A LEFT-WING ANTI-VAX NOVEL

Recently I wrote about Michael Palmer’s 2004 medical thriller, The Society, which has taken on new relevance since the murder of UnitedHealthcare CEO Brian Thompson last December. Palmer’s novel deals, in part, with the search for an assassin who is murdering the CEOs of various managed-health-care corporations. The book seems to have anticipated the antipathy towards for-profit medical corporations that that inspired alleged murderer Luigi Mangione to stalk and kill Thompson.

Today I’d like to write about Palmer’s 2002 novel, Fatal, which deals with another subject that, with the rise of Robert F. Kennedy Jr. to the role of U.S. Secretary of Health and Human Services, has gained more relevance lately: anti-vaccination sentiment. Palmer’s novel, though not an anti-vax screed, is sympathetic to the idea that childhood vaccinations can, in some cases, lead to extremely negative outcomes for the patient. And the book specifically cites extreme autism as one of the rare, but very real, side effects of immunizing young children. Nowadays, it is the political right that seems infatuated with the idea that early childhood immunization has led to an explosion of autism diagnoses in America over the past few decades. But Palmer, who died in 2013, was not a right-winger. I can’t say exactly how liberal Palmer was but, having now read seven of his novels, I feel confident that he possessed, at the very least, the political beliefs of a moderate member of the Democratic Party. He was born and raised in the highly Democratic state of Massachusetts. As a medical doctor, he possessed the kind of elite educations that, nowadays at least, is widely associated with left-leaning individuals. He spent most of his life either in liberal Massachusetts or New York, which is also a left-leaning state. What’s more, his novels tend to look askance at such things as for-profit medical corporations, Big Pharma, coal mining and other environmentally harmful industries, and Republican politicians. In Fatal, the President of the United States – President Marquand – isn’t identified by his political party but he is a conservative who wants to dismantle the Social Security system, which suggests that he isn’t a Democrat. But in spite of Palmer’s center-left political leanings, he seems to have genuinely believed in a link between early-childhood vaccinations and a huge increase in autism diagnoses. Certainly, the heroes of his novel all share this belief.

The main character in Fatal is Matt Rutledge, a doctor who works at the Montgomery County Regional Hospital in fictional Belinda, West Virginia (Montgomery County is also fictional). As the story opens, Matt has recently seen several people suffering from a condition similar to neurofibromatosis type one, more popularly known as “the elephant man’s disease.” Matt isn’t sure but he believes an outbreak of this rare disease – which he dubs Belinda Syndrome – may have been triggered by toxic chemicals improperly stored on the property of the Belinda Coal and Coke Company, a major employer in the area. Matt’s efforts to get the BC&C investigated by the Environmental Protection Agency, OSHA, or some other government entity have made him very unpopular in Belinda, where a lot of residents rely on the BC&C for their livelihoods. Meanwhile, a Boston bluegrass musician named Kathy Wilson also seems to have come down with symptoms similar to Belinda Syndrome. She is acting paranoid, rapidly spiraling into madness, and her face has developed several alarming fibrous tumors. Her best friend, Dr. Nikki Solari (a pathologist and an amateur bluegrass musician), is alarmed by Kathy’s sudden transformation and wants to bring her into a hospital for medical tests. But before Nikki can bring Kathy in for any kind of medical care, Kathy vanishes and remains missing for several weeks. Eventually a seriously deranged Kathy will run out into the path of a speeding vehicle and be killed. Nikki’s code of professional ethics forbids her from performing an autopsy on Kathy herself, but she asks her mentor, Dr. Josef Keller, to conduct the autopsy and to order special expensive tests that are not ordinarily called for in a standard post mortem. The tests reveal that Kathy was suffering from a condition similar to Mad Cow disease. This makes little sense to Nikki. But she decides to do some poking around into Kathy’s background while she is attending Kathy’s funeral. The funeral, as it turns out, is set to take place in Kathy’s hometown, Belinda, West Virginia, a place Nikki knows nothing about and has never visited. There, she will run into Matt Rutledge, and the two doctors will begin to suspect that Kathy is another victim of the environmental poisons that BC& C has been leaching into soil around Belinda for decades.

A third strand of the story involves a Maryland woman named Ellen Kroft, whose healthy young granddaughter, Lucy, suddenly became afflicted with severe autism after receiving her standard childhood vaccinations. That was roughly ten years ago and the child is now largely nonverbal and mentally retarded. Since then, Ellen has become active in a group called PAVE (Parents Advocating Vaccine Education) who are trying to warn Americans about the link between early-childhood vaccination and various afflictions such as ADHD, autism, and so forth. As the novel opens, First Lady Lynette Marquand is spearheading an effort to win government approval for a new medical breakthrough called the Omnivax, a single vaccine that will inoculate American children against thirty communicable diseases. Ellen Kroft has done extensive research into the Omnivax. One component of this biomedical stew is a vaccine against the lassa virus. Ellen believes that the lassa virus vaccine hasn’t been sufficiently tested yet and shouldn’t be included in the Omnivax. Naturally, Columbia Pharmaceuticals, the company that produced the lassa vaccine, isn’t happy about this. They stand to lose millions – possibly billions – of dollars if their vaccine isn’t included in the Omnivax. And they are determined to stop Ellen Kroft’s efforts at all costs. But Ellen refuses to be silenced. Speaking before a panel of medical experts weighing approval of Omnivax, Ellen says, “I know I have expressed my concerns in this area before, but I still remain uneasy about articles I’ve read – anecdotal, I grant you – hinting at an association between an increase in the number of vaccinations we give our children and an increase in immune-mediated diseases such as diabetes, asthma, and multiple sclerosis, to say nothing of the skyrocketing increase in conditions like ADD and austism.”

Ellen is a heroic character and at times seems to be acting as a mouthpiece for Palmer himself. At one point he writes, “Ellen gazed out the window, thinking about Lucy and the hundreds of other tragedies represented in the files and photos of PAVE. Those were real flesh-and-blood lives, not statistics. Then there were the myriad cases of ADHD, learning disabilities, asthma, diabetes, multiple sclerosis, sudden death, Asperger’s syndrome, and other forms of autism, whose possible link to their childhood shots still begged investigation.”

Elsewhere, Ellen notes that, “Parents are frightened that government agencies and the pharmaceutical industry are keeping information on vaccine side effects from them. Those parents who wish to decline vaccinating their children are prosecuted sometimes even when they can show that doing so violates their basic religious beliefs. This shouldn’t be happening in America. Wherever I go, parents are clamoring for three things: information, research, and choice.” That little speech codes rightwing nowadays, but in 2002, if Palmer can be trusted, it was a largely center-left concern. Robert F. Kennedy Jr. was a mainstream Democrat in those days and was regularly courted by party leaders to run for offices such as Governor of New York and the Senate seat vacated by Hillary Clinton when she became Secretary of State. Had he expressed his anti-vax opinions back then, they wouldn’t likely have hurt his chances of winning a Democratic political race, and might actually have helped him. But, eventually, as the Democratic Party began embracing the so-called “nanny state,” and became associated with government efforts to ban cigarette smoking, sugared sodas, and other products, it also became hostile towards those who question government health mandates. RFK, Jr. was active in the campaign to rid childhood vaccines of thimerosal mercury, a preservative. In Palmer’s novel, Ellen asks, “What about the thimerosal mercury a gazillion kids have gotten dosed with? What about autism? What about the seizures and brain damage and sudden death? What about the asthma and learning disabilities and ADHD?”

At that point in time, reasonable people differed over the danger of preserving vaccines with thimerosal. Since then, the scientific community seems to have largely absolved thimerosal of any involvement in bad vaccine outcomes. A heavily annotated 2010 article in the National Library of Medicine (https://pmc.ncbi.nlm.nih.gov/articles/PMC3018252/) notes that, “Epidemiologic studies continue to provide evidence that there is no association between thimerosal exposure and autism.”

Obviously, I am in no position to weigh in on these scientific matters. But, as a fan of pop fiction, I find it interesting to see that, as recently as 2002, a left-leaning doctor/novelist apparently believed that there could be a connection between childhood vaccinations and a rise in autism and other medical conditions. You could argue that Fatal, being a novel, wasn’t meant to be taken seriously as a meditation on contemporary medical issues. But clearly Palmer meant it to be taken seriously. In many of his novels he takes pains to point out the accuracy of the medical information he has disseminated. The back pages of Fatal include an author’s note that provides the names and contact info of various organizations that readers can turn to for more information about the link between vaccinations and autism.

But enough about the politics and science of Fatal. If you are a pop-fiction fan like me, you probably want to know if Fatal is a good book. In my opinion, Fatal remains a gripping thriller, even if you believe (as I do) that the connection between childhood vaccines and autism isn’t strong and may be nonexistent. Like most Palmer novels, it is most interesting when it is dealing directly with medical matters. When Palmer writes about shootouts and car chases and mine collapses and explosions and other staples of action fiction, the book remains interesting but becomes somewhat generic. His fistfights and gunplay are largely indistinguishable from those written by any other genre writer. Fortunately, Fatal is one of the Palmer novels that never abandons its medical story for long. Nor, despite the subject matter, does Palmer allow his book to become a political screed. For the most part it is an fascinating tale that examines both environmental health hazards and vaccine-related health hazards and does so in a way that never loses sight of the fact that this book is a thriller and not a medical or political tract.

Part of the fun of every Palmer novel is discovering the various amusing bits of banter that the doctors use only among themselves. For instance, in Fatal, the doctors refer to motorcycles as “donorcycles,” because their riders so frequently end up as brain-dead organ donors. Elsewhere he writes, “Tongue-in-cheek wisdom had it that internists knew everything and did nothing; surgeons knew nothing but did everything; and pathologists knew everything, but a day too late.”

If you’re a trivia fan, you may learn a few fascinating facts in a Palmer novel, such as this one about prion disease: “Quick point of interest – most people pronounce it ‘pry-on,’ but Stanley Prusiner, who won the Nobel Prize for describing the beasties, pronounces it ‘pree-on.’ I heard him speak a year or so ago.”

Palmer strikes me as being nearly as good a thriller writer as Michael Crichton was. In trying to figure out why Palmer’s novels didn’t sell nearly as well as Crichton’s did, it occurred to me that his book titles might have been part of the problem. On at least a few occasions, Crichton proved to be a genius at coming up with titles that lodged themselves in the public imagination: The Andromeda Strain, Jurassic Park, etc. And even his less original titles still sounded as if they promised excitement: Eaters of the Dead, The Great Train Robbery, The Terminal Man, The Lost World, State of Fear, Pirate Latitudes. Compare those to Palmer’s generic-sounding titles: The Patient, The Society, The Second Opinion, Side Effects, Natural Causes, Silent Treatment, Fatal, Mercy, Trauma, Flashback, and so forth. Fatal probably should have been titled The Super Vaccine (a term used in the book) or Omnivax or The Belinda Syndrome – something that would have not only hinted at its storyline but also have distinguished it from all of the other generically titled medical thrillers on the shelves at the time it was published. “Fatal” could literally serve as the title of 98 percent of the medical thrillers ever written. They say that you shouldn’t judge a book by its cover. Likewise, you probably shouldn’t judge a book by its title. But plenty of readers do. And a title like Jurassic Park is much more enticing than something like Mercy or Trauma or Fatal. Just sayin.’