An explanation of Galahad Syndrome

Vaccine denial comes in several forms: those who think that vaccines give people the disease they are supposed to prevent; those who think vaccines cause autism in children; and those who think that healthy children don’t need them. A central theme of vaccine deniers is that strength, health and virtue (include piety, if you like), suffice to stop any illness. Some parents think that vaccines are unnecessary for healthy children; it is an Arcadian return to a philosophy of rural bliss. The idea is that there is some ordained state of good health and perfect parenting that renders children immune. The idea is pernicious, but it has been hard to fight — as shown in a recent Republican candidate debate where Donald Trump espoused the debunked theory of autism caused by the measles, mumps and rubella vaccine. 

Perhaps it is time to give this rejectionist approach to modern science and medicine a name. I suggest Galahad Syndrome. Let me explain.

Sir Galahad was a Knight of the Round Table and is a purely literary figure, but at least metaphorically, he too was certain that virtue and strength were sufficient for any challenge. The person who gave life to Sir Galahad was Alfred Lord Tennyson, a romantic if ever there was one.  His poem, “Sir Galahad” (1832), was incorporated in “Idylls of the King,” his rumination on the Arthurian legend. According to Tennyson, Sir Galahad could slash and thrust better than other knights because: “My strength is as the strength of ten/Because my heart is pure.”

The poem espoused a faith in purity and strength, a martial manliness that charged first and asked questions later. We find it in “The Charge of the Light Brigade,” immortalized in another Tennyson poem in which almost everyone dies. 

My favorite alternative portrayal of the Arthurian legend is by Mark Twain. Twain’s character, the Connecticut Yankee in King Arthur’s Court, was a foreman at the Colt Arms Factory in Hartford who, after an unfortunate brawl with one of his workers, was knocked into the 8th century by a crowbar to the head. Waking up, he gradually sized up the situation, realized that King Arthur’s court was populated with amiable dolts and decided to take charge. 

With 19th century Connecticut ingenuity, he does take charge, but not without opposition from Merlin the Magician, whose stock, naturally, was sinking as the Yankee blew things up and predicted solar eclipses. To save his credibility, Merlin convinced King Arthur to do the sensible thing and to test the Yankee in a joust. He was to fight all of the mounted knights of the roundtable, one at a time. The Connecticut Yankee knew a losing proposition and so he appeared, dressed in pink tights, with a lariat on a nimble quarter horse. He deftly lassoed each charging knight, including Sir Galahad, and yanked them off their horses. (Read this great satire for details.) 

Let us define Galahad Syndrome as denial or overconfidence in the face of a threat that is not understood. Modern people suffering from Galahad Syndrome take a rejectionist approach to science and modern medicine, relying on virtue (pure hearts, in the Galahad metaphor) and healthy habits to protect them.  For daily life that is fine practice, but faced with the flu virus or the measles virus your strength is not the strength of 10; a virus or bacterium does not care how healthy or virtuous its victim is. The flu virus of 1918 killed many thousands of soldiers, all young and healthy, then millions of other people. Tuberculosis seemed to have an affinity for the privileged of 19th century society. Polio downed millions of healthy people, including the vigorous Franklin Roosevelt, before science in the form of vaccines stopped it cold. Measles spread from a single infected child at Disneyland and affected hundreds of healthy children. According to records of the Centers for Disease Control, before 1963, when the vaccine was introduced, measles affected hundreds of thousands of American kids a year, practically every child got measles at some point. About 20 percent had serious complications and more than four hundred died in a typical year. People my age who had measles before 1963 will sometimes say it was not so bad, but more than 400 people are not here to agree. 

There is a way out of Galahad Syndrome, as it applies to vaccines. Learn how the immune system works. The immune system can be complicated, but important aspects, such as antibodies and how they are made, can be explained to non-scientists. We have known since Thucydedes in 430 BCE that people who survived a plague in Athens became immune to it. Vaccines provide immunity and spare us the plague part. Thanks to the efforts of generations of scientists, we now know how to make that happen for many diseases.

Richard Kessin is professor emeritus of pathology and cell biology at Columbia University. He lives in Norfolk, Conn. The Taconic Learning Center will offer a course entitled How Your Immune System Works in spring 2016.

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