What's the harm? A child dies a preventable death from an ear infection

A common question, rhetorical or otherwise, that skeptics are asked about alternative medicine is, "What's the harm?" It's seemingly an effective ploy for some modalities, so much so that years ago Tim Farley felt obligated to try to answer the question on a website (whatstheharm.net) that catalogues examples of the harm alternative medicine, supernatural and paranormal beliefs, and other pseudoscience do. After all, most homeopathy (at least anything diluted greater than around 12C, at least) is water, without any remaining remedy, effective or otherwise. On the other hand, some homeopathic remedies are adulterated, and some of the "less potent" (i.e., less dilute) remedies might actually have something in them. (homeopathic belladonna for teething babies, anyone?) Moreover, there can be grave harm when the use of ineffective alternative therapies keeps a person from using effective medical therapy. We have seen this over the years, for example, when parents following religions that do not believe in medicine and tell their adherents to rely solely on god for healing, which, sadly, does not work so well for diabetic ketoacidosis, pneumonia, or leukemia. Dead children, however, do not appear to deter belief in such quackery.

File this one as another example of "What's the harm?" Behold the sad, sad case of Ebed and Christine Delozier and their 18-month-old daughter Hope Elizabeth Delozier, who died in February:

According to a criminal affidavit from Magisterial District Judge Fred Wheaton’s Office, the couple was staying at a camper along Hiduk Road in Herrick Township, a property owned by the Hope Baptist Church. Ebed Delozier brought the toddler to the hospital, who was found to be in cardiac arrest.

Despite efforts made by the medical staff to save her, the child was pronounced dead a short time later. No immediate cause of death was noted.

Criminal investigators were told by a registered nurse on staff that the victim’s mother, Christine Delozier, and aunt, Rebecca Delozier, arrived at the hospital shortly after the victim. The nurse said that the victim’s parents made it clear they were against antibiotics and other chemicals associated with modern medicine.

While emergency room staff worked on the toddler, who was not breathing, the nurse said she overheard Christine Delozier making statements such as, “You’re putting holes in her” and, “You’re putting chemicals in her.”

Yes, the doctors at the emergency room were doing exactly that—to try to save the toddler's life! In the case of a cardiac arrest, if there's any hope at all of reversing the situation and saving the victim's life, it involves some rather radical, invasive medicine. So how did Hope reach this state? It started with an ear infection:

The nurse said that while speaking with the family, they related the child had been sick for two weeks and was displaying symptoms consistent with an earache, headache and a fever. She told police the family indicated they had been treating the little girl with a homeopathic approach and were using herbal treatments to care for her.

Although most children recover from otitis media, which is what Hope appears to have had, and mild cases don't even require antibiotics, the key to treating children with mild otitis media is close followup, because antibiotics become necessary if the child doesn't get better quickly and especially if the child's symptoms worsen, as Hope's did. In cases of severe otitis media, antibiotics are still necessary, and sometimes tympanostomy tubes are even required. That's because, if left untreated, severe otitis media can result in a variety of complications, including but not limited to:

  • Chronic suppurative otitis media
  • Postauricular abscess
  • Facial nerve paresis (paralysis of the facial nerve)
  • Labyrinthitis
  • Mastoiditis
  • Temporal abscess
  • Intracranial abscess
  • Meningitis
  • Cerebrospinal fluid (CSF) leak

Unfortunately, of these Hope developed one of the most severe complications:

An autopsy performed on March 26 at Lourdes Hospital in Binghamton, NY, conducted by Dr. James Terzian, indicated that the 18-month-old toddler had died of “streptococcus pneumoniae meningitis”, which caused a cerebral abscess and terminal cerebral edema. The meningitis reportedly originated in a left ear infection, which had been left untreated by conventional antibiotic therapy.

Dr. Terzian noted “a simple antibiotic would have saved the victim’s life.”

Based upon these findings, Bradford County Coroner Thomas Carman ruled the death as a homicide.

Yes, this child died of something that could almost certainly have been prevented with a bit of that old evil "Western medicine" in the form of amoxicillin. Moreover, the child was sick for approximately three weeks before her death, and, given the severity of her condition, likely suffered horribly, first from pain in the ear and then from the symptoms of advancing meningitis that led to an intracranial abscess and swelling of the brain. Given that the child was being treated with only homeopathic remedies, her illness and death proceeded without treatment even to ease her symptoms. The mother reported that her child had had fevers ranging from 99° to 103° F during that time with occasional vomiting. Five days before her death, the child started draining fluid from her ear, most likely from an ear abscess having ruptured through the tympanic membrane. Finally:

Delozier kept treating the child with natural and herbal treatments to boost her immune system. On the day of the toddler’s death, Delozier laid the little girl down for a nap. Roughly one hour later, she observed her daughter’s breathing to be labored and shallow, taking one breath approximately every 10 seconds. The toddler eventually stopped breathing and went limp.

“I watched her die,” Delozier told police.

She performed CPR on the victim for approximately 30 minutes, at which time Ebed Delozier arrived home and took the child to the emergency room.

By which time it was far, far too late to save Hope. After 30 minutes of CPR and a trip to the emergency room, she had almost certainly sustained, at minimum, severe neurological damage and was most likely dead by the time she reached the emergency room. Another thought comes to mind: WTF was Delozier thinking as her daughter's breathing slowed to 6 breaths/minute. Didn't she figure out that something was very, very wrong at that point? Her story implies that, at some level, she must have realized that something was very wrong. It's not clear how long she watched her daughter's breathing, but it sounds like the Cushing reflex, which occurs in response to increased intracranial pressure and involves increased blood pressure, lowered pulse, and slower, irregular breathing. Although I don't like citing Wikipedia for medical matters, the Wikipedia entry on the Cushing reflex has about as apt a statement of the significance of this finding as I've ever heard: "Whenever a Cushing reflex occurs, there is a high probability that death will occur in the near future (seconds to minutes). As a result, when a Cushing reflex is detected, immediate care is needed."

Of course, Delozier is not trained in medicine; so it's unreasonable to expect her to recognize the Cushing reflex or realize how serious it is when someone breaths like this, but even lay people know that breathing once every ten seconds is too little, particularly if it keeps slowing down. Certainly Delozier recognized that there was something badly wrong with Hope's breathing. If Hope had been taken to the hospital while still breathing, she might still have had a chance, although probably relatively small. Instead, Delozier did exactly as she stated, and we have no reason to doubt this part of her story. She sat there and watched her daughter die without intervening to try to stop the process.

Not surprisingly, Delozier distrusted "Western medicine," which meant she was also antivaccine:

Interviews conducted with Christine Delozier on March 24 and March 30 found that her child had been born at home without the use of a midwife and from there on, had never seen a medical doctor, nor did she receive any vaccinations. She said her views against modern medicine stem from her childhood as she was raised without taking pills or receiving shots.

She told police she has done her own research on vaccinations and found they can be related to death, SIDS, autistic disorders, immune disorders and shaken baby syndrome. While her views are not religiously motivated, she said she does feel God is the ultimate healer.

So once again we see the toxic combination of fundamentalist religion and belief in alternative medicine resulting in the preventable suffering and death of a child who could have been saved with the fairly straightforward use of an antibiotic. True, in this case, religion appears to have played a supporting role rather than the primary role, but it's clear it was important. Be that as it may, unfortunately such is the power of beliefs like this that even now, three and a half months after Hope's death, Christine Delozier has learned nothing and knows nothing new:

Newswatch16 spoke with Christine Delozier at length at her home on Hiduk Road near Wyalusing. She declined to go on camera, but did explain her religious convictions, how she still mourns the loss of her daughter, and about her lack of trust in the American medical community.

“If doctors expect people to trust them, they need to become trustworthy,” Delozier said. “People are a lot healthier in countries where doctors aren’t paid by patients.”

With tears streaming down her face, she went on to say, “I believe the medical community is at least the third, maybe the first, leading killer in the United States.”

Wait a minute. What does she mean when she says people are a lot healthier in countries where patients aren't paid by patients? Does she mean countries like Canada or the U.K., which have single payer systems in which the government pays its citizens' medical expenses? It's a pretty safe bet that, had Hope been seen by a physician in Canada or England, for example, she would have been prescribed antibiotics and treated pretty much the same way that local pediatricians in Bradford County would have treated her. The treatment of otitis media is fairly standard. As for the trope that medicine is the leading killer in the US, to me it sounds as though Ms. Delozier has been reading too much Mike Adams.

The fact is that the Deloziers' extreme medical neglect killed their daughter. Period. Sadly, cases like this, though thankfully uncommon, aren't nearly as unusual as they should be in the US, where a warped view of religious freedom produces an extreme deference to religious beliefs as a justification for the medical neglect children.

In fact, when I first posted this on various social media, at least a couple of people responded by pointing out to me that cases like this aren't rare but that rather what is rare is that the parents are actually being charged with involuntary manslaughter and endangering the welfare of children. For example, in 2009 Catherine and Herbert Schaible let one of their children die at age 2 months of a treatable pneumonia, which had developed after a cold. Even though the child got sicker and sicker, they refused to take him to a doctor because of their religious beliefs. The courts, bending over backwards not to take the rest of their children away, put the Schaibles on probation and granted them custody if they would promise to take their children to the doctor when they are ill. In 2013, another of the Schaibles' children died in almost exactly the same manner, of pneumonia that developed after a cold. He was 7 months old.

Indeed, one can't help but wonder whether, if the Deloziers had asserted that it was their religious belief not to use doctors or medicine (as the Schaibles, who belonged to a church that explicitly forbade its members from using conventional medicine, did) rather than saying that she just didn't trust doctors and medicine, they would be facing the serious charges they're facing. As it is, I highly doubt the Deloziers will ultimately serve significant jail time even if convicted. Parents who kill their children through medical neglect like this rarely do. Whatever the case, the Deloziers' next court date is today.

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C. Delozier said she had "done her own research" on vaccines. In other words, she read some rumours and believed the ones that supported her original opinions.

By DANIEL GAUTREAU (not verified) on 16 Jun 2015 #permalink

She told police she has done her own research on vaccinations

Meanwhile in recent comments:
I believe in a parents right to research and decide what is best for their child [...]
I’ve done my research on both sides. Have you?

Any concerned parent who has actually done their own objective research can see that there is a pitiful lack of un-biased study on this issue.

Christine Delozier seems to have memorised the whole script word-for-word.

the toxic combination of religion
I can't see a great role for "religion" here ("While her views are not religiously motivated"). More like a case of "motivated spirituality", analogous to "motivated reasoning". Delozier felt entitled to her own facts, and went "researching" for websites that would confirm her prior believes, and in the same way she went looking for a God-the-ultimate-healer" because she's entitled to a religion that will agree with all her beliefs.

“If doctors expect people to trust them, they need to become trustworthy,”

So her child died after a long painful, untreated illness while an abscess ate through the side of her head into her brain, and it is all someone else's fault.
I know that people have always been stupid, but sometimes these days it seems like people have less shame about opening their mouths in public and letting the stupid out.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

The end sentence of the news article points says the child was found to be "malnourished and dehydrated". What kind of parent would ignore the fact their child is too ill to eat or drink?

A tragic story.

Based upon these findings, Bradford County Coroner Thomas Carman ruled the death as a homicide.

Definitively "homicide par imprudence", as we say in my country. Another way of saying, by behaving stupidly you killed people around you.

she has done her own research on vaccinations and found they can be related to death, SIDS, autistic disorders, immune disorders and shaken baby syndrome.

"shaken baby syndrome"
Holy cow. Here we go again.

*sending a stream of French expletives toward Buttar and other child abuse apologists*

What's the harm, indeed? Just other people taking your sh!t seriously and getting afraid of life-saving treatments.

By Helianthus (not verified) on 16 Jun 2015 #permalink

I can confirm that over here with our socialistic NHS (while we still have it) the standard treatment for otitis media is antibiotics, like what I was prescribed last year when I had it.

And if I had been in Merkinania I would happily have paid for the same thing, 'cos it works...

But I am a retired nurse and so obviously a Big Pharma Shill, so I would say that, wouldn't I?

“If doctors expect people to trust them, they need to become trustworthy,” Delozier said. “People are a lot healthier in countries where doctors aren’t paid by patients.”

With tears streaming down her face, she went on to say, “I believe the medical community is at least the third, maybe the first, leading killer in the United States.”
_____
Pardon my French, Mrs, Delozier, but f*ck you, you baby-killing cretin. You sat there and watched your baby Cheyne-Stoke for God knows how long while you sat on your ass and did nothing.

Rot in prison. Rot in hell, since you're so religious.

By NH Primary Care Doc (not verified) on 16 Jun 2015 #permalink

She performed CPR?

I doubt it was anything remotely close to CPR.

By Chris Hickie (not verified) on 16 Jun 2015 #permalink

Chronic suppurative otitis media

Side note, we French had a king with this condition, and a few co-morbidity, including epilepsis. Historical chroniclers agreed his medical conditions didn't improve his character.
Coincidentally, he was the one who ordered the St-Bartholemy slaughter.

Actually, I will stop beating around the bush and try to be more precise:
It's chaffing at me that people who expressed - and still express - fears of vaccines/medical treatments inducing neurological damages ended up letting a real infection with real risks of neurological damages run wild on their defenseless baby.

And it's not as if the risks of such damages were unknown, for anyone with some education.

@ hdb

So her child died after a long painful, untreated illness while an abscess ate through the side of her head into her brain, and it is all someone else’s fault.

Maybe she should sue her god, since apparently He forgot to intervene.
And the FSM will answer, "there was a frelling hospital 10 clicks away, what's next? I have to tile your fields and empty your chamberpot myself?"

@ NH Primary Care Doc

Pardon my French, Mrs, Delozier, but f*ck you, you baby-killing cretin.

I, for one, pardon your French, and give you licence to swear more, should you wish to do so.

By Helianthus (not verified) on 16 Jun 2015 #permalink

With tears streaming down her face, she went on to say, “I believe the medical community is at least the third, maybe the first, leading killer in the United States.”

Says someone who's child died from being treated with homeopathy.

So, if mrs delozier was so concerned about chemicals, why in the world would she be eating or drinking anything, considering that everything we consume is a chemical?

Stories like these made me angry and sad. Sad for a child that had died needlessly, angry that a parent caused the death, even if indirectly. What makes me more furious is that it could have been completely preventable, and that the mother saw the child declining yet did nothing to help the child, then when medical and nursing staff was trying to save the child's life, she had the gall to complain.

I doubt it was anything remotely close to CPR.

Probably true, although the father apparently had some EMT training. Perhaps the mother had taken a BLS course or something. Who knows? It doesn't affect the outcome.

“People are a lot healthier in countries where doctors aren’t paid by patients.”

The unavoidable implication is that if only the US had followed a different model for paying doctors, Delozier would have allowed her child to receive exactly the same medical care that she refused out of deep philosophical principle. The rigidity of her principles apparently vary with the funding model.
That makes no sense at all, but has the advantage that it's someone else's fault.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

So, vaccinations are now linked to shaken baby syndrome? Someone shakes the hell outta their kid in a fit of rage, enough so that the child is badly injured, and the vaccine did it? I thought I'd heard (read) just about everything.

No, wait. A mother that let her child die horribly from a treatable condition cries and says the medical community is the biggest killer she knows. The complete lack of self awareness and accountability is gobsmacking. Unbelievable.

By SelenaWolf (not verified) on 16 Jun 2015 #permalink

I am a little confused by Orac's jump to attacking religion in this case. Like commenter #2, this murder appears to be due to the organic fallacy that natural is better and chemicals are evil.

Interviews conducted with Christine Delozier on March 24 and March 30 found that her child had been born at home without the use of a midwife and from there on, had never seen a medical doctor, nor did she receive any vaccinations. She said her views against modern medicine stem from her childhood as she was raised without taking pills or receiving shots.

How does she know what modern medicine is like if she has had no experience with it? This paragraph implies that Christine might not have ever seen a doctor. It also tells us that she's a second-generation anti-vax loon. Is she young enough to have been able to attend school with a philosophical objection waiver on her parents' part, or was she home schooled?

And what about her husband? I didn't see anything in the post regarding his views. Does he share her mistrust of (or lack of experience with) doctors? Did he try to do anything to get Hope treated sooner, and was overruled by Christine, or did he go along with it?

By Eric Lund (not verified) on 16 Jun 2015 #permalink

@SelenaWolf

Put shaken baby syndrome into the search box of this blog. You'll find a number of stories where anti-vaccine folks have tried to blame SBS on vaccines in an effort to exonerate some parents. The most famous example is Alan Yurko.

@Eric Lund

Not sure about Mr. Delozier's views, though I did find his FB page, as well as a couple police reports from 2013 and 2014 for DUIs. The DUI reports were for an Ebed S. Delozier of Falls, PA. Could be a different Ebed S. Delozier than the one in Orac's post, but I doubt it.

Todd, I am guessingthe same Ebed S Delozier. One news report I read stated he was not bailed due to an outstanding warrant. It also quoted him as stating, in somewhat unconvincing fashion, that he agreed with his wife's opinions about medicine. My guess, goshIam doing a lot of dot joining, is that Ebed had not drunk the koolaid quite as deeply, but let his wife have her way for a quiet life.

I would suspect there is more going on here. That line about western medicine being the number one killer in America suggests to me she is suffering some form of delusions. Clearly she was totally disconnected from the world. Perhaps a postpartum mental disorder was in effect.

She believes her dead child would have been treated differently in England? To some extent that is true. I do not think she would have been allowed to not give her newborn baby any form of post-natal medical examination. I think if she had continued to refuse a check up the child would have been taken in to care by its assigned social worker and therefore still been alive today. So there would have been that much difference.

The arrogance of this woman is sickening. He ignorance barely less so. The combination is toxic.

By Gemman Aster (not verified) on 16 Jun 2015 #permalink

That line about western medicine being the number one killer in America suggests to me she is suffering some form of delusions

If Ms Delozier is deluded then it is a delusion shared by Mike Adams and his countless acolytes; it is a delusion repeated across bulletin boards and the Faceborg; it is a very profitable delusion from the perspective of quacks and grifters, and one that they encourage.
When a delusion is sufficiently widespread it is a symptom of our shared human stupidity, rather than of individual post-partum psychosis.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

I wonder if the strain of Streptococcus pneumoniae was one of those covered by Prevnar (you know, one of the evil childhood vaccines).

By Dead blood analyst (not verified) on 16 Jun 2015 #permalink

I seem to be more emotional the past couple days (over tired from a busy weekend, I think). I am sitting here crying for a baby I never knew. Mr Woo is a bit disgusted (strong believer in antibiotics; his woo is intermittent, and usually based on the fact woo assures you they "cure" while medicine only "treats"). Part of me would feel sorry for the mother, but the fact she is three months after the fact and still has no real remorse horrified me.

Sadly, this story should be kept at hand to combat the vaccinations mean ear infections anti-gay assertion.

I don't know what to believe... let your child die? My kid ran a fever more than two days and I was frantic for a doctor.

Stupid question - are they very poor without health insurance?

The post-partum mind disturbance seems plausible, and as a mother, so tempting. I cannot fathom watching your baby die. But as the baby got sicker, she would actually be a lot less active, sleeping more... a mentally ill mother, rather than being alarmed, might find it a relief.

Poor baby girl.

# Herr Doctor Bimler
I know that people have always been stupid, but sometimes these days it seems like people have less shame about opening their mouths in public and letting the stupid out.

When you are that ignorant you don't even realize how stupid you sound.

On the other hand “People are a lot healthier in countries where doctors aren’t paid by patients.”
seems true if you look at OECD stats. But it does not seem to have anything to do with treatment, more likely, access to healthcare.
As they say, even a stopped clock is right twice a day.

I always liked Shaw's statement.
That any sane nation, having observed that you could provide for the supply of bread by giving bakers a pecuniary interest in baking for you, should go on to give a surgeon a pecuniary interest in cutting off your leg, is enough to make one despair of political humanity. G. B.Shaw http://www.online-literature.com/george_bernard_shaw/doctors-dilemma/0/

By jrkrideau (not verified) on 16 Jun 2015 #permalink

The father said they couldn't afford the medical bill for the hospital and they live in a camper on a church's property. You have to wonder if they're equally distrustful of government. It doesn't sound like they have Medicaid, and are just one step above being homeless.

I would suspect there is more going on here. That line about western medicine being the number one killer in America suggests to me she is suffering some form of delusions.

She shares this delusion with at least one of her parents--note her claim that she didn't take pills or shots when she was growing up. In an environment like that, she would think that distrust of doctors was normal. And one of the downsides of the internet is that she can easily find like-minded people, such as Mike Adams (as HDB notes above), who appear to people who don't know better to have some credibility on the issue. I can't rule out post-partum mental illness in Christine's case, but her mistrust of doctors does not originate from that.

@Todd W.: Thanks, that clarifies the situation a bit. With two DUI incidents in two years, it's likely Mr. Delozier's driver license has been suspended or revoked, so he would not be able to take Hope to the hospital even if he thought it necessary, and if he was also a fugitive, I can understand his reluctance to call an ambulance. That doesn't excuse his not calling somebody else for help--apparently they lived on the grounds of their church, so he could have asked the pastor or one of the other church staff (assuming he and his wife weren't the church staff), who ought to be willing to help out in such a situation.

By Eric Lund (not verified) on 16 Jun 2015 #permalink

Certainly on certain point Mrs Delozier know more than the author of the article, (assuming the author really believe what he wrote). Indeed it is an established fact that american medicine
1) has been toroughly corrupted by pharmaceutical companies and some greedy (to a psychopathic level) doctors
2) and it has now become a major mortality cause in the USA.
Yes Mrs Delozier is very scientific on this because she could be defended by some of the world leading epidemiologists, including Dr Pete Gotzsch (co-founder of the prestigious Cochrane Collaboration group) (see his latest book: Deadly Medicines and Organized Crime: How Big Pharma has Corrupted Healthcare). Dr Marcia Angel, former editor in chief of the New England of Medicine wrote that she has come reluctanly to the conclusion after many years at the NEJM that she cannot trust the studies she read in mainstream medical journal, just like Mrs Delozier.
Furthermore I found the harrassment against the well-meaning lady incredible, especially given the atrocious pain for this lady of losing her child.
The author of the article (who does not state if he has any link to pharmaceutical public relation firms) won't put in contrast this rare death with other death created by anaphylactic reaction to antibiotics, and millions of death caused by pharmaceutical companies. On the whole for 1 exceptional case like Mrs Delozier child there might be 100 other cases (probably a lot lot more) that would be saved by a systematic distrust of the pharmaceutical establishment.
And while Mrs Delozier clearly had the best of intention, it is not the case with pharmaceutical who have and will continue to favor profit over customers death.
And I see no pharmaceutical CEO being charged with "homicide by imprudence" even there are dime a dozen cases cases of mass "premeditate homicide" with a clear profit motive (a recent one is Mediator in France)
A big mistake was for Mrs Deloziers to stay in the extremely toxic society that has become the USA in 2015 and move to some place where she could have found a less-corrupted medical community which could have respected and even shared some of her views while gently providing the missing knowledge and help that might have saved her child.
As the jews in the nazi germany have learn the hard way, it is sometime imperative to leave a toxic country

I am going to make my standard observation for such cases:

Notice that 'Dumbfuck A' on the left is wearing glasses. These people believe their god is 'the great healer' yet won't even trust their own myopia to said healer. But their daughter's bacterial meningitis clearly run amok? No problem, they'll sit back and do nothing.

Which to me, this reveals an extreme narcissism on the part of the parents. I've noticed that these healing cult adherents almost always wear glasses; i.e. they aren't willing to experiment their 'faith' on themselves.

If it were them slowly dying, I highly doubt the would have just sat there and let nature take its' course. But their defenseless daughter whose wellbeing is dependent on them? Sure, they're willing to go Holy Roller on her.

Evil. Pure evil.

What the fuck! I hope all of their other children are taken to safe homes, and never allowed to be near their relatives ever again. How do you not notice a toddler in that much distress? Why do anti-vax parents even have kids? Is it just for the social points?

Personal story: me and little sis at about fiveish and three got ear infections. We were in pain and spent most of that time screaming. We got treated quick, because our parents actually cared. Of course, we subsequently made their lives a misery because the antibiotic was awful (and little brother got in on the action because he thought the anti-biotic was a special Big Kid thing.)

By Politicalguineapig (not verified) on 16 Jun 2015 #permalink

I once talked to somebody very much against "Western medicine", who told me that she'd never give her children antibiotics. When I asked about treatment for, say, an infection, her response was that she'd cure them by squirting breast milk wherever the infection was (I swear I'm not making this up.)

@ Andrew
I like to see her treat an urinary-tract infection.

This was in an online forum 5 or 6 years ago. I wish I could find it. There were a lot of crazy statements on that same line.

(the breast milk thing came from her belief, which I know I've heard other places, that she doesn't need to vaccinate because breast milk provides antibodies. Then I asked about other things kids are taken to doctors for, like ear infections, and she mentioned breast milk with that too.)

There's more going on here than mere distrust of "modern medicine". I trust modern medicine; but if my kid was in this much pain and unable to eat and drink, and modern medicine had failed to cure him, I would try anything - anything! - to make him feel better. That includes homeopathy and chicken sacrifice. Watching you kid suffer and die while not doing anything is not normal.

(waving at Helianthus: salut, fellow countryman! Homicide par imprudence is manslaughter, if I'm not mistaken)

It takes a special level of evil to dismiss the death of a child. Oh look, there's Johnny @35, right on cue.

Herbert from Canada:

Indeed it is an established fact that american medicine...has now become a major mortality cause in the USA.

Citation needed. Citation needed that Medicine is a "major mortality cause". Citation needed that patient outcomes would have been better without medical treatment.

The author of the article (who does not state if he has any link to pharmaceutical public relation firms)

Pharma Shill Gambit. Oh, and if you click on Orac's name at the top of the page, you'll be taken to his "About" page, which will tell you all you need to know.

this rare death with other death created by anaphylactic reaction to antibiotics, and millions of death caused by pharmaceutical companies.

As I said before, citation needed.

By Julian Frost (not verified) on 16 Jun 2015 #permalink

" warped view of religious freedom produces an extreme deference to religious beliefs as a justification for the medical neglect children."
While cultural deference toward faith is certainly part of the reason so few cases of religiously motivated medical neglect are prosecuted, I don't think that it is the only or even primary factor in the failure to hold the guilty responsible. When parents who love their child lose that child due to their ignorance, there is a tendency for observers to say two things: 1) "they have suffered enough already." and 2) "they didn't know any better so it's not really their fault."

Congratulations, Johnny! You've identified one real, serious adverse event associated with one vaccine used during a single seasonal flu season--albeit one with an very low incidence rate (1 cses per every 1000 inocculations). By compariosn, note that the overall clinical fatality ratio's associated with influenza infection in the Untied Kingdom was 0.4 per 1000 infections over the same time period--20 times higher--and within specific at risk groups much higher (for example, 1.5 fatalities per 1000 in indviduals aged 65 or older.)

Of course, public health agencies rapidly acted to withdraw the vaccine from use, and to investigate whether other 2009 and later seasonal flu vaccines containing the same A(H1N1)pdm09 virus strain were associated with increased risk of narcolepsy (they were not--see http://www.neurology.org/content/early/2014/10/15/WNL.0000000000000987…)

So if your argument is that the 2009 Pandremix flu vaccine was associated with a severe adverse event occurring at a very low incidence rate, you've succeeded.

Other than that, though...

Johnny-

Running away from our conversation yesterday on SBM, I see. I've posted several questions for you that you have conveniently ignored. I'm patiently waiting... but then again that's your MO. Make claims you can't support, then run away, only to return the next day with the nice memory hole where the rebuttals resided...

Another success story for homeopathy.

Key paragraph from the story

She told police she has done her own research on vaccinations and found they can be related to death, SIDS, autistic disorders, immune disorders and shaken baby syndrome. While her views are not religiously motivated, she said she does feel God is the ultimate healer.

This is not really a case of medical neglect.Deliozer is just another rabid antivaxer.A graduate of Google U.She is no different than the crazies that post at Age of Autism.

I really feel sorry for this poor child.I have some idea what she went through.I had recurring inner ear infections for many years.Well into adulthood.I did develop labyrinthitis,that mostly eventually improved.I found out eventually that my ear infections were just one manifestation of a cellular immune deficiency secondary to inborn metabolic disease.

Antivaccine beliefs kill children.It's as simple as that.

By Roger Kulp (not verified) on 16 Jun 2015 #permalink

@Todd W. #16

"Put shaken baby syndrome into the search box of this blog. You’ll find a number of stories where anti-vaccine folks have tried to blame SBS on vaccines in an effort to exonerate some parents. The most famous example is Alan Yurko."

Good gawd. I have no words after reading ...

By SelenaWolf (not verified) on 16 Jun 2015 #permalink

While cultural deference toward faith is certainly part of the reason so few cases of religiously motivated medical neglect are prosecuted, I don’t think that it is the only or even primary factor in the failure to hold the guilty responsible. When parents who love their child lose that child due to their ignorance, there is a tendency for observers to say two things: 1) “they have suffered enough already.” and 2) “they didn’t know any better so it’s not really their fault.”

Although religion is probably not the primary motivator in this case (as it was for the Schaibles, for instance), it clearly is a factor. (If I were the defense attorney, I'd build a case based on parental rights and religious freedom, because that's the only one that might work.) Also, there does tend to be more of a reluctance to prosecute parents who lose a child as a result of their belief in religion—but only if it's a good, Judeo-Christian religion, no matter how nutty the fundamentalist sect is. No such deference, I will admit, is given for fringe religions that are not offshoots of the dominant Judeo-Christian religious paradigm. (For instance, imagine someone who is Muslim justifying her actions with respect to refusing conventional medicine based on her religion. I doubt the deference would be anywhere near as great.)

Still, you make good points, but you forgot yet another reason for deference. Parental rights trump the rights of the child in many cases.

And there goes Johnny - whistling past the cemetery again....

I can't even imagine the pain and suffering that these parents allowed their child to endure before death....they deserve to be burned at the stake or subjected to the exact same treatment that their child suffered through....that would be justice.

And for Herbet above - really, the same applies as to Johnny - asshats who wouldn't know reality if it came up and bit them.

"As the jews in the nazi germany have learn the hard way, it is sometime imperative to leave a toxic country"

Ah! And there it is! Was waiting for it...

By SelenaWolf (not verified) on 16 Jun 2015 #permalink

The post-partum mind disturbance seems plausible, and as a mother, so tempting.

The question of whether or not the mother was suffering from some sort of mental illness has undoubtedly been looked into from a legal and medical standpoint since this utterly disgusting event occurred; it doesn't seem to have been a factor, and discussing it seems pretty pointless.

^ That was in regards to the discussion of delusion, post-partum disturbance, etc., in general, not directed specifically at Mrs. Woo.

Although religion is probably not the primary motivator in this case (as it was for the Schaibles, for instance), it clearly is a factor. (If I were the defense attorney, I’d build a case based on parental rights and religious freedom, because that’s the only one that might work.) Also, there does tend to be more of a reluctance to prosecute parents who lose a child as a result of their belief in religion—but only if it’s a good, Judeo-Christian religion, no matter how nutty the fundamentalist sect is.

I am quite possibly missing something, but I didn't pick up any suggestion that these awful b@stards belonged to any particular sect, or even that they were Christians. "[S]he said she does feel [G-d] is the ultimate healer" could simply refer to a vague belief in some sort of G-d, even a "Life Force" or whatever.

If her views are "not religiously motivated," and there's no evidence that she belongs to any particular religion, I'd go with HDB in surmising that the problem is simple stupidity and rejection of the "medical paradigm" in favor of, well, nothing, I guess.

^ Oh, derp, I did miss something - the reference to the Hope Baptist Church. Should not be commenting while grading homework.

Orac@43

I think we can all more or less agree that antivaccinationism and all that goes with it,has become very much like a religious cult.The mistrust of government and mainstream medicine,the belief that homeopathy,MMS and other "sacraments" can "heal",the god like worship of Andrew Wakefield,etc,etc,etc.Deliozer may not have had an autistic child,but neither do a lot of parents in the antivax cult.There are parents who fervently believe in this stuff,who think that their antivax,anti mainstream medicine beliefs prevented their child from becoming "vaccine damaged".

By Roger Kulp (not verified) on 16 Jun 2015 #permalink

Notice that ‘Dumbfuck A’ on the left is wearing glasses. These people believe their god is ‘the great healer’ yet won’t even trust their own myopia to said healer. But their daughter’s bacterial meningitis clearly run amok? No problem, they’ll sit back and do nothing.

Further to this point: she is wearing earrings in that photo. I may not be the best judge of such things, but those don't look like clip-ons to me. So at some point she had her ears pierced. A procedure which I would expect (I have not been through it myself) to involve having some kind of needle stuck through the ears. So she's not anti-vax because she's afraid of needles--that would still be wrong, but at least understandable. But no, she's willing to have needles stuck in her, as long as the person doing the sticking isn't a doctor.

Yikes, every time I think about this, she comes off looking even worse.

By Eric Lund (not verified) on 16 Jun 2015 #permalink

As the jews in the nazi germany have learn the hard way, it is sometime imperative to leave a toxic country

Thanks to the misguided parents the child has left this( toxic) world.
And please, leave nazi germany out of the equation.

I wonder if the strain of Streptococcus pneumoniae was one of those covered by Prevnar

"In May, police investigators met with Dr. Paul Bellino, who is the director of the pediatric residency program at Geisinger-Janet Weis Children’s Hospital. Bellino reviewed the pathology report prepared by Dr. Terzian as well as the investigative details and photographs associated with the victim’s death. Bellino agreed the child could have been saved with a vaccination or simple antibiotic."

@ Gargoyle

salut, fellow countryman! Homicide par imprudence is manslaughter, if I’m not mistaken

*waving back*
It's nice to know I'm not the only Frenchman/woman wandering here :-)
(although there are a few other French people among the regulars, I believe)

And yes, manslaughter is the proper translation for "Homicide par imprudence". Oddly enough, the "slaughter" part makes it much more ominous than the French sentence, to my ears.

By Helianthus (not verified) on 16 Jun 2015 #permalink

These folks live in rural north central Pennsylvania. These beliefs and more are common there and up into rural New York where I am. (A local woman once told me that deaths from vaccinations and "big Pharma" were a secret method of government population control.) Mrs. Delozier is sadly not uncoommon in these parts.

@JP, as much as it might seem like I was wondering that, I was admitting to my own very human reaction - "was this woman crazy? Only a crazy mother could endure watching that kind of suffering in a child..."

I am tempted to disagree with Orac on her best defense. I think I would use extreme emotional disturbance and suggest that she was suffering from undiagnosed post partum psychosis and that her childhood made her more prone to be scared of medical intervention in her deranged state.

It is likely a lie, but most human beings cannot fathom refusing a child valid medical treatment and would struggle to remain skeptical about mental illness.

My son was very colicky and I would do anything and everything to relieve his discomfort. When it was obvious he inherited my familial allergies, ear infections became the norm until he was old enough for Zyrtec. He seemed the least bit off and we were at the pediatrician's again. I cannot imagine no, wait, I can. I am watching an adult kill himself. You can find it more comforting to believe in woo's absolutes rather than science-based medicine's honest percentages. Still... not even believing in antibiotics... then again, I suspect the neighbor doesn't vaccinate, and I know she believes in "natural progression of fevers to heal." Not sure where she stands on antibiotics. She does do surgeries...

@herbert

Furthermore I found the harrassment against the well-meaning lady incredible, especially given the atrocious pain for this lady of losing her child.

I'm sorry? Well-meaning? So it's OK to kill people if you are well-meaning?
And harassment? I don't force her to read my opinion.

Atrocious pain?
And the atrocious pain of the baby during three weeks, before she died, did you think of it, you self-righteous douchecanoe?
Please go tickle a brown bear pooh in front of its mother.

By Helianthus (not verified) on 16 Jun 2015 #permalink

If we want to prevent such harms in the future, we need to understand why they occur, and chalking them up to 'stupid' does not help at all. I suppose the usage is figurative, but it still over-simplifies complex mental mechanisms, and short-circuits our understandings of what are most likely social pathologies. Even if Ms. Delozier has mental health issues, there are reasons she went down this particular anti-medicine path in her distress that have nothing to do with brain chemistry.

So yeah, the particular form of spirituality she holds (as opposed to 'religion' per se) is likely a significant factor, though not THE cause. I like HDB's concept of "motivated spirituality", and suspect it's a good guess that Delozier went 'shopping' for both 'research' and 'theology' that would confirm her existing beliefs. The questions are: how did she come to those beliefs in the first place, how can we best 'innoculate' against the adoption of such dangerous beliefs, and best 'treat' the mental maladies when they do occur?

If we frame the problem as 'stupidity', the answers are too easy, and likely just wrong. If anything is clear from reading Orac's reports on the woo-besotted and the troll posts that follow, it's that exposing folks to the factual discoveries of medical science has no curative power. Literally stupid people don't process well in any direction. They're more befuddled than anything. That Delozier has developed a detailed mythological belief system to which she holds fast even after her child's easily preventable death indicates not befuddlement, but rather what we might call a warped active intelligence.

The language of 'stupid' functions to keep us on the plane where scientists and skeptics are most comfortable: 'fact', 'reason', yada yada yada. Yet, if science and reason tell us anything about 'the human condition' they tell us that homo sapiens sapiens generally are not inherently 'rational' and scientific. Our ol' lizard brains remain closer to the stem than out cerebral cortex, and 'instinct' or 'the subconscious' are going to trump (or dictate) abstract cognitive function most of the time.

Science speaks with great authority about objects and phenomenon that don't involve consciousness. On matters of human thought and behavior, what passes for 'science' remains woefully bad. A couple millennia later, we still haven't really improved on Aristotle's .Rhetoric as a model for understanding persuasion and belief. Ari posed three parts of rhetoric, working in combination. Logos (the logic of the word) remains the least of these, the most easily 'disposable'. Then we have Ethos, the personal 'vibe' of the rhetor apart from the subject at hand (e.g. I'm likely to accept things Orac says as i <i.feel he is generally knowledgeable, trustworthy, well-intentioned, witty, etc. etc.) And finally, the least dispensable element is Pathos, the activation of emotions.

Of course, that's all extremely broad-brush. The question at hand would seem to be how these elements played out in specifics as Christine Delozier developed her hostility to conventional medicine. To begin to venture an answer, we would need to dig into her personal history. I doubt she came to her position by reading at pseudo-science websites. More likely this was a way of working out an identity that either meshed with her family and immediate community, or her define herself in opposition to them. Perhaps she had or witnessed some extremely painful experience she (or they) attributed to a medical professional, or medical professional are serving as a locus of projection of some other psychological injury at the hands of an authority figure too painful to deal with directly. Of course, the animus could be utterly idiosyncratic, but if it did turn out to be paradigmatic of some larger pattern, we might get some pointers on useful reforms to the way medicine is delivered in practice.

Again, i must suggest that anyone wishing to better protect the innocent Hopes of our society, including sbm advocates, could gain some insights on the issues here from cultural studies, specifically analyses of postmodern culture: which suggest that 'virtual communities' are coming to replace the roles of meat-space personal connections in many people's everyday lives. Which is to say, pseudo-science web forums could indeed become places that function as identity-formation agents in the form or either conformity or rebellion. Baudrillard would likely consider them simulacra, a form of 'the hyper-real', but point out that in our ever more media-saturated culture, the hyper-real not only becomes experientially indistinguishable from the concrete real, but supersedes it in some cases. ("Television is reality, and reality is less than television" is a line from Videodrome, but it might as well be J.B.)...

Which leads me back to another thought i have regularly reading RI and SBM... It seems Orac and the SBM bloggers scan news feeds for instances of woo, and then critique the woo itself, as if the stories about the woo are some transparent window on things that already matter in the real world. This, I argue, misses the forest for the trees, the forest being the media representations that define these subjects one way or another and give them a 'reality effect.' The OPs have hyperlinks to the sources, but rarely cite them, and almost never interrogate why and how the 'news organizations' are covering the story at hand, or what the effects of the choices made in framing that coverage might be. Also, stories on internet sites with minimal readership are treated the same as stories distributed by wide-circulation media agencies... It's all about the relative face-palm reaction to the degree of woo involved... In more than a few cases, the woo at hand is utterly trivial in itself, for, even if outrageous, there are only like a half-dozen wiggy people in one obscure involved — but the story about the woo is anything but, as it acts as metaphor or synecdoche for larger trends and may reaches millions (and millionss... and...)

One positive aspect of Hope Delozier's otherwise horrible death may be that not only has a prosecutor brought manslaughter charges, but an editor has decided the case is newsworthy, and presented it within the conventions of a hard news crime story, which may add a few drops to the bucket of dissuading others from following in the Delozier's footsteps. What the conventions of reporting on criminal cases will not do, though, is offer any insight into how the Deloziers came to do such a 'stupid' thing...

Chris Hickie@7

She performed CPR?

I doubt it was anything remotely close to CPR.

She missed the first step: call for help. These stories break my heart.

Anyone else note the dissonance between

"I watched her die,” Delozier told police.

and

With tears streaming down her face, she went on to say, “I believe the medical community is at least the third, maybe the first, leading killer in the United States.”

As always it's never about the child; she's too busy blathering on about the evils of modern medicine. It might be denial or even just how the reported wrote the article but it seems like I'm more upset over this child's death than her own mother.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

"Bellino agreed the child could have been saved with a vaccination or simple antibiotic.” NobRed

What more could we expect from the rubbery one. So from looking at photos the kid could have been saved.

Looks like more marketing promotion for the vaxxers to me, lots of appeals to emotion and false promise, taking advantage of undereducated people.

If it was science alone your opinion would be less than worthless. Get out that tissue box

"I’m sorry? Well-meaning? So it’s OK to kill people if you are well-meaning?
And harassment? I don’t force her to read my opinion." Helikunt

Well doctors do it all the time with vaccines and antibiotics. The latter overprescription has now put the whole world at risk of untreatable death according to the WHO.

http://s.telegraph.co.uk/graphics/projects/antibiotic-resistance/

"I think we can all more or less agree that vaccinationism and all that goes with it,has become very much like a religious cult.The mistrust of nature ,the belief that vaccines, drugs and other “sacraments” can “heal”,the god like worship of Paul Offit,etc,etc,etc. may not have had an autistic child,but neither do a lot of parents in the vax cult.There are parents who fervently believe in this stuff,who think that their vaccines and mainstream medicine beliefs prevented their child from becoming “vaccine damaged”. Roger Burp

"Well into adulthood.I did develop labyrinthitis,that mostly eventually improved.I found out eventually that my ear infections were just one manifestation of a cellular immune deficiency secondary to inborn metabolic disease.

Antivaccine beliefs kill children.It’s as simple as that. Roger Burp

No Roger, those recurrent ear infections were probably due to the DPT vaccine. childhood vaccines kill children. period

"Looks like more marketing promotion for the vaxxers to me, lots of appeals to emotion and false promise, taking advantage of undereducated people."

That preventing the infection (vaccination) or treating the infection (anti-biotic) could have saved her life is undebatable. Well, at least to people with a shred of intellectual honesty. Which you have clearly demonstrated you don't have. There is someone under-educated here and it isn't just the parents of this child...

I'm still waiting for your response over on SBM. Running away simply reinforces the fact that your arguments are specious and you know it...

Sadmar, I think that comment above should properly have gone on your "One Ragged Claw" blog.
johnny:

So from looking at photos the kid could have been saved.

Given how easily the conditions are treated if they're caught in time, yes the child could have survived.

By Julian Frost (not verified) on 16 Jun 2015 #permalink

Religion in the USA is very cultural and I find that many people are more spiritual than they are religious although they identify as Christian. It is an American thing and goes along with "God Bless America' and national pride. It seems that this couple were more spiritual than religious.
They are probably going to use religious freedom in their defence as it will go better than the actual truth of neglect.

Also, not to detract from how evil this couple are but the US health care system is truly awful. All doctors need to band together to reset it completely. I am working here for a short time and being treated so shabbily makes me want to rush back home where I am treated with respect AND in a timely manner. Your current system is contributing to turning people away from science based medicine and over to this woo based nonsense.

There was an outbreak of mumps among NHL (National Hockey League) players on several teams this past winter. Does anyone know how it began, and whether failure to vaccinate was involved?

By DANIEL GAUTREAU (not verified) on 16 Jun 2015 #permalink

"No Roger, those recurrent ear infections were probably due to the DPT vaccine."

This child's parents were strongly anti-vax and anti-medicine. Nice try...

@Johnny - your one of the most vile and idiotic people I think we've ever had the unpleasant experience of dealing with.

#1 - the child was unvaccinated

#2 - the child died of an ear infection

#3 - the parents did absolutely nothing to treat the child (homeopathy is just that, nothing)

How many children do you know that die of ear infections, Johnny-boy?

Orac said: As it is, I highly doubt the Deloziers will ultimately serve significant jail time even if convicted. Parents who kill their children through medical neglect like this rarely do.

I second this. I had a toddler whose mother beat him to death with a table leg. She only got 11 years for murdering her son. Medical neglect is so passe compared to actual abuse, or at least our legal system seems to think so. :mad:

This whole thread is a repeat of the Disney bull about measles. Ok a couple of sad uneducated parents demonstrate pizz poor parenting, absolutely. But to use that to promote vaccines is again a sick piggy back and definitely not going to stop this kind of thing happening.

There is no justification for vaccinating dogs, let alone children. That is the real issue.

Andrew #32: it is true that breast fed babies are less likely to get ear infections. It has less to do with the antibodies in the milk and more to do with how the babies suck from a human nipple as opposed to a bottle nipple. And while there's some evidence that breast milk rubbed on an umbilical cord stump results in outcomes as good as soap and water or alcohol, there is a big difference between that and treating an actual infection.

I hate it when people conflate something that is healthy in one way as being a magic bullet to treat everything :facepalm:

I'm wondering if any of the medical pros here might have some thoughts/suggestions for a young friend (seeking) seeking an education program toward a career in medicine;

She isn't qualified enough to pursue an M.D., and doesn't want that level/sort of work anyway. Her plan was to become a PA, but she wound up only being wait-listed at any of the schools where she applied, all of which were in CA (where her family is) and are apparently among the more competitive for admission nationally. She's trying to decide whether to cast a wider geographic net for PA programs, or seek training for Nurse-Practitioner instead.

I take it some readers here know this terrain pretty well, and I'd welcome any comments on the relative merits of the two career paths, or recommendations for good programs in either where she might have a better chance of gaining admission. (She's an A1 'kid', BTW, and would be a valuable contributor to medicine in either capacity, imho.) The pragmatic limiting factor is that her partner is a young chef working his way up in the world of 'fine dining' cuisine. So they pretty much need to live in a city with an active restaurant scene that would have job opportunities conferring some cred in the culinary world — which probably leaves out any universities in 'university towns'.

Her dad's a retired English professor; mom's a graphic artist... there's no personal resource for info/advice on medical training among close family and friends, so any informed input the minions might share would be great! (tia)

To Daniel: it's thought that outright failure to vaccinate against mumps probably wasn't a big factor in the NHL outbreak - but that players not getting the recommended second vaccine dose (which wasn't instituted until the early '90s) and close contact between team members were likely involved.

http://www.forbes.com/sites/tarahaelle/2014/12/16/nhl-mumps-outbreak-wh…

What struck me as mind-blowingly stupid is that even after the outbreak was well underway, some players were quoted as saying that no big deal, they weren't going to get booster shots. Even if you don't care about being sick and out of action, thus hurting your team, personal considerations should drive you to get that shot.

By Dangerous Bacon (not verified) on 16 Jun 2015 #permalink

Julian #66; Fair enough. Mea culpa. Been too busy to use the blog. Shifted topics in one comment, too. Which could/should have been separate posts. So it goes.

Orac - I know you hate people telling you how to run your blog, but isn't there any way to prevent troll johnny from appropriating proper Johnny's username? I generally ignore his word salad but its difficult when he's impersonating a commenter who actually has worthwhile things to say (which is doubtless why he does it.)

Agreed that the mother is a horrible person, let's not let Dad off the hook. Screw the bench warrant, his daughter was dying.

(I also have some problems with the 30minutes of CPR. Whatever she was doing for thirty minutes it wasn't CPR.)

Even if you don’t care about being sick and out of action, thus hurting your team, personal considerations should drive you to get that shot.

We're talking about pro sports here, so sick leave provisions are going to be especially generous; e.g., I assume that at that level you'd be covered for games missed due to a game-related injury. But would that extend to a major illness like mumps? If not, then I would think that simply getting paid would be incentive enough for most people.

I can understand the first few cases. In this case the recommended vaccination schedule changed after they were the appropriate age, so they may not have thought to go back and get booster shots. But once the outbreak was well underway, what possible rationale (other than already being sick, meaning it's too late for you) could there be for not getting the second vaccination?

By Eric Lund (not verified) on 16 Jun 2015 #permalink

Once again, johnny argue by assertion as the facts are not on his side/.

By Julian Frost (not verified) on 16 Jun 2015 #permalink

Not 100% sure but I think for NP you do go through nursing school first and get your RN liscence (but there may be combined programs).

Main difference out in the real world is NP's can at least in some states practice solo where PAs usually have to work under a physician. In the practices around here they often have both and usually NP solo practices tend to be out in very rural communities where you wouldn't usually see much in the way of fine dining (although I've had some great meals as some small rural diners).

sadmar@75
Pretty much what Kay Marie said. I'm fairly sure you need to be a nurse before getting NP. Whether that means a degree (BSN, ADN) or licensure (RN, LPN) I don't know. That being said every NP I know had some years experience working as an RN before getting their NP. As far as PA school is concerned it is incredibility competutivw

Not sure if this is a general trend but in my experience I've seen more PA's working in hospital settings and NP's more often in private practice. I think it might be a function of what Kay Marie said about PA's working under an MD. That being even in those cases the PA's seem to operate pretty much independently of the docs.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

Oops, hit submit too early.
As far as PA school is concerned it is incredibility competitive. My friend took three years of applying to get in. It might be worth looking into getting a CNA (can usually be done at community college in a semester) and applying for tech jobs at hospitals. That and casting a wide net.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

@johnny (#64):

childhood vaccines kill children. period

I sincerely wish you had received all your childhood vaccines.

By Richard Smith (not verified) on 16 Jun 2015 #permalink

Sadmar-

My alma mater (Pacific University) has a PA program that is only 20 minutes from Portland, which has a sizeable restaurant business.

http://www.pacificu.edu/future-graduate-professional/colleges/college-h…

Might be worth looking into a trip up I-5, though I think admission is also highly competitive there as well.

Not quite as lucrative as PA, but ultrasound tech seems to be an interesting job...

@ Roger Kulp:

Imho a good point about pseudo-religion in #51, which is why I couldn't disagree more with #41's attribution of blame to homeopathy and Google U Dunning-Kruger. I think Gargoyle's right: something much deeper is at work here than any con-man can sell, or prime a rube to pick up on dubious websites. I also thing HDB has it pegged that whatever she Delozier adopted as treatment or rationale was mere convenience, guilty only of not being totally incompatible with her worldview. That the 'modality' happened to be homeopathy is likely no more significant than had she just kept wearing lucky underwear and tossing salt over her shoulder every four hours. Following Gargoyle, I'd note the con-ucopia of woo is overflowing with remedies she DIDN'T try as she watched her daughter sicken and die. And her reference to autism strikes me as grabbing anything that's floating anywhere in the woo-o-sphere and tossing it against the wall opportunistically.

@JP:
By the same token, I don't see a warrant to dump on the Baptists either (unless her specific church was fringey in that particular way, anyway). I think I understand your reluctance to consider mental health issues as a desire not to add to the demonization of the vast majority of us affected with same who pose no physical threat to anyone but ourselves. And Mrs. Woo's query on PPD strikes me as perhaps too kind (in the wayfor which we love Mrs Woo), and not very likely a factor. But personality disorders are not the kind of things police uncover in investigations, even when the suspect has been diagnosed by a psych professional —which most haven't and would be especially unlikely for a mediphobe such as Ms. Delozier. I don't have a clues to what her 'issue' might be exactly, but I'm guessing it's in the DSM. (Fwiw; afaik, personality disorders do not qualify as legal defense...e.g. I don't think they let you off if you're a sociopath.)

In addition to CNA she might look at CMA (certified medical assistant) especially if she thinks she wants to be more out in ambulatory clinics than in a hospital or nursing home sort of setting.

I think the CMA is usually a 2 year program and you can do it at the community colleges around here.

Sadmar @ 75: to become an NP you must have completed a BSN and then go on to a NP program (these are now offered at the doctoral level). Some DNP programs allow entry for students without a nursing bachelors, where the student first completes the BSN requirements and takes the RN licensing test, but continues seamlessly into the DNP.

Rules for practice as a mid level provider (PA or NP) vary mightily from State to State, so it is hard to clearly state which preparation would be "better". NP programs may be less hard to get into, as many of these allow for part time study, and may be partially or fully online.

By Mnemosyne (not verified) on 16 Jun 2015 #permalink

@renate in #31

I like to see her treat an urinary-tract infection.

My initial response was to invoke Rule 34, but then I thought don't bother, because it's too easy.

By Marry Me, Mindy (not verified) on 16 Jun 2015 #permalink

@Sarah A - I can understand wanting to avoid troll johnny's inputs (fascinating - my Kindle auto corrected "johnny" to "nothing"). It has been my experience, though, that much of the longer discussions at RI are spent rebutting troll assertions, so I at least scan even the worst of the trolls' screeds.

I do have to admit that troll johnny seems to do little to make him worth reading...

FUCK FUCK FUCK FUCKITY FUCK

What fucking monsters.

By Marry Me, Mindy (not verified) on 16 Jun 2015 #permalink

@sadmar:

By the same token, I don’t see a warrant to dump on the Baptists either (unless her specific church was fringey in that particular way, anyway).

I wasn't dumping on the Baptists, actually; I doubt the Baptist Church she belonged to had much of anything to do with her beliefs or actions, TBH. It was just that I hadn't read her statements as indicating that she even belonged to any religion in particular, and then noticed the reference to the Hope Baptist Church, so I was just correcting my own slip-up.

I think I understand your reluctance to consider mental health issues as a desire not to add to the demonization of the vast majority of us affected with same who pose no physical threat to anyone but ourselves.

There may possibly have been a little of that involved, but I actually don't think so. It's more that if there were mental health issues present in a way that might explain anything - i.e., actual psychosis, for instance - I imagine that that would have gone into the sentencing. It doesn't appear to be the case from the information we have, which granted, isn't that much, but I still don't really see the point of speculating about it.

But personality disorders are not the kind of things police uncover in investigations, even when the suspect has been diagnosed by a psych professional —which most haven’t and would be especially unlikely for a mediphobe such as Ms. Delozier. I don’t have a clues to what her ‘issue’ might be exactly, but I’m guessing it’s in the DSM.

If it doesn't affect her moral agency, sentencing, or anything else, what's the point of speculating about whether or not she has a personality disorder of some point or whatever? I really don't see what the point of diagnosing personality disorders over the internet based on limited information is.

Everything's in the DSM these days, BTW.

KayMarie@88
I was thinking CNA because it would be easy to do in between application seasons and experience always helps. As far as medical assistant goes, when I originally considering my career someone told me not to bother with CMA and just shoot for PA instead. Working as a CNA pretty much anywhere but the ER would be miserable and CMA does seem better for ambulatory settings (this is all just my experience so grain of salt).

Some people get an EMT-B (also generally only a semester) and work for a private ambulance, company as experience for helping to get into PA school. I'd like to plug my profession but if the end goal is a PA degree I've been told that the CNA/tech route is a better choice.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

Orac – I know you hate people telling you how to run your blog, but isn’t there any way to prevent troll johnny from appropriating proper Johnny’s username?

I'd second this, but I've been complaining about it for some time.

I want to finish the comments later but I have to run out now. I saw this on FB and was deeply saddened. Even if the parents were poor they could have taken the child to the ED and had care provided. EMTALA doesn't allow you to be turned away for inability to pay. No, this is craziness that they sat there and watched a baby die from an ear infection. It makes me cry that the child is the one to suffer for the parents gross stupidity. My child looks a bit sick or runs a fever and he's going to the pediatrician immediately. The last scare was not illness but him shoving a mint leaf up his nose. The joy of toddlerhood.

Thanks KM, capn and EB!

She been working as something like a CNA for a few years, in a private practice in Brooklyn, though I don't know if she has an official certification for that. The desire for PA/NP isn't financial, but wanting to help patients in a primary-care kinda way, and I don't think she'd find any kind of med tech work satisfying.

What I got from her dad is that her applications were strong enough to get wait-listed at very selective schools (I don't know which, but i'm guessing Stanford is one since they're from Mountain View), so she might make the cut somewhere that's still quite competitive, but just a notch or too less so.

That NP gigs are mostly in the sticks is good to know, and Pacific sounds like it could be an option! I can think of some universities with 'name' med schools in cities that would be on the culinary map (e.g. Minnesota, Northwestern or Loyola in the midwest, and various on the northeast or mid-Atlantic) but i have no clue which might be good choices for an aspiring PA. So, please, post other specific wider-net suggestions like Pacific if you have 'em!

capnkruch: For aspiring NPs, once they've obtained a basic nursing degree and worked a bit as an RN, what sort of competition do they face for admission to the NP programs? It sounds like this could be a long road with a possible dead end if staying an RN wasn't a satisfying second-choice — is that so?

Ironic NB: My friend got her primary ed at the Waldorf School in Mountain View, now a major exemplar of a private school with atrociously low vax rates. I'd met parents of some her classmates there who had formed friendships with her folks (old friends of mine from grad school). This was over 15 years ago, and i had no specific woo-awareness really, but I never caught of whiff of any of crazy in this circle — though that might have been self-selection since my friends are art & literature types, but far too satirical-cynical to be New-Agey. They'd picked the Waldorf School as the best nearby alternative to the public schools they would have preferred, had those schools not been a mess at the time – the tech boom not yet having expanded into their 'hood. It's Google-town now though, gone way upscale. They couldn't come close to buying their very modest townhome at current market value). The other Waldorf parents I met through them were similarly regular middle-class folks, not notably privileged at all, and with none of the 'me, me, me' attitude that seems to go with the money. Times change. Anyway, I thought the minions would like to know at least one young person emerged from a Waldorf School unscathed and seeking work in conventional medicine out of a desire to help sick people with methods actually proven to work by legitimate science. (Though public high school and college at UCSC did occur in-between.)

@ Mrs Woo

I do have to admit that troll johnny seems to do little to make him worth reading…

I would agree, he think himself of being clever but even his insults are rather lame.
Why, he just called me a sousaphone. That's a pretty instrument, why should I feel insulted?

In the meantime, he is carefully no saying what his good pal the osteopath would have done about this baby's situation.
Oh, wait, his rants about mainstream medicine said it all: he would have done exactly the same thing as the parents, eschewing antibiotics for "herbal treatments", if any, and thus killing the baby.

By Helianthus (not verified) on 16 Jun 2015 #permalink

This is terrible. The whole reason hundreds, maybe thousands, of physicians over the decades have developed modern medicine was to avoid children dying like this. Poor, poor, little girl.

Kiiri: "No, this is craziness that they sat there and watched a baby die from an ear infection."

It's one of those things that make me wonder why religious people think God is benevolent. He and most of his followers are malevolent more often than not.

By Politicalguineapig (not verified) on 16 Jun 2015 #permalink

"That NP gigs are mostly in the sticks is good to know, and Pacific sounds like it could be an option!"

Pacific really is a great school. If your friend would like to pick my brain, I would be happy to send you my info...

"It’s one of those things that make me wonder why religious people think God is benevolent. He and most of his followers are malevolent more often than not."

That's the power of 'God's Will'. Did it happen? Yay! It was God's will! Did it not happen? Yay! That too is God's will! Did you get no answer to your request? Yay! God's Will is that you wait until the timing is right. God's ways are not our ways!

When your heuristic for belief is based on an unfalsifiable premise, random chance coupled with post hoc justification takes the helm. Unfortunately, dying of an untreated ear infection is within the set of random chance outcomes...

The really sad part? The mom now has to double down on her non-sense lest she come to realize the reality of the situation: her daughter died for nothing.

@ EBMOD

The mom now has to double down on her non-sense lest she come to realize the reality of the situation: her daughter died for nothing.

Let's not mince words. She killed her daughter.

By Helianthus (not verified) on 16 Jun 2015 #permalink

The scary thing is that despite the occasional prosecution, the purveyors of homeopathy chiropracty and similar quack remedies get away with this and even influence legislators.

@Julian Frost

"Citation needed"
You need to buy a new pair of glasses :-)
The full title of the book and the author are clearly stated. The entire book is the proof you (don't really) want to hear about

However you should have ask (but didn't) for Dr Marcia Angel (professor at Harvard, and former editor in chief of the NEJM - one of the leading medical journal in the world) exact citation because this is the most devastating blow ever written to the foundation of medicine. So here it is:

“It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” (New York Review of Book)

And this was not enough she added:
“No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top 9 U.S.-based drug companies that it comes to tens of billions of dollars a year in North America alone.By such means, the pharmaceutical industry has gained enormous control over how doctors evaluate and use its own products. Its extensive ties to physicians, particularly senior faculty at prestigious medical schools, affect the results of research, the way medicine is practiced, and even the definition of what constitutes a disease.”

No you are not reading Mrs Delozier, you are reading a top-notch medical professor at the leading medical school of your country.

While cultural deference toward faith is certainly part of the reason so few cases of religiously motivated medical neglect are prosecuted,

They should have moved to Idaho.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

The author of the article (who does not state if he has any link to pharmaceutical public relation firms)

The author of this comment does not state if he has any link to alt-med quacks, grifters and scammers.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

Herr Doktor Bimler-

As someone who was born and raised in Idaho, that link doesn't really surprise me. Idaho is run by the LDS Church. Something like 80% of the Idaho legislature is Mormon. We sometimes semi-jokingly refer to Idaho as 'Northern Utah'.

Makes my blood boil reading this from your link:

"But Rep. Christy Perry (R-Nampa) said the law, as it stands, represents the constituents of her district, Canyon County, where Peaceful Valley Cemetery sits. “They have a clear understanding of what the role of government should be,” she said. “[It] isn’t how to tell me how to live my life.”

And perhaps, she said, Followers of Christ are more comfortable confronting death. “Children do die,” Perry said. “And I’m not trying to sound callous, but [people calling for reform] want to act as if death is an anomaly. But it’s not. It’s a way of life.”"

Yes, but if the relative risk for children dying is far higher than elsewhere? Faaaaaack you.

Lastly, one of the jobs of the govt IS to protect the rights of it's citizens. In this case, the parents are abusing their children's rights as individual human beings; they are not possessions for their parent's wanton medical experimentation...

Nice argument from authority, herbert. Understanding the actual context of her position at Harvard is important:
http://www.nytimes.com/2012/03/20/science/a-drumbeat-on-profit-takers.h…

she cannot trust the studies she read in mainstream medical journal, just like Mrs Delozier

Something tells me Mrs. Delozier has never even been in the same room as a mainstream medical journal. Do you think your revered St. Angell would advocate that parents refuse medical care for their child?

Herbert-

You are correct that there are areas where medicine needs to improve. John Ioannodis comes to mind as someone who is doing great work to police medicine.

However, you are completely off base to think that this is influencing anything beyond the fringes and minor details of medicine. The broad strokes remain.

Vaccines don't suddenly not work. Anti-biotics don't suddenly not work for severe ear infections.

Further, your claim has a few things that draw my skepticism:

"No one knows the total amount provided by drug companies to physicians, but I estimate from the annual reports of the top 9 U.S.-based drug companies that it comes to tens of billions of dollars a year in North America alone."

This makes it sound like the pharm companies are paying off the physicians. Which I highly doubt. Show me paper trail as if that much money was moving around, the IRS would absolutely care.

Sounds to me like it is more accurate to say that is how much pharm companies spend promoting their products to doctors, through ads, presentations, and the like.

Lastly, there is a lot of research that occurs independent of pharm companies. So you have to keep that in mind.

Anyway, no one is claiming medicine is perfect. But the ramifications of such articles is far from enough to 'shake the foundations of medicine'.

Even if the parents were poor they could have taken the child to the ED and had care provided. EMTALA doesn’t allow you to be turned away for inability to pay.

For that matter, if you're down to living in a "camper" (scare quotes because I'm not sure what this really denotes) parked on church property, I'm pretty sure that the very contention is absurd.

I cannot speak for Dr Angell, but I can tell that after reading Dr Angell, Gotzche, Frachon, Kassirer, (to name just a few) as a retired medical doctor I do refuse to apply medical guidelines to myself and currently enjoy perfect health without any medication.
If I had knew what I know now, or if I had to make a career choice today, I would not have chosen to be a medical doctor because it has become almost impossible to practice ethically in the current toxic situation

@EBMOD
What you are quoting is not from me, it is from Dr Angell who was the frontline. But Gotzsche has listed lot of information that is publicly available (and some from his own epidemiologic research and contacts). Frachon talks in detail about Mediator, which is a special example, but the way it was treated by the official supposedly trusty medical independant organisation shows that you canot trust the regulatory bodies in France (and the other authors have example for Usa and other countries as well).
The conclusion of those who have studied the matter thoroughly is the same as Dr Angells: the corruption is thorough, pervasive, highly effective, and deadly. It isnt a special unfortunate case of an isolated unethical doctor as I previously thought and most of my colleague thought or are still thinking

Herbert: "I would not have chosen to be a medical doctor because it has become almost impossible to practice ethically in the current toxic situation"

So you would refuse to treat a child with a bacterial infection with antibiotics. Good thing you are retired.

Here is a book you might be interested in.

@Julian
@Herr Doktor bimler
No, it is a very appropriate concern.
Orac does not say in his blog description that he is not receiving any money from the pharmaceutical industry for this blog.
It is standard when you are truly independant to unequivocally say so when you write a medical article or a sensitive blog.

I can state personally that I am not receiving any money or advantage by any individual or organisation to rebuke the preposterous Orac. And I am not a fan of alternative medicine. I believe in true science, and am defending a poor woman from the ferocious inhumane attack of this ignorant doctor who refuse to state his independance from the pharmaceutical industry

Are you really defending "a poor woman" whom watched her child suffer for two weeks and then gasp for air before trying to help the child? This seems like an odd place to draw your line in the sand.

Because as we all know, every doc gets a check for ten thousand dollars for each dose of amoxicillin, and an all expenses paid to vegas, hookers and blow inclusive.

Herbert: "Orac does not say in his blog description that he is not receiving any money from the pharmaceutical industry for this blog."

That is very lame. Perhaps you should try his blurb at this not so secret other blog. And, no, I will not give you a link, because figuring out what it is comprises a sort of intelligence test.

It is standard when you are truly independant to unequivocally say so when you write a medical article or a sensitive blog.

This is a part of blogging ethics of which I was not previously aware, and had not seen codified in this way. My own comments are extremely sensitive and yet I had neglected to write unequivocally in each comment that I am not paid by the Laughing and Pointing at Numpties and Eedjits lobby. I will endeavour to do better in the future.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

@Chris

For your information, these are the official guidelines in a country where there is free health care for all, and as would Mrs Delozier say doctor are not being paid by their patient:

"The routine use of antibiotics to treat middle ear infections is not recommended as there is no evidence that they speed up the healing process.
...
Using antibiotics to treat minor bacterial infections also increases the likelihood of bacteria becoming resistant to them over time. This means more serious infections could become untreatable in the future. "
http://www.nhs.uk/Conditions/Otitis-media/Pages/Treatment.aspx

Only if later the situation does not improve should antibiotic be given.
Now what is not discussed and is crucial for fairness:
1) How quickly did the situation develop?
2) Was inadequate financial resources a factor is waiting a little bit more to see if it would improve? (of course, this is a USA-only problem)
3) How fulminant was the meningitis? (It may well be the case that even with the antibiotics the final outcome would have been similar)
4) Even though Mrs Delozier said she was against antibiotic, did she implicitly meant as a first-line treatment for otitis media (wise choice) or even if the situation deteriorate?
5) Even if she meant for all situation, can we really blame her with the education she has to be able to know when she can trust the treatment proposed by doctors and when she cannot ? (considering that many doctors might still be given antibiotics to all cases of otitis media in the usa)

Orac does not say in his blog description that he is not receiving any money from the pharmaceutical industry for this blog.

I suspect that would carry about as much weight in your case as your declaration that you're a retired M.D. does in mine.

Herbert-
I understand that you were quoting others. However, you were then extrapolating off of that information as if to imply that the notion of anti-biotics treating severe otitis media is a sham.

Nothing of what Orac criticized in this article would be changed even by pervasive corruption. With all of the independent research and adverse drug event reporting systems, to simply invent a drug out of whole cloth that offers no benefit and somehow get it through to market? Extraordinary claims require extraordinary evidence.

Lastly, as DZ pointed out, it is a really awkward spot to bring up your concern in light of this case.

Pretty clear that the mom was homicidally negligent...

I am unable to believe a single thing herbert says because there is nothing in his posts explicitly disclaiming financial remuneration from religious organizations, supplement companies, alt med clinics, or any source that might prejudice his comments.

This is the problem in our toxic society, everyone has an ax to grind and doesn't admit what it is before opening their mouths.

Disclaimer: I got a half sandwich, pickles and a large chocolate chip cookie supplied by a vendor during a presentation on lab equipment today. It's the least I should have gotten for having to sit through an hour-plus talk with boring slides when I could have been getting work done.* Obviously though, this conflict-of-interest puts me in no position to be critical of parents who let their child die, and then blamed her death on the medical system for compelling them to have foolish beliefs that prevented them from seeking proper care before it was too late.

*the dill pickle slices were pretty good though.

By Dangerous Bacon (not verified) on 16 Jun 2015 #permalink

Now what is not discussed and is crucial for fairness:
1) How quickly did the situation develop?

So, you're too lazy to even read the post?

2) Was inadequate financial resources a factor is waiting a little bit more to see if it would improve? (of course, this is a USA-only problem)

Or the comments?

No puppies were harmed in the making of the comment

Herbert: "Using antibiotics to treat minor bacterial infections also increases the likelihood of bacteria becoming resistant to them over time"

How minor is a bacterial infection that leads to death?

As far as your other questions: read the article! Seriously, it goes into quite a bit of detail.

The woman was not a rational intelligent person; there will always be women who are not capable of intelligent parenting.
She might also have had a mental disorder-delusions can occur with depression.
However, I also cannot forget these parents. www.iansvoice.org

No you are not reading Mrs Delozier, you are reading a top-notch medical professor at the leading medical school of your country.

I've never read Ms. Angell's book. And I've heard good things about it. But since I have, with my very own eyes, seen her pass along completely ridiculous, false, biased and easily disprovable assertions about psychotropic medications in the NYRB, I know for a fact that she's capable of being very unreliable. Possibly dishonest. It's hard to say.

That doesn't mean she's wrong about everything, of course. But, you know. In the piece I read, she was repeating Robert Whittaker's deranged line of non-reasoning about how Prozac caused mental-health disability claims to sky-rocket as if it made sense. And it's complete crap.

So caveat lector.

This comment was made with 100% recycled material.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

@EBMOD
---Nothing of what Orac criticized in this article would be changed even by pervasive corruption.---

It is the other way around: if there was not pervasive corruption, there would be more trust toward doctors and Mrs Delozier might have followed her doctor recommandation (and come to the hospital quicker when things worsened + take the antibiotic when required)
The pharmaceutical corruption affects even perfectly ethical doctors by making it difficult for patients to know how they can trust or not.

---With all of the independent research and adverse drug event reporting systems, to simply invent a drug out of whole cloth that offers no benefit and somehow get it through to market?----
I was thinking like you 4 years ago.

---Extraordinary claims require extraordinary evidence.---
You will find them in the writing of the previously cited doctors. You might be totally surprised and shocked as I was when I learned it. We are not talking of a free pen or a free conference or trip. We are talking of things like psychiatrist at leading institutions receiving 1 million dollar to sensibilise doctors to the presence of manic-depressive illness in 2 year old children and coaxing them to prescribe an early treatment consisting of a non-approved experimental multi-psychotrop treatment. Yet even when everything was revealed, there was close to zero consequence to the corrupted doctors.

However, I also cannot forget these parents.

Of course not. As the author of this essay right here notes:

Ian Gromowski’s story is so powerful, so pervasive, and so difficult to refute because it is just that: a story. And personal accounts, particularly as utilized by the anti-vaccine movement, are seemingly immune to facts.

It's just your style.

#132 It's documented- My style is the truth-yours is denial.

I have great problems believing herbert is a retired doctor of medicine. Perhaps a "naturopath" or "herb doctor" or something. My beloved grandfather, who WAS an MD, didn't over-prescribe antibiotics. But he did give them when he saw the need.

For pete's sake, herbert! You OBVIOUSLY didn't read the article. The poor baby was sick for 3 weeks, with fevers up to 103. And she had an abscess rupture. AND, she was dehydrated and malnourished which means she'd been too miserable to eat or drink for several days. If you WERE a real physician, wouldn't that have alarmed you?

Oh, and, herbert, if you did ANY research, you would know Orac does not get any remuneration from drug companies. He's written about it enough.

(no kittehs were harmed in the creation of this comment. I am only paid by BIG INSURANCE, and not to comment.)

#132 Ann
Medical errors occur- he should not have been given the Hep B shot.

"We are talking of things like psychiatrist at leading institutions receiving 1 million dollar to sensibilise doctors to the presence of manic-depressive illness in 2 year old children and coaxing them to prescribe an early treatment consisting of a non-approved experimental multi-psychotrop treatment. Yet even when everything was revealed, there was close to zero consequence to the corrupted doctors."

Links?

herbert, you have one seriously warped and ignorant view of this example.

Catherine Delozier was a convinced anti-vaccinator and had been brought up that way. Her distrust of doctors was not what drove her to her position, but an argument she invented to justify her activities. This is known as motivated reasoning.

As to recent recommendations about antibiotics and ear infections, the bit you avoided citing from the NHS Choices website was:

"Antibiotics are therefore usually only considered if:

1) your child has a serious health condition that makes them more vulnerable to complications, such as cystic fibrosis or congenital heart disease
2) your child is less than three months old, or they are less than two years old and have an infection in both ears
3) your child's symptoms are severe
4) your child has discharge coming from their ear
5) your child's symptoms show no signs of improvement after four days"

Hope Delozier's symptoms as described in the blog post and the media reports clearly fitted numbers 3 to 5.

Why you failed to mention this in your comments of the official guidelines, I don't know. At the moment I am considering the options: 1) ignorant and unable to read a website or 2) duplicitous.

Big Pharma saves lives w/o a doubt. Vaccines save lives w/o a doubt. But where do you draw the line as to what is necessary
and in the best interest of the patient?
I will not advise anyone not to vaccinate-that is between them and their pediatrician.
Please tell Offit to update his info on aluminum.
"Aluminum quantities fluctuate naturally during normal cellular activity. It is found in all tissues and is also believed to play an important role in the development of a healthy fetus.
vec.chop.edu/service/vaccine-education-center/vaccine-safety/vaccine-ingredients/aluminum.html

We are talking of things like psychiatrist at leading institutions receiving 1 million dollar to sensibilise doctors to the presence of manic-depressive illness in 2 year old children and coaxing them to prescribe an early treatment consisting of a non-approved experimental multi-psychotrop treatment. Yet even when everything was revealed, there was close to zero consequence to the corrupted doctors.

Is that from the book?

Hmm. Well. I say again: I've seen her make very bad, very biased arguments. For example, she opens this here article entitled "The Epidemic of Mental Illness" by saying:

It seems that Americans are in the midst of a raging epidemic of mental illness, at least as judged by the increase in the numbers treated for it. The tally of those who are so disabled by mental disorders that they qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) increased nearly two and a half times between 1987 and 2007—from one in 184 Americans to one in seventy-six. For children, the rise is even more startling—a thirty-five-fold increase in the same two decades.

They changed the f*cking eligibility criteria for mental-health disability in order to make them easier to meet. It took effect in 1985. And that is primarily why there was an increase. The rest of it is due to similar socioeconomic factors that aren't at all obscure or difficult for anyone who is making an honest attempt to answer the question "Why did mental health SSI/SSDI claims increase so much between 1987 and 2007" to think of or locate.

I know that because it took me less than ten minutes to locate them. And I wasn't being paid to give my prestigiously persuasive, highly credentialed opinion to the readership of the NYRB. I just went to the Social Security Administration's website. And there the answers were!

It really practically couldn't be any more straightforward. That's not an increase that represents any kind of epidemic.

And yet, that's the hook on which Marcia Angell hangs her entire argument that there even is one.

Caveat lector.

It is standard when you are truly independant to unequivocally say so when you write a medical article or a sensitive blog.

The only places I have seen people insist on being independant are alt-med blogs and articles.
And funny that, when you dig down, these people forgot to mention that, while being indeed non-related to, say, Merck or Bayer, they do have other conflicts of interests.
Like having a supermarket corporation as sponsor, or being themselves a successful entrepreneur in the alt-med field.

By Helianthus (not verified) on 16 Jun 2015 #permalink

@#ken --

You have no idea whether it had anything to do with the Hep B shot. You just like the story.

herbert@121
I cannot believe you are apologizing for the parents.

1) How quickly did the situation develop?

The child was found “malnourished and dehydrated". That suggests she was not eating/drinking properly for days. Heck, it sounds like she had a fever for around two weeks. That alone should have prompted medical attention.

2) Was inadequate financial resources a factor is waiting a little bit more to see if it would improve? (of course, this is a USA-only problem)

The parents make it pretty clear that distrust of modern medicine was the primary motivator.

3) How fulminant was the meningitis? (It may well be the case that even with the antibiotics the final outcome would have been similar)

If it had been followed by a doctor the hope would be that she got antibiotics before the otitis media developed into meningitis. Even if it didn't this is no excuse. There would've been at least a chance to save her life, by doing nothing the parents reduced that chance to 0%.

4) Even though Mrs Delozier said she was against antibiotic, did she implicitly meant as a first-line treatment for otitis media (wise choice) or even if the situation deteriorate?

Irrelevant. She didn't take her daughter in until she was in cardiac arrest!

5) Even if she meant for all situation, can we really blame her with the education she has to be able to know when she can trust the treatment proposed by doctors and when she cannot ? (considering that many doctors might still be given antibiotics to all cases of otitis media in the usa)

Again, and I really hope you can grasp this, this woman watched her daughter decompensate and die and then still didn't seek help for 30 minutes. I don't know what twisted world you live in but back in reality land there is absolutely no circumstances where this is acceptable.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

@EBMOD
Here is the link requested:
http://www.nybooks.com/articles/archives/2009/jan/15/drug-companies-doc…

@MiDAWN & alia
My apology. Orac did provide a timeline.
And yes, if there was more trust toward medical doctors she would have consulted earlier.
So if Orac is so eager to put blame on someone, than he should bite those who have corrupted medicine, not those who are the victims of it (the child and the mother).
Perhaps he has done so in the past, I dont know as this is my first time here

#141 Ann Do not tell me I like the story. What are your speciall qualifications to practice mind reading woo?
What exactly is your position in the medical field?

If it weren't for the plethora of quacks, frauds and profiteers running around spouting BS about how horrible, corrupt and untrustworthy medical practice is, fewer gullible people would lead to make bad decisions that cost the lives of their children.

^ gullible people would be lead

And yes, if there was more trust toward medical doctors she would have consulted earlier.

This woman was very clear in not wanting the ER staff putting holes in her daughter or injecting her with "chemicals".
That level of trust would have overcome this?

It's easy to rewrite history with "if".

By Helianthus (not verified) on 16 Jun 2015 #permalink

ken: "But where do you draw the line as to what is necessary"

Well, definitely you need to at least take a child to a clinic when fluid is coming out of her ears!

Orac would not be pumping out this blog w/o being paid.
If he is not being paid, he should use his gift of high intelligence and stick to researching and developing better diagnostic tools and treatment for breast cancer.
This blog has a very limited influence on changing anything.
It's sort of like publish or perish- to get pharma grants.

What exactly is your position in the medical field?

I don't need one to see that there is nothing on that website that constitutes a reason to think the Hep B shot was responsible for that child's death apart from that being the story the parents are telling.

And it's not the only possibility. As the same piece I linked to above notes:

However, for someone with a background in science or medicine, the Gromowskis’ blog paints a more nuanced portrait of Ian’s short life. In it we learn his mother was induced due to preeclampsia. Ian aspirated meconium. He also had allergies to various antibiotics. Further, doctors believed Ian had contracted a virus. In fact, Ian did not receive the hepatitis B vaccine until he was eight days old, because he had been in the NICU since birth.2 Finally, when Ian seemed to be improving, he was accidentally administered the very antibiotic he was allergic to before his condition had rapidly declined.2

I have no idea if the Hep B shot was the cause. And neither do you. It might have been. Or it might have been something else. You just like the story.

herbert@143

And yes, if there was more trust toward medical doctors she would have consulted earlier.

I don't know if you missed my comment or what so I'll say it once again. The mother watched her daughter die and then waited 30 minutes to get help. At some point reasonable people would realize that what they are doing is nit working. One hopes it would be sometime earlier but at the very least death should be a reason to try conventional medicine regardless of how distrustful you are of it.

I think, as sadmar noted before, it is important to examine the why behind this neglect. I also think it is important to call it what it is, namely murder by medical neglect, regardless of the motivations. Most people would take their child to get treatment much earlier, distrust is not an excuse.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

@ doug

If it weren’t for the plethora of quacks, frauds and profiteers running around spouting BS about how horrible, corrupt and untrustworthy medical practice is,

Exactly.
Whatever faults the medical establishment has, it's a bit difficult for physicians to prove that, contrary to the beliefs in certain circles, they are not grounding down babies to make vaccines.
Mrs Delozier's littany about vaccines makes it pretty clear that she has some extreme beliefs about the medical community.

You could be the nicer guy in town, if someone has been convinced that you attend black mass, you are not going to earn his trust no matter what.

Eh, herbert is putting us on the defensive.
Nice strategic move, mister. This way, we stop looking at the people who failed to save the baby, from the parents to the purveyors of useless treatments.

By Helianthus (not verified) on 16 Jun 2015 #permalink

ken: "Orac would not be pumping out this blog w/o being paid"

That is hilarious. I see you have not yet found the other not so secret other blog.

So if Orac is so eager to put blame on someone, than he should bite those who have corrupted medicine, not those who are the victims of it (the child and the mother).

Seriously, herbert. The child was barely breathing. Unless it's reasonable to think that doctors are far likelier to kill their patients than not, distrust is not a reasonable excuse for not seeking help under those circumstances.

This blog has a very limited influence on changing anything.
It’s sort of like publish or perish- to get pharma grants.

And you base that on what?

It can't be on your wide experience of and intimate familiarity with how research grants are awarded. And it can't be on Orac's not-so-super-secret actual track record. So I'm stumped.

Orac would not be pumping out this blog w/o being paid.
If he is not being paid, he should use his gift of high intelligence and stick to researching and developing better diagnostic tools and treatment for breast cancer.

Ken would not be pumping out these comments w/o being paid.
If she is not being paid, she should use her gift of high intelligence and stick to, I dunno, shutting up until she has something to say.

By herr doktor bimler (not verified) on 16 Jun 2015 #permalink

Quote-
"The most successful people on Scienceblogs are the best paid and none of them have left, so in a capitalist world, that means being paid did not damage their quality or the audience would not read them.   In a capitalist world where corporations win, they are the biggest and therefore the best.   And they are most certainly huge capitalists.    The miracle was convincing everyone for so long that they were not.
www.science20.com/science_20/blog/should_science_bloggers_be_paid

@EBMOD
Here is the link requested:

That is what I would call a whole bunch of anecdotes glued together with water-carrying for Chuck Grassley, who does not exactly have a great track record as a reliable, impartial investigator of fact.

My opinion of Marcia Angell gets lower practically every time I read her. And yet, I know smart people who say the book is good.

@capnkrunch
--Most people would take their child to get treatment much earlier, distrust is not an excuse.--

All people except psychopath would not market Mediator, greed is not an excuse.
Why are you not seeking indictiment for filthy rich well-educated mass murderer instead of a indigent and poorly educated helpless woman?

I suspect it is some sort of cowardice: pharmaceutical company will fight back and there are stronger than you. This poor woman can"t. So it is easier to beat her and humiliate her.
"?
@ann
Regarding your first post on Angell article.
Read her carefully
"It SEEEMS that Americans are in the midst of a raging epidemic of mental illness, AT LEAST AS JUDGED by the increase in the numbers treated for it."
So what she is telling (as confirmed by the rest of the article, is exactly the same as what you say. This is an artificial epidemic, and she had that pharmaceuticals were behind those changes (that part you may not yourself be fully aware, and that"s ok -- that"s the point of my intevention: bring awareness on this)

This is an artificial epidemic, and she had that pharmaceuticals were behind those changes

The hell they were. The Reagan administration's attempt to slash the Social Security rolls, the catastrophe that followed, and the backlash against it were behind those changes.

Citation needed, to say the f*cking least.

(that part you may not yourself be fully aware, and that”s ok — that”s the point of my intevention: bring awareness on this)

Great. I really can't wait to hear how pharma strong-armed the Social Security Administration into changing the eligibility criteria for mental-health disability in advance of the roll-out of Prozac in order to accommodate the anticipated uptick in incapacitated mentally ill people they were planning on causing.

So please don't keep it to yourself. Connect those dots. I'm all ears.

From the Canadian Paediatric Society, a quite thorough discussion of approaches to treatment of otitis media, intended as guidance for physicians, but in language I think should be reasonably easy for lay people to understand.

I note that the first-line drug of choice, amoxicillin, is described as inexpensive, which might make one think that perhaps there isn't a lot of shilling for big pharma going on.

Someone should make sure Dr. Jay sees this post. He needs to know what happens when parents follow his advice.

From http://drjaygordon.com/alternative/earinfections-2.html

I treat ear infections with prevention (anti-allergy measures such as dairy avoidance, dust reduction and getting rid of feather pillows and quilts) and with herbal and homeopathic remedies. I have some formal training in these methods but nowhere near enough to call myself an authority. I have been trained by my patients’ actions and by years of experience watching the way children respond to gentler methods of healing otitis media and other infections.

I like to put mullein/garlic oil in the ears hourly for a day or two and give pulsatilla 6X or 12C (homeopathic strength–the range I have given indicates homeopathic ignorance… but it works) or lachesis homeopathically hourly for two days.

So Gordon dumps a bunch of useless crap in kids' ears when he should know full well that otitis media very often will resolve without treatment.
What the blazes is mullein divided by garlic oil?

Great. I really can’t wait to hear how pharma strong-armed the Social Security Administration into changing the eligibility criteria for mental-health disability in advance of the roll-out of Prozac in order to accommodate the anticipated uptick in incapacitated mentally ill people they were planning on causing.

The reach of the Illuminati (and all those other -atis) is great. They are playing the long game. Knowing that Prozac would eventually be invented all they need to do was direct the mind-control rays at the President's head, take over his body for a while to get the law signed.

When you are omnipotent, like the Illuminati, getting the President to sign the country's money over to you is far too simple, making them pay through the nose for Prozac is much more satisfying.

The best thing about this is that no-one would see it coming and hence would not recognize the long reach of the Illuminati in it.

@sadmar:

If we want to prevent such harms in the future, we need to understand why they occur, and chalking them up to ‘stupid’ does not help at all. I suppose the usage is figurative, but it still over-simplifies complex mental mechanisms, and short-circuits our understandings of what are most likely social pathologies.

Yah, I intended "stupid" as shorthand, basically, as I have no idea of the actual cognitive functioning of these a$$holes.

I think everybody who's not an actual monster thinks that things like this happening less often, or not at all (which is a nice dream), would be great. However, even if one could understand precisely why this happened, there would still be the question of what to do with that knowledge.

It's my contention, though, that it's hard to even know why this happened when there's so little information to go on. It's easy to make lots of speculations, but I'm not really sure what that accomplishes.

So yeah, the particular form of spirituality she holds (as opposed to ‘religion’ per se) is likely a significant factor, though not THE cause.

Sure, absolutely. Anybody who refuses actual medicine because "G-d is the ultimate healer" believes in the G-d of maybe a seven-year-old, a G-d who can, and is willing to, and is interested in intervening in the vagaries of each believer's life in the way the beliver sees fit. This is not G-d so much as Santa Claus.

The tropes which influence religious believers to reject medicine usually amount to:

*"arrogant" doctors/scientists think they know more about life than G-d does, are too big for their britches, etc., and

*nasty materialist reductionist scientific worldview, yuck. (They prefer the true, spiritual reality. Gnosticism by any other name...)

If we frame the problem as ‘stupidity’, the answers are too easy, and likely just wrong.

Not taking your kid to a clinic when there's (probably smelly?) fluid leaking out of her ears and she has been sick, feverish, probably squalling in pain and suffering for a couple weeks at least is not only cruel and disgusting, it is also stupid. I really cannot think of another word besides "stupidity" for that kind of behavior. These folks' IQs could be normal, I dunno, but they're definitely morons.

The question at hand would seem to be how these elements played out in specifics as Christine Delozier developed her hostility to conventional medicine. To begin to venture an answer, we would need to dig into her personal history. I doubt she came to her position by reading at pseudo-science websites. More likely this was a way of working out an identity that either meshed with her family and immediate community, or her define herself in opposition to them.

You're missing some of the information we do have: she was brought up in the belief that shots and medicines and the whole nasty medical paradigm are worthless at best, harmless at worst. Her mom "didn't believe in" medicine.

Why did her mom get into that worldview? Your guess is as good as mine. There are plenty of just plain contrarians out there.

Re: the idea that whatver issue she has, it's in the DSM:

Maybe. I mean, probably, given the state of the DSM. I doubt we're ever going to be privy to that information. So let's look at what could actually be done if any of the myriad conditions in the DSM did have something to do with her actions:

*Could be some sort of severe depression, sure, maybe with psychotic features, maybe related to post-partum something. Could be another "axis I" disorder - I understand the "axis" classification has been ditched with DSM V - like some sort of psychotic disorder. What could be done, if that were the case (which I doubt it is) to prevent more of these things from happening? More awareness of mental health issues, especially among young mothers*, say, better access to treatment, less stigma surrounding treatment. Those are good things to work toward regardless, I think.

*Could be a "personality disorder," I suppose. But this brings me to one of my key problems with personality disorders: they really have no utility as diagnoses. Except for BPD, which has recently seen some success in treatment with DBT, they are generally regarded as untreatable. Making the diagnosis doesn't really help anybody - really, a lot of the time, it is just a medical-sounding, officially sanctioned way for a shrink to say "(I think) this person is a jerk," and to effectively have them treated that way within the system. Maybe it is fun to sit and say, "I bet that person has Narcissistic Personality Disorder!" but I don't see what good it really does. I mean, I have no problem with insulting people, but I can think of more fun and honest ways to do it.

*It would help if our society could get over its cult of motherhood and admit that being a parent is not all light and joy, IMO.

^ Cognitive function, it shoulda been, I think. Also, sorry about the long comment - I was composing it offline in gedit. Looks like there's an italics fail, as well.

What's very upsetting is that in many states, "personal belief" or "religious belief" is an affirmative defense to child neglect charges and many other things. Some states have religious defenses to manslaughter and murder. The organization CHILD (Children's Healthcare Is a Legal Duty) works to get these laws revised. All children deserve the same basic standard of care, no matter what beliefs their parents have.

herbert@159

All people except psychopath would not market Mediator, greed is not an excuse.
Why are you not seeking indictiment for filthy rich well-educated mass murderer instead of a indigent and poorly educated helpless woman?

It's not one or the other. This (false) dichotomy is entirely your construct.

By capnkrunch (not verified) on 16 Jun 2015 #permalink

So Gordon dumps a bunch of useless crap in kids’ ears when he should know full well that otitis media very often will resolve without treatment.

I'd say he does it because he knows full well that it will probably resolve without treatment - he's a profiteering opportunist, not a "true believer." After all, the affluent clientele he caters to are paying a (cash-only) premium for his services; if he wants to keep the gravy-train rolling he needs to ensure that they feel they are getting some sort of "special" care they wouldn't get from one of those run-of-the-mill, evidence-based allopaths.

Never mind the treatment for externa being applied as if media.

JP: I dunno, my money's on 'the parents are just terrible people' and someone's telling them what to say.

Herbert: She is not defenseless or harmless, she KILLED her toddler. I suppose you think kids winding up dead- of an easily treatable disease- is just fine.
Where the hell did you get your medical degree? Sagitta Volante Per Diem University? Oral Roberts? Or did you just buy a lab coat and stethoscope off somebody and start calling yourself a doctor? I don't think you could pass a drug test, let alone medical boards.

Johnny: Pretty sure a mullien is a weed, might be related to a plantain.

By Politicalguineapig (not verified) on 16 Jun 2015 #permalink

My mistake, looks more like a cabbage.

By Politicalguineapig (not verified) on 16 Jun 2015 #permalink
Johnny: Pretty sure a mullien is a weed, might be related to a plantain.

My mistake, looks more like a cabbage.

Well, the bigger mistake is that it was doug that was asking in a rather sarcastic (I'm sure) joke, not me.

I don't care what's in a homeopathic nostrum, because, unless something went wrong, the answer is nothing much.

Johnny: Pretty sure a mullien is a weed, might be related to a plantain.

My mistake, looks more like a cabbage.

In fact it is a Scroph. A member of the figwort family.

I don’t care what’s in a homeopathic nostrum, because, unless something went wrong, the answer is nothing much.

Should've stopped aspiring to a "Big J," while you had the chance, Phildo.

Of course, you've already demonstrated that you're willing to shіt on your very wife to try to distance yourself from the tediously, desperately, enthusiastically dedicated perv show that seems to be your very being when you're not playing Lance Kerwin.

Hell, they're probably the same thing.

I have noted before, "Mr." Hills, that your aborted attempt to figure out Twatter is not generalizable.

Govern yourself accordingly.

@ ann

I note that the first-line drug of choice, amoxicillin, is described as inexpensive,

Amoxicillin is a old penicillin (1972), but still a very good choice as an all-purpose antibiotic. Unless the pathogen bacteria turn out to be penicillin-resistant, of course. At that point, it will be time to bring in more recent - and more expensive - antibiotics.
It's used in cell cultures by scientists to prevent bacterial contamination.

To draw a parallel, amoxicillin is to antibiotics that aspirin or acetaminophen are for painkillers. Cheap and effective.

------------------------------------------

herbert would maybe have more chance if he was talking about Vioxx rather than Mediator, the latter barely made the news in North America, AFAIK.
At the risk of off-topic, I heard about some change in drug regulation the US implemented some years ago: from now on, studies of safety and efficacy of a drug would be accepted by the FDA as part of the approval process only if the studies have been registered on a public database when they were started. It should suppress the temptation for Big and not-so-big Pharma to hide studies with poor or bad outcomes.
I am not sure how well it has been implemented, I haven't followed it closely.
I believe the UK government was thinking about adding a similar rule to its drug regulation system. But, again AFAIK, there is no such rule in the European drug approval system. I would certainly approve of any politician submitting such an improvement.

By Helianthus (not verified) on 16 Jun 2015 #permalink

I'm an otolaryngologist so quite familiar with ear infections; the term for this type of infection is acute otitis media (AOM). In recognition that many AOM infections are viral and in an attempt to reduce antibiotic-resistant bacteria, we try to hold off on antibiotics for the first couple days unless a child is really febrile or acting really sick. But if there is no improvement over 2-3 days then we usually start an antibiotic like high-dose amoxicillin or Augmentin (both are now available as generics). This child was apparently sick with an untreated bacterial infection for 3 weeks, leading to the brain abscess. Complications like this from ear infections were not that uncommon in the days before antibiotics and ear tubes.

Amoxicillin is a old penicillin (1972), but still a very good choice as an all-purpose antibiotic.

I can't remember seeing so much as a veterinary script that wasn't the equivalent of Augmentin on this front. (In fact, the 850/150 proportion is the same for the feline dose; I've had to resort to it a couple of times.)

^ Oh, f*ck, #175 was friendly fire. Apologies, real Johnny.

The general sentiments regarding DJ "Mr." Mini-skule Jayzz, of course, stand.

Herbert,

Granted, there are problems in the world of medicine. I agree with Dr. Angell that medicine ought not be for profit, and that the sheer amount of money involved is worrisome. Her objections to cherry-picking positive studies and time periods within studies, e.g., presenting positive data for a six-month period when the study ran for a year and showed negative results overall, also seem perfectly reasonable to me.

But that, so far as it goes, describes a reasonable skepticism based on knowledge. The Deloziers are clearly not reasonable or knowledgeable, so whence their skepticism? It's all very well to lay the blame at doctors' collective feet (or other ambulatory appendages) and say that it's their fault that the Deloziers and others mistrust medicine, but it's not true. When a belief is based on profound, multi-layered misconceptions about reality, it's not enough to make the reality better. We need to encourage more careful absorption of information and challenge the sources of misinformation. That's part of what this blog is about.

Also, Honoured Narad @175, that may have been friendly fire: I think that was the real, sane, smart Johnny. Philip Hills, of Hope Osteopathic Clinic, Essex, would surely not have castigated homeopathy as useless and consisting of nothing, as British Osteopaths do not fleer at any quackery, great or small.

See a dead-baby apologist like Herbert just makes me ill inside - he's in the same category as the "shaken-baby / vaccine-causation" people....

I can speak as a mother who has actually directly experienced hospitalisation of my child with Strep pneumo bacteraemia - my 7 month old had experienced very non-specific viral-like symptoms - GP recommendation was fluids, paracetamol - then the spikes in temperature started. I cannot imagine a mother who is of sound mind who would ignore the symptoms that my little girl experienced. Perhaps I can thank my degree in Microbiology and knowledge of what temperature spikes mean, but more likely it is the pretty simple observation of a child becoming listless, not wanting food etc that would trigger a desire to get professional help - and quick. Thankfully after 3 days on an antibiotic drip, she was fine. The Prevnar vaccine was introduced into the schedule later that year. She celebrated her 15th birthday on the weekend.

By janerella (not verified) on 17 Jun 2015 #permalink

Sorry, Johnny. But could you chill a little? I appreciate that this thread has gotten heated, but that's no excuse to be rude to those who don't deserve it.

Janerella: Oh my god, my sympathies. That must have been terrifying. I'm glad she's all right now.

Lawrence: For a while now, I've been wondering if anti-vaxxers think children are people. I'm very sure that they don't, since you'd think being against kids dying unnecessarily would be a no-brainer. Instead they only talk about the death of children when they're trying to score points, and end up supporting a lot of vile people.

By Politicalguineapig (not verified) on 17 Jun 2015 #permalink

Does the general public really know what 'research' is...

Does the general public really know what ‘research’ is

As used these days, it almost invariably means "bore a hole in the intertoobz and collect a few buckets of effluent" then apply the arrogance of ignorance and confirmation bias in deciding which buckets contain the good stuff.

Several years ago I heard some say something very appropriate. IIRC, the exact words were "The good thing about the internet is that anyone can publish anything. The bad thing about the internet is that anyone can publish anything."

doug that was asking in a rather sarcastic (I’m sure) joke

Yes, I was mocking jay/gordon for using a slash as a sort of universal conjunction/operator. It's one of my pet trivial annoyances ....... along with ellipsis abuse ...... and misused apostrophe's.

" It’s a pretty safe bet that, had Hope been seen by a physician in Canada or England, for example, she would have been prescribed antibiotics and treated pretty much the same way that local pediatricians in Bradford County would have treated her."

Calling it a "safe bet" is an understatement akin to the one from the knight in Indiana Jones, "He chose...poorly". We all had to deal with ear infections growing up, then later ear infections in children, nephews, nieces, friends' kids, etc. Antibiotics were prescribed if the infection wasn't resolving or if it was getting worse (when we were kids antibiotics were probably prescribed as a first resort, but that was decades ago).

By Dan Andrews (not verified) on 17 Jun 2015 #permalink

I agree with Dr. Angell that medicine ought not be for profit, and that the sheer amount of money involved is worrisome. Her objections to cherry-picking positive studies and time periods within studies, e.g., presenting positive data for a six-month period when the study ran for a year and showed negative results overall, also seem perfectly reasonable to me.

I really don't know what to make of her. But if she objects to cherry-picking when pharma does it with the time periods of results they report, she herself should not be doing it with the time periods of SSI/SSDI claims for mental health disability.

Two wrongs, etc.

Especially because it's really almost not possible for that many people to be iatrogenically disabled by meds in two decades all across the country without it coming to anyone's attention or their noticing it themselves. I mean, nobody likes taking those drugs. Or being disabled. Or being mentally ill. It's just a very implausible scenario. That she doesn't question it does not speak well of her.

...

The thing is that it's probably true that those numbers would not be so high if the care and treatment of serious mental illness wasn't primarily a perfunctory exercise in prescription-writing. But it's not actually the fault of psychiatry or pharma that alternatives to them don't exist.

Anyway. If she's not arguing that mental illness is caused by the diagnosis and treatment of mental illness, I'm not sure I know what she's saying. And while there's certainly room for improvement in the diagnosis and treatment of mental illness, that's just not a supportable argument. I find it hard to take her seriously.

@ PGP:

You mention something that I agree with in a more complicated way-
whether anti-vaxxers see their children as people or not:

I feel that they probably would recognise children as 'people' BUT they fail to see that their children have independent existences from their own, that they have or will have their own ideas, abilities, thoughts and dreams and that parents do not OWN their children or have omnipotent power over their lives. Parents have to answer to society ( or the state, if you wish) about their actions in regard to their children- they can't just do as they like, harming or neglecting children who have as much rights as strangers and adults in this case.

You may remember that I've discussed how the concept of children itself has changed over the millennia:
obviously at one time, perhaps they WERE property of a sort; later religious folk believed them to be human but heathen and in need of a Christian education and the sacraments.. Children were imagined as being small adults and thus capable of working long, hard hours in farms, mines or factories even 100 years ago. More recently, laws that protect children emphasise their differences from adults and why they need governmental supervision when their parents fail to care for them appropriately.

AS you know, people vary in their abilities to take the role of the other - to understand how others think and comprehend the world differently from themselves. I would venture that some antivax parents may choose to ignore whatever inklings of recognition of these differences seep through their own set piece beliefs about their children if those inklings come through at all. Not all parents are sensitive to their children's needs and ideas especially when they clash with their own.

Of course, adults may not be entirely able to choose what they believe about others - including their own children- and indeed, all of us are constraied by our limited abilities, be they cognitive, interpersonal or emotional. Everyone has limits in these realms. but learning is possible and hopefully, lifelong. Limits may be imposed because of psychological ills, lower intelligence and poor early experiences as well as choice. In other words, we can't blame parents for their lack of compassion and self-centeredness 100% of the time- but some of them,sometimes, sure.

By Denice Walter (not verified) on 17 Jun 2015 #permalink

@ann
--Especially because it’s really almost not possible for that many people to be iatrogenically disabled by meds in two decades all across the country without it coming to anyone’s attention or their noticing it themselves. I mean, nobody likes taking those drugs. Or being disabled. Or being mentally ill.--

You are starting to wake up. YES this is possible because of the hyper-efficient public relation firm that are able to pretty much mold what an american thinks (and not just americans -- they have exported their know-how everywhere). The level of thinking shown by Fox news and typical newspaper is hair raising for anyone who is old enough to have lived in better times, but I am sure most american really think they are being informed (and not entertained and brainwashed) by fox news ,cnn and the economist (to name just a few)

As far alternative, they exist, for example for depression, with successful clinical trial showing as good or better than the best of anti-depressant, but you wont here much about them because they are virtually free (search on cognitive or rational-emotive therapy for example)

herbert, have you bothered to read the above article yet? Because without you actually doing that, it would be pointless to discuss anything with you.

herbert- Allow me to explain to you the scope of what you're suggesting. How large a PR firm would you need to convince everyone that the World Trade Center is still standing?

By Gray Falcon (not verified) on 17 Jun 2015 #permalink

@ fellow and sister sceptics :

I am on my way out the door so I wish that someone else would discuss the herbal/ supplement vs anti-depression meme put forth by herbert.
I KNOW you can do it.

And yeah, right, I ALSO use slashes to denote either conjunctive choice and/or variable names
e,g,
Alties/ woo-meisters/ prevaricators/ liars.

By Denice Walter (not verified) on 17 Jun 2015 #permalink

for example for depression, with successful clinical trial showing as good or better than the best of anti-depressant

This is further confirmation that you have no clue what you're talking about. Can you cite the specific clinical trial you're referencing here? Because the actual literature shows that a combined approach is most effective (see http://www.ncbi.nlm.nih.gov/pubmed/25142196 , for example)
Maybe you should, you know, actually do some research yourself?

they are virtually free (search on cognitive or rational-emotive therapy for example)

Thanks for the laugh. Do you honestly think that regular access to CBT-based care for depression is "virtually free"?

Slashes are acceptable/appropriate in lots of cases, but not the way J.G. used one in this particular instance. He certainly isn't alone/unique in such misuse.

One the matter of apostrophes, very shortly after I posted my comment above I ran across this comment at the CBC:

Your full of it. How about anti-Christ's killing Christian's on a daily basis??

Talk about over- possessive ...

JP @165:

Anybody who refuses actual medicine because “G-d is the ultimate healer” believes in the G-d of maybe a seven-year-old, a G-d who can, and is willing to, and is interested in intervening in the vagaries of each believer’s life in the way the believer sees fit. This is not G-d so much as Santa Claus.

This. So much this.

By Julian Frost (not verified) on 17 Jun 2015 #permalink

Ok, pharmaceuticals throlls you won. I`m quitting.
But if even 1 person saw the light from reading the information I posted that it would have been at least worthwhile.
As for americans being desperate cases, I get that is being confirmed once more. There will beat up any indigent black or woman to death (emotionally or physically) but will keep their harvard corrupted psychiatrics killers untouched, simply because they have more money and that the brainwashing that money is the ONLY thing that counts (thanks Murdoch & alia) has been deeply imprinted in the american mind
I am so glad I refused 20 years ago an offer that would have double my income but would have forced me to move to the USA, given the sad state of these assieged people

herbert, "pharmaceuticals throlls"? Did you just falsely accuse us of being in the pay of someone else in lieu of an argument?

By Gray Falcon (not verified) on 17 Jun 2015 #permalink

Herbert, did you provide information? When?

Gray Falcon please don't bait him. It is a waste of his time and ours to have these endless recycles of tired arguments. Herbert expressed his wishes clearly please respect them He posted "Ok, pharmaceuticals throlls you won. I`m quitting." and to try to bait him back into this blog is really a disservicee to all concerned. My deepest hope is that those of his ilk who talk about a mass exodus from California upon passage of SB 277 will also honor their word and leave. I am sure there are other places more to their liking, such as Uzbehkestan or perhaps the moons of Jupiter.., where they won't have to worry about the measles.

So please no final parting shots let Herbert leave in peace. His well intended wooery will be remembered with other well intended false consciousnesses of the Luddhite bent as we prepare to uncork our Chateau de Rothschild at the Big Pharma victory celebrations in Sacramento.

Sorry about that. I tend to react badly to false accusations.

By Gray Falcon (not verified) on 17 Jun 2015 #permalink

Well, if herbert sticks the flounce it will be irrelevant, but, I believe that awareness of some practices influencing prescribing practices were noted, and much stiffer restrictions put in place. I, personally, believe pharmaceutical companies should not be allowed to advertise to the general public. However, in all fairness, since supplement companies get to send twenty-page, full color brochures vaguely hinting at studies that may or may not be accurately portrayed, filled with testimonials from possibly non-existent patients and then sell the miracles directly to their marks er, um, customers from wonderful protectors of health freedom like "Dr. Whittaker," "Dr. Mercola" (and honestly there's a Dr. Merola running around relying on confusion) and others... it would be lovely to reign in their "liberties" as well as ending direct-to-consumer advertising by drug companies.

As a rational observer, I believe that one of the biggest contributions to all this patient mistrust is alternative medicine advertising which looks like "research" and "unbiased information" to uninformed patients doing Google searches. The mother in this case was raised by a mother who followed alternative medicine, then to further reinforce her thinking, probably spent any time on the internet in echo chambers that further confirmed her worst fears. She didn't have a balanced view of medicine - one that knew doctors are not paid for the drugs they prescribe (unlike chiropractors andnaturopaths, who have their "prescriptions" right there in ttheir offices), that many doctors, especially since Vioxx, prefer to prescribe drugs that have a few years post approval, or that many insurances demand all generic (therefore, older) drugs be tried and fail before name brand, newer drugs are offered.

The U.S. medical system sucks. I am known (and sometimes mocked, in daily life) for insisting a system more like our Medicare system, opened for all residents, would be a major improvement. I cannot fathom how a supposedly wealthy country like ours can be so incapable of providing something so basic to its citizens. I won't argue that.

This woman, though, had a very unrealistic view of doctors and how they care for patients, and herbert, for whatever reason you do, too. Outliers are never good examples of anything as a whole, and people can cherry pick examples to make anything look like a dismal failure or glowing perfection, especially something as complicated as "modern medical treatment" (especially if it is defined broadly).

On a tangential topic, I was under the impression that antibiotics were ineffective for ear infections. Period. I was given the impression that this was one of the greatest misuses of antibiotics.

Obviously, I was wrong, but perhaps all the warnings about over-prescription of antibiotics has had a downside.

By Harold Gaines (not verified) on 17 Jun 2015 #permalink

Well, one good thing we learned - herbert doesn't live in the US. Now if he'll only stick the flounce. Though, I do believe it's poor form to flounce after labeling us all pharma shills.

@Harold

I never saw any report that say every ear infection would always be harmless and would always go away on its own and no matter what no one should ever give a kid an antibiotic.

The way I read it was most of the time the antibiotic is not needed and many of the infections are not bacterial so it won't help.

So don't prescribe them right off the bat for anything with the set of characteristics of those infections that are unlikely to be a problem. Only prescribe immediately when there are these symptoms that something more serious is going on or when the symptoms do not resolve on their own in X time.

But I can see where some of the reporting could lead you to think NEVER prescribe rather than reduce the prescribing.

We do overuse antibiotics but all of the use less come with guidelines on when they really are needed. It was never meant to be be a never use them again at all because they are always in every case completely and totally useless.

So herbert flounced after being presented with an actual citation contradicting his assertions? I'm shocked.

In his early post(s), herbert claimed to be in Canada. Some of the words he used were clearly French or very close thereto, some of his spelling was British, and he had problems with plurals, so I'm baffled as to where he actually might be or be from.

Harold, if you haven't already, do follow the link I posted at 161. It really is a good discussion, with analysis of the pros and cons of how and with what to treat AOM.

Mrs. Woo, it is my understanding that there are only two countries where advertising aimed at end uses of prescription drugs is legal - the US and New Zealand. Though apparently the rules aren't enforced as strictly as they should be here in Canada, it is illegal, but advertising of all manner supplements and wooish methods are pretty common. It sort of seems that if it is real medicine the advertising is illegal, but if it is pseudo/mock medicine it is OK.

This woman, though, had a very unrealistic view of doctors and how they care for patients, and herbert, for whatever reason you do, too.

Yes, herbert is very much part of the problem.

Just to clear things up. Homeopathy is utter bollocks, just like the idea that a little bit of flu in a vaccine is supposed to prevent flu. it doesn't and never did, the research tells us and decades of trials trying to make people 'catch flu' by spraying virus aerosols up people's noses has failed to prove the contagion theory over and over again.

This thread is not news, it is just another vain attempt to validate a flawed vaccine on the back of a sad death.

Just like the one death from measles in Germany recently

As for NobRed and his 'friendly fire' he has to stop playing with it, it's simple, he will go blind if it carries on. Some one give him some herbs or something, I am surprised he can even see his screen.

If false "johnny" ever paid attention, he'd realize that this thread is about antibiotics, not a vaccine.

@shay

Although one would think that if one completely rejects the notion that germs cause disease one would be against antibiotics as well as vaccines.

But it could very well be he doesn't know there is a difference between the two, although if I give him the benefit of the doubt there is a comment that mentions a vaccine in it so maybe he's replying to that not the main theme of the article (or he's just looking for any excuse to spew on any given thread).

Slashes are acceptable/appropriate in lots of cases

Putting on my editorial hat for a moment, the use of the virgule in text denotes nonexclusive "or." It is nearly always avoidable in formal writing, the exception being when the corrections get to be more clumsily distracting than just letting it stand after a certain point.

In particular, this implies that the sense "per," e.g., "km/s" (or, worse, "m/s/s") is right out unless there are no suitable superscripts available. Like here, where some genius has Wordpressed the buttons to exterminate <sup> tags.

In his early post(s), herbert claimed to be in Canada. Some of the words he used were clearly French or very close thereto, some of his spelling was British, and he had problems with plurals, so I’m baffled as to where he actually might be or be from.

It's likely that herbert is a Francophone Canadian. His writing style is similar (IMHO) to that of other Francophone Canadians who have commented here. This would also explain the British spelling. Most likely he lives in Quebec or New Brunswick, but not necessarily.

Putting on my editorial hat for a moment, the use of the virgule in text denotes nonexclusive “or.” It is nearly always avoidable in formal writing, the exception being when the corrections get to be more clumsily distracting than just letting it stand after a certain point.

I had a professor in college who had a real bee in his bonnet about using the virgule pretty much at all in writing, so the use was beaten out of me (metaphorically speaking) at a young age. He found it lazy.

F'r instance, instead of writing, say, "bees and/or bonnets," I was specifically instructed to write "bees or bonnets or both." It is nicer to read, I think.

^ I was fairly eviscerated in his office, actually, over a piece of writing which he did not feel was up to snuff, at least compared to my usual efforts. Even then I got some useful pointers.

He was always jealous of the late Professor Lewitsky, though, who could actually bring himself to make students cry of shame over bad writing.

sadmar@97

I see NP's all the time at my large regional medical center. I think whoever said that about rural areas and NP's was just saying that sometimes there is only a NP in some rural areas that can't get a full time doc.

By darwinslaapdog (not verified) on 17 Jun 2015 #permalink

^ Oh, I also forgot that W—press automatically logoizes invocations of its magic name. I wonder whether Word​press thought about ​.

^ Well, apparently it did consider U+200B, but only to break the HTML escape for &.

It’s likely that herbert is a Francophone Canadian.

That was what I initially thought, but would that explain the lack of proper plurals?

I though Virgule was Dante's guide through Hell.

You are starting to wake up. YES this is possible because of the hyper-efficient public relation firm that are able to pretty much mold what an american thinks

Then why does everybody in the entire country hate the very thought of psychotropic medications, just exactly as they always have?

No, it is NOT possible that the number of people on SSI/SSDI increased by two-and-a-half times between 1987 and 2007 because of meds-induced mental illness. Furthermore, it is UNTRUE. They changed the eligibility criteria in 1985. That accounts for most of the increase. The rest is due to demographic, socioeconomic, and similar factors.

How dense are you that I can keep explaining that without making any impression on you at all?

but I am sure most american really think they are being informed (and not entertained and brainwashed)

I find it distressing to be accused of being brainwashed by people who are mindlessly repeating CCHR/Scientology propaganda about psychiatric meds.

Herbert:
1 million dollar to sensibilise doctors
Is this a word-for-word translation from some other language? "Sensibilise doctors" is a popular phrase among cheap-drug spam sites, but nowhere else.

By herr doktor bimler (not verified) on 17 Jun 2015 #permalink

pharmaceuticals throlls

"Throll" is perhaps a portmanteau of Troll + Thrall, and I am adding it to my vocabulary.

By herr doktor bimler (not verified) on 17 Jun 2015 #permalink

I was about to write:
' Is throll an enthralled troll.. a troll thrall?'

Sounds like somethingthat would be featured in the Game of Thrones.

-btw-
I use the / @ RI exclusively not in any of my more formal writing endeavors. I kind of like the way it looks.

By Denice Walter (not verified) on 17 Jun 2015 #permalink

"But if even 1 person saw the light from reading the information I posted that it would have been at least worthwhile."

No doubt oodles of people have contacted you privately to say that they agree with your drivel, but can't say so publicly due to potential harassment. Isn't that usually the way it goes?

By Dangerous Bacon (not verified) on 17 Jun 2015 #permalink

@ Barefoot #200

Fwiw, I agree the arguments with trolls are mainly skipping-phonograph-record repetitions, tiring and (imho) pointless. I have to imagine the minions have better things to do with their time...

But I must object to labeling anti-vaxers as Luddites – since the typical contemporary use of that term springs from, and reproduces, a highly ideological, regressive, and false view of history. The actual historical Luddites were not opposed to scientific or technical progress, just the use of technology to throw them into poverty. (http://tinyurl.com/3xf3mgz). To employ them as a signifier of waging a wrong-headed and pointless war against progress is to demean the intelligence of industrial workers, and trivialize or cover-up the social horrors of the early industrial era in general and the mills in particular.

Besides, anti-vaxers aren't beholden to an anti-progress or even anti-science ideology. They invoke 'older is better' rhetoric only opportunistically, as they will invoke ANY and ALL ideas opportunistically — no matter how mutually exclusive and contradictory — as long as they can twist them somehow to support their bedrock conviction that vaccines are definitive sources of harm to their special snowflake offspring.

Thus, they present Wakefield and the aluminum research at UBC as 'true' science, and cast all the evidence against their beliefs as corrupt propaganda advanced by the shills of 'Big Pharma'. They are convinced that the progress of science, left uncorrupted, will validate their position and bring forth the 'cures' for their 'damaged' kids Big Pharma is repressing in its quest for vaccine profits. Yeah, that's 'unscientific'. But believing bad science will save the day isn't the same thing as opposing scientific progress...

Not sure if banning advertisments for life saving drugs would pass co nstitutional muster and the smell test especially while the anti-pharma propaganda and advertisement for "immune boosting" supplements would continue unabated. Maybe we should *incentivize* drug companies to market more effectively.

Why not get rid of them both? Drug companies argue direct to consumer advertising raises patient awareness, but so many people have, well, a bit more anxiety about their health. Between ads and the internet, some more vulnerable people seem to be stricken with an alphabet soup of conditions. Worse, if it is real, they sometimes have a drug recommendation for their doctor (the goal of those ads to begin with), rather than the doctor suggesting medication to the patient.

If I had my way, alternative medicine would be illegal, period. They sell false hope and do more harm than good. :-(

It used to be drug companies didn't advertise prescription drugs, I believe. We could at least get them off of television. We don't allow tobacco advertising on television. Obviously there is legal precedent for limiting advertising some ways

It used to be drug companies didn’t advertise prescription drugs, I believe.

Yah, direct-to-consumer advertising didn't start in the US until 1997. I recall the televized listing of side-effects becoming a big source of amusement around that time, drug ad parodies on SNL, etc.

I don't know how realistic it is to imagine the good ol' US of A going back on corporation-friendly policies, though, what with, y'know, lobbying and all.

That was what I initially thought, but would that explain the lack of proper plurals?

In French, the plurals ending in "s" are written but the "s" is not pronounced in speech. The plural is indicated by the article: le or la - singular, les - plural. Francophones have a tendency to not pronounce the "s" in English plurals, so I guess that this would carry over into writing.
This is based on a lot of speculation, since I am basing this on my high school French (which was so long ago it may be Old French), a few Francophone acquaintances (not many, I live in Western Canada) and some commenters on RI and elsewhere. If anyone more knowledgeable wants to take me to task, feel free.

Not sure if banning advertisments for life saving drugs would pass co nstitutional muster

An outright ban on DTC pharmaceutical advertising would probably have a rough go with the Central Hudson test, but the FDA already has some regulatory power, which is why the "brief summary" in small print or barely intelligible speech exists for a subset of advertisements. This could probably be tightened, including a requirement for advertisement preapproval (logistical issues aside), for example.

In short, by making DTC more expensive.

On a not-unrelated note, AofA has one of their typical, odious "defending baby killers-shaken baby syndrome is really vaccine damage" stories today. I won't link; those of you so inclined know where to find it.

I still don't understand how they can claim vaccines break bones, however.

As for the equally-odious Herbert, not to claim I'm a genius but I recognized his writing pattern as a francophone "speaking" English immediately. Every single francophone I work with speaks English the exact same way: no "s" on plurals and all kinds of unusual verb usage, for example. As TBruce points out, it's a by-product of thinking in French and then mentally translating.

By Woo Fighter (not verified) on 17 Jun 2015 #permalink

Recent US Supreme Court decisions, except for an occasional exception, have pushed free speech beyond what it ever used to be. It is annoying to me that the "Information Press" in SLO publishes claimed cancer treatments in articles written by the very people who advertise therein. Herbal tea and the like. Yet if Merck or GSK publish people think it is Big Pharma Propaganda Enslaving Us...

I now feel pretty convinced that herbert is francophone. Everyone I've ever known whose first language was Quebecois French spoke English very well, so I've never noticed the dropping of s from English plurals.
Actually, one of my first thoughts about herbert, given that I thought he was probably French Canadian, was that he might be related to the Deloziers.

Alties/ woo-meisters/ prevaricators/ liars.

Certain things warrant a good slashing.

Yah, direct-to-consumer advertising didn’t start in the US until 1997

No, Virginia Pharmacy Board was decided in 1976. I can't dig into the whole timeline at the moment, but see generally here (PDF) and, probably, here.

@Narad:

Thanks for the correction, and the links; I'll read through them in a little bit here.

Memory is notoriously unreliable, and I was pretty darn young in the '90s, but I seem to remember DTC starting fairly abruptly sometime around 1997. I would've been about 9 years old at the time, so who knows how accurate my memories are. Did something happen WRT drug ads on television at that time? Did DTC advertising just become more common?

@ doug:

My point exactly!

By Denice Walter (not verified) on 17 Jun 2015 #permalink

‘ Is throll an enthralled troll.. a troll thrall?’

Glámr in Grettis Saga is the opposite, an entrolled thrall.

By herr doktor bimler (not verified) on 17 Jun 2015 #permalink

@Sadmar:

Nursing instructor here. Your friend would have to finish a program in registered nursing first, and pass the NCLEX-RN before she could become a nurse practitioner.

While there are some ADN to FNP programs out there, generally the path is BSN to MSN to NP program. NP programs are moving to the DNP level (we're supposed to be there now nationally but the faculty shortage is pushing the deadline back). There are some direct BSN to NP programs, and many MSN to NP programs, but she'll need to do her research in her area. YMMV.

ADNs once could practice in practically any specialty in nursing for their entire careers but generally can't get into management, and now it's pretty much a given you have to get your BSN within 5 years to keep your job.

NPs can practice solo in many states, but not all states. In other states, they have to have a practice agreement with a physician. A PA can never practice solo, they are always attached to a physician. So NPs have some different options than PAs, but PAs often have access to specialty training (often highly technical and surgical oriented) that NPs don't.

NPs can and do see their own patients in the hospital, whether they are solo practitioners or not. In my state NPs and PAs have very similar roles, except some NPs can set up independent businesses such as home health agencies and PAs can't.

Competition to get into both ADN and BSN programs (the first step) is also stiff in many parts of the country. A national shortage of nursing faculty means that many programs can't take in as many applicants as they would like. My program has three applications for every seat, and we start two cohorts every year (Fall and Spring).

My recommendation is she start community college (cheaper) and take her pre-reqs including 2 semesters of A&P, Microbiology, and Chemistry if she can fit it in, along with Intro to Psych and Developmental Psych. Then she'll have the background to successfully get into to either an ADN or a BSN program, and she can focus on the nursing courses. We find that students, even top students, who take the general science courses WITH the nursing courses struggle more. Those who take them before hand have a better foundation and to better.

Hope this helps.

Ah. Re: DTC: I have arrived at the part on "major" vs. "minor" risks.

Did something happen WRT drug ads on television at that time? Did DTC advertising just become more common?

I'm not sure. If you see footnote 38 in the PDF above, it has this to say (boldface added):

"From 1997 to 2001, the percentage of DTC advertising for print ads declined from 74% to 35%, while the percentage of spending on television ads increased from 25% to 64%. See General Accounting Office, Prescription Drugs: FDA Oversight of Direct-to-Consumer Advertising Has Limitations 10 (GAO-03-177) (Oct. 2002) . . . . For a history of the FDA’s regulation of DTC ads, see[*] Timothy S. Hall, The Promise and Peril of Direct-to-Consumer Prescription Drug Promotion on the Internet, 7 DePaul J. Health Care L. 1 (2003)."

* Bluebook FAIL, BTW.

The Great Gazoogle tells me this:

In 1995, the FDA held a hearing to discuss easing broadcast DTCPA regulations in recognition of the prohibitive time and expense that the rules then required.2 In 1997, the FDA issued draft guidance on this topic (and final regulations in 1999) that allowed broadcast DTC product claim ads to include a “major statement” and “adequate provision” to satisfy the “fair balance” requirement, rather than the lengthier “brief summary,” which listed all product risks.2,4 Now, advertisers had to include only “major risks” and provide an “adequate provision” that would direct viewers elsewhere to access complete “brief summary” information (from a toll-free number, a health care provider, a Web site, or a print ad).4

I now feel pretty convinced that herbert is francophone.

I'm with the former MSII on the that-seemed-obvious front (the rest I'm not going to delve into).

Everyone I’ve ever known whose first language was Quebecois French spoke English very well, so I’ve never noticed the dropping of s from English plurals.

Have you ever imagined what C.W. McCall's Convoy would be like in Français québécois, given the documented divergences in C.B. lingo?

Have you ever imagined what C.W. McCall’s Convoy would be like in Français québécois, given the documented divergences in C.B. lingo?

My dad and I used to play that record* more-or-less specifically to annoy the bejeesus out of my mom; it was sort of an in-joke.

*It was a "greatest hits" compilation on vinyl, if memory serves. This one, I'm pretty sure.

^ My dad's side of the family is "mostly" French Canadian, incidentally.

Actually, one of my first thoughts about herbert, given that I thought he was probably French Canadian, was that he might be related to the Deloziers.

Probably not. Ebed Delozier's parents seem to be part of the Twelve Tribes sect and while the cult does have links into Canada, they are rather more firmly ensconced in Vermont. They also have rules about limiting contact for non cult members. Ebed seems to have broken from the cult, but the cult's child rearing activities have come under much scrutiny in the past.

This means that I am going to have to take back many of my speculations from comment 18.

Christine's family seems to be from Pennsylvania, but they also have some odd ideas. Christine's mother has written a series of not so best selling novels about Godly courtship.

No herbert seems to be just some random with a bee in their bonnet about big medicine.

The Great Gazoogle tells me this

It sounds about right. I ran across that earlier, but I only glanced at it, because I was looking for legal opinion.

My dad and I used to play that record* more-or-less specifically to annoy the bejeesus out of my mom; it was sort of an in-joke.

Ah, but that invocation was for a specific reason. I have a history on this subject.

I have a history on this subject.

Do tell.

Do tell.

I think the first mention is here.

If Alain were here, this would be simpler. I damn well better still have the proof-of-concept audio track,* but I could swear there was a short video, too.

* Which itself has a back story involving, yes, the vicinity of saffron robes for the vocal credit, and on and on.

Every time someone dies in the 'care' of a doctor, maybe we should sue them. currently being killed by a doctor on the wrong medicine is only slightly less dangerous than being on the right medicine.

As a francophone, I feel frankly embarrassed by Herbert, especially when he tells us he read Frachon's book and only got out of it something akin to "Wake up sheeple !!"
Herbert, as a francophone and if you really followed the Mediator affair, you don't have any excuse not to know about the journal Prescrire, who does their hardest to make sure the real schemes of pharma labs are known by doctors, in order to fight against them more efficiently.

If Alain were here, this would be simpler. I [d*mn] well better still have the proof-of-concept audio track,* but I could swear there was a short video, too.

Goodness, I'd like to see (or hear) that.

I also echo AdamG at 194, on combined antidepressants + cognitive therapy.
And in France I know quite a few people who don't have, for one reason or another, access to a therapist ; so they are stuck with the antidepressants alone. It is not a matter of not knowing about the benefits of therapy and blindly believing in the drug, but of psychiatric / psychologic support still severely lacking in some areas.

@ChrisP

The possibility of herbert being related to the Deloziers was just a fleeting thought.
Vermont does share a border with Quebec, Canada's predominantly francophone province. Canada was also on the pathway between France and the US for many US citizens of French ancestry. I wouldn't rule out the possibility of blood ties between herbert and the Deloziers, but it really is of no importance one way or the other.

Has there been any discussion here about the Hep-B vaccine's apparent protective effects against childhood leukemia?

http://www.nature.com/ni/journal/vaop/ncurrent/full/ni.3160.html

Maybe it's not news. But it was to me.

(Off-topic, but I came across it while looking for something else; the Hib was mentioned upthread; and it's where's-the-harm-ish.)

Orac, here is a homeopath's analysis of this article > http://tun.in/tgUiFe (Should be Tuesday 16th June Hour 1)

Antibiotics are worse than homeopathy, apparently.

By Rational Bee (not verified) on 18 Jun 2015 #permalink

<ciaparker>That means the real thing must be even better!!1!</ciaparker>

I'm here and yes, I can confirm that Herbert sound like a French canuck but I'm not what Narad refer to. Give me a few hours of sleep and a few coffee later on and I can give better answer.

Alain

*not sure...

NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday.

Read more: http://www.dailymail.co.uk/news/article-2161869/Top-doctors-chilling-cl…
Follow us: @MailOnline on Twitter | DailyMail on Facebook

So is this any different to an uneducated family allowing their child to die?

@ TBruce

OT, English spelling by French people

Francophones have a tendency to not pronounce the “s” in English plurals, so I guess that this would carry over into writing.

I'm not sure it's part of my own random placement of "s", but I could be unaware of this factor. I do have a very strong accent, so that may effectively "hide" proper spelling.

(conversely, I did find out that if I can spell an English word, then I can pronounce it much more effectively)

Speaking for myself, my own take on my floating "s" comes from a major difference between verb declination between French and English:
In French, we put "s" at the end of many verbs when using the second-person singular form (singular "you")
In English, you put the "s" when using third-person singular (he/she/it).

I know that, in the course of writing, I could be confused as to which is which. Is it singular but there is need for a "s", or is it plural bu there is no need for one?

Anyway, as you said, our floating "s" are certainly linked to thinking in French before translating in English.

By Helianthus (not verified) on 18 Jun 2015 #permalink

Was there an over/under on when Johnny would link to the Daily Fail?

Anyone here ever had AOM as an adult? I did, and it struck in the first hour of a 12 hour flight. Excruciating, unremitting pain.

Delphinette suffered from bouts of AOM from the age of 16 months to just over two. I would know when it was coming on when she would grab the affected ear as she was nursing. She started to do that on day 2 of a trip to NYC at the age of 2 and it went downhill from there. My wallet had been stolen earlier in the day, which meant that I didn't have our private health insurance card. Nor did we have a working credit card since Mr. Delphine's cards had to be canceled as well.

We showed up at NY Presbyterian's ER with a febrile, screaming toddler, and told them we a. had no money and b. no insurance card, to which they said, that's fine. Delphinette was examined and admitted. Within a few hours of her first dose of Augmentin she was feeling much better.

The bill was later paid for via our insurance.

The Deloziers are poor but that is not relevant here. They are ignorant narcissists who elevated their beliefs to stand above their own little girl. Hope was a living, breathing child, and she died a terrible death because her parents are stupid selfish a$$oles. No more, no less.

So is this any different to an uneducated family allowing their child to die?

There's no reason to think it's happening apart from it being the opinion of the guy who wrote something saying so for the Catholic Medical Quarterly, who appears to have been motivated by a religious objection to palliative end-of-life care, which he's calling euthanasia because he would prefer to see the divine spark of life kept lit, like G-d wants it to be.

Which is certainly his prerogative. As is voicing his opinion. However, there is zero evidence that any excess unnecessary deaths are occurring, let alone hundreds of thousands of them.

So in the sense that it's purely notional, whereas the Delozier's little girl is both real and really dead, yes, it's any different.

So is this any different to an uneducated family allowing their child to die?

Only the difference between about 80 years life expectancy versus a few days or weeks.

yes I suppose so indeed. But clearing doctors clearing hospital beds by withdrawing care is very similar. I suppose the doctors are trained and therefore know what they are doing.

And J/johnny...if you can bring us ANY PROOF that this is being done WITHOUT the patient and/or family's consent, then we'll believe you. However, no matter what you may or may not believe or like, a patient (or identified famiily member) may choose to have all lifesaving measures withheld so someone dies.

So, proof - and not the Daily Fail - is required.

Of course there isn't any proof of anything to do with that Daily Heil article "Johnny" cites: it's the Heil, probably the worst of the mainstream British press for its lackadaisical attitude to accuracy (although the Independent has run it close lately with its HPV vaccination scare stories); the Heil, being a huge proponent of "free market" dogma, has for years taken every opportunity to slagg off the NHS.

Disclaimer: my sister is a senior nurse in palliative care and may know a thing or 2 about this end of life stuff...So that probably makes me a proxy Shill for Big Death or something...

Further disclaimer: a few years back I made a complaint about the Heil to our Press Complaints Commission (as it was then) about mega-inaccuracies in a piece about my area (CAMHS).
And another friend made a complaint about other health-related lies.

So, I'm a Shill for Big Complaint About The Heil too

@ TBruce

Only the difference between about 80 years life expectancy versus a few days or weeks.

That's a bit rash.
I will say it's the difference between something witch could be easily cured (ear infection) and something for which there is no certain cure (old age's infirmities).

By Helianthus (not verified) on 18 Jun 2015 #permalink

@Murmur #273, as a former hospice nurse myself I guess it makes me one, too.

Appeal to authority is not the best way to get your point across. Then again, when someone IS an expert at something, their opinion ought to count for something.

Back to homeopathy,there is this post over at Science Based Medicine.

By Roger Kulp (not verified) on 18 Jun 2015 #permalink

Delphine @ 268
Yes.See my comment upthread @ 41

By Roger Kulp (not verified) on 18 Jun 2015 #permalink

Sorry, Johnny. But could you chill a little? I appreciate that this thread has gotten heated, but that’s no excuse to be rude to those who don’t deserve it.

PGP -
I apologize that this is coming rather late (yesterday was very hectic) but if my post at #173 caused you any distress, it was not my intent. My comment about the contents of homeopathic nostrums was intended to reference the fact that homeopathy is full of nothing (I am assuming you were not offended by me pointing out that it was doug's joke, and not me, asking about mullion). I did not intend to be rude towards you about your post that my #173 was in response to, as your related post did not offend me in any way.

That my sloppy writing has offended you disturbs me, and I promise that, in the future, you will be sure if I take exception to anything you post. For example, I may post something like 'PGP, you are an ignorant bigot', or, in the words of friend shay, 'You effing idiot…'. But I will not post anything relating to homeopathy in your general direction.

I hope you find my apology satisfactory.

Proper Johnny
Accept no substitutes.

A bit late to the thread, but I found the use of The Godwin by Herbert to be a bit ironic. He is perhaps unaware that the Nazis were also unappreciative of antibiotics, in spite of the fact that the first successful antibiotic put on to the market came from Nazi Germany. I suspect that their reluctance was not due to any distaste toward corrupt big companies (they had no reservations about corruption) but had more to do with their idiotic notions of "purity".

The first good commercial antibiotics were the sulfa drugs, discovered by Bayer and marketed in the mid-1930s. The German scientist who discovered the drug and led the effort to develop it was arrested by the Gestapo, and tossed in jail for a while for the crime of getting a Nobel prize.

Sulfa ended up saving far more Allied soldiers than Germans because the German military was reluctant to use it. It was mostly replaced by penicillin by the end of the war.

@Robert Bell: It's been not a big deal since parents decided a corpse was preferable.

I do not care how many co-morbids your child has (but they're not Autism), they have a better chance of progressing than a dead child.

"According to the DSM 5, autism (Autism Spectrum Disorder) is characterized by:

"Persistent deficits in social communication and social interaction across multiple contexts..." and
"Restricted, repetitive patterns of behavior, interests, or activities, currently or by history..."

That is IT. Period.

It's not epilepsy. It's not gastro-intestinal distress. It's not allergies, or anything else. Though it can exist alongside those things.

And it can (but does not necessarily have to) exist along with intellectual disability.

I was just reading a download on my hard drive of the front page of AoA and the articlke on the left side, from a day or two or a few ago, had a link to an article alleging that the medical establishment is the third most lethal whatever...apparently the perps imbibe of the woo...[!]

"I FOUND IT"
(The link, not Jeeezuz)

Drug Industry Operates Like Organised Crime – But Kills More

People Than The Mob – Says Dr. Peter Gøtzsche of the Cochrane

Center in Copenhagen:

https://childhealthsafety.wordpress.com/2015/06/02/200000-

americans-pa-killed-following-doctors-instructions-

prescription-drugs-3rd-leading-cause-of-death-in-west-drug-

industry-operates-like-organised-crime-but-kill-more-people-

than-the-mob/

& https://www.youtube.com/watch?v=dozpAshvtsA

Sia
I am sorry,but a very large percentage of autism researchers do not follow the purity of the DSM description of autism.You seem to believe in.You might be surprised how many mainstream psychiatrists and psychologists do not use the DSM when diagnosing autism.

A sizable chunk of research articles are about (Fill in name of medical condition) "in children with autism spectrum disorder".Often with detailed tables of all the medical conditions the children have.You should spend sometime reading this stuff.

There is a big debate in the autism research and medical communities about "autism pure" VS "autism plus".I might add that those in the neurodiversity movement,who are neither doctors,psychologists,or researchers,are some of the biggest advocates of the "autism pure" model of the condition.

By Roger Kulp (not verified) on 19 Jun 2015 #permalink

DSM V completely revamped everything about it.

“I FOUND IT”

CHS is John Stone's BFF* Clifford "Graph Boy" Miller.

* And, for a time, Wakefraud's "foreign counsel" in the comedy that was the Texas libel suit. (Sadly for the popcorn crowd – as opposed to the defendants in this asshattery – the anti-SLAPP was never reached, so it didn't make it to the Götterdämmerig level that it truly deserved.

A very terrible and virtually incomprehensible story.

It's unclear to me just how prevalent this sort of mistrust of conventional medicine is although presumably there are some stats on refusal of vaccination that could be used to extrapolate. Certainly the internet seems full of it but that may be increased awareness on my part and increased desire on the part of alternative practitioners to promote their viewpoints and sell their books, remedies or whatever.

What concerns me is how to counter it. There are of course some very real problems with the way drug development takes place, not least the lack of publishing inconclusive or negative data. There are also problems with the overprescription of antibiotics. I will even agree that there is the very occasional problem following vaccination. None of these things in any way negates the overall worth of conventional medicine or should overturn the system of clinical trials.

Why have a number of people suddenly been persuaded that they know more than their medical doctor because they've done their own internet 'research' and what stops this infection spreading?

What concerns me is how to counter it

In a just world, we wouldn't have to. Decent, rational people see these parents for what they are; it's the cranks and the ghouls who don't.

I know, it's not politic to say it, and not really nice to think it, but stories like this leave me wanting to beat the living shit out of the so-called parents. How in the name of all that's good in life can you sit blithely by and watch your child suffer through three goddamn weeks of pain and suffering, doing nothing but throwing vitamins and homeopathic water at it, when you know full well where the bloody doctors are ? Not even fucking Tylenol for her pain ? what goddamn inhuman vacuum-headed pus-bags. You should be made to suffer the exact same death. (okay, rant over.) By the time they "performed CPR" it would have already been way too late anyway. and WTF ? you can't pick up a phone and call EMS ? flag down a passing motorist ? Scream for help ? Clearly they had some ability to communicate with the outside world, if they had internet to read antivax bullshit on.

Didn't you all read the full article? They didn't bring the child to the hospital 60% for financial reasons and 40% for their beliefs. In other words, the major reason was financial. A continueing problem with those not insured or poorly insured. Obviously, in retrospect, they made a bad judgement call in thinking they could have treated this on their own.

People with misconceptions about vaccines will only start to change their minds if the rest of society stops hating them for their fears.

How can you say that someone who tho.is vaccines/antibiotics are bad for their child and therefore refuses to use them hates their child? It can't be so, but this would be a case of misguided good intentions.

60% for financial reasons and 40% for their beliefs

Oh yes? These percentages are stated In the full article, you say, and not something you pulled out the air just now?

By herr doktor bimler (not verified) on 24 Jun 2015 #permalink
60% for financial reasons and 40% for their beliefs

Oh yes? These percentages are stated In the full article, you say, and not something you pulled out the air just now?

I couldn't even find the numbers 60 and 40 in the article, let alone as percentages.

Given the family background of both parents and the attitude displayed by the mother, I suspect the real percentages would be closer to 200% and 20%.

"Obviously, in retrospect, they made a bad judgement call in thinking they could have treated this on their own."

Letting your 4 year old eat Frosted Flakes right before bedtime was a bad judgment call. Giving her an Elsa doll without an off switch was a bad judgment call. Nuke shaking off Crash was a bad judgment call.

The Deloziers were criminally neglectful. Watching your toddler die a wholly preventable death because you're too bloody narcissistic and ignorant to do the right thing is not a bad judgment call.

They waited until their daughter was almost dead before they took her to the hospital, or did you miss that part?

Regardless of my financial status, I think that after the second week of her running a fever, screaming in pain and draining fluid out of her ear, I might have decided that getting help for that baby girl trumped any and every other consideration.

Just finished reading Dr. Off it's book, "Bad Faith." As far as stopping or greatly reducing this type of medical abuse, it appears that stricter laws do a lot to reduce these kinds of "choices," even though they don't end them completely.

Lots of opinion articles recently about the rather proud anti-intellectualism rampant in American culture and the bad outcomes it produces. One suggested that Christianity and how it is practiced in this country, our history, etc., are a big reason these problems exist.

The complexities of all of this are fascinating... and the carnage it creates breaks my heart.

Regardless of my financial status

Perceived financial status, charitably; as I mentioned above, she was trivially covered by Pennsylvania's Medicaid plan.

I'm leaning toward this being Freakish, Scripted Apologetics on Fro's part. Their public defender(s)* seem to have little option but to go with downright stupidity as a mitigating circumstance. The charge is involuntary manslaughter,** after all.

* I presume; a really cold-hearted bastard might observe that the state can still try to flip one against the other with the sentencing carrot to secure a conviction.

** Going by the news reports; I'm not going to look up the penal code and so forth.

this would be a case of misguided good intentions

There is this old fable about the village idiot who decided to chase the flies which are bothering his sleeping friend. He grabbed a hammer for this job, and proceeded to smash the flies with it. Including the one which landed on the head of his friend.
Of course, the hammer blow killed the friend.
(the story does't tell if at least the fool hit the fly).

The morale of the story: it's better to have a smart foe than an idiotic friend.
Or, in the case of Hope, than an idiotic mother.

If someone doesn't realize than certain actions have lethal consequence, it's past time to sit this someone and have a long talk with him or her. In short, don't put fools and hammers together.

By Helianthus (not verified) on 24 Jun 2015 #permalink

Just finished reading Dr. Off it’s book, “Bad Faith.” As far as stopping or greatly reducing this type of medical abuse, it appears that stricter laws do a lot to reduce these kinds of “choices,” even though they don’t end them completely.

This was actually one of the, ah, "themes" in the latest entry from AoA's newest serialist, Martin J. Walker:

Mark Oppenheimer wrote of Bad Faith: (6) ....

Bad choice.