My letter to Dr. Feinstein, continued from page 7
3. You can help to end the baby-blinding epidemic

I realize that the evidence I documented to you contradicts much of what you have been told about ROP throughout your career, and that the ugly story which emerges from the evidence fits a comment that Santayana made in his book on beauty:

"Too wicked a character or too unrelieved a situation revolts us for this reason."³⁸

However, once you evaluate all this publicly available and easily verified evidence you will find that Dr. Jacobson's and your intellectual autopsy of only the early blunders in the medical approach to ROP was as incomplete as the physical autopsy here in Vineland last year in which a coroner reportedly overlooked the bullet hole in the skull of a murder victim and ruled the death accidental.

You wrote your Santayana-essays to help the medical profession clean up its act and bring its doctrine to a more professional level, and you concluded your comments with the assertions that "truth eventually triumphs" and that "hiding mistakes or hiding from them poisons the soul". Let me add this excerpt from Santayana himself which he wrote a few lines after the above comment:

"However unpleasant truth may prove, we long to know it, partly perhaps because experience has shown us the prudence of this kind of intellectual courage, and chiefly because the consciousness of ignorance and the dread of the unknown is more tormenting than any possible discovery. A primitive instinct makes us turn the eyes full on any object that appears in the dim borderland of our field of vision -- and this all the more quickly the more terrible that object threatens to be."

I hope your instinct tells you that you cannot just ignore these terrible crimes and hope they will somehow go away. I showed you the open bullet wound and some of the blood lost through it, as well as the arsenal of automatic machine guns stuck in shooting mode and heavyweight loose cannons that keep inflicting more of those wounds.

I hope therefore that you will join me in exposing the killing and blinding to end the spree. If you do not want to become an accomplice to the crime, you must break the medical omertà and speak out against the continued asphyxiating and careless blinding of premature babies that you can help to halt.

You described and named the Santayana Syndrome and diagnosed some of its dangerous manifestations. Now help to cure it!

Disprove Molière's maxim that the purpose of medicine is not to help the patients but only to name their diseases in Latin. Lance the boil I showed you before it spreads the infection any further, cut out this cancer without delay, and free the medical profession from this Santayana- Syndrome- caused poison which makes some of its members commit heinous new horrors in their attempt to hide an ongoing old one and to hide from it.

You believe in learning from history, so let me draw your attention to a parallel case of discovering how shaky the foundations of a trusted knowledge were, this time in the supposedly bedrock-solid science of mathematics. The astronomer John D. Barrow relates how the philosopher Bertrand Russell discovered a paradox that shook his confidence in the self-consistency of logic, and how another scholar reacted to this challenge of virtually all he had always believed:

"After discovering this paradox, Russell had communicated it in a letter to the great German logician Gottlieb Frege who was completing the second volume of his classic treatise on the logical foundations of arithmetic. The news was devastating to his work. He responded as few other scholars would have done when faced with such a disaster at the culmination of twelve years of meticulous work, adding to his book one of the most deflating acknowledgments one could ever wish to read:

A scientist can hardly meet with anything more undesirable than to have the foundation give way just as the work is finished. In this position I was put by a letter from Mr. Bertrand Russell as the work was nearly through the press."³⁹

This happened in a field which had seen no such drastic U-turn since the days of Zeno, so Mr. Frege must have felt all the more surprised and disoriented.

By contrast, the historical zigzag course of medicine and the clumps of precedents in its Santayana-Syndrome-overgrown field must have prepared you much better for the discovery that yet another one of the medical mainstream doctrines turns out to be flagrantly wrong. You even exhort your colleagues on your first Santayana page "to prevent or to find and correct the contemporary errors".

I am therefore confident that you will prefer to be known as the upstanding physician who speaks out with courage and integrity against these patient-harming abuses, not as one of the many dishonest doctors whom I and others informed about the still unrefuted facts but who shy away from the necessary "detection and exploration of error" that you recommend on Santayana page 80, and who try instead to sweep boners and bones under the rug.

Can the babies to be born tomorrow count on you? Thank you in advance for your continued courage and for your positive response which I hope I can soon post on the Internet.

I look forward with great interest to hearing from you, and I remain

sincerely,

H. Peter Aleff

List of attachments sent with this letter

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I sent a copy of this letter and its attachments to
Dr. Richard L. Landau, Editor at Perspectives in Biology and Medicine, Culver Hall 404, 1025 East 57th St., Chicago, IL 60637.  I received from Robert Perlman, the other Editor at that journal, the reply dated January 28, 1998, which you find below:

Dear Mr. Aleff: 
 
Thank you for your package of information and for your interest in writing an essay on the retinopathy of prematurity for Perspectives in Biology and Medicine. Although I agree that the retinopathy of prematurity is an important problem, I do not believe that the information you sent us provides a new "perspective" on this problem that will be of interest to our readers. I am sorry, therefore, that I cannot encourage you to write an article on this subject for the journal. I hope you will be able to find another venue in which to publish your ideas about this disease.

Sincerely,

Robert Perlmann

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Postscript to this series in 2002:  The medical determination to blame genetics for the baby-blinding continues.  A self-described "concerned group of physicians and volunteers" established a fund- raising site to finance "further genetic research" into the disease.  They assert at www.ropard.org/history.shtml :

"ROPARD research has begun to identify a genetic link between premature birth and retinal detachment."

Since neither birth nor detachment have genes and can thus not be linked through them, the author of this puzzling passage presumably meant to say that both these conditions are now being linked to genetic reasons. 

This may well be true for premature birth which tends to occur more frequently in some families than in others.  And of course, retinopathy of prematurity is linked to prematurity.  Duh.  However, those doctors' alleging to link the blinding again to genetics appears to herald another cycle of dangerous medical cover- ups. 

As in the past, it seems to be easier for nursery doctors to again blame the baby- blinding on defective parents and to milk the continuing epidemic for whatever funds it can yield, now that genetics is fashionable again, than to admit the patient- harming accumulation of doctrinal wrongs and to learn how to change the light bulbs.

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