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By

Tori Marlan

July 8, 2005

Section One Letters 3ColumnsHot Type 4Can Conrad Black drag Jim Thompson down with him?

The Straight Dope 5Why aren’t the Great Plains forested?

The Works 8God v. mammon

Chicago Antisocial 10Thrills and spills at Great America and onMilwaukee Ave.

The Sports Section 12The Cubs’ mirage of a season

Our Town 14Not house painter—horse painter.

Q&A 18Freaks and Geeks creator Paul Feig on his new book and more

ReviewsMovies 24Rosenbaum on Yes

Photography 26“Painting on Photography: Photography onPainting” at the Museum of ContemporaryPhotography

Theater 28Amerikafka at Trap Door Theatre

Books 30Two Trains Running by Andrew Vachss

Ink Well 31This week’s crossword: Loafing Around

B efore December 9, Jackson Presley Diamond wasa healthy kid. He’d learned to crawl, sit, walk,and run right on schedule. At 18 months he was

starting to talk and was rapidly accumulating vocabu-lary words. He liked to stack blocks and knock themdown, and when he heard music—his father, Lee, playsdrums in the local punk duo the Douglass Kings—he’dpull his parents up from their chairs to dance with him.After December 9 he could do none of those things.

It began as a typical day. Chaney Diamond woke herson up at 6:30, chased him around the room getting himdressed, then brought him downstairs, where she fed himsome yogurt and let him watch Sesame Street. She left hernorth-side home around 7:15 and drove to Wells Com-munity Academy High School in Wicker Park, whereshe taught special ed. A little while later Lee droppedJackson off at day care, then headed to his downtownoffice, where he worked as a mortgage consultant.

When Chaney arrived at the day care center thatafternoon to pick up Jackson, she saw emergency vehi-cles parked outside. She remembers assessing the situ-ation and initially feeling relief—the building obviouslyhadn’t burned down, she could see people inside. Buther worst fears were soon realized: the emergencyinvolved her son. Jackson had had a seizure, she wastold, and he’d been taken away in an ambulance. TheDiamonds later learned that no one at the day carecenter had been able to rouse Jackson from his nap,that his lips had turned blue, and that several peoplehad performed CPR on him until paramedics arrived.

A firefighter drove Chaney to Our Lady ofResurrection Hospital. In the emergency roomJackson lay on a table in his diaper, unconscious. Hewas intubated, and a nurse pumped air into his lungsthrough a bag, artificially breathing for him. He worea neck brace—a precaution in case of a spinal injury—and a bracelet that said BABY DOE. Lee arrived a shortwhile later, coming in on what he calls a “chaotic”scene. Doctors and nurses hovered over Jackson, con-ducting tests, taking notes, looking at readouts. “Itwas the scariest moment of my life,” Lee says.

After receiving antibiotics for bacterial infectionssuch as meningitis and pneumonia, Jackson wastransferred to the intensive care unit at Children’sMemorial Hospital, where doctors began furiouslytrying to diagnose his condition. continued on page 22

ON THE COVER: BRAD MILLER (FEIG)

Was Itthe Shot?

One day JacksonDiamond was ahealthy, active toddler.The next he couldn’thold up his own head. What happened inbetween was a routine vaccinationfor whooping cough.

By Tori Marlan | Photographs by Jim Newberry

Chaney, Lee, and Jackson Diamond

The Diamonds with Jackson at six months

16 CHICAGO READER | JULY 8, 2005 | SECTION ONE

CHICAGO READER | JULY 8, 2005 | SECTION ONE 17

22 CHICAGO READER | JULY 8, 2005 | SECTION ONE

Within a few days tests revealedthat Jackson had encephalopa-thy—damage to the brain. But noone could say what had caused it.

The Diamonds told doctorsthat Jackson had been fighting aslight cold for the past couple ofweeks, but that overall he was ahealthy child. He’d never beenhospitalized before, and he wasup-to-date with his immuniza-tions—he’d gotten the propershots at birth, two months, fourmonths, and six months. OnDecember 8, the day before hisbrain stopped functioning nor-mally, he’d had another round.

At the time the Diamonds hadn’tthought twice about the vaccina-tions. “I just assumed becausethey’re mandated and every childneeds them there wouldn’t be aproblem,” Chaney says. But asdoctors struggled to make senseof the situation, the Diamondscouldn’t help but wonder whetherthe vaccines were related to theirson’s sudden collapse. They askedthe doctors if the immunizationcould have been responsible.

“There was a wholesale rejec-tion of the notion that anythingrelated to the vaccinations waseven conceivable,” Lee says. Evenweeks afterward, “when they hadconducted countless tests on ourboy—and I’m talking about mul-tiple spinal taps, multiple CATscans, multiple MRIs, EEGs,video EEGs, blood tests, X-rays,a brain biopsy, even after all this,we kept saying, ‘Are you sure itcouldn’t be related?’”

Within 24 hours of taking theirson in for his shots, the Diamondshad lost the little boy they’d known.Jackson could no longer communi-cate with them or express hisneeds in any way. He could barelyeven move. The Diamonds tookturns spending nights at the hos-pital by his side, waking every twohours to turn him over so hewouldn’t get bedsores.

Doctors were stumped. Theyexplored several possibilities—including his having been stran-gled—subsequently ruling outeach and every one of them. “Atone point they thought it wassomething related to his liver,”Lee recalls. “At another pointthey thought it was genetic. Orviral. Or maybe he got suffocat-ed. The one thing that they uni-laterally told us that it couldn’tpossibly be was the vaccinations.”

“It wasn’t even like, I’ll thinkabout it, I’ll look into it,” Chaneysays. “It was just like, No.”

Yet encephalopathy is known tobe a possible side effect of theDTaP shot, one of the fourJackson received on December 8.The DTaP protects against diph-theria, tetanus, and pertussis, orwhooping cough, and the govern-ment acknowledges that theremay be a causal relationshipbetween the pertussis componentof the shot and brain damage. Onthe Centers for Disease Control’svaccine information sheet for theDTaP, permanent brain damage,coma, and “lowered conscious-ness” are listed as possible side

effects—with the caveat thatthey’re “so rare it is hard to tell ifthey are caused by the vaccine.”John Iskander, a medical epi-demiologist and pediatrician withthe CDC’s immunization safetyoffice, says doctors may not recog-nize encephalopathy as a vaccinereaction because it’s so rare—“onthe order of one in a million.”

Which leads Lee Diamond towonder if adverse reactions aremore common than we think. “Ifthe medical profession that shouldbe at the forefront of recognizingsigns of a reaction not only doesn’trecognize them but disavowsthem,” he says, “how could wepossibly have accurate reporting?”

The CDC maintains that vac-cines are extraordinarily safe

and effective. They undergo a bat-tery of tests before they’re licensedby the FDA and recommended foruse by the CDC, which publishes achildhood immunization sched-ule. States then adopt it, makingthe vaccines mandatory. Proof ofimmunization is required to enrollchildren in school, though everystate allows for medical and reli-gious exemptions, and 18 states—Illinois is not among them—allow for so-called philosophicalexemptions.

As a result of widespread immu-nization, deadly and debilitatingdiseases like polio and smallpoxhave been eradicated in theWestern Hemisphere, and otherslike measles and chicken pox havebeen greatly reduced. But main-taining these public health bene-fits requires that each new genera-tion be immunized. That’s whythere are mass immunizationcampaigns, government assistancefor vaccination, and national vac-cine awareness months.

The CDC recommends thatchildren receive 21 shots by thetime they’re 18 months old toprotect against 12 infectious dis-eases, including hepatitis B,chicken pox, measles, mumps,and rubella. The CDC also rec-ommends giving children multi-ple shots at a time; some, like theDTaP, are combination doses,containing more than one vac-cine. Health care providers willsometimes administer even morethan what’s on the schedule in aneffort to bring kids who’vemissed appointments up to date.It’s not unheard of for kids to getinjected with a dozen vaccines inone trip to the doctor’s office.

Yet for all the good vaccines do,they can sometimes do harm. TheCDC acknowledges that no vac-cine is 100 percent safe. They’rebiological agents, and since noteveryone shares the same geneticmakeup or biochemistry, people’sreactions to them differ.

Doctors are required by federallaw to provide patients with theCDC’s vaccine informationsheets. The Diamonds can’trecall if they received any, but saythat even if they had it wouldn’thave educated them adequately.“Overall there’s a lack of infor-mation and a very aggressiveimmunization policy,” says Lee.

And as with any medical proce-dure, he adds, “you trust the doc-tor, and by default you’re goingto do what the doctor tells you.You get the shots they tell you toget, you sign the papers they putin front of you, you cross yourfingers and hope for the best.”

The Diamonds say that afterJackson’s seizure the doctors toldthem he couldn’t be having a vac-cine reaction because vaccinereactions don’t present themselvesso quickly. (Children’s MemorialHospital wouldn’t make Jackson’sphysicians available for comment.)It was only after Chaney followedan Internet link to the Depart-ment of Health and Human Ser-vices’ vaccine injury table that theDiamonds learned otherwise.Studying the table, a documentthe government refers to whenhandling compensation claims,they found encephalopathy listedas a possible reaction to the per-tussis vaccine if it occurs within 72hours and doctors can’t find anyother likely cause.

Around this time the Dia-monds came across the NationalVaccine Information Center, aparent-run advocacy group that’sbeen agitating for vaccine policyreforms for more than 20 years.The NVIC claims to receivebetween 20 and 30 calls a day, 5to 10 of them describing symp-toms that could indicate seriousadverse reaction. The group saysthat, like the Diamonds, manyparents have been told that theirchildren’s conditions are unrelat-ed to vaccines. “Doctors denythere are problems with vac-cines,” says Kathi Williams, whocofounded the NVIC with Bar-bara Loe Fisher after their sonssuffered neurological damagefollowing shots of DPT, the pre-cursor to the DTaP vaccine. “It’san ongoing problem”—and one,she says, that can cause furtherharm to children. According toFisher, if a child has a negativereaction that’s overlooked ormisattributed, it’s likely he’ll bebrought back for booster shots,putting him at increased risk for

a negative reaction, perhaps oneworse than the first time around.

Until about 15 years ago therewas no centralized system for

tracking adverse reactions to vac-cines. The CDC and the FDA eachoperated its own database, andreporting was purely voluntary.The National Childhood VaccineInjury Act of 1986 changed that,making it mandatory for doctorsand vaccine manufacturers toreport adverse events occurringwithin 30 days of a vaccination.In 1990 the FDA and CDC beganjointly operating a centralizeddatabase for monitoring them,the Vaccine Adverse EventReporting System (VAERS).

According to John Iskander ofthe CDC, VAERS receives about15,000 reports a year. Most involveminor side effects such as fevers,rashes, and swelling and redness atthe injection site. But about 15 per-cent involve hospitalizations andlife-threatening events and ill-nesses such as convulsions,seizures, and brain damage.

VAERS can help identify pat-terns—collecting the names,manufacturers, and lot numbersof vaccines as well as informationregarding the amount of timebetween their administration andthe suspected reactions. But thegovernment doesn’t study indi-vidual cases to determinewhether a reported incident wasanything more than a coinci-dence. According to Iskander, it’svirtually impossible to know howmany serious neurological disor-ders like Jackson’s are caused byvaccines. During a recent three-and-a-half-year period, he says,seven reports of encephalopathyor encephalitis following a DTaPshot were made to VAERS out of35 million administered doses.But even if those seven were fol-lowed up on, he says, it probablywouldn’t tell the CDC much.

“It’s scientifically extremely dif-ficult for individual cases to cometo a determination,” he says—there’s too much uncertainty withsuch small numbers and, with the

inactivated pertussis toxin usedin the DTaP shot, there’s no livevirus to isolate. “It’s hard,” hesays, “to imagine a situationwhere you could say yes, thatwas definitively the cause.”

F isher and the NVIC believethat, as a rule, the govern-

ment understates the risks ofvaccination. Her reluctance totake the feds—or for that matterthe pharmaceutical industry ormedical establishment—at itsword goes back more than 20years. In 1985 she coauthored abook with Harris Coulter, a med-ical historian, called A Shot in theDark: Why the P in the DPTVaccination May Be Hazardousto Your Child’s Health. Thoughevidence linking the whole-cellpertussis vaccine, or DPT shot,to neurological disorders wasmounting, the U.S. governmentappeared to the authors to belooking the other way despite theexistence of an effective and saferalternative, the DTaP, which usesthe acellular pertussis vaccine.

Other governments were moreresponsive. Sweden banned theDPT in 1979. Japan stoppedusing it in 1981 after worriesabout adverse effects led to adrop in vaccination in the 70s—and a resulting pertussis epidem-ic. Japan reported a significantdrop in complications afteradopting the alternative vaccine.

In 1985, according a 2002 arti-cle in the Journal of the Historyof Medicine and Allied Sciences,the Institute of Medicine, anindependent research organiza-tion charged with advising thegovernment, found the whole-cellpertussis vaccine to cause seriousneurological disorders once every110,000 injections and result inmore than 10,000 seizures, 164cases of encephalitis, and two tofour deaths per year.

Nevertheless, according togeneticist Mark Geier, the arti-cle’s author, drug companiesdeemed it too costly to test andmanufacture the less-reactivevaccine. The FDA finally licensed

Vaccines

continued from page 1

CHICAGO READER | JULY 8, 2005 | SECTION ONE 23

the DTaP for boosters in 1991 andfor routine use in 1996, and in1997 the CDC recommended it asa full replacement for the DPT.Yet the DPT shot wasn’t taken offthe market until 2001—20 yearsafter Japan had made the switch.

Even VAERS’s greatest successstory may give pause. In 1999VAERS made it possible for theCDC to learn that 15 infants haddeveloped intussusception—arare but dangerous condition inwhich the bowel folds in onitself—within a couple weeks ofbeing immunized for rotavirus, adisease that can cause severediarrhea and that results in about50,000 hospitalizations a year.By the time the vaccine, whichwas introduced in March of 1998,was yanked from the market inthe fall of 1999, a total of 55 caseshad been reported to VAERS.

While looking into how the vac-cine wound up being licensed andapproved for use, the HouseCommittee on GovernmentReform gained some insight intovaccine policy that surprised anddisturbed its chair, Indiana con-gressman Dan Burton: the CDCand FDA advisory panels that rec-ommended adding the rotavirusvaccine to the childhood immu-nization schedule were mannedwith people who had conflicts ofinterest. Several panel members,the House committee learned,owned stock in pharmaceuticalcompanies that manufactured vac-cines. One person—a member ofthe CDC committee—even owneda patent for the rotavirus vaccine.

The NVIC does not consideritself antivaccine but pro-

informed consent, which itbelieves is possible only with bet-ter research and education. Thegroup questions the way we goabout administering vaccines tochildren. What was the logic,Fisher wonders, of adding a hepa-titis B vaccine to the childhoodimmunization schedule in 1991?Why do infants need to be immu-nized against a disease whose riskfactors are dirty needles and sex,especially when that disease “isnot highly contagious, is notdeadly for most who contract it,and is not in epidemic form in theU.S.?” Iskander says that hepatitisB is a serious and even life-threat-ening disease—particularly whencontracted early in life. In manycases there’s a risk of motherspassing it on to their children.

The NVIC has also long beenconcerned about whether there’sa connection between autismand thimerosal, a mercury-basedpreservative pharmaceuticalcompanies started using in somevaccines in the 30s. A controver-sial article in Salon by Robert F.Kennedy Jr. recently linked sky-rocketing autism rates to threenew thimerosal-laced drugsadded to the immunizationschedule in 1991, which had theeffect of tripling the amount ofmercury injected into children’sbodies. This week, however, anarticle in the journal Pediatricsargues that while there may be

an autism epidemic, the govern-ment figures cited in support of ahuge increase are unreliable.

Although the CDC maintains onits Web site that the “vast majorityof studies, which have involvedhundreds of thousands of childrenin a number of countries, havefailed to find any associationbetween exposure to thimerosal invaccines and autism,” the agencyrecommended in 1999 that drugcompanies begin manufacturingpediatric vaccines without

thimerosal “as a precaution.”Without arecall order,however, drugcompanies con-tinued to drawon their oldsupplies, andthimerosal stillis in use as apreservative influ vaccines.

The NVICalso questionsthe one-size-fits-all approachto immuniza-tion, where vir-tually all chil-

dren are given the same vaccina-tions on the same timetable. MaryMegson, a Virginia pediatricianwho specializes in treating autisticchildren she believes wereharmed by thimerosal, would liketo see a more customizedapproach to immunization.“There’s a subset of children thatcannot get vaccines in the sameway other children can and toler-ate them,” she says. Megson saysshe’s found a genetic marker foradverse reactions, claiming thatchildren with G-alpha proteindefects such as night blindness aremore likely to experience prob-lems after vaccination. Iskandersays the CDC is sponsoring a studyon siblings that may shed light ongenetic risk factors in vaccination.

A fter the rotavirus vaccinedebacle, the CDC eventually

concluded that 112 cases ofintussusception—one fatal—haddeveloped during the time thevaccine was administered, morethan twice the number reportedto VAERS. While VAERS madeit possible to get a dangerousproduct off the market relativelyquickly, better reporting mighthave made it happen sooner.

Kathi Williams suspects thatsome doctors refrain from report-ing adverse events out of the fearthat they’d be opening them-selves up to potential lawsuits.

They wouldn’t be—at least notinitially. As part of the 1986 vac-cine act, Congress, to keep phar-maceutical companies in thebusiness of making vaccines afteran onslaught of DPT lawsuits,established a no-fault systemthat compensates injured partieswhile protecting from liabilitypharmaceutical manufacturersand the health care providerswho administer vaccines. Underthe act, parties claiming injurycannot file civil suits against

health care providers, clinics, ordrug companies until they’vegone through vaccine court,where claims are filed againstthe Department of HumanServices, defended by theDepartment of Justice, anddecided by special mastersspecifically appointed by the U.S.Court of Federal Claims to man-age and arbitrate cases. If theparties lose or reject a judgmentin their favor they can pursuecivil litigation, but the processdiscourages it: if people lose invaccine court they’ll probablyhave trouble in civil court as well.

Lee Diamond finds the shieldfrom liability troubling. “Where’sthe incentive for a company tomake a safer product if that’s howit’s set up?” he says. “What’s theacceptable rate of failure? I wouldsay everything that happened toJackson is ridiculously severe.What’s the acceptable number ofkids that can happen to?”

Sherry Drew, of the Chicagolaw firm McDowell & Drew, isone of a handful of attorneys inthe country who specialize in vac-cine injury claims. She says thegovernment’s compensation pro-gram was created to be a swiftand fair alternative to civil litiga-tion, but that in reality the casesoften drag on for many years, andthe Justice Department fightsthem tooth and nail. “The vaccineact was intended to be nonadver-sarial,” she says. “But the Depart-ment of Justice is very zealouswith their cases. And they have apoint of view, and I have a pointof view, and it’s like any plaintiffand defendant in any case—thepoints of view diverge.”

Drew says she probably files anew petition every other monthbut that lately half of them areclaims she’s simply adding to anomnibus proceeding that’s pend-ing on behalf of autistic childrenwhose parents believe they wereinjured by vaccines.

The vaccine act permits peopleto file claims only after an injuryhas persisted for six months. “I’llhave someone call me and say,‘My child had a shot, just had thishorrible seizure with fever andthis and that and spent a week inthe hospital. What should I do?’”Drew says. “And I’ll tell that par-ent what you do is you keep ajournal and keep records of yourexpenses, but if your child goesback to being what he was beforethat seizure and doesn’t have anymore seizures, then you don’thave a vaccine case and youshould be very, very happy in spiteof the fact that you just incurred$50,000 in medical bills.”

Before taking a case, Drewcombs through a client’s medicalrecords to see if factors unrelatedto the vaccine were ruled out aslikely causes for the injury. Claimsare harder to argue if there’s nopresumption of causation.

In Jackson Diamond’s casethere was, and Drew filed a claimon his behalf on June 3. If a spe-cial master rules, or the govern-ment concedes that he’s entitledto compensation, the case will

enter the damages phase andeach side will bring in “life plan-ners” to decide how much heshould receive for such things asmedical care, special equipment,and loss of future wages, as wellas pain and suffering.

A fter a month doctors atChildren’s had done all they

could do for Jackson, and he wastransferred to the RehabilitationInstitute of Chicago, where hestayed for two months. TheDiamonds brought him home inmid-March, and Chaney took aleave of absence from her job tocare for him.

Jackson turned two on May 31.He no longer tries out his newwords, or for that matter speakshis old ones. When propped into asitting position, his chin falls to hischest—he’s unable to hold hishead up by himself. His expressionis often blank. His eyes some-times cross. He has a feeding tubeconnected to his lower intestine,and a tube in his stomach thatmust be vented to release gas.Gastrointestinal problems causehim to experience discomfortwhen he’s held in an upright posi-tion, so the once lively toddler nowlies on his back much of the day.

Jackson’s on several medica-tions to prevent seizures, reducestomach acid, and control secre-tions. He’s gotten better at show-ing emotion—he’ll smile or laughsometimes now—and it seems asif he recognizes his parents’ voic-es, but, Chaney says, “We have noidea how much he understands.”

The Diamonds say that some-times people who mean well tellthem their son will be bettersomeday, that he’ll be out on theswing set before they know it.“They want it to be true, and sodo we, but it’s just not likely,” saysLee. The couple says they have noillusions. While they occasionallynotice improvements in Jackson’scondition, they acknowledge thatwhat they consider triumphs—his smiling and kicking whenthey say his name, his toleratingsomething in his mouth—“wouldprobably be very depressing topeople on the outside.”

“He’s going to need care therest of his life,” Chaney says. “He may never be able to liveindependently.”

Because Jackson can’t getaround on his own, theDiamonds know they’ll have tostart looking for a new house,one that’s handicapped accessi-ble. “He’s two years old now andhe’s a big boy. What about whenhe’s five?” Lee says. Chaney adds,“We have to carry him in, wehave to carry him out, we have tocarry him up to his room.”

Now getting by on just onesalary, the Diamonds pay out ofpocket for insurance. They worryabout finances. Jackson requiresspecialists for physical, occupa-tional, speech, developmental, andvision therapy. The co-pays addup, and only a certain number ofrehabilitation hours are covered.Some equipment that theDiamonds think would be good

for Jackson—a car seat that wouldallow him to be strapped down in ahorizontal position, for example—isn’t covered at all because it’s notdeemed a medical necessity.

The support they’ve receivedso far astonishes them. Lee’sbandmate and his girlfriend havespent hours learning to care forJackson so the Diamonds cansometimes enjoy a reprieve. Justrecently they went out to dinnerto celebrate their 11th anniversary.Chaney’s colleagues at WellsCommunity Academy threw abenefit for Jackson, raising over$20,000. Another benefit—ashow at Subterranean featuringLee’s band, the Douglass Kings,along with Shellac, Silkworm,and Telenovela—will be held onSunday, July 10. The Diamondsplan to donate 10 percent of thedoor and all the Douglass Kings’merchandise sales to the NVIC.

John Iskander warns that if peo-ple lose faith in vaccines we couldfind ourselves in the midst of apublic health crisis. August hasbeen declared National Immuniza-tion Awareness Month—a time for“celebration and recognition” aswell as for renewing the commit-ment to work for the continuedsuccess of vaccines, according to aletter the CDC’s director, JulieGerberding, sent to the executivedirector of the National Immu-nization Partnership, a group thatpromotes immunization. TheNIP’s pamphlets—headed “AreYou Up-To-Date? Vaccinate!”—callvaccines among the “safest medi-cines available” and point out thatthe “potential risks associated withthe diseases that these vaccinesprevent are much greater than thepotential risks associated with thevaccines themselves.”

But improving awarenessabout those potential risks, Leesays, “doesn’t have to mean caus-ing a panic.” Even now, with allthat he and Chaney have learnedabout vaccine reactions, he says,“We’re not of the mind-set thatimmunization does more harmthan good. But we think thereare quite a lot of things thatcould be done differently.”

One thing the CDC advisesagainst is vaccinating sick childrenif they have a moderate or severeillness. Jackson’s physician wasfollowing protocol when he gavehim shots though he’d been fight-ing a mild cold in the weeks beforehis December 8 appointment. Butsome researchers recommendavoiding vaccinations altogetherwhen a child is ill. “It’s hard to tellwhat’s a mild cold,” says MarkGeier, who’s studied vaccines for30 years. “It could be a seriousviral infection that maybe theyhave a mild case of. It’s better towait until they’re not sick.”

The Diamonds would like tohave another child someday, andthey say if and when they dothey’ll approach immunizationdifferently. They’ll ask questionsthis time, they’ll demand answers.They’ll talk to the folks at theNVIC. And without a doubtthey’ll seek a medical exemptionfor the pertussis vaccine. v

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