophrenia, autism was, was, was an emerging diagnosis in the early 1990s. And in fact, the American Medical Association and the World Health Organization both brought out diagnostic categories in the early 1990s identifying, uh, a spectrum of disorders, one of which was autism, and there were several others. Um, so this was a, this was something which when this Jackie Fletcher, this woman run- running this, uh, she, she's running this effort to sue for her own child, she set up a group and they started doing surveys, and in those surveys they came up with quite a few cases of autism because it was beginning to be diagnosed. And so they, they kinda said, "Okay, well, that's what, that's the most common diagnosis we can cluster together, so we'll go after that." So that's why they went after MMR and autism. Um, simply the, simply the, the, the artifactual situation of there being a newly emergent, um, [lip smack] uh, diagnostic category and also the introduction in the UK of the MMR vaccine. So they went after this idea, and Wakefield was then enlisted. So Richard Barr provided what initially was most important, was the money for Wakefield to do research. And so what they did is they made a grant application, very similar to any scientific research who wants to look into something. You, you make a grant application to somebody who's got some money. And the people who had the money were this government agency. It was actually called the Legal Aid Board, uh, r- operating a thing called the Legal Aid Fund, which funded people who couldn't afford to sue drug companies to sue the manufacturers of MMR. So Wakefield had the job of ensuring that this lawsuit was launched. At the time, the lawsuit hadn't been launched. It had just been collecting clients, collecting anecdotes, collecting stories, taking statements, and preparing so that the go- this government agency would fund them to go forward and sue the drug companies. So that was Wakefield's mission, and they made the grant application to the Legal Aid Board, um, in, uh, June of 1996. Now, the paper we're getting to that you mentioned was published in February 1998. So this scheme between these people, and there were a couple of other people involved in it as well, was the origins of the idea that vaccines cause autism, and ultimately we would find they were, this was the origins, the acorn, if you li- or acorn, if you like, from which the anti-vaccine movement, even of today, emerged to create the issues they're creating over the coronavirus shots. So it's this, that was the explanation in very sketchy ter- sketched out terms of why they hired Wakefield. Richard Barr was gonna get the money from the legal board. Jackie Fletcher, this woman, she started an organization which she, she gave, uh, the name of JABS to. Um, she would bring the clients, she would recruit the clients, and Wakefield would do the tests that were going to show that the MMR vaccine was a cause of t- was the cause of autism. In fact, he, the proposal he put to the Legal Aid Board with this solicitor Richard Barr said in advance of a single child in this paper, the 12-child paper which you mentioned, before a single one of those children had been investigated at that hospital, they had made the proposal to the Legal Aid Board that they would show that there was a new syndrome which included both inflammatory bowel disease, which is what interested Wakefield, and autism, which int- which interested the lawyer and Jackie Fletcher, the campaigner, and they bolted it all together, made a grant application, and a, a duty lawyer in the government's Legal Aid Board, a woman, she was in her late 20s, ultimately signed the document for Wakefield to be employed to do research that ultimately was what ended up in The Lancet 18 months or so, year and a half later, in this paper that created this enormous furor. And what nobody knew until, well, you know, I came along, I suppose I have to say that, although everyone criticizes me now, particularly doctors, who sort of say I'm always self-aggrandizing, and they do things like saying, "No, I actually did one at my publisher's university, Johns Hopkins, the other day," and somebody said, oh, some of the people around said, "Oh, well, you helped, you helped to unmask this." I said, "No, I didn't help it. I did it." And that's one of the extraordinary things about this story, that the medical establishment just kind of sat back and let all this go on, and it appeared that only a journalist spotted the grounds to believe there was something funny going on here. But anyway, so this was the background to this paper. And then in February 1998, I'm sorry to talk so long, but anyway, in February 1998, this paper was published in The Lancet, which in terms of general medicine, I would say was the number two journal after the New England Journal of Medicine. It, it's way down the rankings from Nature and Science, but they're general science journals, so they, they carry a lot of other stuff other than medicine. When you get into general medicine, it goes, broadly goes New England Journal of Medicine, uh, The Lancet, which kind of, um, has a bit of a tussle with the Journal of the American Medical Association, Annals of Internal Medicine, then you get to the British Medical Journal, and onward down you go. So very prestigious journal, a 12-child case series. And you said, Peter, earlier that, I'll shut up in a moment, but you said earlier that, that this was a, a ropey paper and so on and so forth. I don't agree with that, actually. At, at face value, if you... It's, it's kind of with, with the, the, the, the knowledge of hindsight. Once you know the story, you look at that paper and you say, "Well, this is all a joke," and yeah, but at the time, at the time it was very credible because it was a case series. Now, when you think about case series, um, it, it just, it's literally a collection of anecdotes So for example, Crohn’s disease, when that was discovered in the 19- well, it wasn't discovered, but when it was formally characterized in the 1930s, fully described, um, that was a, a case series of, of tissue samples taken from 14 patients. Um, autism itself, which was first characterized and properly described, uh, in fact from Johns Hopkins University, you know, publishers of my book, um, uh, on 11 children. It was a, it was a case series of 11 children. AIDS, what came to be known as AIDS was first described, classically described in 1981 based on five gay men in Los Angeles. So there's nothing, there's nothing, uh, uh, questionable or improper or inadequate about a case series of 12 children.

   6. PAPeter Attia43:46

      Yeah, I think, I think what I was referring to is something we'll get to later. Uh, so it's less the size of it, and I think if my memory serves me correctly, Brian, there was not an institutional review board that had approved what those children went through.

   7. BDBrian Deer44:03

      Well, the paper said there was. The paper said there was.

   8. PAPeter Attia44:06

      I see. I see.

   9. BDBrian Deer44:06

      It said-

   10. PAPeter Attia44:07

       But that turned out to be incorrect. Is that-

   11. BDBrian Deer44:09

       Turned out to be li- turned out to be a lie. It was a lie. Um, and, uh, no, the, the, the, um, that, the, it's the, see, what inter- just as a, as kind of a brief aside, a lot of people think I'm like, you know, a pro-vaccine campaigner, and I think you probably think this, and I'm not, and that is not what got me involved in this in the first place. What got me involved in this in the first place was to do with the scientific method. How, how was, how did this paper, how did this paper work? What was going on behind it? And one of the things that really bugs me is people who believe they can judge research by, uh, a text on a piece of paper or on a screen, and you can't. Those papers are not even the study. People use, I'm sure you, you're aware of this, that the people use the word study and paper interchangeably, and they, they believe that, that the paper is what it's all about. And what I was able to do, and I still believe, I, I believe it. Nobody's ever done it. I don't think, but certainly no journalist has ever done it. I've, I've been asking, like, for, since last year publicly for if anybody knows someone who's done anything similar, I'd like to know about it because it would be interesting and I'd incorporate it into the, into the story, to go around the back of the paper and find out who the patients were, what was wrong with them, what was their diagnoses, what was their histories, what were their test results, and all of that. And I did it on these 12 children.

   12. PAPeter Attia45:33

       So, so let's, let's talk about it because it is, it's so powerful, and as you said, if this is the acorn of the movement, uh, we have to resort to the long and arid dissertations as, as, as Bastiat said, and really understand that. So let's start with a fundamental question of how were these subjects recruited?

   13. BDBrian Deer45:57

       Right. Well, at face value, they appeared just to be part of the routine caseload of this hospital's, uh, bowel clinic, a pediatric bowel clinic. And essentially the picture was this. Over a period between, um, uh, well, a period of about, over a period of about maximum six to nine months, a series of parents turned up with their children at this bowel clinic in the hospital, a pediatric bowel clinic, and they said words to the effect of, "My child was developing perfectly normally, perfectly happy child." 11 of these children were boys, one was a girl. Uh, all of them were white. Um, and they, "My child was developing perfectly normally. We gave him," or in one case her, "the MMR, took him to the doctor, got the MMR, and within days," specifically within 14 days, that was the range, that was the maximum range that they, they allegedly reported, within 14 days, uh, and some of them, one of them was, is said to have come on immediately after the vaccine. So between immediately and 14 days, eight out of these 12 family, parent, the parents of... I have to express it carefully because two of the children were brothers, so I have to say the, the parents of eight of the 12 children, uh, said that their child, the first symptoms of their child's developmental issue, autism overwhelmingly, um, came on within 14 days of an MMR shot. And at face value, if that was true, then that could be potentially the first snapshot of a hidden epidemic of catastrophic injuries to children. It may be that these doctors at this hospital were just better doctors, more thorough, asked more questions, um, had, uh, had, you know, just more time or whatever, and that possibly all over the world children were experiencing this and just nobody had noticed. So the fact that this paper said these things, um, was extraordinary in itself, and it, it, it got network coverage right across the spectrum that night. We, the UK then had five national networks, and they all carried it on the evening news. Very substantial media coverage because the hospital and medical school convened a press conference, which was chaired by the dean of the medical school. And one of the people on the platform, well, well, the table anyway, w- with Wakefield was a professor of gastroenterology, the man who in fact had hired Wakefield from Canada. So- So the media thought, well, this must be something important. And it had been trialed in advance. There had been leaks and promotional things that had been done to attract more and more attention to this thing. They absolutely knew what they were doing. Extra phone lines, extra landlines were installed in the hospital. This is back in the day of mechanical answering machines. They went out and bought mechanical answering machines to field the public alarm that they knew they were going to create. And this hospital, this medical school, and this Andrew Wakefield announced to the world their probable cause of autism as the MMR vaccine. And of course,

5. 49:35 – 1:07:05

   The many flaws and disturbing aspects of Wakefield’s study: suffering children and failure to do strain-specific sequencing;

   1. BDBrian Deer49:35

      the result would be obvious. And it was.

   2. PAPeter Attia49:39

      Tell people what actually, what those kids went through when they were enrolled in a study that, as we would later learn, did not even have an IRB to approve it. What was the actual set of procedures that these children went through?

   3. BDBrian Deer49:55

      Well, it was described in advance. This is very interesting too. It was described in advance to the legal board, to the funding agency to which they'd made this grant application to do this work. So first I should say these children are children who don't like their lives being disrupted. These are kind of children who the slightest variation in some cases to their routine will cause them great distress. It's one of the curiosities of autism. So they were brought to London. None of them lived in London. The nearest family was 60 miles away. Some were 280 miles away.

   4. PAPeter Attia50:39

      And one was in the United States.

   5. BDBrian Deer50:42

      Yeah, one was on the island of Jersey in the English Channel near France, and one was from the Bay Area of California.

   6. PAPeter Attia50:47

      And just to hit pause for a second, that immediately speaks to the idea that these weren't just kids being seen in this hospital as part of the routine caseload, but let's put that aside for a moment.

   7. BDBrian Deer51:00

      Yeah. I mean, the idea that you would bring somebody from the Bay Area of California to London for medical treatment is, particularly that hospital, is absurd. The idea that there aren't good hospitals in San Francisco or California generally is an absurdity. So that in itself. Interestingly enough, that child was never, well, anyway, I won't go into all that. It's like, that's, I go into-

   8. PAPeter Attia51:27

      But yes, back to your point. We're talking about children who any disruption of routine is traumatic. And so we're going to bring these kids here and what was done to them?

   9. BDBrian Deer51:39

      Okay. So the children were brought in on a Sunday, different Sundays. They didn't all turn up at the same time, different Sundays. On Sunday afternoon, they would turn up. A doctor would take their histories from the parents. So the parent would simply be interviewed as to what they could remember. The child would be examined. They would then be bowel prepped for colonoscopy. In fact, it was an ileocolonoscopy. I mean, I've had a colonoscopy, but I've never had an ileocolonoscopy. In a colonoscopy, you go in, I don't need to tell you, but there might be a few people who might just need the route map. You go in through the anus, you come up through the sigmoid colon, you come up the descending colon, you cross at the splenic flexure, across the transverse colon, which sort of sags across behind the breastbone. You turn at the hepatic flexure, you go down the ascending colon to the cecum, which is pretty much where the appendix is. And then there's a valve there. So that's a colonoscopy to do that. Then there's a valve, a little valve. And if you go through that valve, that valve separates the large bowel, the colon, from the small bowel. And that particular stretch of the small bowel is called the ileum. And the first couple of centimeters of that is accessible to an instrument, a colonoscope or endoscope, if you like. And you can get into the first two centimeters. And the thing is, when you go past that valve into the small intestine, the small intestine is the bit that takes nutrients out of food. It's actually prior to the colon. So from your mouth, this is the top end rather than the bottom or the distal end. So you get into the distal end of the small intestine. The small intestine is what takes nutrition out of food. And the large bowel more or less takes water out of your feces so that we don't trail stuff around behind us. Well, for most of our lives anyway. So this scope, this instrument would go up, round, down, and then there was quite a difficult maneuver to get into the small intestine. It's quite a significant piece of work in itself. And in fact, later, not actually one of the 12, but later in the series, a child had catastrophic damage caused to him by this procedure. And there was a huge financial settlement from the hospital. But anyway, so that was the first thing they do. Some of them also had upper endoscopies where you push a tube down the throat and look around mostly in the duodenum and that area. So that would be the first thing that would happen the next day. And then most of the children had lumbar punctures, spinal taps, which is a needle basically pushed into the spine to take fluid, essentially brain fluid through the spine. They were required to undergo MRI scans, EEGs, electroencephalograms, and let me think what else, barium meals where you're essentially X-rayed. You drink a radioactive drink and you're X-rayed to see, to get an image of the gut. Uh, blood tests, which generally required with these kids three people to hold them down. In fact, Andrew Wakefield sued me over some of this. We maybe get to that at some point. He sued me. And one of the things he sued me over was saying that these children were being held down by three people. In fact, yes, they were. There were children screaming. One child collapsed three times in the corridor. Two children had to be one had to be admitted to another hospital after discharge from the Royal Free for apparent side effects or consequences of lumbar puncture. Another one had an emergency doctor called to their home. So they had that. They had blood tests. And what else did they have? I've probably forgotten something.

   10. PAPeter Attia55:44

       And some of these children were so constipated upon arrival that if I recall, the colonoscopies were very difficult colonoscopies. They did not have easy bowel preps the way, you know, a child might. The irony, of course, is that most of these kids were anything but having inflammatory bowel disease or Crohn's disease, given the incredible constipation that many of them experienced.

   11. BDBrian Deer56:09

       You can have constipation with inflammatory bowel disease, but it's very it's unusual and it's usually part of the differential diagnosis that the patient doesn't have inflammatory bowel disease. And they also had blood tests. In fact, the the clinicians working on this had themselves devised, well, I wouldn't say devised, but published on a panel of blood tests, which they used to do, which which determined whether or not there was a probable cause to do colonoscopies or ileocolonoscopies in this case. And those blood tests all came back normal. But they still went ahead and did it anyway, because Wakefield had said to them, which is part of his contract with the legal board to help sue vaccine manufacturers, that that there might be some minor lesser inflammation that wasn't being picked up by the blood test, just like with the with the measles virus not being detected by the PCR because the PCR wasn't sensitive enough. So the blood tests weren't sensitive enough to detect the bowel disease that he said these children had or suspected they had. In fact, he told the Legal Aid Board that they did have it before he did the research, which purportedly discovered it. But anyway, that's just that's just the way things go in this story.

   12. PAPeter Attia57:24

       So how does John O'Leary enter the story? Because he becomes a very important collaborator as effectively doing the most important pathology here, correct?

   13. BDBrian Deer57:35

       Yeah. So what Wakefield, see, what Wakefield was trying to do, the reason why he wanted these tests done was that he was looking for measles virus. So if your hypothesis is that measles virus causes Crohn's disease or causes autism or whatever, well, those two things, the thing about the last part of the small intestine, the ileum, that is the most characteristic part of the bowel where Crohn's disease is found. Crohn's disease can manifest anywhere between the mouth and the anus. In fact, it can. But where it most characteristically manifests is exactly where they went to. And this got Wakefield really excited. So what he wanted to do was to get into the small intestines of these children in order to find the measles virus. Because if you found measles virus live long after vaccination, we talked about it persisting years after vaccination. Some of these kids were aged nine. The youngest was three. The oldest was nine and a half. So you're talking about children who would have been vaccinated years previously. And his hypothesis was that the measles virus was persisting in the small intestine and he was going to find it. So when the endoscopist, so basically when you do a colonoscopy, you go all the way in without doing very much. You just try and get in. And as you say, some of these children were so constipated they couldn't get in and actually had to abandon the thing and clean them out again. And then one child, they said they were going to ultimately were going to do it three times until the mother said, no, no more, no more of this. But so he wanted to find the measles virus in the small intestine. So when the endoscopist got as far as the small intestine, he then man named Simon Murch did some of it and another guy called Mike Thompson did some of it. They would take little biopsy snips. They would snip off on the end of the colonoscope. They got little jaws and they would snip off a bit of tissue and bring it back through the thing. There'd be a nurse standing to one side who would like be pulling these things back through little rods down the tube. And then the colonoscope would come back through the gut, taking little bits of tissue at each of the points at the ascending colon, at the transverse colon, at the descending colon, in the sigmoid colon, at the rectum. But the gold in this for Wakefield was in the small intestine. And so waiting in the endoscopy suite where this went on, there was a scientist who was actually a PhD. He was doing his PhD working under Wakefield's direction, waiting to take samples of the tissue away and freeze it in liquid nitrogen so that it could be tested using the polymerase chain reaction for measles virus. And yes, they, this scientist, um, did this way. In fact, he, his PhD was a, was a very good piece of work. It's not like a PhD in the arts, I mean, where you can, well, you just, I think in the arts sometimes you get a PhD just for turning up and writing the thing. But he actually did a bit of science and, uh, and he, he, he developed the, a gold standard, uh, poly- PCR test for measles virus and Wakefield, uh, supervised that and they published on that and then they went on in Wakefield's own lab to use the PCR technique to identify measles virus and they couldn't find measles virus in any of these children. And Wakefield's answer to that was, "Oh, the PCR wasn't sensitive enough."

   14. PAPeter Attia1:01:54

       And, and why had he switched to PCR here as opposed to going back to the immunohistochemistry? Because he had already made this criticism in '95 when the Japanese group said, "Using PCR, we can't find it," and he had previously in '93 said, "Oh no, it's here with immunohistochemistry." So why in '98 is he not going back to immunohistochemistry?

   15. BDBrian Deer1:02:15

       That's a good question. Um, I like, I like your questions. I mean, it's, it's, I don't normally get doctors, uh, doing these conversations, so nobody asks that. It's a very good question. The reason why he wanted to do PCR and had to do PCR was in the grant application to the British government's Legal Aid Board, he'd said upfront in years bef- well, 18 months before the paper was written and before any of these children had been investigated in the hospital, that they would undergo PCR for strain-specific sequencing. And I think probably everybody, well, everyone who's got a television set or radio these days knows what that means because it's, it's so part of the discussion over, um, over vaccines. Um, so he, he wanted to show that this virus came from a vaccine because virus, the measles virus could come from three, there could be three possibilities. One, it's a virus that comes from nature. You, you caught it from somebody. One is that it's a laboratory strain because there are particular strains of the virus which are kept for laboratory work, and the other is it came from a vaccine. But in order to determine which one it was, you couldn't use immunohistochemistry 'cause it wouldn't, it wouldn't get you down to the nucleotides, which is what you need to get down to in order to sequence. Classic procedures, absolute workforce procedure.

   16. PAPeter Attia1:03:39

       Yeah. I mean, I mean, maybe to just explain to people, it's sor- immunohistochemistry might have the ability to recognize there's a person there. P- uh, PCR can fingerprint the person, and this is sort of like saying there are three people, you know, and I just need to see which fingerprint it is to know if it's the lab strain, which would be a contamination if it showed up in your sample; a naturally occurring strain, so it's a transmission that you acquired; versus a vaccine strain.

   17. BDBrian Deer1:04:06

       Yeah. Yeah. 100%.

   18. PAPeter Attia1:04:07

       And he was trying to demonstrate and test the hypothesis. If we're gonna continue to give him the benefit of the doubt at this point, he was testing a hypothesis that said-

   19. BDBrian Deer1:04:15

       Yeah, I'd have to take issue with your use of the word testing. Um, he, he, he wasn't testing a hypothesis. He was advancing it and simply trying to prove that it was so. Um, he, he at no stage did what a scientist would do, which would be to test it by attempting to falsify it, try and find some, some reason to believe that he was wrong. He simply wanted to prove that he was right, and he'd, he'd set out what it was he was going to find in his grant application before a single one of these children went anywhere near the hospital.

   20. PAPeter Attia1:04:54

       This is a totally random aside, but I remember you made the point about the relative lack of rigor that went into his grant application. Um, it wasn't like he was applying through the most rigorous, uh, or applying to the most rigorous granting entity, and it actually reminds me of the first grant application I ever wrote in my life, which was in medical school for a very small, uh, project. It was for a summer research project and, um, at my medical school, they had this amazing thing where you could get paid an enormous sum of money to do research for a summer. It was basically a great way to offset your tuition. It was, it was, it amounted to about a third of your tuition for the year. And so I put my little application together, and I just happened to review it with, um, a guy named Pat Brown, who's a very famous scientist at Stanford. Um, and I must say, I have to hand it to him, he just schooled me on what it means to write a scientific proposal, and, uh, he didn't pull any punches with how pathetic it was. And part of it was, you know, this lack of, at the time, understanding. You know, I was a first-year medical student. Um, I really didn't understand what it meant to have a hypothesis, generate a series of questions, and go through this, this, this process we're describing. Um, and I had to go back to the drawing board and start all over again. And I bet that if someone like a Pat Brown were to take a look at the proposal put forth by Wakefield, they would've had the same reaction, which is this is not a person who has the chops to do this type of investigation. Um, and again, I think it speaks to the, another point you made, which is the relative lack of policing in the field, and by policing, I don't mean literal policing, but I mean self-auditing and self-policing.

   21. BDBrian Deer1:06:47

       Yes. I mean, the, the, the, the grant application he put in was received by somebody with no medical background and no medical, no medical or scientific advice or contrary opinion or anything was sought by the funding agency. It was literally a lawyer, a young lawyer with no, uh, back-

6. 1:07:05 – 1:33:15

   The epicenter of fraud: Bogus PCR testing furthering the belief that measles virus from the MMR vaccine caused autism;

   1. BDBrian Deer1:07:05

      background in, in science who simply, uh, authorized the work.

   2. PAPeter Attia1:07:10

      So after Wakefield and his, his colleague cannot find any evidence of the measles virus either naturally occurring or through vaccine, um, in the distal ileum via PCR, uh, in theory that should be the end of this inquiry at this point in time, but what happens next?

   3. BDBrian Deer1:07:29

      Well, so what he did was he, using public money, he flew to New York and found a, a profe- an Irish professor who was then doing, uh, teaching in, uh, in New York, and, um, and asked him if he could use his PCR, uh, equipment. This, this professor, man named John O'Leary, was going back to Ireland, back to Dublin to work at a hospital, the Coombe Women's Hospital. It was a maternity hospital, not exactly a great center of scientific, uh, inquiry, but he was going back there, and he said to Wakefield, "Yes, I can find, uh, whatever you need to find," and then proceeded to set about trying to find measles virus in, uh, bowel tissues taken from children at the Royal Free Hospital in Hampstead in North London. And he was paid an enormous amount of public money to do this. Um, and, uh, he ultimately from his lab, they published a paper claiming that they'd found measles virus in nearly all the children that Wakefield's, uh, had sent samples, uh, from.

   4. PAPeter Attia1:08:44

      Now I think to really explain what happened in O'Leary's lab, one has to understand a little bit about PCR and what the number of cycles mean, what amplification means, um, and ultimately we'll even talk a little bit about the controls. And again, I, I, I don't, I don't ask this of you lightly because I know that these are technical topics, but again, if one truly wants to understand what took place, I think one has to understand what took place in O'Leary's lab because in many ways that is the epicenter, in my opinion. I could be, I, maybe you would interpret the facts differently and I would respect your opinion more than my own, but I almost view O'Leary's lab as the epicenter of the epicenter, um, of the fraud.

   5. BDBrian Deer1:09:33

      I agree with you. I mean, I, actually I agree with you. Um, and, and I agree, and I, I appreciate the point you're making because you would not believe how difficult it is to describe, um, molecular amplification in a single paragraph. I think I used two paragraphs in different places, but, uh, then, then to a certain extent I repeat it slightly. Um, to get it down to its, to its simplest level and yet still be accurate. So maybe I'll try. I mean, I'll, I mean, I'm doing it off the top of my head now and I can't obviously, I haven't got words in front of me to shuffle around. But essentially this is, this is, in fact, it's what's topical at the moment. All over the world, this stuff is being done on samples from ge- members of the public, uh, who are being tested for, uh, evidence of infection with the coronavirus.

   6. PAPeter Attia1:10:26

      That's right. Every time we go out and get a, I mean, I've probably had 20 coronavirus tests via PCR in the last nine months, and maybe that's more than the average person, but very few people at this point will not have had PCR touch their life. So whether it's a coronavirus test or a crime scene that is trying to demonstrate if that microscopic drop of blood is from a suspect, it, it would go through this amazing technology for which the Nobel Prize was awarded in the 1980s to, to Kary Mullis.

   7. BDBrian Deer1:11:01

      Yeah. So, um, and it, something that isn't in the book, I don't think, I'm not sure it's in the book, is that, um, partly it begins with, um, the discovery of, um, a polymerase, uh, in the Yellowstone National Park. Now, you can say, "What's a polymerase? Tell me what a polymerase is," just to shorten it a bit.

   8. PAPeter Attia1:11:23

      So it's an enzyme basically that catalyzes a reaction. So, I, I mean, I can even shorten a bit of this whole thing for you, right? Which is, um, you, w- when a, when you have a double strand of DNA, how does DNA replicate? So there are basically two reactions that you wanna be able to do with DNA. Sometimes you want to just make more of it, so you, to, for, for when a cell is dividing to make another version of itself, it has to break apart that double strand of DNA, and it has to make another template of each of it, and it uses enzymes to do the breaking apart and then the building. And there's a code for DNA. It's a very simple code because there are four letters, um, and each letter has a known corresponding letter. So you, you, you have these, uh, you have this code where you basically break it apart, you, where you replicate it, and then you, you duplicate the strand. There's another side of breaking apart DNA, which is if you want to make protein. And here you actually break it apart to make a single strand of something called messenger RNA, and the RNA carries that message out to be transcribed as a protein. So, um, it depends on the application in which you're doing it, but, but these polymerase enzymes basically facilitate different aspects of this process.

   9. BDBrian Deer1:12:43

      So like, like, um, like the evening news, I'll do a little bit, [laughs] maybe, maybe on that. So, so, um, so yes, there, so there's this ladder, uh, joined together, and this is, this is the classic double helix of DNA. And so we'll do the machine version because that's what we do. These days this is all automated. Not so long ago, not so many decades ago, this was all done, uh, manually, very time-consuming, extremely boring process, now done by machine. And the machine, uh, heats up the, the test tubes with this, with your samples in and a few other things, controls and what have you. And the-- as it, as it heats up with these, these things, the, the ladders split apart. Um, so that instead of having something joined together, you've got them separate. Um, and it, and, and, and in, in the case of measles virus, you have a, you have something, a, a preliminary step called reverse transcription, where, where because the virus is a... RNA is a single strand. Rather than DNA, which is a double strand, RNA, ribonucleic acid, is a single strand. So for this, this technology to work, you need two strands, um, for reasons which I'm sure you'll probably get to. Um, so you then-- So what happens initially is a, a second strand is created, um, s-synthetically so that you then have s- what is called cDNA, which is a, which is, is, is a kind of an artificial con-construct of DNA. And then once that's done, won't go into how it's done, but once that's done and you've then got this piece of DNA, the machine heats up the, um, the material, the test tubes in it, and these two, uh, ladders split apart. Um, and at that point, this polymerase, this enzyme that amazingly was discovered in the Yellowstone National Park, um, goes along the broken rungs of this ladder and creates a complementary second ladder. So for each of the points, rungs on the ladder, it creates another one which joins to it. And these are the nucleotides that, uh, you know, the, the base nucleotides, the fundamental building blocks of life. And so, so when you start off with these, these two, they split apart. The polymerase runs along from one end of the, of the-- It's unbelievable, really. Runs along from one end of the ladder, um, to the other, and then you've got two, um, DNA, two double-stranded samples. So then you cool it. The, the cooling brings these two together, and they solidify. And then you pr-repeat the procedure. They split apart again. The Taq polymerase goes along and creates the extra thing, and then instead of two, you've got four. And then you cool it down ag- you-- As you cool it down, then you heat it up again, and you keep repeating this process until two becomes four, four becomes eight, eight becomes 64, is it? Uh-

   10. PAPeter Attia1:16:00

       Uh, 16. Yeah, it, it goes ex- it goes, it goes exponentially.

   11. BDBrian Deer1:16:04

       Yeah, 16.

   12. PAPeter Attia1:16:05

       Um-

   13. BDBrian Deer1:16:05

       And on you go until-

   14. PAPeter Attia1:16:06

       F2, yeah. It's two powers, yeah.

   15. BDBrian Deer1:16:08

       Yeah, before very long, you get-

   16. PAPeter Attia1:16:10

       It becomes astronomical

   17. BDBrian Deer1:16:11

       ... unbelievable numbers. And then at that point, you can, you can, uh, read it, and it's read by... Well, it's read by things called primes, primers and probes. What primers do, these are, these are other little bits of, um, of, uh, nucleotides in a chemical solution which bind to very specific nucleotides. They're like bookends. So you've got these, the, you've got these, these, these, uh, primers which take a slice, essentially mark out a slice, and this other thing comes along and, and identifies. It's called a probe. And if the thing that you're looking for is present, the whole thing, by magic, which is now all being monitored by laser beam, uh, which is like, uh, taking, taking samples, measurements, uh, by millisecond as to while this is going on, will, uh, give a, give a signal, which is then recorded on a, recorded on a computer and generates a, uh, a curve. And this curve, um, uh, it, it, it starts off flat, and then it rises, and then it goes-- What's the word? Uh, the, um-

   18. PAPeter Attia1:17:33

       Well, it asymptotes into a flat.

   19. BDBrian Deer1:17:35

       It's kind of a rough kind of S shape. And with before it asymptotes, um, goes flat, you take a reading, uh, and that's usually at about 35 cycles.

   20. PAPeter Attia1:17:47

       Right. And that's, to put that in perspective, that's, that means two to the 35 copies you've potentially made. And, you know, by the time I was doing this, it had become so automated, um, the kit was called TaqMan, like T-A-Q, because of the polymerase you mentioned, the Taq polymerase. And so it was called, you know, real-time quantified PCR.

   21. BDBrian Deer1:18:13

       Quantitative.

   22. PAPeter Attia1:18:13

       And it was really quite amazing because as the scientist, you only had to prepare the reagent, and it was literally as simple as a Betty Crocker cooking exercise, where you put in your primers, you put in your probes, you put in your Taq, you put in your sample, and the machine would go through everything you just said, the heating, cooling, heating, cooling, heating, cooling cycles. And it would spit out for you the information of what's present and how much of it is present. Because remember, you can go up to 35 cycles, but if you start with a large amount of nuclear material, you'll see it much sooner. And in fact, even with the coronavirus, that's an important feature, right? So when a patient tests positive via PCR, r- you know, you have to remember these tests are really geared for their negative predictive value more than their positive predictive value. You would like it if a lab would report how many cycles were necessary to demonstrate a positive test. And in a clinical assay, we're gonna come to why all of this is relevant. In a clinical assay, you need to be able to report the number of cycles, 'cause it matters if it was positive after 20 cycles versus 30 cycles. That's a far greater-- That's a, that's a very big resolution difference in something being present. So I think you did a fantastic job, by the way, explaining PCR.

   23. BDBrian Deer1:19:34

       No, I think there's gonna be all kinds of people like, like listening to this who are gonna go, "Oh, no, no, it's not, no, he's not."

   24. PAPeter Attia1:19:39

       Yeah, yeah. So, so, um, let's now go back to O'Leary's lab. So he... I mean, the way you describe it, it's like he was basically paid to find something.

   25. BDBrian Deer1:19:50

       Yeah. Yeah.

   26. PAPeter Attia1:19:51

       So O'Leary is now sent the samples, the ileocecal biopsies of these children, and he has what at the time is a state-of-the-art machine, right, the ABI Prism 7700?

   27. BDBrian Deer1:20:02

       Yeah, I guess at the time, yeah. Yeah, yeah.

   28. PAPeter Attia1:20:04

       Um, and as you said, this is a machine that is not rated for a clinical diagnosis, correct?

   29. BDBrian Deer1:20:12

       Right.

   30. PAPeter Attia1:20:12

       It does not have a CLIA. Yeah, it does not have a CLIA certification. One cannot make clinical diagnoses with it. It is a research tool only, and the, um, the company that makes it says, what? If you go more than 35 cycles, what is the inference of what you're looking at?
7. 1:33:15 – 1:43:50

   Additional issues that contaminated the study results;

   1. BDBrian Deer1:33:15

      to promote vaccines and so on and so forth.

   2. PAPeter Attia1:33:17

      B- b- before we get to that, there are a few other things I wanna go back to that I, I also think are technically important to understand. Um, can you talk a little bit about the, the formalin-stained samples in O'Leary's lab? Because I think that in addition to the failure to do strain-specific sequencing, which was the absolute mandate of this research, right? This was the purpose of the study. So in addition to failing to do this one thing you set out to do, um, when you look at the formalin staining, it, to me, is one of the most revealing parts of how contaminated this work was. Do you wanna give people a sense of what that found?

   3. BDBrian Deer1:33:59

      Yeah. Well, okay, so if we go back to the royal free endoscopy suite, uh, and these children being scoped, as they call it, when they, they, they go into the small intestine, um, they, uh, would bring out these samples, these pieces of tissue, and they were divided and went in two directions. One direction went to Wakefield's own researcher, scientific researcher, this guy called Nick Chadwick. He's actually left science now because I, I think in part because he became so disillusioned after this whole farrago. Um, he went off and froze his tissues in liquid nitrogen. So they're, they were frozen, just like frozen peas, uh, which preserves the, the, um, the, the DNA or in fact the R- if, and, and the, the sample of the RNA of the virus were there to be any there, but there wasn't. But anyway, would've preserved the virus, but, uh, i- in, in pristine deep frozen form. And then the, there was another set of samples split from this set that went to the hospital's pathology, um, uh, unit and for what is a routine process in, in, in hi- it's called histopathology in hospitals where, uh, pathologists look down a microscope at samples which they stain with chemicals and, um, y- you, you get various reactions, uh, that they're looking for. So this second set of samples, um, is fixed in formalin, and I think everybody knows what formalin is, it's a preservative. And the, the thing about when you pr- preserve things in formalin is it tends to slightly scramble or at least make less accessible the, uh, molecular, the, the nucleic acid in the, in the samples. So when you come to run a PCR test, you have to run more cycles to get to the same result. So if you had, if you sa- if you fro- if you took, if you split a biopsy and you froze this sample and you, uh, used the other sample in, w- or you preserved it in for- the other sample in for- in formalin and ran the machine, you would find the virus much quicker in the frozen one than you would in the formalin-fixed one. And because-

   4. PAPeter Attia1:36:38

      Right. So just to, just to go back to what we were talking about, that means if you, you know, you take the exact same piece of tissue, you cut it in half, one goes in formalin, one goes in nitrogen. Let's say the nitrogen one hits its PCR threshold in 20 cycles, you might expect the formalin one to require 30 cycles to reach the same amount of genetic material because you functionally started with so much less because the formalin had degraded it.

   5. BDBrian Deer1:37:04

      Yes. Great. Thank you.

   6. PAPeter Attia1:37:05

      So what happened in O'Leary's lab?

   7. BDBrian Deer1:37:07

      We should be doing, uh, we should have a show on CNN and we could, like, bat it back and forth. [laughs] Um, yes. So, so the, the thing about this, and the only reason this ever came out, and you see, that's another thing I have to say about my work is it's, it's le- it's less to do with vaccines and s- promoting vaccines or anything like that, which is not really part of my agenda. It's, it's, it's the, the, the scientific questions going on behind all of that, which are applicable to all sorts of, uh, all sorts of... It's much bigger than just vaccines. So, so yeah. So what happened was they came up against Because the, the, the particular importance of the vaccine program, and they were suing vaccine manufacturers, they came up against the pharmaceutical industry. Pharmaceutical industry, effectively unlimited money. They can, they can pay for anything, any kind of legal, scientific test whatsoever. Came up against the pharmaceutical industry, who hired Britain's top expert on the PCR technology. So they hired him, and he, uh, produced reports which looked at the, which made the comparisons, among other, many, many other things, made the comparisons between the, uh, number of cycles on, on, uh, the fresh frozen, uh, biopsies and the formalin-fixed biopsies, and found... And, and they were compared with a, a, well, it gets very complicated. They were compared with another gene. And essentially what he found was that it took the same number of cycles to, um, get, the co- the same number of cycles on both samples, um, on both the formalin-fixed and the, uh, fresh frozen samples.

   8. PAPeter Attia1:38:58

      To which there's only one explanation.

   9. BDBrian Deer1:39:00

      To which there's only one explanation, which is that the virus got into the samples after they were fixed in formalin.

   10. PAPeter Attia1:39:08

       In other words, they could not have come out of the children. So the most gracious explanation is that this was purely a laboratory contamination. A less gracious interpretation is that it was deliberately, uh, falsified.

   11. BDBrian Deer1:39:27

       Well, this PCR expert, he went a stage further, a man named Steve Bustin. Um, and he went a stage further, because he was paid enormous, enormous amounts of money to do this. Uh, long, I'm not saying he g- got, got paid too much money because, you know, you pay for what, you get what you pay for. Um, he then went further and started looking at the individual, uh, wells, because this machine would be have, would ha- like have a whole, have a whole rack of wells. I think there are, off the top of my-

   12. PAPeter Attia1:39:58

       96.

   13. BDBrian Deer1:39:59

       Is there 96? Yeah, so you have 96 wells, uh, in a tray which goes into the machine, and some of these wells would have, uh, the samples you're testing for, some would have positive measles controls taken using a laboratory strain of measles would be in some other ones. Some would have distilled water, and some would be empty. And he found that by analyzing... And these, these, these wells are being monitored second by second by second by second by the machine, and all this data that's spewing out of the machine, um, I think hundreds of data points for each well, if not thousands, I can't remember off the top of my head. Uh, for each well, all this material was gathered, and O'Leary was very keen to avoid it being disclosed to the drug companies who were demanding. In fact, ultimately, the drug company's lawyers had to go to the High Court in London, who then made an application to the Irish High Court to order Wa- um, O'Leary to produce the data, uh, to produce the outputs from this machine. And he came up with all kinds of reasons why he couldn't. He was in Australia, the machine broke down, um, the dog ate his homework, and on it went. But ultimately, this guy Bustin did get data, and he found that wells that had been, uh, reported by the machine to be positive for measles virus were in fact, uh, submitted in legal papers as being an empty well, as having nothing there, as though somebody had taken an eraser and rubbed out the result. In other cases, he found that wells that were them- themselves empty were reported positive and rubbed out. And so there, in his analysis, there had been manual human intervention to adjust the results coming out of those machines, that machine, in fact, well, there were two actually, but out of that machine, um, in order to make the results consistent with what Wakefield wanted to find. So the interpretation of that by many people, and I just simply observe it, um, was you would have to assume that a person or persons unknown had deliberately cleaned up the output of that machine.

   14. PAPeter Attia1:42:35

       Yeah. Let, let's reflect on that for a second, right? So let's pretend we were talking about a company, say Enron, who had deliberately, with its accounting firm, manipulated its books in such a way that it could deceive shareholders. What would be the consequences of that? Well, in that example, the consequence is jail.

   15. BDBrian Deer1:43:03

       Well, I don't know what's happened with Volkswagen, because w- part of the Volkswagen Group did precisely that with, um, fuel emissions from their cars, where they rigged the results. I don't actually know how that one's played out yet. I don't know if anyone's gone to jail on that one, but, um, you would think, yeah.

   16. PAPeter Attia1:43:19

       And, and so it's interesting when you look at, um, at this case, it, it really doesn't... If, if you just viewed it through the lens of the behavior, not the consequence, but the behavior, um, it, it is, it's as nefarious as the most nefarious thing that, you know, we see in cor- you know, the, the stories of corporate greed and things like that. Um- And, and certainly, uh, more than, than even the corporate incompetence

8. 1:43:50 – 1:50:25

   Discovering the misrepresented medical records for the kids involved in the study leading to the retraction of the Lancet paper and Wakefield losing his license;

   1. PAPeter Attia1:43:50

      that, that sometimes masquerades as greed. Um, another thing that I, I, I, again, I don't wanna just dwell on this beyond anything, but again, it's, it's worth noting how when you finally got a hold of the medical records of those 12 kids, or at least a subset of them, they were not, which, which again, if you were looking at medical records of children that went back to when the events actually occurred, meaning when they were actually vaccinated, when their symptoms truly showed up, so before they were recruited into the study, how consistent were the true findings with what, uh, were ultimately reported? Were they... I, my recollection is they were not entirely congruent in that regard.

   2. BDBrian Deer1:44:30

      Oh, that was all bullshit. I mean, the, the, the, the, we kind of skipped that one, but, uh, y- yeah, no, I was, what happened was that when I f- I, I first broke the story in the Sunday Times, a series of pieces, and then I was invi- invited to make a, uh, a television documentary, an hour-long, um, it was in the Dispatches strand in the UK. And, um, and in the course of that, uh, Wakefield then sued us using actually the medical profession's money at the time. He was still a doctor at the time, and he sued us. And because he, he, he sued us, but then he, he wanted to have his lawsuit frozen so that he didn't actually have to go ahead with it. So he was going around telling people he was suing us, but in fact, he'd had his suit stayed, is the legal word to, to freeze these things. So we, me and the television company, Channel 4 television, which is a national network with, with statutory duties for fairness and, uh, and balance and, um, and accuracy, uh, we took him to court and forced him to sue us. So he'd either have to put up or shut up. And in the course of that, I was able to read these children's medical records and gain and, uh, get other documents disclosed to me, um, which, uh, evidenced to me that these children did not have what he said they had. Uh, there was not a single one of those 12 children whose cases were accurately reported in that paper in The Lancet in February 1998. Not one of them. There were children who, uh, whose developmental issues preceded their vaccination. There was ch- there were children whose issues were not 14 days or less after vaccination, but months, in some cases many months later. In fact, his, what he called his sentinel case, the first parent who, who came to him, who phoned him, uh, at the suggestion of the, the, the Jackie Fletcher, who'd set up the campaign group, the first patient, she ultimately admitted in court papers that her child had shown no issues associated with inflammatory bowel disease or autism or anything like that for nine months after vaccination, and yet when she went to the hospital, she said 14 days. Uh, with actually never, nothing before nine months later. So, and then there were children who were reported in the paper as having a diagnosis, a behavioral diagnosis of autism who didn't have autism at all. Didn't have, well, didn't have an autism diagnosis at all. I don't, can't say what people did or didn't have. I can only say what the, I can't bring them back and, you know, I can only say what the, what the reporting said. They did not have autism diagnoses. So what Wakefield had done was to change the, the times to onset, change the diagnoses, um, diagnose, and he was a, he was a non-clinical academic gastroenterologist. Wasn't a clinician, had no patients, as I call him in the book, a doctor without patients, although some other doctors who don't have patients have taken issue with that. Um, but, um, he changed diagnoses. He represented as an inflammatory bowel disease, uh, normal, uh, pathology findings. Um, and there was nothing in that paper that could be reconciled with the actual children's, uh, diagnoses, records, histories, um, and, uh, laboratory and blood tests at all. Not, not one of them. And, um, and, uh, that really, I suppose is, um, is what I was able to do. I mean, I, i- interestingly, 'cause he sued us in the UK and then abandoned that when I, he actually abandoned it on the day I was sitting reading the medical records of the children at my lawyer's offices. Um, and, uh, I, I couldn't use that material because it was sealed material. I was seeing it as pursuant to court order. I was reading the children's medical records pursuant to a court order, which allowed me to do it. In fact, one of the parents turned up to court and challenged and said, "They shouldn't be allowed to read my child's medical records. It's confidential." And the judge said, "I'm not having these parents saying who can have what documents," and gave an order for me to read the children's medical records. But I couldn't use it until, what happened then was there was a huge medical board hearing, went on for 217 days, longer than the trial of O.J. Simpson, at which these medical records were studied and, and, uh, read aloud over and over and over by lawyers, uh, in London. And at the end of it, Wakefield lost his license to practice medicine, and The Lancet retracted the paper. Um, so that, uh, medical board hearing, which was a reinvestigation of my findings in the Sunday Times, and really as a newspaper, we forced them to do it. They, they had, and it cost, I, I think the ultimate figure was about 10 million pounds to have this, this hearing. You know, the, um, but I couldn't use that material until it was, was ventilated at that hearing, and other documents I couldn't use until Wakefield then sued me again in Texas when I did some reports for The British Medical Journal, 'cause they asked me to do a series of, of, um, of reports for a, for a medically qualified readership. So we did that, and then Wakefield sued On that, he was funded by a New York financier called Bernard Selz and his wife Lisa, who, who put up the money, who ponied up the money for him to sue me and the British Medical Journal, and that was thrown out too. But in the course of that, the documents that were disclosed, uh, behind seal in the UK l- litigation was, uh, unsealed in the American litigation, and I was able to use it in my book, The Doctor Who Fooled the World. Um, and, uh, that tells

9. 1:50:25 – 2:04:24

   The resurgence of the anti-vaccination movement, Brian’s motivation to write the book, and parting thoughts;

   1. BDBrian Deer1:50:25

      the story of all of this, and indeed a lot more. Um-

   2. PAPeter Attia1:50:28

      There, there's one piece of this story, Brian, that I think I, I'd love for you to also tell because it still comes up a lot to this day, and it's the story of, quote-unquote, the CDC whistleblower.

   3. BDBrian Deer1:50:41

      Yeah, I, uh, to, to be, to be honest, Peter, I, I mean, I think I'm, I'm getting a bit tired now.

   4. PAPeter Attia1:50:45

      [laughs]

   5. BDBrian Deer1:50:45

      I mean, we've been, we've been talking for more than two hours. Uh, and, and that is, I mean, I think people-

   6. PAPeter Attia1:50:51

      That's a record for you. I know that's a record

   7. BDBrian Deer1:50:54

      People wanna know about the CDC whistleblower and this movie Vaxxed that Wakefield came out of, and the rebirth of the anti-vaccine movement. 'Cause, 'cause by the time I'd finished this aspect of the investigation, Wakefield was finished. I mean, he had haircuts worse than mine. This is a COVID lockdown London haircut.

   8. PAPeter Attia1:51:11

      [laughs]

   9. BDBrian Deer1:51:11

      Now, I've never m- I haven't had my hair cut for, like, I don't know, two months or something, three months. God knows what. He was walking around looking like me now. Yeah? Um, he was finished. He was written off. He was o- none of his colleagues would speak to him. He was done. But then came the, the return of Andrew Wakefield, um, on the scene, and that's the next stage. That's the fourth part. The book is in four parts. The first part is, um, is, uh, big ideas. The second part is secret schemes. The third part is exposed, and the fourth part is avenged. And you then come to avenged, Wakefield's, um, what I would characterize as a vindictive, uh, riposte to his personal ruin, where he started to do what he's always done, which is to mirror, uh, his own behavior onto others, and accuse, uh, or claim, falsely claim that a researcher at the CDC had accused his colleagues of fraud, and that Wakefield had discovered with this fraud through this alleged whistleblower, and that wasn't true either. But I mean-

   10. PAPeter Attia1:52:30

       Let's let people, let's, let's give people a chance. They'll, they'll read the book. It's, it's, you, you, you, you, you do a very good job describing this with full transcripts. Um, and again, I think it's, I think it's important for people to understand this. Um, do, do you think that, that Andrew Wakefield would ever sit down with me for an interview?

   11. BDBrian Deer1:52:49

       Uh, no. No. No. He will only sit down for an interview with somebody he knows will not ask him questions that are difficult. That's the first thing. And secondly, um, you, you w- you would not, you would not be able to field his replies. So for example, he will say, and he does say, um, "I never got involved in the lawsuit until after the children were seen at the hospital," which is just a most flagrant lie. I mean, I've got the paperwork. I've got the contract. I've got the, the, the-

   12. PAPeter Attia1:53:32

       Right, he was, he was involved two years before

   13. BDBrian Deer1:53:34

       Before, yeah, but he would just lie to you. I'm just giving you a really obvious example.

   14. PAPeter Attia1:53:38

       I see. So you're talking, the degree of pathologic lying is so great that it becomes, there's, you're, you're, you're in a fact-free zone. I wanna end on two, uh, two things. The first is I wanna read you something from the New England Journal of Medicine, which in 2011 wrote an article, uh, or published an article rather, titled The Age-Old Struggle Against Anti-Vaccinationists. Uh, I'm gonna read you a quote from it, and I want you to tell me if you think this is accurate or if you think this is too harsh. So, um, it states that this has been an issue that's existed since the 19th century, but now the anti-vaccinist, anti-vaccinationist media of choice are typically television and the internet, including social media outlets, which are used to sway public opinion and distract attention from scientific evidence. The editorial goes on to characterize such people as they tend toward complete mistrust of government and manufacturers, conspiratorial thinking, denialism, low cognitive complexity in thinking patterns, reasoning flaws, and a habit of substituting emotional anecdotes for data, including people who range from those unable to understand and incorporate the concepts of risk and probability into science-grounded decision-making, and those who use, presumably on the other side, deliberate mistruths, intimidation, falsified data, and even the threats of violence. Do you think that's too harsh?

   15. BDBrian Deer1:55:04

       I think that's absolutely right. What I would say about it, now that's, uh, that's, that's absolutely right, but what I would say about it, that is static prose exposition. Yeah? Now, that's one way where somebody could say, "Well, I don't know who wrote that, but, um, whoever it is, is, is probably a very learned person with enormous experience. I'm telling you this." That's what he's doing. "I'm telling you this," in the New England Journal of Medicine. What I've tried to do is to take a different approach to it, which is to tell the story and to show people, which is why we go into all that stuff about cycles of PCR and things like, is to show people the real characters behind this and the specific facts of how they did it, and that's what I've tried to do in the, in The Doctor Who Fooled the World, is to tell the story as a narrative. Who did what? And the Closing point from me would be a quote from my own book, I suppose, if I can remember it, is, and this is just before the, this is before the pandemic, uh, began I wrote this, was that to me the importance of it was not just about vaccines and vaccine safety and the issues that you deal with in your clinical practice, but it's this: If he could do what he did, and I show you what he did, who else is doing what in the hospitals and laboratories that we may one day look to for our lives? Now, we are looking to those hospitals and laboratories for our lives, and that's the, really the message behind the whole thing. It's not, I, I had no message to convince people to vaccinate their children. I don't advise people to vaccinate their children. I don't accept, uh, endorsements of my book from vaccine manufacturers or the usual suspects whose names we all know. Um, I was interested in that question. If he could do what he did, who else is doing what in the hospitals and laboratories that we may one day look to for our lives? And that's the importance of it, because the reason Wakefield got caught was because he took something as high profile as vaccination, um, affecting everybody's children, pri- a pr- subject of primary concern to almost everybody, and he chose to do what he did within that. So therefore I was able to, for my very first story, I got four months to investigate before we published a single story. I did a television program that I, I think were about eight months or nine months preparing that. The BMJ series, which took six months to prepare for, uh, publication. The book, and all of this is subject to the scrutiny of lawyers, other journalists. My contract with Johns Hopkins University, my North American publishers, requires that I've told the truth, and if I hadn't told the truth, my publishers would be in a position to pulp the book and send me the bill. That is the contractual position I'm in. Uh, the book has been reviewed by f- it's been peer reviewed. Two different libel lawyers, one in New York and one in London, have looked at it, and two members of staff at the Johns Hopkins University Press went through all my documents against the 2,000 references, footnoted references in the manuscript of this book to sh- be sure that what I've been saying is backed by the evidence. It's not just me saying it. So while I appreciate those words from, handed down by somebody who knows about these things and summarizes it based on their expertise and their s- you know, their life story themselves, what I've tried to do is to tell the story of the real people and the specific facts as to how we got the anti-vaccine movement that is today causing all this mischief over, um, SARS, uh, COV-2, uh, shots. So, uh, so that's my pitch, and that's why I wrote the book, and I, you know, hope somebody might go out and buy it.

   16. PAPeter Attia1:59:18

       I, I think people absolutely will, and I, and I, and I think that people should not assume that because they've heard this podcast they know all that's in the book. The, the book is incredibly rich with detail. Um, a- as I said at the outset, I, I read the book twice because I ne- it, it's not, it's a book that you can easily miss parts the first time through. I think my, my closing thought, Brian, will be this. Um, first, I guess I have two. One, I really appreciate the point you just made, which is this is really less a book about vaccines, and it's more a book about how science can go wrong and how science can be corrupted by bad people, and I think we can say that. Um, I think for me, a very sad footnote to this story, which you've alluded to, begins with the kernel of those 12 children who were summarily tortured in a hospital, uh, some 20 years ago. And if anybody listening to this has a six or seven-year-old child, and especially if any parent listening to this has a child with autism, um, they will understand what you said, which is these are children in whom any deviation from a normal routine is devastating. That means bedtime being at a slightly different time, never mind going to a hospital, sleeping in a foreign place, being tortured through a bowel preparation when you're constipated, having a colonoscope rammed into your colon, one child having 12 perforations, if my memory serves me correctly, having a lumbar puncture, multiple venous punctures. Um, to then realize all of this was done without even a modicum of investigational review board oversight. In other words, this was not even deemed an ethical thing to do. To think that that's the kernel of evil that then went on to produce so much angst for so many parents who now are left wondering, "Have I done something to cause harm to my child?" Um, I think that is the absolute saddest legacy of this, and despite, um... You know, if, if, if effective tomorrow, if this story vanished, which it won't, um, there would be no undoing, um, what I consider that unspeakable harm. So I thank you for doing what you've done. Um, I wish we could end on a happier note. Um, and I thank you for staying up so late. I know it's very late there in London. Um, but I'm, I'm greatly appreciative for this time, Brian.

   17. BDBrian Deer2:01:57

       No problem. Thanks, Peter. Thanks for your interest.

   18. PAPeter Attia2:02:01

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Episode duration: 2:04:24