Remember how I’ve been following the story of two Texas nurses who were fired and prosecuted on trumped up charges, first in September and then a couple of days ago as the case went to trial? Of course you do. I made it very, very plain that I view this malicious prosecution to be a horrific miscarriage of justice that will have a potentially grave chilling effect on nurses who witness physician misconduct and want to report it. After all, Anne Mitchell, RN and Vickilyn Galle, RN found themselves facing jail for doing nothing more than living up to their professional code of ethics when they reported Dr. Rolando Arafiles, Jr. of Winkler County Hospital in Texas for dubious practices, including hawking supplements that he sells to patients in the county health clinic and Winkler County Hospital ER. The nurses reported him through hospital channels and, a couple of months later, were fired without explanation. They reported Dr. Arafiles to the Texas Medical Board, and when Dr. Arafiles was notified of the anonymous complaint against him he went straight to his good buddy Winkler County Sheriff Robert L. Roberts, who happened to have been a patient of his. This good ol’ boy left no stone unturned, hunting down these two nurses with a single-minded determination that one can only hope he devotes to hunting down real criminals. Then, in cahoots with Winkler County Attorney Scott Tidwell punished these nurses by prosecuting them for “misuse of government information” and HIPAA violations, even though the Texas Medical Board wrote a scathing letter pointing out that neither of them had done anything wrong.
Although the prosecutor dropped Galle from the case, the unethical and abusive prosecution continued against Mitchell. As it is going on, it makes me think. What about Dr. Arafiles? In my last two posts, I’ve taken him at face value. Having read the reports I thought that perhaps he was into a bit of woo and a bit of hawking supplements on the side, an unfortunately not-too-uncommon phenomenon. Maybe he isn’t a particularly good doctor (well, it’s almost certain that he isn’t). Overall, he sounds very run-of-the-mill.
Very, very wrong. The first indication is a link to a television show on God’s Learning Channel. It’s a two hour documentary on some serious, serious woo, specifically Morgellon’s disease. And guess who’s one of the doctors on the show?
Yep, it’s Dr. Arafiles himself, in part one of a five part video:
I must confess, I couldn’t watch all of these videos. They’re just that painful, not unlike watching Jenny McCarthy in action, the only difference that in aggregate they are so long that they tax even my ability to handle woo. I also didn’t know who Marc Neumann was; so I referred to the almighty Google and found his Morgellons Research Organization, which, according to the website, is caused by “bacterial-fungal GMO used as a bioinsectizide.” Shockingly, I don’t think I’ve written about Morgellons before, even after five years. It’s a rather fascinating disease, one that probably doesn’t exist, in which those who think they have it and those who claim it exists postulate things like–well, the sorts of things that let Marc Neumann believes (German version). Although it’s not clear whether Neumann’s incoherence is due to his not being a native English speaker or to his being, well, in coherent, apparently this “disease” is a rather strange syndrome involving skin ulcerations and a whole host of vague somatic complaints. He claims that the “human skin and hair, the proteins (collagen, fat, keratin) will be eaten up and converted into biopolymers” and that genetically modified organisms, which he calls “bioinsectizides,” are to blame. On cached versions of some of his pages, Neumann also blames Morgellons on bioweapons spread by chemtrails.
Whether he agrees with Mr. Neumann that Morgellons is due to GMO, in the video Dr. Arafiles launches into a description of the dubious disease as being characterized by skin lesions from which fibers can be found. It is these “fibers” that are at times variously referred to as coming from insects or parasites causing the disease or even (as above) “plastification” of host cells. Its advocates like Randy Wymore describe it thusly:
Morgellons is a multi-symptom disease that is just now starting to be researched and understood. It has a number primary symptoms:
- Sponanteously Erupting Skin lesions
- Sensation of crawling, biting on and under the skin
- Appearance of blue, black or red fibers and granules beneath and/or extruding from the skin
- Short-term memory loss
- Attention Deficit, Bipolar or Obsessive-Compulsive disorders
- Impaired thought processing (brain fog)
- Depression and feelings of isolation
It is frequently misdiagnosed as Delusional Parasitosis or an Obsessive Picking Disorder.
There’s a good reason for that, namely because it very much resembles delusional parasitosis. Indeed, that is very likely what many, if not most, cases of Morgellons are in reality a form of delusional parasitosis. For example, one aspect that is always claimed are “fibers” or “granules.” However, no advocate of Morgellons has ever been able to produce these fibers and show that they are anything other than contaminants from clothing or fibers from the environment or that these “spontaneously erupting skin lesions” are anything more than the consequence of scratching or picking at the skin due to sensations of crawling, itching, or biting on or under the skin.
PalMD pointed this out, but if you really want to see the weakness of the evidence for the existence of these fibers as anything other than clothing fibres, check out the “research” section of a major Morgellons website. I mean, really. How hard would it be to recruit a bunch of people who think they have Morgellons, take fiber samples and possibly skin biopsies, and then subject the fiber samples to real chemical analysis and have pathologists look at the skin biopsies systematically. That’s probably because pretty much every Morgellons “fiber” that I’ve ever seen looks to me like oils and dirt from impacted pores, fibers from clothing, or clumps of dead skin cells that we all flake off. It doesn’t help that all the “evidence” on various websites has not been subjected to anything resembling peer review or independent replication. Indeed, every Morgellons website I’ve seen save one (Morgellons Watch, which concludes that the fibers are environmental and unrelated to any illness; that Morgellons is not a distinct disease; and that eople who think they have “Morgellons” probably have a mixed variety of physical and/or mental illnesses) demonstrate serious crank qualities. Indeed, Neumann’s site, the one being hawked by Dr. Arafiles, thinks that the organisms causing Morgellons are some sort of genetically modified organism. Some even blame that woo of woo, chemtrails.
Does this mean Morgellons doesn’t exist? Possibly. Or it might very well exist. There are lots of patients with symptoms to which they have placed the label “Morgellons” who are genuinely suffering, but evidence is lacking that there is even such a disease as Morgellons. That’s why it’s really hard to say whether the disease exists, because the “evidence” for Morgellons disease can only be found on websites devoted to promoting the idea that Morgellons exists as a distinct clinical syndrome. If you do a PubMed search, all you’ll find are articles on delusional parasitosis and commentaries asking whether Morgellons actually exists as a disease. Oh, and you’ll see a single case series that suggests Morgellons may be a distinct entity. Having perused the case series, which consists of 25 patients carrying a diagnosis of Morgellons from whatever source, let’s just say I’m not convinced. It’s a small case series; there are no statistics to speak of; the autoimmune measures reported are wildly inconsistent; and there are no consistent abnormalities that stand out as pathognemonic of a distinct disease. Yet that doesn’t stop the investigators from concluding:
The authors conclude that Morgellons disease is a multi-systemic illness that has been presumed as a delusional phenomenon for decades as its most obvious and disconcerting manifestations resembled actual (but “unverified”) parasite infestation as well as various psychopathologies. However, using recent technology and even a modicum of consistently obtained physical data supports that Morgellons manifest as a skin phenomenon, an immune deficiency state and a chronic inflammatory process. Since infectious agents can initiate and maintain chronic diseases, the behavioral and other CNS manifestations here are more likely effect than cause . We suggest that the Morgellons label be considered to displace any label suggesting delusion as the primary cause of this phenomenon.
The authors may “conclude” anything they like, but their data do not support their conclusions in this case. I think PalMD put it best when he described Morgellons as a “group of patients in search of a disease.” There are no defined diagnostic criteria for Morgellons, no lab tests that clinch the diagnosis, no distinct constellation of physical symptoms and signs. Compared to Morgellons, vague, difficult-to-define diseases like fibromyalgia seem as diagnostically straightforward as a classic case of appendicitis in a 21-year-old otherwise healthy male. I’m not alone in my skepticism that a distinct entity that can be called “Morgellons disease” even exists. Steve Novella and Wally Sampson have both also expressed significant skepticism about the existence of Morgellons as a distinct diagnosis due to infection or toxin; Steve in particular agrees with me that most cases of Morgellons are very likely psychiatric in nature.
But back to Dr. Arafiles. All I can say is: Wow. There’s some serious woo in those videos, and Dr. Arafiles is in the thick of it. His conversation with Marc Neumann ranges form blaming “bioinsecticides,” regular old insecticides, pheromones, and a whole lot of other unproven causes. In part 5 above, Dr. Arafiles hawks his website Health2Fit.net. At least, I assume it’s his website, given that its contact information lists Kermit, TX as where it is located and Dr. Arafiles’ LinkedIn profile lists him as the owner of Health2Fit. In any case, there is some serious woo on that website. For instance, he buys into “alkalinization” woo. Even worse, Dr. Arafiles appears to be selling colloidal silver (yes, that colloidal silver!) for H1N1 treatment (for which it is useless) and includes links to anti-vaccine websites like the National Vaccine Information Center and to a lawyer specializing in vaccine exemptions. To top it all off, he has a presentation on the swine flu with his name on the first slide that includes slides like this:
Couple all this with Dr. Arafiles’ promotion of vaccine exemptions, his links to anti-vaccine sites like this one, his links to sites like Morgellon Disease and his trying to convince people that the H1N1 and seasonal flu vaccines are not effective, and it looks like we have an anti-vaccine loon in Kermit, TX going after nurses who called him out on his practices. But it’s even worse than that. Dr. Arafiles appears to be selling colloidal silver for Morgellons disease. Whether you accept the existence of Morgellons disease or not is irrelevant in this instance. The reason is that colloidal silver is pure quackery when used against the flu in my not-so-humble opinion. It’s also pure quackery when used against Morgellons, and heavy users can turn into Papa Smurf. While it’s true that various silver compounds are used as topical antibiotics (one such compound is commonly used in burn patients), they aren’t useful as antibiotics when ingested because the concentration required for them to work is too high and the potential for problems (i.e., the Papa Smurf syndrome) too high. So what we have here appears to be an anti-vaccine loon of a doctor who is e selling serious woo like colloidal silver and a very expensive water alkalinizer for $1495 (what a bargain!) on his website. Meanwhile, he’s actually testified in this case that diabetics heal as well as anyone else. Funny, but that’s not what they taught me in medical school and surgery residency. Maybe those days as an intern in the “foot room” at the Cleveland Wade Park V.A., where I got to see diabetic foot ulcers up close and personal until I couldn’t get the smell out of my nose and mouth the entire month I rotated on the vascular surgery service, were just my imagination.
Oddly enough, I hadn’t known that Dr. Arafiles was that bad the first time I wrote about how he got the Sheriff, who had been a patient and appears to have been in business with him in the past selling supplements, to be his personal instrument of vengeance against nurses who stood up for science-based medicine and called him out, and I didn’t know up until yesterday evening that he was this bad. Mea culpa. I should have done this digging in September when I first wrote about this case. However, I do know now, and as a result I’m even more appalled at this case than I was when I first found out about it. Not only is it the biggest miscarriage of justice in medicine I can recall having seen in many years, but it really is a case of using the law maliciously to prevent supporters from science-based medicine from acting against practitioners of dubious “alternative” medicine.
To donated to the legal defense fund for these nurses, go to the Texas Nurses Association website and follow the link to the legal defense fund.