September 29, 2005,
I love L.A., but every so often I come across something that makes me think maybe people here really are crazier than average. Take this horrifying Sept. 24 Los Angeles Times story about Christine Maggiore, an influential HIV-positive activist who believes that HIV doesn’t cause AIDS, isn’t infectious, shouldn’t be treated with “toxic” anti-retroviral drugs like AZT and certainly needn’t prevent HIV-positive mothers like herself from breastfeeding.
In May, Maggiore’s three-year-old daughter Eliza died of AIDS-related pneumonia. Her regular doctors were two pediatricians popular with the Hollywood crowd: Paul Fleiss, the anti-circumcision crusader and tax-evading father of Hollywood madam Heidi Fleiss; and Jay Gordon, whose anti-vaccination philosophy has helped grow such a busy practice that this year he began declining new patients.
Although they knew Maggiore’s HIV-positive status, neither Dr. Fleiss nor Dr. Gordon had ever insisted that Eliza (or her older brother) be tested for HIV, even when Maggiore brought her in for an apparent ear infection shortly before the child died. After about two weeks of symptoms (beginning with yellow mucus from a runny nose), Eliza was finally treated – if that’s the right word under these circumstances–-with amoxicillin. The protocol for an HIV-positive patient would have been a much stronger antibiotic, sooner.
“I don’t believe I could have done anything to change this outcome,” Dr. Fleiss told the Times. Maggiore doesn’t even believe in the outcome. She and her husband are having the AIDS-related pneumonia listed in the coroner’s report reviewed. “I am not second-guessing or questioning my understanding of the issue,” she said. Instead she wonders why Eliza chose to “go home,” when children with “a small apartment on a busy street, extended day care, Oscar Mayer Lunchables–-will happily stay.”
Dr. Gordon contributes regularly to the Huffington Post. Typical entries are the anti-Bush “War Kills Children – I Am Licensed to Write About That” (Saddam Hussein’s killing of thousands of children was, apparently, not a pediatric issue) and “Milk Makes Children Fat,” even though childhood obesity has increased over the years that children have been drinking less milk. Still, at least Dr. Gordon had the grace to tell the Times that maybe he should have been more proactive with Eliza. “I’m not blameless,” he said.
What’s especially sad about this child’s death is that it was almost certainly unnecessary. Because of AZT’s success in treating newborns and preventing infection during pregnancy from HIV-positive mothers, pediatric AIDS has plummeted since the ‘90s. But the rate of new cases among adults in the U.S. remains steady, and some AIDS educators blame this on conspiracy theorists like Maggiore, who fuel wishful-thinking fantasies that HIV is harmless. She’s sold or given away around 50,000 copies of her self-published book, What If Everything You Thought You Knew About AIDS Was Wrong?.
The only good thing that can be said about the Christine Maggiore story is at least it’s unusual: How many HIV-positive mothers, after all, can there be who dogmatically refuse AZT when pregnant, insist on breastfeeding their children, and refuse to have them tested for HIV? (In Maggiore’s case, this means breastfeeding ad nauseum; when Newsweek profiled her five years ago, she was still nursing her son, then age three.) And silly as the anti-circumcision, breastfeeding-until-four, family-bed philosophies of Paul Fleiss and Jay Gordon (who began his career in Dr. Fleiss’s office) are, at least they don’t endanger public health.
Sure, uncircumcised boys are more likely to have infections when they grow up, but urologists need to earn a living too. Ditto psychotherapists, who should be kept busy for decades dealing with the results of breastfed preschoolers and children kept in bed with their parents through grade school. (If mom and dad want to have sex, Fleiss advises in his book Sweet Dreams: A Pediatrician’s Secrets For Your Child’s Good Night’s Sleep, the children can just say “Yuck, you need to go on a date,” then “march out of the bedroom and go play elsewhere in the house.”)
What concerns me more is the headway the anti-vaccination attitude has been making lately, because you don’t need to be HIV-positive for a common illness to be dangerous. (Maggiore’s two children, of course, were unvaccinated.) When I was five, my mother was hospitalized and almost died from a flu that turned into pneumonia. My ex-husband’s mother did die, when he was the same age, of the same thing. My grandmother was around 11 during the 1918 Spanish-flu epidemic. She caught it, all her hair fell out, and she liked to recall how she passed the time lying in bed embroidering a beautiful silk scarf to cover her head when she returned to school.
She said: “And my brothers would look into the bedroom while I was working on it and say, ‘Why are you so vain? Half the class is bald from the flu, no one's even going to notice.’” But she ignored them and finished the scarf, and was (at least according to her own recollection) the envy of everyone when she wore it.
My grandmother’s point, like the point of most her stories, was the inability of others to recognize her own fabulousness, and her stubborn insistence on persevering despite cloddish naysayers. But what always struck me about that story was: Wow, what kind of flu makes half the class go bald?
A pretty bad one, to put it mildly. The Spanish flu (which like all flus, was really Asian in origin) killed 50 million people around the world, more than the 32 million dead in World War I. Nothing like it has been seen since. But ordinary flu still kills plenty of people (about 36,000 Americans each year), and there have been reports suggesting that the current policy of routinely immunizing just the elderly and chronically ill is misguided. If schoolchildren – and only schoolchildren were vaccinated instead, infection rates of everyone else would fall dramatically, because schoolchildren are more likely to infect large numbers of people.
And yet even now, too many selfish and medically illiterate parents are sending children to school unimmunized against basic childhood diseases like measles and mumps. They refuse to expose their children to the miniscule risks of vaccination, gambling that the herd immunity of other, vaccinated children will keep them safe. Most of the time it will: responsible families assume all the risks, while irresponsible ones benefit. But it’s a narrow margin of safety, and if enough children in a community are unvaccinated, herd immunity disappears and everyone is in more danger, because vaccinations aren't 100-percent effective.
All states allow children more likely to suffer vaccination side effects because of medical problems to enter school unimmunized (as they should), some allow religious exemptions (as they shouldn’t) and some, like California, allow families to opt out for any reason at all (which is why much of the rest of the country regards us as nuts.)
We’ve spent so many years free of what used to be common but terrible childhood diseases that people have become complacent, even though measles, for instance, still kills a million (unimmunized) children a year around the world. I know how nasty mumps was because I got it when I was around three. One of my most intense childhood memories was sitting miserably down at the breakfast table with both fists pressed against my jaws as my parents laughed cheerfully, “Oh, she's got the mumps!” Another childhood milestone achieved, and not worth fretting about in their eyes. But it took decades before I felt pain remotely comparable to that.
I think California’s lax vaccination laws should be changed pronto, and ">maybe required annual flu vaccines for schoolchildren should be thrown in while we’re at it. People with special religious or personal beliefs against vaccinating their offspring can keep them home or send them to special religious or personal schools that will accommodate their very special kids. I see no reason why we should be forced to accommodate them.
Catherine Seipp is a writer in California who publishes the weblog Cathy's World. She is an NRO contributor.