Celia Farber's Serious Adverse Events: An Uncensored History
of AIDS
Since mid-summer 2005, I've published
seven columns in Townsend about AIDS. This column, the eighth focusing
on AIDS, reviews Serious
Adverse Events: An Uncensored History of AIDS by Celia Farber. Why
the sudden spate of columns on AIDS? Over the past year, familiarization
with AIDS research and treatment has convinced me that efforts to quell
dissent within this field are the most stifling in the medical world.
Such a situation requires exposure – as often as possible. In
this connection, I'll quote from a 1990 editorial in the Annals
of Internal Medicine, which commented on disagreement over practice
guidelines and reflected the thinking of a good number of clinicians.
I believe the last sentence applies in spades to censorship by the
HIV-AIDS establishment:
Whoever sets guidelines should expect disagreement.
Indeed, they should encourage it. The debate may not be easy
on egos and may threaten vested
interests, but it is good for the improvement of medicine. It is
unfortunately common to hear an interest group advance its opinions
and then cry
foul when other groups have opinions of their own. If the disagreement
is on the interpretation of evidence, that is all for the good;
but if it is on who is allowed to define what is the correct practice
of
medicine, then we are all in trouble"1 [italics added].
Celia Farber, an independent investigative
reporter, has covered the AIDS scene in the US and abroad for 19
years. In March 2006, Harper's
Magazine published an article by her that roiled the HIV-AIDS establishment,
producing an immediate ripple effect like a small boulder catapulted
into standing water. "Out of Control: AIDS and the Corruption
of Medical Science" reinvestigates the turbid circumstances surrounding
the AIDS community's acceptance of nevirapine, an antiretroviral
drug developed to prevent the transmission of HIV from mothers to children.
Toward the article's end, Faber also relates the nevirapine story
to the political context of HIV-AIDS research, bringing up Professor
Peter Duesberg, who was a respected virologist before he published
articles in peer-reviewed journals in the late 1980s contending HIV
doesn't cause AIDS. (Duesberg is also a cancer researcher; his
work in this field is still widely respected.)
Prior to her article in Harper's, Farber had consistently grounded her
reports on the observations and views of researchers, clinicians, and patients
skeptical of the orthodox position on HIV and AIDS therapy; her stories kept
open questions about AIDS causation and sounded alarms on the toxic effects
of anti-HIV drugs. In her first book, Serious Adverse
Events, Farber asks more
of the same questions and heightens the level of the alarms.
Serious Adverse Events contains 12 pieces, many of them reprinted without changes,
the rest updated to incorporate new information. These articles, which appear
in the book as numbered chapters, still bear their original titles. All but
one appeared in either Spin, Gear, Red Flags, Mothering, or Harper's
Magazine. Chapter One, about Professor Peter Duesberg, was originally written
for Harper's, but was replaced by her story on nevirapine, so this is
a new publication. Also previously unpublished is a preface and epilogue, both
offering fresh observations. Together, these pieces cover most of the important
issues and developments in AIDS since the mid-1980s.
Long or short, there's not a slow read among the 12 chapters. Farber
has a gift for images mirroring situations into which individuals fall when
they challenge the AIDS establishment, and for quotes sharply defining (or
deflating) the people on which she trains her investigative sights. One of
her most memorable images comes three paragraphs into the opening chapter, "The
Passion of Peter Duesberg." In the following excerpt, she's finally
located the Donner Lab, screened by woods at the outskirts of the University
of California campus at Berkeley, en route to interview Duesberg at his office
in the lab. She describes her first glimpse of him:
Thanks to large donations from two pharmaceutical companies, Berkeley's
biology facilities are undergoing extensive renovation. There are bulldozers
here and there, and near the Donner lab is a huge gaping hole where
a building has just been demolished. In the distance, I spot Peter
Duesberg weaving on his bicycle past the bulldozers on his way into
the lab. In the heat of the sun, it seems to me that their jaws might
just reach down and snap him up, putting a quick, merciful end to the
nearly twenty-year battle between the Establishment and the troublesome
scientist.
As her chapter on Duesberg proceeds, recounting
the abrupt shut-off of research funds after publication of his papers
arguing that HIV
has no active role in AIDS, the derision and ostracism he's suffered
in the scientific community and media for persisting in his dissent
on HIV, and his emotional and intellectual responses to the ordeal
he's been through, that initial image of Duesberg threatened
by bulldozers hangs in the mind. Even when Farber speaks of renewed
respect for him because of his research on aneuploidy (an abnormal
number of chromosomes observed in all malignant cells, proposed as
the initiator of cancer), the image of an imperiled Duesberg lingers.
The word "passion" in the chapter title, by the way, is
used as it is in the Gospels in reference to the suffering and crucifixion
of Jesus; in Farber's "passion" of Professor Duesberg,
the torment is real, the crucifixion figurative, of course.
Chapter Eight, "The Rebel Genius," portrays Kary Mullis,
who earned a Nobel Prize in 1993 for figuring out a method of rapidly
mass-producing DNA
segments, called the polymerase chain reaction (PCR). PCR tests have been used
since, among numerous ways, to identify dead people through fragmentary remains,
clear men convicted and jailed for rapes they didn't commit, and reconstruct
genomes of long-extinct species for scientific study.
Like Duesberg, Mullis doesn't think HIV causes AIDS, and public airing
of his disbelief has ticked off many of his scientific peers. But Mullis also
has a reputation as an eccentric, in both his professional and private lives.
The first paper he published (1986) offered his picture of the universe from
a psychedelic viewpoint; giving lectures, he's displayed photos of naked
girlfriends, "their bodies traced with Mandelbrot fractal patterns" (Farber's
words). Farber bunches most of this offbeat stuff up front, together with her
take on his eccentricities, transforming certain of those eccentricities into
scientific virtues.
"Mullis," she writes, "who has been described in the press
as possessing a 'creative nonconformity that verges on the lunatic,' struck
me as a person with a pure and insatiable curiosity…For instance, at the
end of the interview, he asked me to articulate why it would matter if I were
to discover that the hotel lobby, the bar, the bartender, the drinks, and our
conversation had all been an electronic mirage."
Quotes revealing character, deep scientific insight, and motivation are the
highlights in her sketch of Mullis. Midway into the chapter, she has Mullis
expand on why he feels researchers have gone off-track straining to grasp how
HIV causes AIDS:
A lot of people studying this disease are
looking for the clever little pathways that will show how this
works. Like, "What if this molecule
was produced by this one and then this one by this one, and then
what if this one and that one induce this one" – that
stuff becomes, after two molecules, conjecture of the rankest kind.
People
who sit there and talk about it don't realize that molecules
themselves are somewhat hypothetical, and that their interactions
are even more so. You don't need to look that far. You don't
discover the cause of something like AIDS by dealing with incredibly
obscure things.
By the time Farber draws the final lines of
her portrait, Mullis, the eccentric, has been downplayed; another
Mullis,
dismayed by what
he feels is happening in AIDS research, stands out, anguished,
frustrated, and irate:
Do we care about these people that are HIV-positive whose lives
have been ruined? Those are the people I'm most concerned about.
Every night I think about this…The horror of it is every goddamn
thing you look at…seems pretty scary to me…God, I hate
this kind of crap…It just drives me to – I'm making
tears thinking about it. I don't see how to deal with it. I
can't possibly write a book that will describe it to somebody.
You can't do a damn 22.8-minute TV thing that is going to have
any effect… "Science Fiction," Farber's tenth chapter, exposes
the shoddy research and hype that led in 1996 to mass adoption of drug
cocktails – combinations of recently developed protease inhibitors,
AZT, and other drugs – to prevent replication of HIV and drop
viral load to negligible levels. Dr. David Ho, then newly chosen director
of the Aaron Diamond AIDS Research Center in New York, had conducted
the pioneering research on the combination therapy, giving cocktails
to nine AIDS patients, measuring drug-resistant mutations, then calculating
the amount of virus particles produced by infected cells.
Ho based the experiment on the premise that HIV replicates swiftly from the
moment of
infection, slightly faster than the mass-production of T-cells defending the
body, eventually resulting in collapse of the entire immune system. In consultation
with mathematicians, Ho devised a mathematical model to predict the rate at
which HIV would multiply if unchecked by combination drug treatment. He reported
his findings at the
International AIDS Conference in Vancouver in the summer of 1996; after cocktail
therapy for between 90 and 300 days, the nine patients showed no evidence of
HIV in the bloodstream. Hit early and hard, Ho concluded, and it was possible
to eradicate HIV permanently.
Farber quotes Dr. Steven Miles, professor of medicine, University of Minnesota
Medical School, on the impact of Ho's findings and conclusion: "It
was almost like an instantaneous religion, or a cult, right after Vancouver.
You were either a part of that hit-hard-hit-early religion or you were not.
It split the HIV community." Farber sums up the broader effects of Ho's
research: "The 'breakthrough' provided hope to two main players:
HIV-positive people could hope for a new lease on life, and the drug companies
could sell drugs like never before. They could even keep their customers convinced,
through the AIDS-care network itself, that total compliance with the draconian
discipline of the cocktail was the only path to heroic survival. Miss one pill,
the new wisdom held, and HIV, enigmatically, will 'mutate.'"
Having raised the backdrop for cocktail therapy, Farber devotes the rest of
this chapter to bringing its fuzzy premises and substantial dangers center
stage. While doing so, she demolishes David Ho's math model, emphasizes
the absurdities of viral load, details the side effects of protease inhibitors,
calls attention to invasive efforts to ensure compliance with the combination
regimen, and fixes ultimate responsibility for promotion of AIDS cocktails
on the media. All this she accomplishes chiefly by quoting experts critical
of Ho and the cocktails (citing mainstream studies, too). Most of these experts
subscribe to the theory that HIV causes AIDS.
Let's touch on the major points in this chapter; it strikes me as the
most disturbing in the book, with the widest ramifications today. According
to a physician Farber cites in the chapter, three out of four people currently
placed on these drugs are asymptomatic. As she puts it, that's "one
big medical experiment," the outcome of which is uncertain. Add another
uncertainty, the long-term side effects, and that's a huge amount of
potential risk riding on a gamble – that protease inhibitors will pay
off at the last spin of the wheel – with the lives of HIV-positive people
on cocktails.
Puncturing Dr. David Ho's mathematical model, Farber begins with an expert
in math, Mark Craddock, at the University of Technology–Sydney. Craddock
dismisses the model as "mathematical junk"; there's no way
one person can churn out that much virus. "Ho's equations," says
Craddock, "predict that over the course of ten years, an HIV-positive
person will produce more particles of HIV than there are atoms in the universe."
Farber finishes off the model with a quote from Dr. Joseph Sonnabend, an AIDS
clinical researcher originally at odds with the HIV establishment over treatment. "Of
course it's wrong," Sonnabend exclaims. He then deflates another
of Ho's ideas, that hitting HIV hard and early with cocktails can eradicate
HIV: "The notion of 'eradication' is just total science fiction.
Every retrovirologist knows this. The RNA of retroviruses turns into DNA and
becomes part of us…You can't ever get rid of it."
For comments on the absurdities of measuring viral load, Farber summons Dr.
David Rasnick (definitely not a subscriber to HIV), a scientist who was involved
in the development of protease inhibitors, Rasnick observes that testing for
HIV in breast milk requires 45 PCR cycles – a 35-trillionfold amplification – to
detect sufficient genetic material! In essence, he goes on, they start with
a number that's next to nothing, mass multiply it, and use that number
to scare people into combination-drug therapy. HIV starts out undetectable
and ends up more or less undetectable, contends Rasnick, who concludes: "All
this stuff about wanting to get to zero, or to undetectable, is absurd because
it implies that a single particle of HIV is lethal, but it's not…This
is the biological equivalent of counting bumpers in a junkyard and saying they
represent functional cars."
Doing the balance sheet on protease inhibitors, Farber is mostly on her own.
There's a "virtual blizzard of data," she writes, that can
be molded into plusses or minuses. Protease inhibitors have lifted patients,
Lazarus-like, off their deathbeds. They've killed some patients. They've
so impaired the lives of others that these people long for death.
In the minus column she puts in the unexpected "disruption of the body's
fat-distribution mechanisms," resulting in heart attacks and strokes
when markers for CD4 cells and viral load indicated that the protease inhibitors
were "working." A study she cites, conducted at the University
of Colorado Health Science Center, warns of kidney and liver failure; according
to this study, the number of patients on these drugs who died of kidney and
liver failure "surpassed deaths due to advanced HIV in 2002."
For support, Farber relies again on quotes from mainstream experts; Drs. Joseph
Sonnabend, and Steven Mills. "The people for whom benefit has been proven
beyond a doubt are really sick people who would have died without them," says
Sonnabend. "But the target population for the drug companies are the
healthy people, and these people will almost certainly have their lives shortened
by these drugs."
"The vast majority – about 75 percent - of people who go on these
drugs are completely healthy," says Dr. Steven Miles. "Large numbers
of people are being inappropriately treated with drugs they don't need.
And their lives are probably being shortened."
The surveillance system depicted by Farber to ensure compliance with the cocktails
is scary: computer chips in bottle caps, recording the date and time of each
opening; beepers; buddy systems; support groups; observation centers where
patients taking the drugs are watched; groups of AIDS professionals infiltrating
people's social networks to enlist them in helping push the drugs. "They
call it 'treatment compliance,'" Farber writes, "and
it has largely replaced safe sex as the core social imperative of the AIDS
industry."
Who bears ultimate responsibility for the business of protease inhibitors?
Farber turns to Dr. Joseph Sonnabend to answer this question. "Journalists," Sonnabend
answers. "We have traditionally depended on the press to protect us from
nonsense like this – not anymore. Now people who have feet of clay become
oracles thanks to their publicists and the cooperation of journalists. And
the real tragedy is that years have been wasted on this David Ho eradication
hype."
Introducing this column, I summarized the content of Farber's article
in Harper's. In three columns on African AIDS published in the Townsend
Letter (Nov. 2005 - Jan. 2006), I discussed and quoted at length from her two
field reports from Africa, first published in 1993. It's my impression
that these reports have been reprinted without significant change; I needn't
say more about them now. Counting Farber's portraits of Peter Duesberg
and Kary Mullis, from which I've excerpted illustrative passages above,
and the chapter on protease inhibitors, I've covered half her book; there's
no space left to squeeze in even capsule descriptions of the six remaining
chapters. I can say, without reservation, that they abound in the same vivid
images and penetrating quotes that distinguish the chapters I've selected
for review and that their content is equally important in counterbalancing
the HIV establishment's positions on AIDS.
Gleaning Truth
"Truth," remarked Oscar Wilde, "is rarely pure, and never simple." Farber
understands that truth shows a number of faces, some disguised, that it's
no cinch discerning which face is authentic. I believe that soon after she started
reporting on AIDS truth for Farber became everything consequential which the
HIV orthodox sought to deep-six. Thereafter, she took upon herself the task of
giving voice to people the orthodoxy attempted to squelch and airing reliable
contradictory information the guardians of HIV doctrine aimed to smother under
a shroud of silence. If it were in my power, I'd award her a commendation
for public service – and several purple hearts for wounds to her
psyche and reputation suffered in performance.
In the preface to her book, Farber reflects on the meaning of truth within
the context of AIDS. I'm again going to quote several paragraphs, because
paraphrasing or summarizing a writer as adept as Farber is in her selection
and arrangement of words diminishes the acuity and subtlety of her thought.
First, here is the context:
The HIV-causes-AIDS model was nothing
if not mechanistic, and ferociously reductionist. Its net
trapped new and emerging
technologies. It exploited
ancient fears seeded
in sex, shame, and death. The net trapped all those who turned up 'positive'
on an antibody test, a test that has now all but lost all biological
meaning and
specificity. It was a mark of death, understood at the time as a sure
death sentence…
This book is about the twenty-year
war between those who believed in the death sentence and
those who did
not. It was, as I say, an informational
war – a war of ideas, values, money, power, and the ways
that all of those things cast impossible shadows on what was called
'irrefutable
data,' and 'overwhelming evidence.'
From the ashes of that war, a new
narrative is emerging, from the experiences of untold millions
who fell into
the net, usually by way
of a single antibody test, and without any knowledge of the dissent
against the official theory. The AIDS war divided those who believed
and enacted its every dictum, from those who, very early on, saw
a parallel reality, a sister ship loaded with a very different
cargo
of facts and interpretations. This could only happen at the time
when the world was flooded with 'information,' and yet,
mass
media gained unsurpassed powers of persuasion. To question the
core catechism that HIV was the single and direct cause
of AIDS became an
act of not only heresy, but grave moral "irresponsibility," finally
escalating into open charges of murder.
Tomas Transtromer, a Swedish poet admired
by Farber, gave her a phrase for the title of her preface – "The Truth Barrier." For
Transtromer, she explains, this phrase invokes "the membrane
where 'truth' struggles to reconcile itself with a disturbed
world." She goes on: "Transtromer's frequent use
of the word 'truth' is the equivalent of nature itself.
In many poems Transtromer describes how easily 'truth' breaks
when we try too hard to catch it, possess it, personify it. A "scientific
truth' is after all a secret of nature, not of man. It always
rises to the surface and confronts the world. In the poem, 'Preludes,' he
writes: "Two truths draw nearer each other. One comes from inside,
one comes from outside, and where they meet we have a chance to see
ourselves.'"
For Farber then, truth is elusive. And when we catch sight of it, we
seek to evade it, because we tend to avoid knowing ourselves. (She's
following a Transtromer insight into our avoidance of self-knowledge.)
Here's the last sentence of her preface, reinforcing the elusiveness
of truth: "Whatever the
truth may turn out to be, it is something that involves us all, moves
through us, from inside and from outside, drawing nearer and slipping
away."
Is there any certainty that Farber can latch onto? Yes, one: She writes:
Beneath the industrial, social roar
of all we mean when we say "AIDS," is
yet another of nature's secrets that man presumes to have unlocked.
My one certainty is that something very critical is working itself
out here, through this epic scientific clash. Does HIV cause AIDS?
I don't know if it does or not –I'm not really equipped
to know. The story I have tried to tell, and which this book explores,
is the story not of my own beliefs about science (I'm not a scientist)
but of the epic human drama between those who say yes and those
who say no to this question.
Farber's reporting is always clear-eyed,
and her language is livelier than the writings of most journalists.
The pieces selected
for her book allow us to appreciate her "true" face in
its complex make-up. If you care to explore the "parallel reality" in
AIDS on which Farber concentrates, if you're curious to board
a "sister ship" freighted with a cargo of facts and interpretations
very different from those aboard the super freighter "HIV-AIDS," jot
down Celia Farber's Serious Adverse Events on
your required reading list. Serious Adverse Events
Celia Farber
Melville House Publishers
Hoboken, New Jersey
$16.95
Available at bookstores, online, or through Melville House Publishers
www.mhpbooks.com/order.html
1. Fletcher RH, Fletcher SW, Clinical practice guidelines, Ann
Intern Med. 1990 Nov 1;113(9):645-6.
|