Enduring Memories: Prof John Walker-Smith recalls his life and the Wakefield affair.

As an Anglophile Australian, growing up in Sydney, perhaps no early experience could have prepared Walker-Smith for this better than taking part in a school production of Gilbert and Sullivan’s HMS Pinafore, with its time-serving, politically correct politician Sir Joseph Porter KCB (‘I polished that handle so carefullee/ That now I am the ruler of the Queen’s Navee’), of which a delightful photograph  - one of many – appears in this memoir. This is a deep book which tells you a great deal about places and times, by someone who thinks penetratingly about things – many things, not only medicine but religion, art, literature, international affairs. But Walker-Smith is also someone for who the care of children was always of paramount importance, for who the churning accompaniment of political machinations, and in-fighting were never welcome. It was this that led him to leave Australia in 1972 and to move his department across London fatefully – as it turned out – in 1995 from the administratively blighted St Bartholomew’s Hospital in West Smithfield to the Royal Free Hospital in Hampstead. Inevitably, and in spite of the importance of the rest of this history it is this episode on which the most curiosity will focus.

And it is, of course, the point where the clash between science and medicine, and politics becomes most acute. It is hard to summarise all the issues here, but what is fascinating is the question why, from an early stage, were the politicians and the UK Department of Health not only keen to dismiss any connection between MMR and autism but also to dismiss any between autism and bowel disease, stepping well beyond you might think their competence or normal brief (what, we might ask, did they know?). Walker-Smith quotes his letter to the Chief Medical Officer of the time, Sir Kenneth Calman:

“I was personally very dismayed by your letter of 27 March 1998, especially after our cordial meeting with the Minister at Richmond House. I was not surprised by your robust defence of MMR vaccination but I was very concerned not only by your attempt to completely discredit our reported association between ileal lymphoid nodular hyperplasia, non-specific colitis and autism but your targeting of me personally on page 5 of your letter. It almost seems as if someone in your department has looked through my publications seeking to discover inconsistencies and so undermine my personal credibility as the senior clinician in the Lancet letter

“There are many factual errors…(p217)”

Why, we may ask, was it necessary to attack the gut autism hypothesis in order to defend the vaccine programme?