Respectful Insolence

I originally joined this wild and woolly collective known as ScienceBlogs back in February 2006. I was not part of the very first wave of bloggers who made up ScienceBlogs when it launched, although I potentially could have, mainly because I had to work out policies about outside employment with my university before I could join up. In any case, one of the very first posts that I did back then that made a bit of a splash was a little ditty I called in my usual inimitable and restrained fashion, Why not just castrate them?

It was the dark saga of an even darker father-and-son tag team of quacks named Mark and David Geier. Dr. Mark Geier is a physician but has no expertise in pediatrics, endocrinology, vaccines, or autism. His son only has a bachelor’s degree in biology; yet he assists his father in his “research” and in essence helps him treat patients, despite his lack of medical training. Together, they are the Batman and Robin of autism woo (the 1960s camp version, not the updated Dark Knight version) going into battle against autism, which–surprise! surprise!–they blame on vaccines. But not just any vaccines. Oh, no. Batman and Robin–excuse me, Mark and David–were there at ground zero of the formation of the mercury militia. Indeed, even though numerous studies have exonerated the mercury in the thimerosal preservative, in particular the fact that over seven years after it was removed from childhood vaccines other than the flu vaccine new autism diagnoses have shown no signs of decreasing, the Geiers cling stubbornly to the belief that even Generation “autism is a misdiagnosis for mercury poisoning” Rescue has backed away from lately, namely that autism is caused by mercury in vaccines.

Not that the Geiers didn’t put their own personal spin on things. As Kathleen Seidel wrote about first and I commented on later, the Geiers came up with a “hypothesis” (my fingers seized up as I typed that, not wanting to dignify their idiotic idea with such a scientific term) that testosterone somehow bound to mercury, making it harder to chelate. They even claimed that testosterone binds to mercury and forms “sheets” in the brain, leading to a complex that can’t pass the blood-brain barrier and keeps mercury in the body, a complex that the quackery known as chelation therapy won’t chelate. They claimed that autistic children were really undergoing premature puberty and had too much testosterone. So what was their solution?

As I pointed out before, their solution was chemical castration using a powerful anti-sex hormone drug called Lupron. They even called it their “Lupron protocol,” and a disturbing number of parents not only fell for this disturbing abuse of autistic children, but they even paid for it. Even after the revelations of what the Geiers did, I could never figure out, though, since 2006, more than three years ago, is just how. How did they manage to keep subjecting children to a treatment with science so bad that it doesn’t even qualify as junk science? (Testosterone sheets? Any chemist or endocrinologist would laugh at the idea.) And why didn’t the mainstream media ever notice, even though a small cadre of skeptical bloggers, of which I am proud to be part, blogged about it repeatedly?

I don’t know, but I do know that finally a major newspaper noticed. Yesterday, the Chicago Tribune ran companion stories entitled ‘Miracle drug’ called junk science and Physician team’s crusade shows cracks.

All I can say is that it’s about time.

I had first got wind through some of my online sources that the Tribune might be doing a story on the Geiers a couple of weeks ago. I was skeptical, but apparently the inciting event was the yearly autism quackfest known as Autism One held in Chicago every Memorial Day week. Mark and David Geier, as well as Dr. Mayer Eisenstein (whom we’ve met on this blog before and who apparently has fallen under the Geier spell and provides the Lupron protocol to the patients in his exceedingly woo-friendly HomeFirst practice, will be speaking there. For those not familiar with Autism One, it’s best described as an autism Quackapalooza. Chelation, anti-vaccine mania, hyperbaric oxygen, “biomedical” interventions, gluten-free diets, every form of autism woo and quackery that you can imagine is there, all under one roof, and every luminary of the antivaccine movement, including most of the crew of the antivaccine propaganda blog Age of Autism will be there, probably Tweeting and blogging away. Heck, Jenny McCarthy herself will be the keynote speaker in 2009, just as she was in 2008. (Don’t they get bored having the same keynote speaker year after year?)

Moreover, quackfest that Autism One is, the organizers don’t in the least like skeptics or those who don’t buy into the claim that vaccines cause autism to be there. They don’t like it at all. Indeed, one such skeptical blogger, despite remaining polite but firm in his questions, was expelled last year on a trumped up excuse. Indeed, the irony of the timing, so hot on the heels of Ben Stein’s evolution denying movie Expelled!, was not lost on us. This time around, they took measures to prevent any skeptics from infiltrating, but what are they going to do if the Trib decides to send reporters?

In any case, after all the woo that the Trib’s “health” reporter Julie Deardorff regularly lays down, I was very surprised at how good these two articles are. I truly wish they had been published in May 2006 rather than May 2009, but better late than never. Because I’ve already blogged about this before, I’m going to pick some things I learned that I hadn’t known before adn point out what is missing from this article that we in the blogosphere know about that is every bit as disturbing as subjecting autistic children to, in essence, chemical castration, behavior by the Geiers that strikes at the very heart of human research subject protections. If you need the gory details, go back and read my Part 1 and Kathleen Seidel‘s in-depth discussion of the Lupron protocol.

First, I like the chorus of strongly condemning quotes from real scientists studying autism:

Four of the world’s top pediatric endocrinologists told the Tribune that the Lupron protocol is baseless, supported only by junk science. More than two dozen prominent endocrinologists dismissed the treatment earlier this year in a paper published online by the journal Pediatrics.

Simon Baron-Cohen, a professor of developmental psychopathology at the University of Cambridge in England and director of the Autism Research Center in Cambridge, said it is irresponsible to treat autistic children with Lupron.

“The idea of using it with vulnerable children with autism, who do not have a life-threatening disease and pose no danger to anyone, without a careful trial to determine the unwanted side effects or indeed any benefits, fills me with horror,” he said.

Experts in childhood hormones warn that Lupron can disrupt normal development, interfering with natural puberty and potentially putting children’s heart and bones at risk. The treatment also means subjecting children to daily injections, including painful shots deep into muscle every other week.

And:

Specialists in autism, hormones and pharmacology who are familiar with the Geiers’ protocol said it cannot work as they suggest.

“In terms of science, there is nothing suggesting the most basic elements of what they are talking about,” said Tom Owley, director of the Neurodevelopmental Pharmacology Clinic at the University of Illinois at Chicago and a specialist in the treatment of autistic children with medicine. “That there are high levels of mercury in autism — not proven! That they have precocious puberty — not proven!”

I shared Dr. Baron-Cohen’s horror three years ago. So did Kathleen Seidel. So did a number of other bloggers. I didn’t really know, though, just how much money this protocol sucks out of desperate and gullible parents. Oh, I knew Lupron is an expensive drug and that insurance won’t pay for it for autism. That’s exactly why, as Kathleen put it, the Geiers found a way to label virtually every child they used the drug on as having “precocious puberty,” even though by definition any girl older than 8 or boy older than 9 cannot have precocious puberty. That doesn’t stop the Geiers from this:

To treat an autistic child, the Geiers order $12,000 in lab tests, more than 50 in all. Some measure hormone levels. If at least one testosterone-related level falls outside the lab’s reference range, the Geiers consider beginning injections of Lupron. The daily dose is 10 times the amount American doctors use to treat precocious puberty.

By lowering testosterone, the Geiers said, the drug eliminates unwanted testosterone-related behaviors, such as aggression and masturbation. They recommend starting kids on Lupron as young as possible and say some may need the drug through the age of puberty and into adulthood.

The cost of the Lupron therapy is $5,000 to $6,000 a month, which health plans cover, Mark Geier said. However, two families told the Tribune that they had trouble getting insurance to pay for the treatment.

This is big bucks. Seriously big bucks. It’s also arguably insurance fraud, because the Geiers claim precocious puberty but in fact are using Lupron to treat autism. Moreover, the way they do their testing is absolutely guaranteed to produce in most children the “desired” diagnosis. The reason has to do, as I’ve described before, multiple lab values. The “normal” range of lab values, by definition, is designed so that 95% of “normal” patients will fall within that range. That means, for any “normal” child and any single given laboratory test, there is by random chance alone a 5% chance that his or her lab value will fall outside the “normal” range. 5% of 50 tests would mean that the average child would be likely to have 2.5 (or, given that these are whole numbers) between 2-3 lab values that fall outside the normal range. And–presto!–that will mean that they have “precocious puberty” and need the Geiers’ Lupron protocol. It’s all bogus (word choice intentional):

The blood tests the Geiers use as proof of excessive testosterone don’t show that at all, and other data they cite mean nothing, said Paul Kaplowitz, chief of endocrinology at Children’s National Medical Center in Washington, D.C., and an expert on precocious puberty. They also leave out test results that could help show whether the children are in early puberty, he added.

Looking at the tests, Kaplowitz said he asks himself: “Is Dr. Geier just misinformed and he hasn’t studied endocrinology, or is he trying to mislead?”

You know, I’ve been asking myself that question ever since I first learned about the Geiers and their “Lupron protocol.” I still can’t decide if they are true believers or if they are con men. it’s possible that they’re a little bit of both. What’s undeniable is that they are using a powerful sex hormone-suppressing drug on autistic children with no indication. Steve Novella was right to refer to it as an “atrocity.” Indeed, it’s so bad that the antivaccine propaganda blog actually–to my shock!–allowed a post that was critical of the Lupron protocol:

It is of great concern that studies on testosterone and autism are being misinterpreted, leading to the use of therapies aimed at disturbing steroid hormone production in individuals with autism. Currently, many autistic children may be being treated, without proof of safety and scientific and medical evidence of benefit, with a view to reducing their hormonal secretion of testosterone (Lupron Therapy, Spironolactone). The rationale behind advocating these therapies appears to be based on a misunderstanding of autistic behaviours and without systematic laboratory evidence of abnormal testosterone levels.

Word to Mark and David Geier: When Age of Autism thinks you’re a quack, you’re in some serious, serious trouble from a credibility point. So what’s their defense? You guessed it! A panoply of the usual excuses used by purveyors of pseudoscience:

  • Don’t knock it till you’ve tried it: Mark Geier responded that these are “opinions by people who don’t know what they are talking about,” saying the pediatric endocrinologists interviewed by the Tribune don’t treat autistic children and have not tried the Lupron treatment.
  • Misrepresenting the work of real scientists: David Geier said prominent scientists support their work and gave as an example Baron-Cohen, the autism expert who told the Tribune that the Geiers’ Lupron treatment filled him with horror.
  • Conspiracy theories: The Geiers also say mainstream medicine condemns them because of their vocal stance that pediatricians, health officials and drug companies are covering up the link between vaccines and autism. “Nobody likes a whistle-blower,” Mark Geier said in an interview.
  • The pharma gambit: The Geiers are not dissuaded by the criticism. Mark Geier said the courts are biased against him and that the medical establishment is more concerned about preserving drug companies’ profits than about protecting children. “There’s no question this will turn out to be true,” Mark Geier said in an interview, referring to the vaccine-autism connection.

And, most despicable of all, the Geiers demonize the very autistic teens upon whom they are plying their quackery:

“With masturbating there is a degree of normal, and then there is autism. Parents will say: ‘He will hump pillows, he will hump your leg,’ ” David Geier told doctors at Eisenstein’s office. He made similar statements on the same visit to about 60 parents of autistic children.

In an autistic teenager, high testosterone will lead to dangerous aggression, Mark Geier said, mentioning an autistic Ohio teen accused of killing his mother. “They are incredibly strong. They can hurt you,” he said. “You have to respect that these kids are on massive testosterone.”

Autistic children with high testosterone are heading down an ominous path, the Geiers said, and likely will end up hooked on psychiatric drugs, institutionalized or jailed.

I call bullshit, as does virtually anyone who knows anything about autism. Of course, the parents of Geiers’ patients are largely self-selected to believe the woo and have a serious incentive, after sinking thousands of dollars into it, to believe it’s working. And they do provide testomonials. Heck, it wouldn’t surprise me if some of them are even true. If you shut down a child or teen’s testosterone production, they will become more docile and have a decreased sex drive. That doesn’t mean the drug is doing anything at all for the teen’s autistic symptoms. Indeed, it could be doing great harm to the child. While Lupron may not be too risky for prepubertal children, giving it to teens can “put puberty on hold,” as one scientist put it, calling it “chemical castration”:

Said Kaplowitz: “You can lower sex drive, yes, but are you going to do that for every autistic [teenage] boy, do a medical castration? … For a year? For their lives?”

Neither Eisenstein nor the Geiers dispute that what they are doing amounts to chemical castration.

Speaking about one teen he put on the drug, Mark Geier said: “I wasn’t worried about whether he would have children when he is 25 years old. If you want to call it a nasty name, call it chemical castration. If you want to call it something nice, say you are lowering testosterone.”

Karl Rove would be proud of Dr. Geier.

In a companion article, another aspect of the Lupron protocol is deconstructed:

Abbott Laboratories, which sells Lupron in the U.S., once applied for a patent with the Geiers through a now-defunct joint venture with another drug company, yet never pursued work with them. A spokeswoman for the North Chicago-based company said there was no scientific evidence to justify further research.

When a pharmaceutical company decides it isn’t interested in pursuing a potentially lucrative new indication for one of its drugs, you know you’re deep into pseudoscience. I will say, though, that Abbott Laboratories should be ashamed of itself. It’s winking and nodding at the use its product is being put to, even though it knows there is no scientific justification for it. Of course, the Geiers had already tried to patent their Lupron protocol once, because, of course, they’re doing this all out of the goodness of their hearts.

Not:

The Geiers’ first Lupron patient, a Virginia boy with severe autism who is now 13, started the treatment about four years ago. Since then, the Geiers have opened eight clinics in six states, including one in Springfield and their arrangement with Eisenstein, which he described as a “franchise” of sorts.

“We plan to open everywhere,” Mark Geier said in February at Eisenstein’s office. “I am going to treat as many as I can.”

Some of the Geiers’ clinics are headed by doctors; a psychiatrist runs the Springfield clinic. But that is not always the case. The clinic in Indianapolis is run by an X-ray technologist who has an autistic child.

In Washington state, the head is a health advocate and documentary filmmaker.

Again, I ask: How do the Geiers get away with it? These people are clearly practicing medicine without a license!

There were only two deficiencies in these articles. The first one almost goes without saying. There was too much of the “tell both sides” meme, in which testimonials were given far more weight than they deserved. I’ve given up expecting anything other than that from journalists. The other deficiency is that there was no mention of how the Geiers played fast and loose with human research protections in order to ply their quackery. The full length account is here; the CliffsNotes version follows.

Basically, the Geiers created an instituted, which they called the Institute for Chronic Illnesses, as a front under which to do their “studies” of Lupron. As part of that institute, they formed an Institutional Review Board (IRB) to oversee their “research.” They then stacked that IRB with cronies and true believers in violation of federal regulations. Indeed, they even went so far as having the principal investigator sit as the chair of the IRB overseeing his own research protocols. “Unethical” doesn’t even begin to describe this.

Criticisms aside, though, overall, I’m very happy that finally the mainstream media is noticing the Geiers’ pseudoscience and abuse of autistic children. Better late than never. Even better, today and article appeared about luminary of the antivaccine movement, Dr. Mayer Eisenstein.

Here’s hoping the Trib takes it a step further and covers the Autism One quackfest. If there’s one thing I’ve learned over the last four years, it’s that antivaccinationists do not like the harsh light of day shining down upon them. At least, they don’t like it if they can’t control the message, and in this case they’ve lost control of the message.

Comments

  1. #1 J
    May 22, 2009

    Excellent write up. A few stand out points for me:

    1) The same folks that use the “big pharma gambit” in dismissing vaccine advocates will, when it profits them, climb in bed with big pharma to push a pseudoscientific protocol. Apparently, their hypocrisy knows no bounds.

    2) While many IRB’s do an excellent job of protecting human subjects, this article points out the essential weakness of private IRB’s that operate with limited or no state oversight. The Geiers, despite their claims to the moral high ground in the fight against autism, would fail bioethics 101.

    3) How has a state medical/ethics board allowed this to continue for so long without intervening?

    Great job as always, Orac.

  2. #2 Catherina
    May 22, 2009

    So why, if they have indeed opened 8 clinics, have insurance companies not caught on and started to pursue this? A minimum of 100 children treated at $60’000 dollars a year translates into $ 6 million – does that not cross some sort of alert threshold?

  3. #3 MarkW
    May 22, 2009

    Again, I ask: How do the Geiers get away with it? These people are clearly practicing medicine without a license!

    IMO needs asking again and again and again until some law enforcement agency takes notice.

  4. #4 plum grenville
    May 22, 2009

    Orac, can you explain why Dr. Geier’s license hasn’t been pulled or at least his field of practice hasn’t been limited by his state medical association?

  5. #5 Esther
    May 22, 2009

    A little off topic here, but how could any medical insurer with half a brain not smell something incredibly fishy about all these children with “precocious puberty” being treated by these Geier nobodies? PP isn’t common, and the Geiers aren’t exactly the Mayo Clinic, either. Why has nobody sued them for insurance fraud until now?

    For that matter, why do medical insurers provide recompense for any biomedical treatment – none of which has proven efficacy? And why has CLIA not clamped down on labs which provide bogus results like Doctor’s Data?

    I don’t really understand the US medical insurance scene (or the private lab scene, either), so if somebody could explain why this has been allowed to go on for so long, I’d be grateful.

  6. #6 Ruth
    May 22, 2009

    “Why not just castrate them?”

    Do you mean the Geirers?

  7. #7 Joseph
    May 22, 2009

    I always suspected Eisenstein was a liar. I just didn’t realize the extent of it.

    BTW, I don’t think Mark Geier knows the meaning of the term “whistle-blower.”

  8. #8 JD
    May 22, 2009

    I’d rather hump pillows; it is infinitely more productive than anything endogenous to the Autism One “think tank.”

  9. #9 Dr. Steve
    May 22, 2009

    How can Geier use the pharma shill gambit with a striaght face? He is doing more to protect drug company profits (selling $5,000 worth of drugs per kid per month) than just about any other practicing MD.

  10. #10 DebinOz
    May 22, 2009

    This has made me feel sick, and on so many levels – for the deluded parents, for the poor children dosed up with Lupron needlessly, for the new victims…

    Correct me if I am wrong – I have been around children with ASD for over 20 years, and not a single one has exhibited any sign of PP (in fact, quite the reverse). At the expense of sounding trite, I have not heard of one single case of a young rapist with ASD.

    I need to stop thinking about how terrible this is.

  11. #11 Scott
    May 22, 2009

    Does anybody know what the legal penalty for these crimes (insurance fraud and practicing medicine without a license) are? Would the Geiers just get slapped with a fine (hopefully huge), or are we talking actual jail time here?

  12. #12 Prup (aka Jim Benton)
    May 22, 2009

    Reading this gave me an ugly thought. How many ‘Good Christian” parents would, if they knew there was a drug that would suppress their son’s sexual drive until he was 18 would seek it out — whether the son was autistic or not — simply to keep him from the (cue theramin) “dangers of sexuality and masturbation.” (And even more so, those with daughters would like it administered to any boy she might meet.)

    I wish I were just being snarky here. I’m not.

  13. #13 Calli Arcale
    May 22, 2009

    Well, statistically, by now you’d think there would be at least a few rapists with an ASD. After all, they do comprise more than 1% of the population, which while small, is significant. It’s possible that rape was on the mind of the “Craigslist Killer” here in the Twin Cities, who, during his trial, was diagnosed with Asperger’s. But given that he was unable to actually do anything when the gal arrived and ended up just killing her, if he did have sex in mind, his sex drive must not be all that big if it was easier for him to kill her than to rape her.

    I’ve also never known an ASD person with an unusual sex drive or an unusual propensity for violence. Indeed, all the ones I’ve known have had rather quiet lives, and that’s how they like it — they want less excitement, not more, because they tend to get overwhelmed if there’s too much stimulation.

    Don’t like an autistic kid humping your leg? Teach him not to do that! It’s not impossible. Even the most severely autistic can learn stuff like that, if you’re calm, assertive, and consistent in your training. And I’m not afraid to call it training. You’re training them how to get along in life. That’s a parent’s job. It should be done with love, trust, and affection. Chemical castration is a disgusting idea.

    I wonder how many of these parents really understand the implications this could have for their future grandchildren (if any)? I doubt the Geiers are being square with them about that, given that they’re already massively dishonest about the need for the treatment in the first place. And I wonder how many parents would continue to subject their kids to the treatment if they considered the parallel to Michael Jackson, who took hormones during puberty because his stage manager parents wanted to preserve his voice? Do they want their children to be compared unfavorably to Michael Jackson? Teenagers can be particularly cruel, and an autistic boy has enough to deal with without keeping him a soprano.

  14. #14 DebinOz
    May 22, 2009

    To me, as the mother of a 22 yo son with ASD, the exquisite irony of this whole thing is that my son is happy to tell me how he is physically feeling as his body is marching through puberty and beyond. I feel like I have an insight as to how males deal with their hormonal impulses, with the disingenousness (sp?) of ASD. My son will happily chat away with how his body ‘feels’, but he knows what is societally right and wrong re sexual aggression without any input from me.

    And to put it into perspective, my son has had major tantrums when the menu for dinner gets changed. Yet he understands that sexual activity is ‘strictly controlled’ by various measures outside of his control.

  15. #15 Paul Browne
    May 22, 2009

    Nice article Orac, and I’m glad to see that I’m not the only one whose angry about this. It beggers belief that the Geiers are not behind bars for what they have done.

  16. #16 Iron
    May 22, 2009

    Yes, Albert, absolutely. I find that the solution(s) is/are to tripost upwise. Then, it already can be to deliverer total.

  17. #17 DebinOz
    May 22, 2009

    Albert:

    To give you the benefit of the doubt..you sound like me on a Friday night after a few wines, helping an ASD person compete. Not sure what you are saying?

    Then again, maybe you are a troll.

  18. #18 Diane
    May 22, 2009

    “Albert” is spam…

  19. #19 Nostrum
    May 22, 2009

    5-6k a month? Wow. That would buy intensive intervention at a specialized school for one kid or ABA consultation for two or three kids.

    Some states now have laws to force insurance companies to cover evidence-based autism therapies, but most do not. In my state, I’d probably have a better chance of getting coverage for this bogus protocol than I would for ABA.

    So I don’t really blame a parent for going for a “new” treatment insurance will pay for (however fraudulently the claim is made) instead of the proven but expensive therapy. I do blame a system that allows this sort of thing to happen by not covering expensive but necessary interventions. Too bad chemical castration would likely be seen as cruel and unusual punishment for insurance fraud.

  20. #20 medstudent6973
    May 22, 2009

    I gotta say… If I were this father-son team, knowing that Leupron shots don’t work, I think I’d inject saline from a Leupron bottle (ie, the ol’ putting cheap vodka in an expensive bottle trick). Not only would it make more money, but it would be safer for the kids. Is there any reason to suspect that they were actually using the Leupron? Would any person or agency be able to point out how much Leupron was delivered to their facilities and how much was supposedly used?

  21. #21 storkdok
    May 22, 2009

    Not only are they practicing medicine without a license, but they are committing insurance fraud as well as Medicaid fraud.

    Nice takedown. Thanks!

  22. #22 Phoenix Woman
    May 22, 2009

    Reading this gave me an ugly thought. How many ‘Good Christian” parents would, if they knew there was a drug that would suppress their son’s sexual drive until he was 18 would seek it out — whether the son was autistic or not — simply to keep him from the (cue theramin) “dangers of sexuality and masturbation.” (And even more so, those with daughters would like it administered to any boy she might meet.)

    I wish I were just being snarky here. I’m not.

    They’d probably make their daughters take it first. (See also: Magdalene Asylum.)

  23. #23 Kathleen
    May 22, 2009

    You ask “how do they get away with it?” Big Balls.

  24. #24 Rorschach
    May 22, 2009

    Maybe a more productive question than “how do they get away with it?” is “given the egregiousness of this wrongdoing, is there anything we can do about it?” Letter writing campaigns to the state’s attorney in states hosting Geier franchises? Maybe writing to local papers decrying their unethical practices?

  25. #25 perceval
    May 22, 2009

    It may not surprise you that “Geier” is German for “vulture”

  26. #26 Catherina
    May 22, 2009

    and it rhymes with “liar”

  27. #27 Robster, FCD
    May 22, 2009

    medstudent, Since several pharmacies have been nailed for doing just that with a variety of expensive drugs, I would say that unless the scheme was fairly impressive, it would only be a matter of time until they were caught.

  28. #28 _Arthur
    May 22, 2009

    As Kathleen Seidel observes, the experimental treatments/castrations clearly took place before the makeshift IRB was assembled, just another obvious no-no.

  29. #29 medstudent6973
    May 22, 2009

    I’m not sure a pharmacy would have anything to do with it. When I was shadowing a urologist, the patients with prostate cancer would come in each month for their 700 dollar Lupron shot, administered at the office. By the way, the urologists used to make a KILLING off this drug as my preceptor explained to me. He said they barely make 5 dollars now (but whatever, it’s just administering a shot).

    Obviously, if they’re using a pharmacy or they’re billing insurance, they’re liable to be caught. But if the parents are paying straight out of pocket, it would be much much easier to administer saline and say it’s Lupron. Who would know besides the office records?

  30. #30 _Arthur
    May 22, 2009

    As Kathleen Seidel observes, the experimental treatments/castrations clearly took place before the makeshift IRB was assembled, just another obvious no-no.

  31. #31 _Arthur
    May 22, 2009

    As Kathleen Seidel observes, the experimental treatments/castrations clearly took place before the makeshift IRB was assembled, just another obvious no-no.

  32. #32 mike stanton
    May 23, 2009

    Rorschach asks what to doabout it and suggests writing to their local papers. I tried this 3 years ago when I emailed these papers with the story.
    Silver Spring Gazette: jgrbach@gazette.net
    Silver Spring Voice: bond@takoma.com
    Montgomery County Sentinel: editor-mc@thesentinel.com

    No takers then. Maybe the Trib will have more effect on them. I hope so.

  33. #33 DLC
    May 23, 2009

    Ooh Cool . . . I can cook up a quack treatment, form my own research institute and get my brother and my old college buddies to sit on the IRB ? Then, I can sell my special protocol to various lackwits and other suckers ?
    On second thought, I think I’ll stick to running a three-card monty game. Or house burglary. or clubbing baby seals.

  34. #34 dt
    May 23, 2009

    “The treatment also means subjecting children to daily injections, including painful shots deep into muscle every other week.”

    OMG! Not toxins injected directly into the blood stream! Poor kids – they are certain to suffer rampant autism.

  35. #35 Patient
    May 23, 2009

    How do they get away with it? I suspect that they are filling a need that “traditional medicine” has not been able to fill.

    Having worked with ASD children and young adults myself, I can tell you from personal experience that there are a WIDE variety of behaviors that are challenging to deal with at best, and frustrated parents will do anything to find some relief for their child and for themselves. After dozens of trips to doctors, psychologists, and other “traditional” professionals that have offered little in the way of help, a parent may be willing to try anything, no matter how absurd. I have seen this first hand, and it is painful to watch.

    Compulsive and inappropriate sexuality does exist in ASD, in all ages groups, and it can be extremely difficult to deal with. Many professionals working with ASD children have a particularly tough time, as parents first assume the child is getting sexually abused when these behaviors begin. Sometimes they will even accuse the very professionals that are trying to help the child, with creating the behavior or making it worse. That is why this particular issue is so difficult to deal with; the inappropriateness of the behavior itself, the climate of suspected child abuse, the lack of good solid remedies that work every time– all this feeds into a very strong desire to find ANYTHING that will work to stop these behaviors.

    I agree with everything Orac has written, but the medical establishment needs to also see that these charlatans are able to prosper precisely because “traditional” treatments have not proven to be of help, consistently. Through some combination of bad bedside manner, dismissive behavior by medical professionals, or ineffective medications/treatment, parents of ASD children sour on doctors and look elsewhere.

    The fact that Geier and his ilk exist at all should be a wake up call to those that work with ASD pateints that more needs to be done to ensure that these patients are being treated with compassion and their needs are being met with the best medicine has to offer.

  36. #36 Dr. P
    May 23, 2009

    Debinoz writes

    Correct me if I am wrong – I have been around children with ASD for over 20 years, and not a single one has exhibited any sign of PP (in fact, quite the reverse). At the expense of sounding trite, I have not heard of one single case of a young rapist with ASD.

    , Funny , I was just thinking the same thing. In fifteen years I can’t think of a standout case of ASD/precocius puberty.The whole thing is sickening when you thing of the calculated playing on emotional fears( they will be at large raping your wives and daughters). Most of the kids I’ve cared for have been embarrassed and shy if anything.

  37. #37 Dr. P
    May 23, 2009

    How do they get away with it? I suspect that they are filling a need that “traditional medicine” has not been able to fill.

    , I can see some of your point because I’ve seen horrible cases of miscommunication and poor rapport developed between doctor and patient, but scum like this exist even amidst the best of medical success stories( look at the Hauser’s ‘religious advisor’).They’ve been with us for hundreds of years and the failure of medicine isn’t always or even often the whole story.The individuals culture, upbringing, sense of skepticism and willingness to logically consider what makes sense and what doesn’t(read gullibility) has more of an effect than anything else.I say this because when I send a patient to a specialist and it doesn’t work for whatever reason most don’t go the way of the woo, we help them find someone they can work with.

  38. #38 Anne
    May 23, 2009

    “Not only are they practicing medicine without a license, but they are committing insurance fraud as well as Medicaid fraud.”

    Storkdoc, Mark Geier is a licensed medical doctor in the state of Maryland – check on his license here:
    https://www.mbp.state.md.us/bpqapp/

    I can only assume that the Maryland Board of Physicians hasn’t been given a reason to investigate his activities yet.

  39. #39 Sastra
    May 23, 2009

    Prup #12 wrote:

    Reading this gave me an ugly thought. How many ‘Good Christian” parents would, if they knew there was a drug that would suppress their son’s sexual drive until he was 18 would seek it out — whether the son was autistic or not — simply to keep him from the (cue theramin) “dangers of sexuality and masturbation.”

    My first reaction was “not many” — because my guess is that someone in their community is bound to suggest that suppressing testosterone may make teenage boys effeminate (ie, turn them gay.) They wouldn’t consider it after that.

  40. #40 Bronze Dog
    May 23, 2009

    40 comments and no trolls defending Geier?

    That’s weird.

  41. #41 idlemind
    May 23, 2009

    40 comments and no trolls defending Geier?

    They’re taking the long weekend off. Or perhaps they’re already at Autism One and their internet access has failed.

    Thanks, Orac, for hammering on this. We parents with ASD kids owe you a debt of gratitude for making people more aware of those out there who would exploit us.

  42. #42 catgirl
    May 26, 2009

    Reading this gave me an ugly thought. How many ‘Good Christian” parents would, if they knew there was a drug that would suppress their son’s sexual drive until he was 18 would seek it out — whether the son was autistic or not — simply to keep him from the (cue theramin) “dangers of sexuality and masturbation.” (And even more so, those with daughters would like it administered to any boy she might meet.)

    Well, most people like that are much more concerned with female sexuality than with male sexuality. They want all the responsibility to fall on girls to be the gatekeepers and not allow sex to happen. They know that their good little boys could never be rapists or even promiscuous, so it must have been some bad girl that tricked him into it.

  43. #43 andy
    May 9, 2011

    All those making gratuitous comments about Christians and sexuality need to get a life. Why aren’t you brave enough to say the same things about Moslems? Because you know the latter may come and slit your throat while the former won’t. Why don’t you snicker at Orthodox Jews? Because you are a bunch of bleeding heart liberals who would rather die than be accused of being antisemitic? You can make the same points without attacking religious people, period.

  44. #44 Chris
    May 9, 2011

    andy, in the two years it took you to compose your comment, did you even bother reading actual article? It has nothing to do with religion. Or do you actually support chemically castrating autistic children?

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