Dr. Bernadine Healy: Don’t Make it Personal

By David Kirby

Researchers have been arguing with each other since science began, and that is a positive thing. The fights, while often heated, are usually contained to theories, evidence, data quality, confounding factors and the like.

But sometimes, the disputes get personal. Instead of attacking their opponents’ ideas, some researchers resort to attacking their opponents themselves.

Dr. Paul Offit, a prominent and accessible figure in the vaccine-autism debate, this week engaged in some of his own personal criticisms against two people who happen to disagree with his views: Dr. Jon Poling and Dr. Bernadine Healy.

On Tuesday, at the Every Child By Two press conference with Amanda Peet, Dr. Offit criticized Dr. Healy, who is the health editor of US News and World Report, suggesting that she was misinformed on the debate, and not up to speed on recent research which, he said, shows no link between vaccines and autism.

Also this week, Dr. Offit published a letter in the New England Journal of Medicine, (HERE)  in reply to a letter from Dr. Jon Poling, which said that Offit had misrepresented Poling’s position on the debate.

In his letter, Dr. Offit called Poling and Healy “standard-bearers for the poorly conceived hypothesis that children receive too many vaccines too early.” As a result of their actions, he added, “some parents are choosing to delay, withhold, or separate vaccines.”

Finally Dr. Offit, in an apparent attack on Dr. Healy the editor, decried “the failure of the media and the public to distinguish hypotheses from scientific evidence.” (Dr. Healy, has written about her views in US News & World Report).

I called Dr. Healy today to ask her about Dr. Offit’s comments, and to see if she would like to respond.

“He does seem to personalize this issue,” was her initial reaction, but then she went on to address some specific assertions.

She admitted to conducting “none of my own scientific research, specifically, on vaccines,” but noted that, “there’s no reason to be defensive about that.”

Dr. Healy did, however, take exception to Dr. Offit’s assertion that she was not properly informed on all the pertinent research.

“I have never done a scientific paper, nor do I write a column, without doing all the background research needed to make sure that what I am a saying can be validated by legitimate sources,” Dr. Healy told me.

I then asked about Dr. Offit’s statement that she was now the “standard-bearer” of a wrong-headed idea that we vaccinate too early and too often.

“No response,” she said, “other than, ‘Hey, I have been called worse than that.”

Joking aside, Dr. Healy quickly added that, “The bigger issue is that this is a serious scientific discussion – it’s serious for parents, it’s serious for children and it’s serious for physicians, and it need not be turned into something personal.”

Indeed, Dr. Healy declined to offer any personal criticism of Dr. Offit whatsoever.

But she did question this statement in his NEJM letter:

Studies of concomitant use, which are required by the Food and Drug Administration before licensure to show that new vaccines do not affect the safety or immunogenicity of existing vaccines or vice versa, have clearly shown that multiple vaccines can be administered safely.

(I question this statement as well: It does not explain why ACIP recently pulled its recommendation for the PRO-QUAD MMR+Varicella vaccine after it was found to double the risk of seizures. Nor does it explain why the CDC website says that simultaneous multiple vaccination is safe for “children with normal immune systems.” Nor did Dr. Offit provide any references for the studies he mentioned).

Dr. Healy had another take. “By just testing something for safety, but not comparing it to something else, that doesn’t tell us everything we need to know,” she said. “It all depends on what you are defining as ‘safety.’”

For example, she said, “Is it less safe to give hepatitis B vaccine when a child is 8 or 10 years old, than when they are newborn? Has that been looked at?”

And Dr. Healy noted, “No research has been done on the vaccine schedule to say it is the right one, compared to other schedules. As far as I know, there have been no randomized trials comparing different vaccine schedules to what is better medically for children.

“Are we giving children too many vaccines in a very short period of time, so early in their lives? That is the study that has not been done -- looking at the schedule, looking to see if it is better to spread out some vaccines over a longer period of time.”

If we do such comparison, she said, “Are there fewer side effects, fewer fevers? We have very different schedules that should be compared. Have any of them ever been compared with the current one, in terms of the health effects on children?”

“The fact is,” Dr. Healy concluded, (without launching into a single personal attack against any opponent), “there has never been a randomized trial to see what is best for children in terms of their health.”

David Kirby is a journalist, author of Evidence of Harm and contributor to Age of Autism.

Comments

[Fielding J. Hurst]

This thread gives me a headache, but nice debate. I love this blog, but also sometimes like to visit a blog without seeing World War III in progress in some post or another.

I am not saying this is not a good thing, just that as a parent of a child with autism, sometimes I just cannot stand it. Lisa Jo Rudy's About Autism Blog, http://autism.about.com/, gets my vote for the best autism site without a lot of bloodshed. This is especially true since Lisa Jo started cracking the whip. It's great to see so many blogs on every conceivable side of our issues. That is a good thing and I know, just sometimes, I like to put myself in timeout for awhile and ignore the debating. Both sides are good at setting up a Straw Man argument and oversimplifying their "opponent's positions", so they can knock them down. The messengers on both sides of many of these issues are seriously flawed and quote frankly, I am surprised things are not MORE personal than they are now.

Going to take to Tylenol,
FJH
http://autismparents.net

[Allison]

Carrie-
I'm glad you are spending time here and asking questions. I do think we all need to slow down picking at each other personally and stick to the real issues. That being said, a parent cannot always separate their emotion from this debate. I'm assuming you do not have kids, and I do not want to take a thing away from you regarding that. I do want to say that having this happen to your child, and having experiences that most of us parents have had with regular doctors, well, it affects us to the core and cannot be explained in words. The most sacred trust we've placed in others (the lives of our children) has been broken. I DO believe that change will only come when people like yourself choose to be leaders rather than follows, and listen to parents, as you seem to be trying to do. For that I thank you.
I'd like to be able to tell you my son's story, but I could never do the whole thing justice here. I will certainly give you the highlights. Noah is 10; when he was born, the medical establishment was still clinging desperately to the notion that autism is genetic. There is absolutely nothing like autism anywhere in either my husband's or my families. My pregnancy was wonderful, his birth was perfect. Noah came into this world healthy; apgars were 9 and 10, no complications whatsoever at birth. At one day old, he was injected with 12.5 micrograms of mercury - a known neurotoxin. He received a total of 62.5 mcg by six months, on four separate days. He developed normally in many ways, then slowly regressed into autism from his one year shots on. There was not such a noticeable difference after any particular round of shots that we clued in immediately; it was more of a slow realization of everything. However, when he was three and had no language whatsoever, was almost like a wild animal at times, we took him to one of the "top autism experts" in the country at the Kennedy Krieger Institute. This man told us Noah was mentally retarded, would never talk, and not to bother with therapy for him. He suggested WE get therapy to learn to deal with what we had. Thankfully, we did not listen, and after testing, chelation, and many other DAN therapies, he is a different child. His IQ is normal and he talks non-stop. He is no longer screaming from pain, anxiety-ridden, or locked away. He is happy and loving, and Thank God and every person who helped us find or implement DAN, still recovering. The money we spent at KKI was outrageous, and may as well have been thrown in the fireplace. Can a doctor heal or help you if she has no idea what you are suffering from? I doubt it. Our DAN doc treated Noah for vaccine injury and was highly successful, when the "top expert" wrote him off as a candidate for an institution. Nothing the traditional medical community has told us has ever been helpful; and THEY are the ones who still insist that vaccines do not cause children harm. If he was your child, what would you think?
Thanks for your time. Please, keep asking questions and be a leader!
Allison Byrd

[Carrie]

Sigh.

Not that this is important but yes. I'm a US medical student. I am months away from being an MD. I am neck deep in loans (bringing that up on this site was not well received) and I will not be driving a new car nor will I be financially stable for many years to come but yes, I do consider myself to be part of the medical community. Sorry if that offends you. Many on here have lumped me into the "doctor" category and I corrected them many months back (take a look in the archives if that tickles your fancy). My comments are warranted from previous posts here and previous conversations.

I have taken three sets of medical boards which will give me and MD but the Pediatric boards are still a few years away, if that's what you are referring to. Pediatric boards make you board certified. They don't give you and MD. That is already done. So I will be a doctor soon. I don't have long to go at all actually. I've been through 3rd and am virtually done with 4th year.

Also, with regards to referring to patients as "mine" , you should know, since you seem a med school expert that those are semantics. I know they do not belong to me, nor do I treat them on my own. I think those who read this blog are smart enough to understand that I am referring to the patients I encounter. Nurses in pediatrics often refer to their patients as "my kids", and nobody assumes that they mean their children. It is understood that it is jargon. Hope that answers your questions about the status of my studies and salary and loan situation. Oh and I have a 10 year old beater car that I paid for by working for years before medical school. I come from a middle class family and I have put myself through medical school without any help from anyone. I think that covers all your questions.

Re: Dr. Offit, in a nutshell, it's hard to ignore his involvement with vaccinations and his personal gain from their success. I can't think of much else to say about him at the moment.

[just a couple of things...]

Dearest Carrie,

I am a little confused. Do you live in the US? Because, If you are a med student, you are NOT a doctor. Why would you call yourself one or refer to your patients? Med students do not even begin to see patients until their 3rd and 4th year of med school and they certainly are not "their" patients but the residents or attendings patients and they are the scut workers.

That being said, perhaps you are a pyschology student? But you did say med student and that implies the field of medicine.

So, are you or are you not a doctor? If you are a med student you have an awful long way to go before you even take any boards...years that is. I have yet to meet a med student who feels comfortable enough to even consider themselves in the same category!

Please correct me if I am wrong. But you talk about your cars as well and med students, unless they com from mega bucks to begin with, really do not have nice cars....just big time student loans! Anyway you just dont really seem to fit the picture of a doc here in the US but please forgive if I am wrong.

[John Stone]

Twyla

While I agree that the error seems to have been perpetuated on both sides of the argument Haviranasab's account conforms with what I have been told twice by authoritative communication.

[Twyla]

John -
I don't think that my statement was in error. I'm not a toxicologist and I have no expertise in this, but for example Dr. Bryan Jepson, who seems a reliable source, says on p. 123 of his book "Changing the Course of Autism": "Thimerosal consists of two principal compounds: ethylmercury (49.6% of the compound) and thiosalicylate."

The paper "Autism: a Novel Form of Mercury Poisoning" states "The mercury in vaccines derives from thimerosal (TMS), a preservative which is 49.6% ethylmercury (eHg)"

A scientific paper at www.generationrescue.org/pdf/havarinasab.pdfdiscusses "organic mercurials such as methyl mercury (MeHg) and ethyl mercury (EtHg)" and states, "Thimerosal consists of an organic radical, ethyl mercury (EtHg), bound to the sulfur atom of the thiol group of salicylic acid, and contains 49.6% Hg by weight."

As I recall, ethyl mercury is a type of organic mercury, but can be converted to inorganic mercury in the brain (see www.generationrescue.org/pdf/burbacher.pdf).

[Ginger]

Carrie,

Sorry for getting you in trouble by asking the Jenny question.

I was just trying to see if it was unfounded suspicion or some legit complaint that I had not heard yet that needed to be addresses.

Some pediatricians have been telling people that her son was never autistic, a charge she has responded to by sending them Evans UCLA evaluations with his autism diagnosis. I wanted to be sure that it was not that unfounded rumor.

Jenny has generated (and given) tons.

But enough about Jenny already.

I will give you as detailed a response as I can on those. But it won't be today

[Kelli Ann Davis]

"You can either help me help you (a la Jerry Mcguire) or we can try to avoid each other."

For the record, I support debate and trying to educate/help a new doctor on this issue.

What I'm not willing to do is allow someone to come on here and make wild *assumptions* about Jim and Jenny -- which question their character and motivation -- and not challenge them on their statements.

And *that* has nothing to do with *hysteria* or *venting* -- it has to do with speaking up to set the record straight and defend a person's reputation, period.

Bottom Line: Jim and Jenny get *slammed* enough *out there* -- it shouldn't happen here.

[John Stone]

Twyla makes a common error in stating that Thimerosal is 49.6% ethyl mercury. Correctly this should 49.6% inorganic mercury. The error is also made in the PEDIATRICS study Andrews et al, conducted by the UK Public Health Service Laboratory (now incorporated in to our Health Protection Agency) on behalf of the World Health Organization:

http://pediatrics.aappublications.org/cgi/content/full/114/3/584

Not only was this not noticed by the six authors, it was also presumably not pointed out by any of the intensely knowledgeable pre-publication reviewers, the secret audiences of the World Health Organization and CDC, or the aseembled Institute of Medicine meeting, to whom Prof Miller presented the paper.

[Carrie]

Whoa...I don't even know what Left Brain Right Brain is. Elucidatus , you are gravely mistaken. I have no involvement with that whatsoever. Let's be clear on that. I am sure there are many other "Carries" out there in the internet world. I am merely a med student who has only voiced my opinions on this blog. Period.

I agree that the McCarthy subject is not productive. Let's agree to disagree. For the record, I'm not a big fan of Amanda Peet's either. Maybe I have a beef with celebrities in general. Who knows. I *definitely* have a problem with the media. Like I've said many times, if Jenny gives you guys a voice and if you're happy for having her, then wonderful. Why discuss it any further? We all have our opinions about celebrities and I brought up the salary issue mainly because physician salaries were discussed on this very site a few weeks ago (with contempt). You are all right in saying she is dedicating much time to this cause. I am not disputing this whatsoever. I have not dedicated nearly as much time. I am new to this. Trying to understand it. Trying to make informed decisions. Trying to find my niche. Trying to find a way to help and contribute...In my own way. I don't have the flexibility to dedicate 100 hours a week to this cause because I work over 100 hours a week, try to make a living and have a family of my own to suppport.

But my patients will all notice the car I drive and the hours I work (you all noticed and judged your pediatricians on this blog. Someone mentioned a doctor driving a prius, for instance, another one a BMW). So it is only natural that I notice what McCarthy does and how she does it. It's human nature. I also notice what Amanda Peet does. But I digress again.

The topic of this blog was about personal attacks. Civil conversation is the only way to move forward. Grace: I liked your post, it was well worded and I couldn't have said it better myself. I agree with you whole-heartedly.

Teresa: for the love of gosh, I didn't divert the attention onto Jenny, it was a question that was asked of me and I answered it. I am formulating a response to your other question, give me some time please, I am on the last lap of a 30 hour shift and on no sleep. Everything I say on here is scrutinized so I want to make sure I word things in a way that accurately reflects how I feel so that I don't spend the next eternity defending it (like is the case with my opinion of Jenny!). Also, someone mentioned these celebrities aren't perfect and I couldn't agree more. Nobody is. Including us docs. Like I said above, I am just a newbie trying to orient myself in a sea of misinformation, hurt, pain and sadness. Not to toot my own horn, but at least I'm doing that much, no? And I intend to do more in the future because this is exactly why I got into this field. You can either help me help you (a la Jerry Mcguire) or we can try to avoid each other.