Saturday, September 25, 2021

Moral saints, heroes and fanatics

 What's the dividing line between moral commitment and moral fanaticism? This American Life has a fascinating episode on the way climate-change activism tore one family apart.

Friday, September 24, 2021

September

 
 What's running through my head today. One of the all-time great funk grooves, and a horn section that never fails to give me chills. If you want to hear this amazing pop classic broken down by an expert, check out this week's edition of Strong Songs.

Wednesday, September 22, 2021

Allen Hornblum: "The University of Pennsylvania recently apologized for the sins of Albert Kligman, but why hasn’t the city done anything to atone?"

Allen Hornblum, the author of Acres of Skin, is calling on the city of Philadelphia to apologize to the victims of Penn dermatologist Albert Kligman. An excerpt from the Philadelphia Inquirer:

Fifty years ago this month, I walked into the city prison system, which included at the time Holmesburg, House of Correction, and Detention Center. Hot, raucous, and overcrowded that September day, each institution showcased a number of sights, sounds, and behaviors that would shock average Philadelphians. Perhaps the most unusual was hundreds of inmates adorned with bandages, gauze pads, and medical tape. Though prepared to work in an urban jail, I was stunned to discover I had also entered the nation’s largest clinical trial factory.

Inmates desperate to earn money were recruited by doctors and other inmates hired by Kligman to “sell a piece of their skin” for what was pitched as innocuous soap, hair dye, and athletes foot medications; swallow an assortment of “diet pills;” injected with “vitamins;” and participate in what was described as rudimentary academic studies. The dollar-a-day reward meant a trip to the commissary, money to send home, down payment for an attorney, or in a few cases, bail money.

Kligman compartmentalized much of his operations, leaving inmates, and even some doctors and technicians, in the dark about the experiments not only on Phase I drugs but also radioactive isotopes, dioxin, and chemical warfare agents. Many people involved did not know the extent of Kligman’s business interests and therefore could be working alongside a dangerous dioxin experiment and never have knowledge of it.

Friday, September 17, 2021

The Palmetto State is decadent and depraved

Some of you know that I have a long-running contest with my Texan friend Kathryn Montgomery over which state has the higher proportion of crazy people, Texas or South Carolina. Bragging rights shift back and forth with the regular emergence of new crackpots, demagogues and con artists, but I like to think that person-for-person, no state can really match the lunacy of South Carolina. Yes, there's Florida, but those area-man stories are just fleeting, unconnected episodes, usually ignited by Jim Beam or meth. Ours is an epic, sweeping, deep-seated derangement that spans generations. Craziness is as much a part of the fabric of South Carolina life as Sunday School and the electric chair. 

And with that introduction: behold, the latest development in the epic saga of the Family Murdaugh. This is no ordinary murder mystery. It has multi-generational depravity, graft, embezzlement, substance abuse, an amateur hit man and a fake suicide scam worthy of a 1940s film noir. And if the story holds true to form, we're not even at intermission yet. 

Wednesday, September 15, 2021

Macchiarini Watch

The podcast Dr. Death has devoted its third season, "Miracle Man," to the wild case of Paolo Macchiarini, the star transplant surgeon and fraud specialist who scammed the Karolinska Institute and many members of the Nobel Prize Committee into believing that he could implant plastic tracheas in humans with the help of magical stem cells. Most of the podcast recaps the story laid out in Adam Ciralsky's riveting article in Vanity Fair, "The celebrity surgeon who used love, money and the pope to scam an NBC News producer" and Bosse Lindquist's astonishing documentary film, The Experiments, but both the article and the film appeared in 2016. Dr. Death brings the story up to date and includes plenty of additional juicy details about Macchiarini's spectacular rise and fall.

One of the responses to the Macchiarini scandal was a decision by the Swedish government to create a central agency to investigate research fraud. Apparently there is no shortage of business so far. Here's a summary from Nature: 

Scientists have inundated Sweden’s new national research-misconduct investigation agency with cases, and there is no sign of a let-up in referrals.

Researchers brought 46 cases to the organization — called the National Board for Assessment of Research Misconduct (NPOF) and based in Uppsala — in its first year, according to a report detailing its activities in 2020. This caseload was three times higher than officials were expecting.

In most countries, universities and research institutions deal with misconduct allegations in-house, which can lead to some cases not being handled fairly or transparently. Sweden followed Denmark — the first country in the world to set up such an agency, in 2017 — in a bid to shake up research-fraud probes.

Experts had warned that the nascent agency could be overwhelmed, and say that the high number of cases could be down to researchers feeling more comfortable about reporting suspicions to an independent agency than to their own institutions, as they did under the previous system.

So far, investigations into 25 of the 46 cases have concluded, with 11 judged to be outside the agency’s remit, 10 researchers acquitted and 4 researchers found guilty of misconduct. Last month, the researcher at the centre of the agency’s first guilty verdict won her court appeal against the decision.

Plus, there is this interesting detail:

The organization handed down its first guilty verdict in September 2020, against biomedical scientist Karin Dahlman-Wright, former vice-president at the Karolinska Institute, who took up her post in the wake of the Macchiarini scandal but stepped down in 2019 when misconduct allegations against her surfaced.

The NPOF found that Dahlman-Wright committed research misconduct, with four of seven research papers investigated containing manipulated images. Dahlman-Wright denied the allegations, and appealed her case at the Administrative Court in Uppsala, which upheld her claim in August. Although the articles “contain images that do not correspond to the results that the images are said to show”, the court said in a statement, it ruled that Dahlman-Wright had not been grossly negligent — an essential component of Sweden’s definition of research misconduct.


Monday, September 13, 2021

Writing a fake schizophrenia diagnosis in order to drug seniors with antipsychotics

 

How do understaffed nursing homes get away with chemical straitjackets for their vulnerable residents? Just add a phony diagnosis of schizophrenia and nobody will ask questions. That's the scam that Katie Thomas, Robert Gebeloff and Jessica Silver-Greenberg have documented in the New York Times

An excerpt: 

The handwritten doctor’s order was just eight words long, but it solved a problem for Dundee Manor, a nursing home in rural South Carolina struggling to handle a new resident with severe dementia.

David Blakeney, 63, was restless and agitated. The home’s doctor wanted him on an antipsychotic medication called Haldol, a powerful sedative.

“Add Dx of schizophrenia for use of Haldol,” read the doctor’s order, using the medical shorthand for “diagnosis.”

But there was no evidence that Mr. Blakeney actually had schizophrenia.

Antipsychotic drugs — which for decades have faced criticism as “chemical straitjackets” — are dangerous for older people with dementia, nearly doubling their chance of death from heart problems, infections, falls and other ailments. But understaffed nursing homes have often used the sedatives so they don’t have to hire more staff to handle residents.

The risks to patients treated with antipsychotics are so high that nursing homes must report to the government how many of their residents are on these potent medications. But there is an important caveat: The government doesn’t publicly divulge the use of antipsychotics given to residents with schizophrenia or two other conditions.

With the doctor’s new diagnosis, Mr. Blakeney’s antipsychotic prescription disappeared from Dundee Manor’s public record.

Eight months following his admission with a long list of ailments — and after round-the-clock sedation, devastating weight loss, pneumonia and severe bedsores that required one of his feet to be amputated — Mr. Blakeney was dead.

A New York Times investigation found a similar pattern of questionable diagnoses nationwide. The result: The government and the industry are obscuring the true rate of antipsychotic drug use on vulnerable residents.

The share of residents with a schizophrenia diagnosis has soared 70 percent since 2012, according to an analysis of Medicare data. That was the year the federal government, concerned with the overuse of antipsychotic drugs, began publicly disclosing such prescriptions by individual nursing homes.

Today, one in nine residents has received a schizophrenia diagnosis. In the general population, the disorder, which has strong genetic roots, afflicts roughly one in 150 people.