Breast Implants and Chicken Little - A Cautionary Tale

Remember the story of Chicken Little, the one where the chicken gets hit on the head by a falling acorn she doesn’t see, and leaps from that partial evidence to her panicked cry “The Sky is Falling! The Sky is Falling!” The other animals turn into a frightened pack and follow Chicken Little in a mass flight to safety. Now consider the analogous story of silicone breast implants. Not a fable, but certainly a cautionary tale.

To learn the lessons from the silicone saga you have to go back in time to the day the acorn fell. In November 1988, The Health Research Group, associates of Ralph Nader’s Public Citizen, sounded the alarm that silicone breast implants cause cancer. They based their claim on documents from Dow Corning, the silicone manufacturer, indicating that in one test, a group of rats injected with silicone got 23% more tumors at the site of the injection than a control group. Cancer is a pretty big acorn.

The health advocates also claimed that Dow Corning had hidden those findings from the FDA and the public. Now you not only have Cancer, but a lying chemical company protecting their profits at the expense of public health. That would understandably feel like the sky is falling if you happened to be one of the tens of thousands of women who had these devices in your chest.

About two years later, the fear multiplied significantly when the press…we’ll call them Turky Lurky…added their loud voice to the alarm after a high-profile piece on a CBS news program. Most of the newspapers and TV stations in America joined the Sky is Falling chorus, as they usually do with the latest risk du jour. (Mea culpa. I was one of those reporters who did numerous stories on this awful new bogeyman, without really checking out the evidence.)

Women who were suffering scarring and immune system problems and other ailments got understandably scared, and angry. The lawsuits started. The public hearings started. Advocacy groups formed. Politicians took up the cause. And the federal government did what it has to do in a democracy. It responded to the Sky is Falling fears, and in 1992 banned the devices for almost all uses.
No matter that the kind of tumors those lab rats got don’t occur in humans. Never mind that dozens of other studies indicated silicone is not a carcinogen. Never mind that Dow Corning had indeed reported its findings to the government and hadn’t kept them secret. Never mind the far more plausible explanations for why breast implants were harming women.

Time and again this is how we react to the first hints that something is dangerous. We jump to the worst-case possibility on sketchy evidence, and protect ourselves with fear and precaution. Fear is not automatically a bad thing. It helps protect us. And precaution is a great idea and should be the starting place of all government policies.

But too much fear and precaution, too fast, based on not enough information, can do us more harm than good. Thousands of women experienced additional suffering because too little attention was paid to the far more likely reasons for their health problems. Many, afraid of cancer, had their implants removed, running a far more likely risk of serious infection and scarring. How about the excruciating stress hundreds of thousands of women endured? Chronically elevated levels of stress can cause cardiovascular damage, weaken the immune system, contribute to depression, impair fertility, weaken bones. Finally, millions were spent researching the cancer claim, and much less was spent researching the other ways breast implants harm women.

Remember what happened at the end of one version of the Chicken Little story? The frightened animals ran into a cave where they figured they’d be safe from the falling sky. Only to be eaten by Foxy Loxy. Their fear, based on the powerful drive for self-protection but only the sketchiest evidence, did them more harm than good.
Bravo to the advocates who sound the alarm that something out there might be dangerous. But shame on those Chicken Littles who immediately jump from small bits of evidence to “The Sky is Falling.” And shame on all of us, the press and the public, if we blindly subscribe to such alarmism and run to hide in some cave without giving at least a little careful thought to how real the latest peril might be.

Boston, Lite Brites, and the risk of being TOO afraid

Remember Lite Brite, that toy for little kids where they plug colored plastic pegs into a grid of holes and make faces and houses and...terrorist bombs? Welcome to the new normal, post 9/11, where risk is in the eye of the beholder and a lot of people are having trouble seeing straight. And a lot of us are suffering as a result.

Boston suffered in all sorts of ways recently as a result of this impaired vision, as roads, subways, and major facilities were shut down because of a possible terrorist threat that turned out to be innocuous. The response was triggered by vigilance, yes. With hindsight, that vigilance was excessive, and costly. But it can teach us something.

Let’s start with the highway maintenance guy who noticed a ‘suspicious device’ hanging under a highway overpass. Like any cautious citizen these days, he assumed that something with lights and wires in a public place might be a bomb. He called it in and the system went immediately from ‘It’s a normal day’, directly to ‘The Sky is Falling!’. First lesson. How about an intermediate step, like ‘Let’s check this out before we overreact.’

Parts of Boston’s subway system were shut down. Local TV news leapt into alarmist live coverage. Reports of similar devices started coming in from other locations. By early afternoon, major roadways were shut down. The Coast Guard blocked off access to the Charles River. The Department of Homeland Security and the FBI were called in, and the emergency response systems in Boston were in high gear. The devices were removed by heavily armored law enforcement explosives experts. Some were taken to a range and blown up. Some were neutralized with high pressure water cannons.

That’s a pretty frightened response to a bunch of Lite Brite boxes depicting a cartoon character brandishing his middle finger that had been hanging around for the last couple weeks as part of a marketing campaign for a TV cartoon program. Oh, and they’d been hanging around in several other cities too, provoking absolutely no concern. But these days it just takes one Chicken Little and we all turn into Henny Penny and Turkey Lurky and head for the nearest cave. The result of which, in this case, was a really big mess that badly inconvenienced tens of thousands of people, endangered some, cost the economy a lot of money, and took a healthy bite out of the public safety budgets of the city, state, and federal governments.

Fumed Boston Mayor Tom Menino, “It is outrageous, in a post 9/11 world, that a company would use this type of marketing scheme." State Attorney General Martha Coakley promises an investigation into “…the roots of how this happened to cause panic in this city.”

If that investigation is thorough it needs to look at how the government handled things. Maybe the official response had just a little to do with that panic, don’t you think? In these jittery post-9/11 days, governments have the responsibility to be careful, absolutely. But don’t they also have to be careful about how quickly they go to red alert? That highway worker, or his bosses, or somebody up the decision-making ladder, should have taken a closer look at these devices before jumping to worst-case assumptions and contributing mightily to the mess Boston suffered.

Our senior officials, from police chiefs and Mayors up to the Secretary of Homeland Security and the President, have to deliver responsible vigilance, or they play right into the terrorist’s hands. Jennifer Mason, a 26 year-old local resident, had it about right when she told one news organization, "It's almost too easy to be a terrorist these days. You stick a box on a corner and you can shut down a city."

The marketing people who put this stuff up deserve their share of the blame too. Hanging boxes full of lights and wires in public places these days is pretty dumb. Terrorism is real. We are in a new normal. The people trying to create a little buzz for their product have to be careful that they don’t create a lot more than that. (Of course even as they publicly apologize and agree to compensate the city for its costs, the people behind this are probably chuckling over the great exposure they and their program are getting. Except for the head of the Cartoon Network, which was behind the ad campaign, who ultimately resigned after paying the city $2 million for its expenses.)

But the Boston scare should remind us of what happened in the Chicken Little fable. The animals were so jumpy that they readily followed Chicken Little into that cave for protection. Where Foxy Loxy was waiting, to turn them into lunch. Vigilance is fine. But hyper-vigilance can be dangerous. Just ask all the people who suffered in Boston last week. Shame on us, and our officials, if we let our worries get out of hand, and in a well-intended effort to make things better, we make them worse.