Regarding Physician Countersuits
Dear Dr. McCammon,
You seem surprised and frustrated (Medical Sentinel 2000;5(3):92-95) that the law does not provide a remedy to physicians and others for legal harassment or malicious prosecution. Let us look at this logically. When action is taken the plaintiff hires an attorney to file suit. The defendant then hires another attorney to protect his or her interests. The case is heard before a judge (another attorney). The laws are made by legislatures that consist primarily of attorneys thus we have full employment for attorneys (they need it --- 80 percent of the world's attorneys live and practice in the United States).
The laws are made by, argued for and against, and adjudicated by attorneys. If physicians had such a cozy arrangement it would be called conflict of interest and/or fraud by the federal government. The only way to change the system is to 1) elect non-attorney legislatures, and 2) elect non-attorney judges who may have common sense. But I would not bet the ranch on that ever happening, there is too much control and money involved.
Anthony Ross, MD
Cancer Risk of Low Level Radiation
Regarding "The Cancer Risk of Low Level Radiation" by Prof. Bernard Cohen (Medical Sentinel 2000;5(4):128-131), the phenomenon of hormesis appears to be similar to the "healthy worker effect" that I recall being proposed when the long term health consequences with Hanford Nuclear Works employees showed a lower than expected cancer rate. Part of the explanation was that of selection of more conscientious workers, but the other thought that there could even have been a protective effect from the background radiation....
Gerald N. Yorioka, MD
Anthrax Vaccine Controversy
I agree with the concern about anthrax vaccine expressed in the article by Nicolson, Nass, and Nicolson (Medical Sentinel 2000;5(3):97-101).
The government seems to be placing all its bets on an inadequate vaccine against only one of many possible threats. There are additional, desperately needed protective measures: better technology to detect an attack; better, more widely distributed laboratories for identifying the organisms; stockpiles of antibiotics; nontoxic decontaminants; and shelter.(1,2)
Every Swiss home has an NBC shelter (nuclear, biological, chemical) with blast and radiation protection, HEPA filters, and agents to remove chemicals. Iraqi troops in the Iran-Iraq war had buried shelters with Swiss ventilation systems. Israeli citizens had sealed rooms.
American troops in the field have only masks and suits that are both inadequate and impossible to wear for long. American civilians have some paper plans and desktop exercises.
Jane M. Orient, MD
1. Doctors for Disaster Preparedness Newsletter, January 1999.
2. Doctors for Disaster Preparedness Newsletter, March 1999, available at http://www.oism.org/ddp.
Dear Dr. Faria,
I have been contacted by various news agencies [including ABC News after the article on anthrax in the Medical Sentinel], but so far, few have actually run the story...A reporter said that DC insiders had told him that soon the Secretary of Defense will announce that the anthrax vaccine program will be halted. ABC aired this report earlier today [June 30, 2000]. The Army Times is interested, as are some newspapers here in California.
There is so much disinformation being put out from the Department of Defense (DOD) that most mainstream news agencies may be hesitant to run the story just yet and are taking a wait and see attitude. I have been asked to do four national radio programs on the topic (three have been done to this date). Dr. Nass has also been a popular guest on radio programs on the subject, but she will contact you separately on her interactions with the press.
Our recent article comparing 100 GWI veterans' family members with GWI-like illness suggests that after the Gulf War sick veterans began slowly transmitting their illness to immediate family members who have identical chronic infections and now have very similar signs and symptoms (Nicolson et al. Diagnosis and integrative treatment of intracellular bacterial infections in Chronic Fatigue and Fibromyalgia Syndromes, Gulf War Illness, Rheumatoid Arthritis and other chronic illnesses. Clin. Pract. Alt. Med. 2000;1(2):92-102).
Now that we have obtained more detailed information on how the anthrax vaccine is actually prepared, I can conclude that it is no wonder that this vaccine is suspicious and its possible contamination suspect. Making these vaccines is not exactly rocket science, and it is quite easy to criticize the procedures used for decontaminating the vaccine. Since the vaccine is a filtered vaccine and is stored at refrigerator temperatures for long periods of time, I consider it extremely likely that some of the lots could have been contaminated with airborne microorganisms like mycoplasmas. It's interesting that the British MOD released information to British Gulf War veterans that several U.S. made vaccines used in the Gulf War were removed because of "microorganism contamination." Although the type of contamination was never revealed, one of the more common types of contamination found in commercial vaccines is mycoplasmal contamination (Thornton D. Vaccine 1986;4:237-240). Unfortunately, my request to the U.S. Army Surgeon General's office to test "field" lots of the anthrax vaccine has been effectively rejected after being buried at Fort Detrick for several months. (I refuse to test "sanitized" lots of vaccine from Fort Detrick). Only by testing "field" lots that have been released for use at DOD facilities can we know that vaccine contamination is not an issue. This might also explain the recent rejection by the FDA of a high percentage of some of the recent lots of anthrax vaccine made by Bioport....
Garth L. Nicolson, PhD
Huntington Beach, CA
Regarding NEJM Editorial Stance
Dear Wall Street Journal Editor,
Restoring the erosion of the public's confidence in the practice of medicine must be the foremost priority of the new editor of The New England Journal of Medicine in light of questions about the objectivity of recently published articles ("NEJM Appoints Drazen as Editor in Chief," 5/11/00).
The Association of American Physicians and Surgeons (AAPS) is both optimistic and skeptical about the recent appointment of Dr. Jeffrey Drazen. As your article states, Dr. Drazen's clinical research credentials are impeccable. But much of Dr. Drazen's work has been funded by pharmaceutical companies with an inherent conflict of interest in the results of that research. Therein lies the basis for our skepticism.
While the NEJM has long held a place as one of the most influential medical journals in the country, the efficacy of the research on which a number of recent papers were based has been called into question. Many government- and pharmaceutical-funded researchers published in the NEJM have breached accepted scientific practice by refusing to release and make available original data for critical analysis by other researchers. One can only conclude that this was done in the self-interest of protecting their cash-cow sources of funding, at the expense of the truth.
Last year, the Medical Sentinel, the Journal of AAPS, announced a new truth-in-research policy, requiring public disclosure of all raw research data for all scientific papers it publishes. Editor-in-Chief, Miguel A. Faria, Jr, M.D., issued a challenge to all other medical journals to adopt the same policy: "We invite the editors to join us in restoring trust in published medical and scientific research in the medical literature by requiring public review of scientific information." The NEJM did not respond.
As politicians now pounce on every unsubstantiated kernel of medical research to make their partisan points in public policy, particularly in the area of guns and violence, HIV-AIDS, sexual behavior, and mandatory vaccines, medical journals must be vigilant in allowing objective review of their articles, the data, as well as disclosing potential conflicts of interests of the authors.
We urge Dr. Drazen to make one of his first official policy moves to announce support for a full disclosure, truth-in-research policy to restore public trust.
Kathryn A. Serkes
Public Affairs Counsel, AAPS
This letter was sent but not published in The Wall Street Journal. It is printed here for the interest of the readers of the Medical Sentinel. ---Ed.
AAPS Involvement in the Elián González Case
...The steps taken by the AAPS on the Elián González matter are most commendable and we hope that AAPS continues to be one of the loud voices of the medical community to appeal to the conscience of the nation in how this was handled by the Clinton Administration.
My name is Alfredo Manrara and my field of work is real estate. My wife is Dr. Lydia Usategui, psychiatrist, who had met the child Elián González and his Miami family --- although she was not Elián's treating physician.
On the day of the raid by federal agents, Lydia was at the González home as described in her article in this issue. I was there accompanying her and, within 10 feet of the home's front door, was thrown by the agents against a fence, sprayed with pepper gas, and witnessed the screaming child being taken right in front of me to the waiting van....
Alfred Manrara, Jr.
(with Dr. Lydia M. Usategui)
Dear Dr. Faria,
I did receive the package [of recruitment materials] from AAPS. We'll be at the physician's convention this weekend recruiting. We feel this is an excellent opportunity to let physicians know about the AAPS.
My wife and I had plans to go to the Keys for the 4th of July weekend, but when I told her that I had to stay for most of the day on Saturday and will have to come back on Monday, she almost fainted...Thank God I married a woman who supports me 100 percent in the work I do. She really thinks the AAPS is a great patient-physician-advocate organization. She wondered as I did, where were you all these years?...
I will keep you posted on the outcome of the convention. Also, depending on how successful we are recruiting, we want to extend our efforts to our Cuban Pediatric Society (150 members), and possibly our medical staff in different hospitals in South Florida.
Lo de Elián no se a terminado ("The ramifications of Elián's case are not finished"). Remember, the enemy wants us depressed, down, inactive and discouraged. We are saddened by the decision of the Supreme Court and the outcome, but this should serve for us, as a means to re-double our efforts in any campaign we are set to do.
Enrique Canton, MD
Past-President, Cuban Pediatric Society in Exile
Bovard, Bastiat and Solzhenitsyn on Resisting Tyranny
As we learned from the Clinton administration and much of the media, a machine gun in the hands of a federal agent is now a symbol of benevolence and concern for a child's well-being.
Author, Lost Rights
Each of us has a natural right --- from God ---to defend his person, his liberty, and his property...the preservation of any one of them is completely dependent upon the preservation of the other two...If every person has the right to defend - even by force --- his person, his liberty, and his property, then it follows that a group of men have the right to organize and support a common force to protect these rights constantly. Thus the principle of collective right --- its reason for existing, its lawfulness --- is based on individual right...Thus, since an individual cannot lawfully use force against the person, liberty, or property of another individual, then the common force --- for the same reason --- cannot lawfully be used to destroy the person, liberty, or property of individuals or groups.
The Law (1850)
And how we burned in the camps latter, thinking: What would things have been like if every Security operative, when he went out at night to make an arrest, had been uncertain whether he would return alive and had to say good-bye to his family? Or if, during periods of mass arrests, as for example in Leningrad, when they arrested a quarter of the entire city, people had not simply sat there in their lairs, paling with terror at every bang of the downstairs door and at every step on the staircase, but had understood they had nothing left to lose and had boldly set up in the downstairs hall an ambush of half a dozen people with axes, hammers, polkers, or whatever else was at hand? After all, you knew ahead of time that those bluecaps were out at night for no good purpose. And you could be sure ahead of time that you'd be cracking the skull of a cutthroat. Or what about the Black Maria sitting out there on the street with one lonely chauffeur --- what if it had been driven off or its tires spiked. The Organs would very quickly have suffered a shortage of officers and transport and, notwithstanding all of Stalin's thirst, the cursed machine would have ground to a halt!
If...if...We didn't love freedom enough. And even more --- we had no awareness of the real situation. We spent ourselves in one unrestrained outburst in 1917, and then we hurried to submit. We submitted with pleasure! ....We purely and simply deserved everything that happened afterward.
Alexandr I. Solzhenitsyn
The Gulag Archipelago (1970)
Correspondence originally published in the Medical Sentinel 2000;5(5);149-151. Copyright©2000 Association of American Physicians and Surgeons (AAPS).