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Consanguinity

By Dr. Jim Ferguson

“What kind of dog is that?” asked Mrs. S as I greeted her at my front door.  She was seeing me for a concierge medical visit and was obviously puzzled by my dog, Jack.  I explained to her that Jack is a Mountain Feist, but he is actually a “rescue.”

In my previous life and practice I had a patient who bred feists as squirrel hunting dogs.  My nurse of many years holds a tender spot for all creatures and agrees with George Orwell’s pigs in “Animal Farm” who maintained, “Four legs good, two legs…[not so good].”  As LuAnn checked the breeder’s blood pressure she learned of a runt  in the new litter of pups, and it “wasn’t going to make it.”  LuAnn was horrified to discover that breeder’s often cull undesirables.  The runt needed another option, and so he became our Jack.

Jack’s genes are evident when a squirrel enters our yard because he goes ballistic and  promptly trees the bushy-tailed rodent who dared challenge his range.  Jack is also quick to greet anyone who comes to our farm, though he loses interest quickly unless you have a bushy tail.  I’ve told Becky that our adopted “child” would make a wonderful greeter at Walmart.

As I was relating Jack’s story, Mrs. S was patting his head, but then inquired about Jack’s pronounced under-bite.  And that’s where this week’s essay began.  I told her that Jack also goes by the name, “Uncle Jack” because his father is also his brother!  I’ve learned that breeders frequently violate the laws of consanguinity.  This is a term describing blood relatives or descendents.  In the Middle Ages it was recognized that children of close relatives can produce genius, but more often idiocy.  The prohibition of marrying closer than a fourth cousin derives from these observations, and subsequently became English Common Law.  I haven’t discussed the taboos of consanguinity with Jack.

Human’s are inquisitive creatures.  In fact, this inquisitive nature may have induced us to explore our environment and perhaps stimulated the development of reason.  There is something about us that makes us want to know, “Why?”  My wife, Becky loves mystery stories; I do not, but I am intrigued by the “why” of things.  However, I’ve observed an inherent danger in explanations.  People and doctors sometimes blindly accept explanations and stop inquiring and thinking.

The recent murderous rampage in Santa Barbara again raises the question, “Why?” Mental illness is a quick answer, but I believe it’s far more complicated.  As a parent I empathized with the murderer’s parents who apparently tried to help their dysfunctional son who was said to have “high functioning Asperger’s Syndrome.”  Was mental illness the cause or just our collective need to explain why he chose to kill others and then himself?

A scientific paper on autism spectrum disorders (ADS) in the May 2014 JAMA (Journal of the American Medical Association) seems timely.  These disorders are defined by impaired social interaction and communication as well as restricted interests and repetitive behaviors (Hollander, Textbook of Autism Spectrum Disorders).  Apparently, ASD affects 1-2% of children in the general population, and includes Asperger’s Syndrome, considered by the American Psychiatric Association to be a mild form of ASD.  I read some years ago that there was speculation of Bill Gates being someone with “high functioning Asperger’s Syndrome.

What is normal behavior?  This is not a rhetorical question.  How long does it take you to realize something or someone is not right?  If you trust your instincts I’ll bet it doesn’t take long to conclude someone is dysfunctional.  When I was a boy we had a beautiful white Persian cat who my mother euphemistically named Marilyn after Marilyn Monroe.  Neither of these Marilyns was “right.”  The beautiful cat would sit in a mud puddle and birds would flock to our yard to swoop at poor Marilyn until she escaped their torment by huddling under a bush.  The cat’s namesake killed herself.

Discernment is a part of human nature, but what if we override our common sense?  We accept a wide variation of “normal,”  and that’s good.  I’ve often quipped, “It’s good to be a mongrel.”  How tragic it would be if we were all bred to tree squirrels or judged by Aryan standards.  Our problem is that political correctness and the attempt to mandate equality has run amok.  It now trumps common sense, and has begun to endanger us all.  What if political correctness prevents us from saying someone is dangerous to himself and others?  We once had institutions where impaired people were sheltered and treated.  Now these folks are on the street talking to themselves, selling their bodies for drugs, and preying upon each other.  Now, we strip-search granny at the airport, and set terrorists free.  It’s not the guns or knives that are dangerous.  Pogo said, “We have met the enemy, and he is us.”

Science can help us find our way if we don’t close our minds to reason tempered by compassion and pragmatism.  We can’t legislate morality, but we can muster the courage to speak the truth in love and act accordingly.

The JAMA article also reiterates that medical conditions in our kinfolk matter.  The researchers found that the risk of ASD was 10-fold higher in siblings of ASD patients.  And though the risk of ASD lessened as “genetic relatedness declined,” there persisted a 2-fold increased risk in cousins of ASD patients.

Clint Eastwood once starred in a movie called The Good The Bad and The Ugly.  Perhaps the same relates to our genetic inheritance.  However, you should realize that while you may inherit a predilection for a problem, disease is not an inevitability.  Science can aid us by identifying potential problems and reducing disease through focused screening and preventive therapies.

So pay attention to your family’s medical history and your own health risks.  Don’t surrender common sense to political correctness.  And don’t marry your cousin, or your kids may look like Uncle Jack.

 

 

 

 

 

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