I got into the AIDS debate with Dean again. I know, I know, I really shouldn't, but this one pissed me off.

The argument is based on this article from the LA Times detailing the death of Eliza Jane Scovill, the 3 year old daughter of a well known "HIV does not cause AIDS" activist mother. EJ was conceived, carried, and breast-fed by an HIV positive mother who was not on medication and because of her beliefs, refused to have either EJ or her brother Charlie tested for HIV.

EJ's death was recently ruled by the LA county coroner's office to be due to "AIDS-related pneumonia".

This pissed me off on so many levels: the parents, the doctors, and the article.

1. The kid was sick with a cold and then an ear infection that got worse for over two weeks from the first peds visit until her death

2. Given her well documented risk, why did NONE of the 3 doctors who examined her even think to give her antibiotics or take a culture swab to see what was causing her symptoms? They knew mom was HIV+ and she was at risk (according to the article)

3. The second doctor suspected an ear infection but never gave her drugs, the third doctor FINALLY gave her an antibiotic the day before she died. I'm no fan of over medicating, but in a case where a kid (or an adult) is at risk of being severely immunocompromised, you do a swab and then use a drug that kills whatever you found. It's too easy for something relatively innocuous to take hold in someone who is already defenseless. I know from experience.

3.5 What about the drug they gave her? The article says she was vomiting severely the day after starting the amoxicillin. Was she having a reaction? Amox and the other cillins and some derivatives make me break out, vomit, or both. Did her reaction (if any) to the drug contribute to her death? Was she too sick before starting the drug to overcome any effects of a reaction? Did a drug reaction weaken her to the point that she could no longer fight the illness?

4. I don't appreciate anyone (this girl's mother) who equates "small apartments on busy streets, extended day care, and oscar mayer lunchables" with neglect. Just because not all parents can AFFORD to stay home and give their kids organic vegetables doesn't make their kids any less special than yours or make you any less neglectful and selfish. I'd rather VACCINATE my babies (which this mom didn't), make sure I knew what ALL their health issues were, and give them junk food than be so deep in denial that I can't face the fact that it might have killed my baby and let the doctors take the blame.

UPDATE: Dean points out in the comments that not all vaccines are safe and effective. I actually agree with him, but I had forgotten about the "new" vaccines, which I utterly disagree with: chicken pox, pneumonia, and ear infection. The long-term safety of these vaccines is clearly unknown as they are less than 10 years old, and the effectiveness of them is also in question, as a large chunk of kids who get these vaccines still get sick when exposed....

5. Where's the HIV test? They say she died of AIDS related pneumonia, but there was no mention of them even doing an HIV test. I know there are some legal issues with reporting someone's HIV status, but I assume the parents would want the truth to be told, since they say that they still believe HIV doesn't cause AIDS.

I guess what gets me here is the disconnect and the denial. On the part of the parents AND the doctors. Look, I respect your right to parent as you see fit, including whether or not you find out about your kids HIV status if they are at risk. However, that doesn't give you the right to act imprudently. Based on ALL the evidence out there, HIV is clearly linked to AIDS, and MOST LIKELY causes AIDS. If your child is at risk of being HIV+ and you choose not to find out, for whatever reason, then you have to be aware that when that child gets sick, it could spiral out of control quickly, as it may have in this case. If you choose not to vaccinate your child, you have to be aware of the risks that go along with that and the risks that your children import to other people because they have not been vaccinated. If you choose to avoid antibiotics, then you need to be aware that your child can die just as quickly from a bacterial infection as from a car accident. It can happen that fast.

In this case, prudence dicated an aggressive treatment strategy. One that should have started by determining what bacteria/virus/fungus was causing the symptoms, instead of looking, guessing, and sending the kid home. More than once. It took two weeks before she was given anything other than "naturopathic remedies"(link)

And what of the reporting? Surely the author of the 5 page LA Times article was intelligent enough to ask the questions I've raised. Especially with regard to the HIV testing. That's clearly relevant here. Perhaps the journalist wouldn't know enough about the possible side effects and reactions to amoxicillin, but a simple Google search would have sufficed. Also, the journalist doesn't appear to have enough healthy criticism of the doctors. While the writer allows Dr. Gordon to second-guess himself, Dr. Fleiss is paraded out as the pediatrician to the stars, notorious and controversial, but well established. Little criticism of the treatment strategy of any of the doctors is offered, except by unnamed, uncredentialed "experts". While it is likely that the little girl died of HIV related symptoms, no direct evidence to support this is presented except the single conclusion of the coroner.

I am flabbergasted by the ignorance and denial among educated people. By all accounts this was a healthy, active, intelligent child who should not have fallen so fast. Something was missed. Whether or not it was AIDS remains to be seen (where's the test??), but clearly there was more going on here than meets the eye.

Posted by: caltechgirl at 11:18 PM | Comments (5) | Add Comment
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Over at Vodkapundit, Steve posits that the NY Times is making a bad business decision, between laying off hundreds of employees and charging for access to their opinion pages.

To me, it signals the end of a long era in journalism. The layoffs and the desperate bids for increased revenue tell me that the Times is bleeding and is trying unsuccessfully to staunch the flow. Instead of looking seriously at the big knife stuck in their chest, they're trying to stitch around it.

Ok, enough with the blood metaphor. Clearly the growth of new media and the internet has taken a chunk out of their business, and they are scrambling to catch up. You could argue that these layoffs represent the first concrete evidence that "flammable" media is dying. The problem is that like most large corporations, those who are responsible for fixing the problems refuse to examine their own biases. A paradigm shift has taken place in the last 5 years. Media consumers now have multiple sources for news, and freely compare the information they get from each. They don't just accept the editorializing found at one source or another. Editors and publishers haven't (as yet) been able to look carefully at their own papers or broadcasts to see what it is that consumers are turning away from.

The Times will never be the same. It will never wield the same kind of authority that it did in days past. Why? Because as they lay off reporters they will lose the newsroom flexibility to cover breaking news, update older stories, and fact check pieces before publication. Forget editing, if you've even perused the Grey Lady over the last couple of years, you know that went out the window a long time ago.

Another step away from the "old media" also took place this week, though it was largely symbolic. During Sunday night's Emmy broadcast, Tom Brokaw, Dan Rather, and the late Peter Jennings were honored for their contributions to network news over the last two decades. Although the segment was supposed to serve as a memorial to Jennings, and a recognition of the careers of Brokaw and Rather, it was also a tacit memorial to the role of network news in American culture. Since the birth of TV, the majority of Americans got their national and international news from the evening broadcasts of each of the three major networks. With the retirement of Brokaw, the "retirement" of Rather, and the death of Jennings, clearly an era has ended. What remains to be seen is whether the evening news will ever be as important in American culture as it was before.

It is likely that in years to come we will look back at this week as highly significant in the history of media in that the events of this week represent the emerging importance of "new media" and the effect that internet journalism and blogging have on the bottom line of older media outlets.

Posted by: caltechgirl at 11:20 PM | Comments (4) | Add Comment
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