Complementary and alternative medicine Medicine Pseudoscience Quackery Skepticism/critical thinking

HIV/AIDS denialist Celia Farber on the death of Christine Maggiore: It was a “radical detox” regimen, not HIV

Yesterday, I commented on the tragic death of HIV/AIDS denialist Christine Maggiore, who was HIV-positive herself and refused to use antiretroviral drugs during her pregnancy to prevent maternal-fetal transmission of the virus and insisted on breast feeding even though the virus can be transmitted to the baby through breast milk. Her cultish clinging to the belief that HIV does not cause AIDS against all scientific evidence showing otherwise cost her daughter her life in 2005 and, very likely, cost her her own life a few days ago. I concede that it is quite possible that Maggiore did not die of AIDS, but the circumstances surrounding her death, from what I can glean from news reports, are damned suspicious for for an AIDS-associated pneumonia.

Leave it to HIV/AIDS denialist crank Celia Farber, writing on on the blog of that HIV/AIDS denialist blogger Dean Esmay (who, by the way, really, really doesn’t like me) to jump into the fray and provide an “alternate” explanation. Not unexpectedly, her claim is that Christina Maggiore did not die of AIDS. Rather, according to Farber, a combination of stress and a “radical detoxification” regimen killed Maggiore. However, even if her account is accurate (a huge “if” given that Maggiore has never been particularly forthcoming with her medical history), then, no matter what killed Maggiore, HIV or quackery, her case stands as a shining example that pseudoscience and antiscience kill. Farber starts:

I got the devastating news yesterday that my very good friend Christine Maggiore died at home on December 27th, from a bout of bilateral bronchial pneumonia, that afflicted her in recent weeks, and which she was unable to overcome.

Of course, Pneumocystis carinii pneumonia (PCP) frequently presents as bilateral pneumonia; so at this point the story continues to sound suspiciously like AIDS-related pneumonia. Indeed, in patients over 50, PCP is often how HIV infection first presents. Of course, in older patients, the reason is that the index of suspicion for HIV infection tends to be lower and primary care doctors may not look for it, but in Christine Maggiore’s case clearly her refusal to be treated for her HIV infection could conceivably have led her to present the way that AIDS patients used to present back in the 1980s; i.e., with an opportunistic infection like PCP as the first sign. Before I get to the meat of the topic, I can’t resist pointing out a bit of drama typical of Farber:

The news has been shattering to all who loved her around the world. Speaking for myself, I can say that Christine Maggiore was one of the strongest, most ethical, compassionate, intelligent, brave, funny, and decent human beings I have ever had the honor to know. I spoke to her in great depth about all aspects of life, death, love, and this battle we both found ourselves mired in, and I will be writing about her and about those conversations here, in the future. No matter what she was going through, and it was always, frankly, sheer hell-every day of her life, since 2005, she faced, acute grief, sadistic persecution, wild injustice, relentless battle, and deep betrayal-she was always there for her friends, and she never descended to human ugliness. She always tried to take the high road. She always tried to be stronger than any human being could ever be asked to be. I feared for her life, always. I feared the battle would kill her, as I have felt it could kill me, if I couldn’t find enough beauty to offset the malevolence. This is a deeply occult battle, and Christine got caught in its darkest shadows.

While I understand the pain the death of a loved one produces and even though one never likes to speak ill of the dead, I have to point out that Maggiore brought that “sheer hell” on herself to a large extent when her cultish belief in HIV/AIDS denial led her to fail to take simple steps that could have prevented the death of her daughter. Her medical neglect arguably directly led to her daughter’s death and the “persecution” described by Farber was nothing more than the medical and legal establishment trying to discover the truth. That Maggiore got off without punishment does not mean that she was not responsible for the death of her daughter.

I have no doubt that Maggiore suffered horribly from the grief that comes from losing a child, and I’m not unsympathetic to that. She suffered a loss that no parent should have to suffer, made all the more tragic because it was potentially preventable. Indeed, the clear preventability of Eliza Jane Scovill’s death is why my sympathy for her mother only went so far. While my sympathy for Eliza Jane for having had her young life snuffed out prematurely by AIDS, my sympathy for Eliza Jane’s mother ended at the point where she hired an HIV/AIDS denialist hack, toxicologist Dr. Mohammed Al-Bayati, to try to whitewash her daughter’s autopsy report and try to spin the cause of death as being from an antibiotic reaction and the cause of her profound anemia as being due to a common childhood virus based on a highly dubious extrapolation. My sympathy also bumps up against her prominent role in spreading a denialist philosophy that has led to the deaths of an estimated hundreds of thousands in Africa. As for this being a “deeply occult” battle, Farber is more correct than she knows, but not in the way she thinks. The battle is “occult” in the sense that HIV/AIDS denialism is very much like magic and the occult; it is based on faith, not science, and its adherents cling to it in the face of all evidence, science, and reason to the contrary like some dark religion.

So what did actually kill Christine Maggiore? Well, if we’re to believe Celia Farber, quackery killed her:

She had apparently been on a radical cleansing and detox regimen that had sickened her and left her very weak, dehydrated, and unable to breathe. She was shortly thereafter diagnosed with pneumonia and placed on IV antibiotics and rehydration. But she didn’t make it.

Later in the post, Farber tries to refute the reports that Maggiore had been ill for a while:

She had been HIV positive since 1992, and never had an AIDS defining illness. Her foes have predictably begun their attacks, and there is already a misleading statement from the LA County Coroner’s office, against whom Christine was scheduled to testify two days from when she died, stating that she had had pneumonia for six months. This is incorrect, but helps foster the impression that it was an AIDS related pneumonia (PCP) which is a longer term illness.

This is a twisting of what the news reports actually said, which was: “According to officials at the Los Angeles County coroner’s office, she had been treated for pneumonia in the last six months.” To me that means she had been treated for pneumonia sometime within the last six months. It does not mean that she had had pneumonia for six months prior to her death. But leave it to Farber to dishonestly spin it that way. Also, that Maggiore lived symptom-free with HIV for 16 years does not mean that HIV doesn’t kill. As Nick Bennett explains, a period of 16 years is not too far outside of the range for the normal progression of untreated HIV infections.

More importantly, though, Farber’s account has a glaring inconsistency. Can you see what it is? Here Farber is, trying to argue that Maggiore was as healthy as the proverbial horse, aside from her understandable emotional distress over the death of her daughter due to AIDS, and yet she was undergoing a “radical detoxification regimen.” (One wonders if she was undergoing the Gonzalez regimen, which is certainly a radical detoxification regimen–and about as dubious a “therapy” as there is.) So here’s my question: If Christine Maggiore was so healthy, why was she undergoing such a radical detoxification regimen? True, sometimes healthy people undergo such regimens for vague symptoms or as a “preventative” measure, but usually only people who have a serious illness are drawn to the radical detoxification regimens. Healthier people, a.k.a. the “worried well” who are most drawn to “alternative” medicine, tend to opt for much less radical detoxification regimens. Yet, here we have Christine Maggiore undergoing a “detox” regimen so radical that Farber perceives it as being plausible that the regimen was what caused Maggiore to lose weight, become weaker, and finally become susceptible to the pneumonia that killed her.

I can’t help but think of an alternate explanation, one that fits more with the facts as we know them so far. I admit I’m speculating, but, without hard evidence from an autopsy to tell us what killed Christine Maggiore, I submit to you that my speculation fits the know facts better than Farber’s histrionics. My explanation would be that Maggiore had been ill for a while. Because she had become ill, she started a “radical detoxification” regimen. Perhaps she even had a little dry cough that got a bit worse, which she would never allow herself to recognize as an early symptom of PCP. She became weaker and thinner not primarily because of whatever quack regimen she was undergoing but because of HIV. Most radical detoxification regimens, even the worst, usually do not sicken people to the point of being so weak they are susceptible to fatal pneumonia–unless, of course, they are already seriously ill.

There is, of course, one way for HIV/AIDS denialists to prove me wrong, and it’s one area where I actually agree with Celia Farber:

We all agree that it is imperative that an impartial and thorough autopsy bring to light all facts about Christine’s cause of death, and the state of her immune system, and how these facts might bring us all closer to the ultimate truth we all seek.

I agree with the expressed sentiment, and, if an autopsy is done and it turns out that Maggiore did not die of an AIDS-related pneumonia, I will forthrightly admit my speculation was incorrect. I will also point out that, even if Maggiore did not die of AIDS, it would not in any way validate her HIV/AIDS denialist beliefs, although no doubt that’s exactly what denialists like Farber and Esmay would try to do. I will also point out that, if Farber’s account is confirmed, then Maggiore’s death would be prima facie evidence that unscientific quackery can kill.

If, on the other hand, however, an autopsy is performed and it does show PCP and other evidence of AIDS, will Farber and Esmay concede that AIDS killed Christine Maggiore? I sincerely doubt that they would, if the behavior of HIV/AIDS denialists after the death of Eliza Jane Scovill and Dean Esmay’s comment this morning are any indication:

The child never tested positive for HIV, Rune, not even in the autopsy. Instead, once the coroner found out it was Christine, they simply declared it to be AIDS even though all the symptoms the child showed looked like a pretty simple case of an allergic reaction to penicillin.

The child was perfectly healthy with no issues at all until she got an earache and sniffles. The autopsy even confirmed that at the the time of death, the child’s leukocyte count was elevated-if she had a suppressed immune system, it wouldn’t have been. Also, if her immune system was depressed, she shouldn’t have had a severe allergic reaction to an antibiotic.

So unless you’re saying that “AIDS” is now defined as the *possible* presence of HIV in your mother’s body, and that typically a child with AIDS is perfectly healthy, then one day gets the sniffles and an earache and dies suddenly-with symptoms identical to an allergic reaction to penicillin-then, there’s far more to explain than what you’re pointing to here.

It is not true that Eliza Jane did not test positive for HIV in her autopsy. Indeed, HIV protein was detected in her brain. Nor was Eliza Jane’s death due to an antibiotic reaction, an utterly ridiculous and desperate pseudo-explanation concocted by the antivaccine HIV/AIDS denialist Mohammed Al-Bayati. If there is an autopsy and it shows that Christine Maggiore died of AIDS-related pneumonia, expect more of the same dissembling. Expect more dubious attempts to spin the results as being something else. Expect HIV/AIDS denialists to trot out Dr. Al-Bayati again, who will dutifully examine the autopsy report and come up with an equally inane “explanation” for Maggiore’s death as he did for Eliza Jane’s.

Unfortunately, all of this speculation, while important from a public health perspective and to refute the pseudoscience that is HIV/AIDS denialism, risks detracting from two tragic facts. First, a young girl died of a potentially preventable condition. Second, the girl’s mother died, possibly–even likely–of the same potentially preventable condition, leaving her husband and son without a loving mother. While I have almost no hope that this tragedy, whatever the cause of Christine Maggiore’s death is determined to be or not to be, will silence HIV/AIDS denialists or even make them truly “rethink” their position, I do hope that Maggiore’s survivors, her husband Robin and her son Charlie, can somehow find some peace and manage to get on with their lives after their mourning is finished. A cultish ideology claimed at least one, and probably both, of them.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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