Who Knows Best?: Physicians and Patients, Mythology and History

On the first day of the class on ancient Greek history that I am teaching this semester, I asked my students,

What is history?

Then I passed out the opening lines of the 8th-century poet Hesiod’s Theogony, which details the birth of the gods of Greek mythology. Why, I asked my students, are we reading mythology—traditional stories and legends including those found in Homer’s epic poetry and the Greek tragedies—at the start of a history class? Isn’t history about “what really happened“—about facts, about reality, the truth? Why read about the birth of Aphrodite and how the titan Prometheus stole fire to give to humans?

The ancient Greek word for “history” is historia,” which means first of all an “inquiry,” and also a “written account of one’s inquiries, narrative, history .” Herodotus, known as the “father of history,” entitled his account of the Persian Waws Historia and writes in one passage about rejecting the myths as different from history—from what really happened.

I’ve written before about autism mythology; about why the vaccine-autism myth continues to endure and is still believed in (and Kevin at Left Brain/Right Brain has a post today on the myth of recovery). Dr. Michael Fitzpatrick, author of MMR and Autism: What Parents Need to Know, writes in the September 1st Times Online about how he responds to parents who think that the government has been covering up an autism-vaccine link:

In Hackney we know that the measles outbreak is real because we have seen 150 cases over the past three months and ten have been admitted to hospital with pneumonia – the greatest number of cases I’ve known in the 20 years I have been here. The high fever, the hacking cough, the sore eyes, the blotchy rash, the inconsolable misery – all these features of the infant with measles had become a distant memory.

The recent upsurge in measles cases in Britain is a sad tribute to the climate of irrationality. Despite all the paranoid conspiracy theories, there has never been a cover-up of the link between MMR and autism. In ten years those promoting this autism link have failed to produce convincing scientific evidence while numerous laboratory studies and epidemiological surveys have upheld the safety of MMR.

It is not only parents of autistic children who exhibit “extreme scepticism towards established sources of authority in science and medicine” and, full of “anxiety about environmental threats to our wellbeing,” have chosen to “put their faith in self-proclaimed mavericks and alternative healers and charlatans.” Fitzgerald describes other patients who attribute other conditions to various environmental factors, and overlook the actual state of their health:

As doctors, we are grappling in our surgeries with fear and confusion, exacerbated by an apparently endless series of health scares and panics. A campaigner came to me convinced that a local mobile phone mast was causing her breathing difficulties; later she admitted that she smoked 30 cigarettes a day. A young man, committed to the “near-death” experiences offered by inhaling the veterinary tranquilliser ketamine in the course of weekend clubbing binges, inquired whether I would check his serum cholesterol level to assess his long-term risk of coronary heart disease. Patients who consume vitamins, antioxidants and herbs by the bucketful commonly refuse to take medication recommended for high blood pressure or some other condition because they “don’t want to get hooked on tablets”. Some patients even refuse chemotherapy for cancer in favour of homoeopathy, acupuncture or aromatherapy.

Fitzgerald takes the government and health officials to task for promoting “consumer choice – and subjective belief – over medical expertise”: It is not only the customer who is always right, but the patient. “[T]he problem revealed by the MMR scare is that individual choice cannot be reconciled with a mass childhood immunisation programme,” Fitzgerald concludes. Parents today can find out quantities of information via the Internet that would have been difficult to access and to access quickly in the past, but how true and accurate is the information? Who knows best, a traditionally-trained physician who “goes by the book,” a “maverick” practitioner who seems to have a new and original view of how to address a child’s health issues, a parent who (of course) is living with and taking care of their child every day and goes with their gut?

Journalist Arthur Allen has written about why there is no dispelling the myth that vaccines cause autism—-as I said to my students in their ancient Greek history class, we have to be careful not just to think of the ancient Greeks as being deluded and irrational for believing in what we call “mythology.” In our culture today, we tend to associate the word “mythology” with something that is not true, with the irrational, with a story that is not grounded in facts and reality. Think of the Greek myths, I said to my students, as a belief system, as a way of seeing and understanding the world. Herodotus, with his rationalizing views and attempts to base “history” on inquiring about what actually happened, challenges this view—-just as developments in science and rational medicine by the fifth-century Greeks also challenged traditional views of nature and of healing.

Perhaps the question to ask is not so much “who knows best, physicians or patients or parents,” but to consider how we all arrive at our different beliefs, and to try to understand each other’s, however much we disagree. There’s a reason that the Greek myths—-of Odysseus on his long journey home from Troy, of Achilles choosing a short life of renown over living a long life and being forgotten—-still speak so powerfully to us, and not because Odysseus and Achilles actually lived.