Curmudgeonly & Skeptical

How Stuff Works

"In 1988, Mr. [Ralph "The Unctious"] Nader and Sidney Wolfe, head of his Public Citizen Health Research Group, started to lobby for regulation of the implants, which had been used by some two million women over 30 years. Soon trial lawyers convened a Breast Implant Litigation Group; one San Jose firm invested $3 million of its own capital in filing some 90 lawsuits. In December 1991, San Francisco lawyer Don Bolton won a $7.3 million jury verdict for a plaintiff who alleged that her implants had caused an autoimmune disease, despite testimony by her own doctors that she had symptoms before the implants. In January 1992, FDA commissioner David Kessler called for a moratorium on the implants, citing no scientific study but the Bolton verdict." -  The Power of Modern Fads

The Power of Modern Fads
By ROBERT L. BARTLEY

A couple of disparate events sent ripples of satisfaction through our editorial-page offices last week. A Massachusetts parole board at long last recommended Gerald Amirault for parole, and a Food and Drug Administration panel recommended that silicone breast implants be returned to the market.

Both are causes which these pages championed. We kept pointing out that the nursery-care child-abuse charges brought against Mr. Amirault and so many others were wildly implausible. And that whatever you may think of cosmetic breast surgery, the case that the implants were unsafe could withstand no scientific scrutiny. In each case, respectable -- and politically correct -- opinion chastised us for such heretical views.

That is to say, what unites the two cases is our willingness to stand against the fads that periodically sweep our society, and especially our chattering classes. In an age of instant communications, we become members of a huge world-wide tribe, in constant contact with the thoughts and emotions of our fellow members everywhere. This carries many blessings, not least in undermining of local totalitarian regimes. But like tribal societies throughout the ages, it's vulnerable to sudden surges of emotions, to shared if unexamined assumptions that harden into instant fads.

When the tribe decided in the 1980s that nursery schools were likely outposts of child abuse, a series of prosecutions swept the country, from California to New Jersey to Massachusetts to isolated Wenatchee, Wash. Prosecutors earned dozens of convictions, often based on stories such as children tied to trees and raped in broad daylight or being impaled by various implausible instruments.

Our Dorothy Rabinowitz had already unwound one of these cases even before she joined the Journal as a critic and editorial-board member. She has since systematically unwound most of the rest, exposing a pattern of prosecutorial assistants using leading questions with "anatomically correct" dolls to elicit testimony from children in support of the charges. A fad, that is, supported by the "politically correct" view that child abuse was likely by nursery workers, as opposed, say, to live-in boyfriends.

Gerald Amirault, remaining in jail after his mother and sister have been freed, is a remnant of sorts. His release will bring down the curtain on this sad saga of American jurisprudence. By now most sensible people recognize that great injustices have been done. The fad has been defeated, but not without horrible costs to Gerald Amirault and others.

Let me say, though, that this was an uphill fight. The rest of the press, in particular, was no help. The editor of one local paper invited me to send a second reporter for a guided tour of the case. The Pulitzer committee rejected Dorothy's nomination three times, but finally did endow her in 2001, when her entry included not only child abuse coverage but her enthusiasm for the presidential campaign of press favorite John McCain.

While victims of the breast-implant fad were not as dramatic as Gerald Amirault, in another way it was even more of an outrage. This was a deliberate, for-profit fad. The tort liability bar proved again that it knows how to exploit modern sensibilities to stoke fears of disease, raise hopes of a cash windfall and shape expectations of a national jury pool. In this it had the considerable assistance of the Ralph Nader empire; his "Public Citizen" sold information kits directly to breast-implant lawyers.

In 1988, Mr. Nader and Sidney Wolfe, head of his Public Citizen Health Research Group, started to lobby for regulation of the implants, which had been used by some two million women over 30 years. Soon trial lawyers convened a Breast Implant Litigation Group; one San Jose firm invested $3 million of its own capital in filing some 90 lawsuits. In December 1991, San Francisco lawyer Don Bolton won a $7.3 million jury verdict for a plaintiff who alleged that her implants had caused an autoimmune disease, despite testimony by her own doctors that she had symptoms before the implants. In January 1992, FDA commissioner David Kessler called for a moratorium on the implants, citing no scientific study but the Bolton verdict.

As early as June 1992, Dr. Marcia Angell, executive editor of the New England Journal of Medicine, published an editorial denouncing the ban. A survey of the matchless epidemiological records at the Mayo Clinic found no association between implants and autoimmune diseases. Both Dr. Angell and Mayo researcher Dr. Sherine E. Gabriel were rewarded with a barrage of subpoenas from tort lawyers.

From the first, in short, it was easy enough to see that the breast-implant scare was a fad, fed by an always underlying fear of science, the pecuniary interests of the tort lawyers and political correctness. One adviser to Mr. Kessler said the FDA should "deliver a profoundly important message to the American public involving basic values, concepts of beauty." This attitude is not so easy to sustain when implants are used for reconstruction following mastectomies, of course, and soon the suspicion of silicone led to a ban on the detachable silicone balloon, a device used against life-threatening aneurysms of the brain.

The press, again, was not much help in getting to the truth. The usual theme was "profit." That is, since companies made implants for profit, their arguments should be discounted. Mention was seldom made of the lawyers' financial interests, which amounted to one-third or more of all awards or settlements -- a third, that is, of what is now calculated at some $4.5 billion. And of course, Dow Corning, the leading implant manufacturer, declared bankruptcy in 1995. FDA approval will vindicate science, but where do shareholders or former employees apply for their money and jobs?

Fads, that is, have real consequences. And with tribal cohesion, it seems, there are not many to stand against them, least of all among guardians of the press. So serious people have to be careful to cling stubbornly to reality, to refuse to give the passing craze the benefit of suspension of disbelief.

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