TV: Hear the Silence
Authors: Michael Fitzpatrick
Journal: BMJ (2003)

Hear the Silence is Channel 5's dramatisation of the case that the measles, mumps, and rubella (MMR) vaccine causes autism. Gastroenterologist Andrew Wakefield, whose 1998 paper (Lancet 1998;351: 637. [PubMed]) first led to claims of a link between MMR and autism, is played by actor Hugh Bonneville. We see him introduce himself as the caring, listening doctor to Nicky (Jamie Martin), a little boy with autism, and his mother, Christine (Juliet Stevenson). “Hello, I'm Andy,” he says. At his positive response to Christine's conviction that MMR caused her son's bowel problems and his autism, she bursts into tears. “You believe me?” she says between sobs of joy and incredulity that she has at last found a doctor who endorses her claims. “Why wouldn't I believe you?” asks Dr Wakefield.

This film presents the gospel according to St Andrew that is now familiar from numerous newspaper and television accounts. In this crudely propagandist drama, there is little scope for character development. In her fight for justice, heroic Christine loses her high-flying banking job and her aloof businessman husband, but not—after all, this is Channel 5—her sultry good looks. The medical professionals she encounters (apart from Andy) are unsympathetic, pompous, and patronising. Dr Wakefield's critics at the Royal Free Hospital, London, and the Department of Health are cynical and scheming, concerned about their own careers or influenced by the vaccine manufacturers. Dr Wakefield is a crusader for truth, a committed scientist, a conscientious physician, and a devoted family man.

At the preview earlier this year, writer Tim Prager indicated that Dr Wakefield had collaborated on the script. It appears that the creators of this drama have listened exclusively to Dr Wakefield and his anti-MMR campaign supporters. As the parent of an autistic child, I wish they would all look at the evidence and listen to the opinions of numerous serious scientific and medical authorities, and not compound the burdens of autism parents with the unwarranted fear that by giving their children MMR they rendered them autistic. As a general practitioner, I wish they would consider the consequences in death and disease that is likely to result from the return of measles, mumps, and rubella if this drama contributes to a further decline in the uptake of MMR.

Anticipating criticism of the decision to broadcast such a grossly one-sided account of the MMR controversy, Channel 5 organised a debate to follow on after Hear the Silence (MMR: The Debate, Channel 5, 15 December at 11 05 pm). However, in the days leading up to the debate (pre-recorded on 3 December) it became clear that viewers, after seeing more than an hour of anti-MMR propaganda, would then see a discussion giving equal weight to arguments for and against the MMR-autism link, when the division of medical and scientific opinion approximates to 99% for and 1% against. Outraged that the Wakefield campaign was going to get even more publicity, a number of leading authorities, who had been invited to participate, decided to boycott the debate.

Although the debate is introduced with the statement that the discussion included experts in child and public health, not a single paediatrician, epidemiologist, microbiologist, or autism specialist appeared. However, I agreed to take part because I believe that the stakes are too high to allow the anti-MMR campaign to go unchallenged.

The debate was not even-tempered. Dr Wakefield made the same extravagant claims for his researches that have failed to impress numerous expert bodies in Europe and North America over the past five years. We did our best, within the difficult framework imposed by the organisers, to challenge some of the arguments and to expose some of the absurdities of the anti-MMR campaign.