Saturday, May 14, 2005


Born Drunk

Today's Washington Post (reg. req.) reviews Janet Golden's Message in a Bottle: The Making of Fetal Alcohol Syndrome, a history that serves as a reminder -- one that, growing up in the post-FAS era, I find mind-boggling -- that at one time the influence of alcohol or just about anything else on fetuses was not well understood.

The book explains how laypeople and doctors alike were hesitant to accept that alcohol might be dangerous. Indeed, not until 1973 did researchers first note fetal alcohol syndrome's characteristics in children -- small size, developmental deficiencies and particular facial characteristics. And a warning on alcoholic beverages advising pregnant women not to drink didn't exist until 1989.... Many people, during and before the 1970s had a "perception of the womb as a protective barrier not easily breached," so they found it hard to believe that alcohol could do any damage; research into the dangers of alcohol and other substances soon revealed that the womb was actually not as tough a shield as they once believed.

I suppose. That said, it was very well understood by then that the fetus could indeed be vunerable -- the thalidomide scandal of a decade earlier was certainly no secret. (Although there's a popular notion that the US was saved from thalidomide only through the FDA's foot-dragging, its safety on pregnant mothers was in fact hotly debated during its ill-fated approval process.) And witness the 19th century literature on folk methods of inducing abortion, pennyroyal being especially popular.

But it probably took coming up with set of definable criteria and, above all, a name for people to become worried about Fetal Alcohol Syndrome. It's almost bizarre, the rhetorical power that nomenclature can have in health care. Without a memorable name to conceptualize a condition or a vunerability, people just can't be bothered.

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