Episode 3: A Cover Up

This episode contains details about how Johns Hopkins hospital and school of public health is complicit in covering up details about the effects of a harmful radiation treatment that was pioneered at the institution. 
The episode features one of the foremost informed people on the treatment who has first hand experience with some of the questionable decisions of Johns Hopkins.

Transcript

spk_0:   0:00
on August 29th 2018. I end up on the phone with a man named Stuart Farber. He'd apparently dedicated a significant portion of his life to raising awareness about nasal radium irradiation. That day, he confirmed for me that Johns Hopkins is complicity in covering up the effects of the treatment. On August 29th 2018 I really had no idea what I was getting myself into, so I didn't record that phone call. But the audio that you hear in this episode comes from a phone call that I had with Stuart Farber this past week on the 16th of April 2020. Blue. Hi, Stuart, It's Kelly. How are you doing? I came up here. I'm doing fine. How about you Now? Since I really started delving into this podcast project a number of weeks ago, I've been in touch with Stuart Barber. We've exchanged some emails. This is our third phone call, and at this point, he's also listened to the 1st 2 episodes of the podcast to go back to August of 2018. I was wandering my neighborhood barefoot, trying to maintain cell phone reception as I had. This call was Stuart Farber. It became clear pretty quickly that I was speaking with the foremost expert on nasal radium irradiation in the country. He knew a lot, and thankfully for me, he was willing to share a lot of what he knew and what he had experienced while dedicating his life to bring awareness to the issue of nasal radium irradiation in the nineties, he was putting a lot of information out in the press. I was working a lot of different, uh, news media to get attention to this. I kind of ah, well, you know, learn toe play to play the game as it were, you know, and got national coverage use. I mean, I've got a thick pile of news clips of back in 94. Some of the initial documents that my mom and I have found about an Arai came from this very deliberate press push on the part of Stewart Farber. This includes some sources that I've referenced in previous episodes, and it includes sources that reference the 1997 dissertation completed at Johns Hopkins by one his sin shed. Yea, yes, Thesis was published in 1997 at Johns Hopkins, but I was unable to find a copy of it. As I said, an episode two I, even as I said, called and left a message for the author of the district ation. But that was before Stewart told me exactly how Johns Hopkins was complicity in covering up the true effects of the treatment. Here he is in April 2020 describing what happened in 1998 after the thesis was published.

spk_1:   3:22
I got the faces shortly after it was published to a normal request. I paid for whatever it was a 30 year so dollars, and I can't remember. But shortly, some time, not too long after I received it, the, um, my thesis service contacted me and asked me to return it. And they give me any thesis of my choice in its place. And I can I ask, you know, whether you calmly could you just put that request in writing so that I know what I'm responding to and up to make a decision. Of course, I never got anything from they didn't wanna put this on the record I did at the time. You know, that became a news article. I think I discussed that issue and Sun reporter somewhere put that, you know, in the in the Open, as it were from contemporary

spk_0:   4:23
here, I'm pretty sure he's referring to the 1999 city paper article, which does tell the story off the bizarre request for the return of the thesis. Well, let's just say that in August of 2018 I did manage to get my hands on a copy of the 1997 dissertation by Hissene Che Yeah of Johns Hopkins University. I'll quickly just read an excerpt from the abstract radium treatment of the native bearings to reduce adenoid. Hypertrophy was widely used in the past for prevention of hearing loss. In 1978 a study exploring the health consequences of naso pharyngeal radium irradiation was conducted at the Clinic for Prevention of Deafness in Children in Washington County, Maryland. The study found an excess risk of brain tumors. The 1997 study that was being completed for this district ation was a continued follow up of the irradiated and non irradiated patients at the clinic to assess the risk of brain tumors and other neo plasm of the head and neck. Developing during a 40 year period to assess possible hormone related disorders resulting from a radiation of the pituitary gland and to compare the cancer incidence, mortality rates and morbidity rates between irradiated and non irradiated groups. The abstract says a significantly increased risk of tumors of the head and neck was observed among the radiation exposed individuals. Seven brain tumor cases, malignant and benign, were identified in the irradiated group versus none in the non irradiated group. Slightly elevated risks were also observed in tumors of pharynx, larynx and thyroid. In the conclusion Yeah, the author urges for further study, she writes, As the size of the irradiated group is small in the study, ah, longer period of follow up would be helpful to improve statistical power. Besides, as the subjects become older and reach the high risk period for developing diseases, the longer period of follow may reveal late effects from radiation exposure and indirect effects. Associate ID with other factors so that research isn't being done. Hopkins hasn't touched the issue since 2001 when they published a shortened version of the dissertation that, let's say, had some minor differences here is Stewart speaking to some of those differences you

spk_1:   7:25
were mentioning the 2001 journal article in The American Journal of Epidemiology.

spk_0:   7:33
Yes,

spk_1:   7:34
yes. What's interesting is the thesis came out in 97. They drag their feet as long as they possibly could. Uh, that's probably, you know, usually when a thesis is a person gets a PhD. They put the results of the main findings in a in an article in a journal article rather quickly just to get, you know, you know, in the open medical literature. Hopkins very a. In writing that article that is the most word engineer kind of absurd, you know, minimization of any radium health effects of the action they could look like. It's good for you in the main points. And if you look at the abstract, this is what most people, most doctors, when they look at any paper that any research that comes out, almost none of them ever read beyond the abstract. In terms of what does this mean to me? You know, this the average doctor doesn't keep up on the medical literature, and certainly if the abstract says it's it's no, don't worry about it. And that's why you know, today or even there 10 years ago or 20 years ago. The doctors of the day had no knowledge of the health effects of this. And it's even worse now that that that what you put into the literature there was quite simply, I think ethically challenged.

spk_0:   9:09
You know what I have? I have it pulled up in front of me right now. And the the abstracts, uh, mentions There were seven brand tumor cases in the irradiated group, three malignant and four benign um, versus none in the non irradiated group. And in the discussion, it says Although there was an excess risk of brain tumors associated with radiation, a dose response effect could not be demonstrated because of the small number of cases.

spk_1:   9:40
Yeah, that is such a bogus argument to say, you know, get have safe. Maybe that we're following up. At that point, about 600 kids 700 max. As a joke, you've got seven benign and malignant brain tumors and zero in the control group twice as large. If you can't, you know if you can manipulate those statistics to come up with some statement that it's not not significant, you know you're doing something deliberately deceitful. The incidence of benign or malignant brain tumors is a certain level. And then you keep saying okay if you work, looked at okay. One case to three. You get up to seven cases in a group of 700 won, one in 100 that that is amazing relative risk. And that's why when they came up with their just when they mentioned in the thesis, they tried Teoh review the relative risk, which means the number of cases seen in the country treated group versus number of cases. The rate in the control group course. You know that you can't have a relative. You can't drive a relative risk. 7/0. That's insanity. So they distance. They get some little statistical manipulation where they attract the case. And then they look. They had a case over to the radiant, untreated group. They came up with an adjusted relative risk as they turned it, uh, 30.9. I think the number waas If you look at the pieces,

spk_0:   11:31
he is correct. The thesis says that the corrected relative risk was estimated as 14.8 for brain cancer and was 30.9 if the four benign and three malignant brain tumors were combined.

spk_1:   11:47
Well, in this case, we have 3000% on the adjusted relative risk basis that you herself arrived.

spk_0:   11:59
Stuart Farber then goes on to express his disbelief that an institution like Hawkins just gets to walk away from this while putting out along with the CDC that there's no malignant or non malignant conditions. Associate ID with the treatment of nasal radium irradiation.

spk_1:   12:18
Yeah, I mean, Atkins is gonna go every direction trying to minimize this thing a lot. And now the CDC joined them that there are no health effects. They the actual statement. If you look at the CDC webpage there, there's no indication of any benign and malignant health effects from these Radian Radian.

spk_0:   12:38
Yeah, Meanwhile, the dissertation says in the abstract, a significantly increased risk of tumors of the head and neck was observed among the radiation exposed individuals. But in the 2001 study, it also says that that can't be significant. So it's like within a matter of years, suddenly the same amount of tumors has become insignificant. Even though it's the same cohort, the same number of tumors, the same type of tumor. Yeah, so at best. The information that's coming out of Hopkins is misleading. At worst, it's a deliberate cover up, and there are presently no follow up studies being done, even though yea was right, the population that is at the most risk associated with this treatment is facing more and more risk every single day. Now I want to return for a moment to what happened in the events leading up to the publication of the 1997 dissertation in the mid 19 nineties. There was some attention being drawn to this issue, as I mentioned earlier because of the press coverage that Stuart Barber was driving up. But there was also some concern around another vulnerable population of people who would receive the treatment. United States military veterans. Now I'm going to read some of Stewart farmers testimony from a 1996 hearing to the U. S. Senate Committee on Governmental Affairs. Stewart's first point in the 1996 testimony is that Acre did not willingly take up the entire I issue, and if not pushed by him, it would have ignored the issue. To remind you, Anchor is Thea Advisory Committee on Human Radiation Experiments, which issued its final report to the president on October 3rd of 1995 after reviewing over 4000 human radiation experiments, We talked about it briefly in Episode two of the podcast to Reiterate. The 1995 report said that the experiment on the 582 Baltimore third grade Children was considered therapeutic research and therefore did not fall under the purview of their study, which only looked at non therapeutic experiments on Children to read directly from the report. It says the NATO Fair Angel experiment thus belongs to a class of research. The committee did not investigate therapeutic research with Children. So in this 1996 testimony at the Senate hearing, Stewart's first point is that Acre did not willingly address the issue at all and that had he not urged them, they likely wouldn't have mentioned it in the report It all. He begins with his first point, saying in early 1994 as a radiation risk assessment specialist, I began a personal effort to bring public attention to nasal radium irradiation, which I recognised as representing an important human biomedical radiation issue which had been largely overlooked and ignored by the medical and scientific community. In an earlier 1992 letter to the editor to the New England Journal of Medicine, I had called for the identification and medical surveillance of a group estimated at that time as numbering no fewer than 5000 navy submariners who, through my research I had estimated to have received nasal radium irradiation on entering the Navy from 1945 into the 19 sixties. However, the response by the medical and scientific communities, as well as the response by responsible government bureaucracies to this 1992 letter to the editor was totally underwhelming. Farber highlights that in their response to the 1992 letter, the Navy spokesperson's reply said that the risk of an Orion veterans incurred were really relatively small, but did not at the time dispute that at least 5000 submariners received radium irradiation as trainees. Further, the Navy claimed that the Navy irradiated patients had a right to privacy rather than a right to know that they were potentially at risk, and they claimed an almost complete lack of patient identification data and exposure data represented practical impediments to a follow up study. I found the Navy spokesperson's response to Stewart's letter, it says, Although the Navy did treat some service members who had hypertrophic lymphoid tissue associated with the Estacion tube dysfunction with radium to 26 irradiation until about 1957 those persons were treated according to U. S practice norms at the time, the risk incurred with these treatments were relatively small, despite the comments of Farber and later. Although I agree that it would be ideal to follow all patients who received news affair, Angel irradiation of fruitful study would be difficult at best to complete tune into next week's episode to hear more of my conversation with Stuart Farber, as well as to hear more of the history about the use of the treatment on US military veterans, along with more of the history of what happened in the 19 nineties, leading up to the dissertation that Johns Hopkins has ultimately kept from the public theme music for this episode is the song Mama said by cat clawed