Antivaccine nonsense Medicine News of the Weird Quackery Skepticism/critical thinking

Fake vaccinations and a suicide note by Dr. Van Koinis

Chicago pediatrician Dr. Van Koinis committed suicide. This week, it was reported that in his suicide note he expressed regret over falsifying vaccinations. Did he actually fake vaccinating patients? Whatever the truth, Cook County health officials now have a huge mess on their hands.

Yesterday’s post ended up being quite long, to the point that I had considered not writing anything today. However, there is a vaccine-related news story that I became aware of yesterday that mandates at least some comment, mainly because it’s so bizarre. Regular readers who’ve encountered this story will understand why I feel I had to write about it. I’m referring, of course, to the case of a Chicago area pediatrician named Dr. Van Koinis who committed suicide last August and who was found dead of a self-inflicted gunshot wound in a forest preserve outside of Chicago. Why did this story attract my attention? It was headlines like this appearing in the news over the last three days:

The first story I saw about Dr. Koinis’ suicide was reported on Tuesday:

According to the report:

Investigators found a suicide note raising questions about his vaccination records.

It was last September when Koinis was found dead from a self-inflicted gun shot wound.

The Cook County Sheriff’s office said his suicide note indicates there might be a problem with records he kept regarding the vaccinations children received, or did not receive, at his office on West 95th Street in Evergreen Park.

“The note was very short. It was a note where he expressed a lot regret and the note was solely driven at the fact that he did things he regretted as far as the vaccinations,” said Cook County Sheriff Tom Dart. He added Koinis also expressed regret in doctoring records.

“He was incredibly regretful for what he did and it was the only thing he mentioned in the suicide note. It was this and only this,” Dart said.

Dart said that the note mentioned a window spanning about 10 years in which he either doctored records or gave fake vaccinations. Koinis was a big believer in homeopathic remedies. The note didn’t express regret in those beliefs but “regrets in what he did.”

Of course, a physician who believes in homeopathic remedies and practices “natural” medicine is very likely to be antivaccine, or at least to have doubts about vaccines and/or believe that they cause autism and other health conditions commonly attributed to vaccination by antivaxxers, which leads to obvious questions. First, did Dr. Koinis actually do this at the behest of vaccine hesitant and antivaccine parents who were attracted to him because he practiced homeopathy and were seeking to avoid vaccination? Illinois only recognizes nonmedical exemptions to its school vaccine mandate based on religious objections, and since 2015 parents seeking a religious exemption to the Illinois school vaccine mandate must submit an official Certificate of Religious Exemption signed by a health care provider, who by signing the exemption form is certifying that he has counseled the parents on the benefits of vaccination as well as the risks to themselves and to the community of not being vaccinated. Presumably, Dr. Koinis wouldn’t have objected to signing such forms, given his focus on “natural” medicine and his apparent antivaccine slant. The situation now is all a confusing mess:

“Our thinking is that would mean that people who came there came with a purpose to get records phonied up, not have to take the vaccine and take the records to a school that would allow their child to be admitted even though their child never had a vaccine.”

Again, why wouldn’t such parents simply ask Dr. Koinis to sign the exemption form for their children? Falsifying medical records is a crime, and, if the crime were discovered, parents would be subject to prosecution if they were complicit in the crime by asking Dr. Koinis to fake the vaccinations. It doesn’t make sense:

“It was a little bit cryptic but in some places, very straightforward in the conduct that he was regretting,” Dart said, who noted the vaccine situation was connected to his suicide.

“There seems to be an overarching depression that was driven by years of not vaccinating people properly. We were not able to nail it down any further,” Dart said. “That was the sole reason he gave for this.”

It was those clues that led his office to investigate the doctor, his records and other connections to his practice. He was a solo practitioner and didn’t work with any other doctor.

“He was an individual who practiced homeopathic medicine and was very much into holistic medicine and apparently a lot of individuals who are against vaccinations were attracted to him,” Dart added.

No doubt that is true. “Natural medicine,” naturopathy, homeopathy, and alternative medicine are very much associated with antivaccine views, both among practitioners and those who seek out such treatments:

Investigators found the possibility that in some cases Dr. Koinis did not provide vaccinations at their parents request.

“Was this just the case where individuals who were against vaccinations came to him. He waived vaccinations and phonied up records or is this larger than that,” questioned Dart.

“We feel that there was people who came to him purposely to get the sign-off on vaccinations that they did not get,” Dart said, who added that those people who got a phony sign-off could face criminal charges, including forgery.

Of course, there is another possibility, namely that Dr. Koinis, not believing in vaccination, thought he was helping children by faking the vaccinations and not telling the parents about it, which is, of course, malpractice. There’s no evidence that he did that, but one does wonder, given stories like this from parents who, unlike the majority of parents, did not gush over Dr. Koinis after his death had been reported:

But another parent, Mary Mullaney, said she’d had doubts about Koinis’ methods.

“My oldest son now is 13, and when we went for his 12-year vaccinations, something was going on with him. He was just very different. He wasn’t the same doctor that I had been taking my kids to,” Mullaney said.

She continued: “He had always been stuck on like the technology aspect of technology ruining children’s brains, but this visit, I mean I sat there for about 45 minutes and he kept going on and on and on. I was just there for the checkup and he actually ended up telling me that my son didn’t need the vaccines that the school had said, so I believed him and then my son’s school actually contacted me saying if he didn’t have these shots that he wouldn’t be able to come back, so when I went back to Dr. Koinis, he was kind of surprised. We got the shots. He gave it to him. I hope that’s what he gave him.”

Mullaney said she went back another time when her son became sick.

“Dr. Koinis kept telling me oh, it’s a virus, it’s a virus, but I knew something was wrong. I kept asking him to send us to a specialist or something and he wouldn’t. He told me it wasn’t necessary. He went back on the technology stuff,” she said. “So I actually ended up pulling my kids from the practice and found out my son actually ended up having like life-threatening food allergies.”

So, from what I gather, is that Dr. Koinis had been deteriorating for some time, likely becoming more extreme in his antivaccine-views, if his encounter with Ms. Mullaney is any indication. Clearly, there also appeared to be mental health issues that were affecting his interactions with at least some parents.

Again, there’s no direct evidence that Dr. Koinis actually failed to vaccinate a child against a parent’s wishes that the child be vaccinated, but some of the stories coming out now are rather odd and do make one wonder. For instance, soon after Dr. Koinis’ death was reported, parents started complaining on local Facebook groups that they were having difficulty getting their children’s medical records, which were in disarray. Because Dr. Koinis was a solo practitioner, an increasingly rare beast in medicine these days, this was a serious problem for these parents, because there was no one to verify the records. In Michigan, this might not have been as large a problem, because here we have a centralized state database of all vaccination record and doctors’ offices and pharmacies (and any other entity where vaccines are administered) are required to enter the name of each patient and every dose of vaccine administered to each patient into the database.

Also, Dr. Koinis was apparently very popular and well-loved by his patients and their parents:

Koinis was wildly popular in the village of Evergreen Park, the suburban Chicago community where he maintained his practice. On Zocdoc, where he received over 1,000 glowing reviews and a five-star rating, parents praised him for being thorough, knowledgeable, attentive and caring. One reviewer also noted Koinis “doesn’t pressure you if you want to be more selective with shots!”

That last observation is unsurprising. AFter Dr. Koinis went missing, residents begged a local TV news reporter at WGN named Patrick Elwood to investigate:

The result:

…(The reporter, Patrick Elwood of WGN, responded that Koinis was his children’s pediatrician, too, “and a wonderful man.”) The news of his death on Sept. 10 inspired an outpouring of emotion from people who described him as “more than just your ordinary doctor,” including one mother who recalled driving all the way from Indiana so she could keep bringing her children to Koinis even after they moved. Another said Koinis once gave her money out of his own pocket to pay for a prescription.

So what to do now? Parents who have doubts over whether Dr. Koinis vaccinated their children are being asked to consult their children’s current pediatrician. For many vaccines, antibody titers can be drawn to see if the child has been vaccinated. This, of course, is not a prospect that parents will look forward to, given how children react to blood draws.

Not surprisingly, Kim Rossi at the antivaccine propaganda blog Age of Autism, were surprisingly negative about Dr. Koinis:

An Illinois pediatrician confessed to lying to parents that their children had been vaccinated. He in fact did not vaccinate them. My first thought is that he may have been committing financial fraud. There’s lots of speculation about his death. I think of the opiate epidemic and the money behind it. One theory, and just a theory, dear readers: money. He was being paid a bonus by the insurance companies for vaccination compliance. He was being paid for well visits – which are actually vaccination visits. But he was not vaccinating the patients. Surely purchasing records will show if he had brought in the product. And his nursing staff must have been aware of something going on? Anything is possible. My father was an orthodontist and he knew of a local doctor who kept two sets of books. One with far lower income that he presented for taxes than the true income. Fraudsters don’t care about the letters after their name. That said, suicide is always a lifelong pain for a family. Suicide with scandal is all the worse. Lying to patients, or in this case Mothers of patients, who trusted him to provide the medical care they expected, is onerous and wrong, no matter our position on vaccination. It’s cowardly too. Perhaps we’ll never know the true story.

That last part is, unfortunately, likely to be correct, and, of course, Ms. Rossi had to slip in a conspiracy theory that he was going for the insurance company “bonuses” for vaccinating children without actually buying vaccines. Unfortunately, that wouldn’t work, because of record keeping requirements to bill insurance companies. Of course, the denizens of the comment section are less circumspect. Some speculations found in the comments after Rossi’s post.

First, of course, is a typical antivaccine conspiracy theory:

I am sorry but the cynic in me does not trust or accept the Cook County’s Sheriff office “interpretation” of the suicide note reportedly left after the suicide of Dr. Van Koinis.

Consider … why would this doctor write a suicide note claiming to have ‘NOT VACCINATED CHILDREN” as their parents had requested him to do .. and not give the reason for so doing so? For instance .. if his intention was to confess misleading his patients .. for purely financial gain … wouldn’t it make sense for him to explain THAT as his MOTIVATION for doing so.

Sheriff’s “interpretation”:

“In his suicide note, he revealed he may not have administered vaccinations to children at their parents’ request. His note indicated he felt terrible guilt over the way he handled some children’s vaccinations going back a decade”

Maybe the doctor did exactly the OPPOSITE … he DID administer vaccinations to children AGAINST their parents wishes … to GAIN THE FINANCIAL REWARD BASED ON COMPLIANCE RATE IN HIS OFFICE????? He just didn’t tell parents he had done so .. which would explain his “confession” that he may not have administered vaccinations as parents had requested???

Somewhere is the TRUTH in what this doctor did … whatever it was caused him great guilt .. and vaccinating children against the parent’s wishes would be a likely cause .. especially if ANY child so vaccinated against their parents wishes had a SERIOUS ADVERSE REACTION THE DOCTOR WOULD HAVE BEEN RESPONSIBLE FOR.

In any event … we will never learn the TRUTH if that was the doctor’s cause of GUILT.

As conspiracy-laden as this commenter’s comment is, there is a grain of a good point there. The full text of the note has not been published. We are hearing only the Sheriff’s interpretation of what Dr. Koinis wrote before his death. The sheriff even admits that the note is rather cryptic in places. Without seeing the full text of the note, it’s hard to know how accurate the Sheriff’s interpretation is likely to be. Even so, wow. Of course antivaxxers would think it was guilt over vaccinating that led to Dr. Koinis’ suicide. Indeed, some even shared the article on social media saying just that.

Another AoA denizen didn’t think it was the doctor who was committing fraud, but rather that the revelation of the existence of a suicide note is a plot by the Illinois Department of Public Health to check up on patients who are likely not to have been vaccinated, given Dr. Koinis’ beliefs:

Another theory – has the suicide note been seen by the public? Is it genuine? This could easily be a scam by the authorities to check up on the patients. The doctor might even have been murdered – he wouldn’t be the first. Don’t believe anything you read.

I was surprised to discover one thing. I had figured that Erin Elizabeth of Healthnut News hadn’t yet added Dr. Koinis to her ongoing series of “mysterious deaths” of “holistic doctors” she’s been using to imply that there is some sort of plot to target holistic healers. She did report on it, though:

Koinis was found dead last September from what authorities say was a self-inflicted gunshot wound. Though he had no kids and wasn’t married, authorities state Dr. Koinis drove to a forest preserve that was some ways from his home and took his life. He was not discovered for weeks, prompting his patients to ask publicly (on our page no less) why he wasn’t found sooner during a popular time of year. We did a live video tonight to many thousands on our Facebook page and had dozens of his former patients (or parents of his patients) leaving comments as to what an amazing man and doctor he was.

Echoes of her “reporting” on the suicide of Jeff Bradstreet! Ms. Elizabeth might not have added Dr. Koinis to her list of victims of her postulated big pharma hit list…yet, but she sure does appear to be getting ready to add his name to the list. Otherwise, why would she make it a point to mention that Dr. Koinis wasn’t married and didn’t have any children before mentioning that he drove to a forest preserve and shot himself, while also “wondering” why it took so long for his body to be discovered. It’s a forest preserve, and it’s not uncommon for people looking for a place to commit suicide to find the most secluded area they can. When Elizabeth starts “raising questions” about whether Dr. Koinis really committed suicide or not, just remember, you read the prediction that she would do that here first.

In conclusion, I’ll just throw in a word of caution over this suicide note and its reliability about the actual reasons that Dr. Koinis killed himself. On Twitter, an actual expert in suicides wrote:

This, of course, goes counter to common wisdom about suicide notes, which mistakenly views them as very truthful, as the person contemplating suicide unburdens himself before taking his life. Whatever the reasons that Dr. Koinis drove into a secluded forest preserve and shot himself, suicide is horrible, and its effects on family and friends are lifelong. I know this, unfortunately, from personal experience, as my brother-in-law committed suicide 13 years ago. I thus conclude by offering my condolences, as little as they likely mean at this point, to all of Dr. Koinis’ family, friend, and patients and their parents. I also hope that the investigation does ultimately turn up the truth regarding his vaccination practices, whatever that may be.

NOTE: Sorry this posted late. For some reason, WordPress’ Scheduled Post feature failed me this morning and I only just noticed.

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]

91 replies on “Fake vaccinations and a suicide note by Dr. Van Koinis”

Claiming that suicide notes are truthful or not is one thing. Claiming that do not contain relevant information is quite another.

Would be very curious to know the full take of the suicidologist on the issue.

Anyhow, now that everyone knows that suicide notes are not taken seriously, I hope everybody will realize there is no point in leaving one. Peter Bergmann likely had no illusion on that topic.

Sincere sympathy to family and friends of the late Dr. Koinis. My 3 children were under Dr. Koinis’ care. My children born in 1996, 1998 & 2001. We moved from the Palos area and when we did we requested medical records sent to our new pediatrician. My children born in 96 and 98 had their medical records sent, however my youngest born in 2001 was a different story. It resulted in myself driving to Dr. Koinis’ office to get the records. No records could be found and my youngest eventually was revaccinated by our new pediatrician. Perhaps these dates might help in investigating this bizarre situation? Additionally, I remember Dr. Koinis to be kind. I did not know about his passing until yesterday (3-9-2020). I do recall Dr. Koinis mentioning natural remedies – but one prescription given for my first born was potent enough that at next visit I told Dr. Koinis I never want that prescribed again because it made my child deep sleep for 3+ hours. If we want to understand, in part, why there is a rise in anti-vaccination parents, it is because of the increase in vaccinations required, many parents have learned vaccinations are made from human embryos and some worry that there is autism connection. Finally, surely those who worked for Dr. Koinis in his small private practice space had to have known something just was not making sense, like when I called to get my youngest medical records and told they could not be located. That was in 2003-2004!!

“Suicide with scandal is all the worse…. It’s cowardly too.”

I’d say “bite me,” Kim, but I don’t know where you’ve been.

Again, why wouldn’t such parents simply ask Dr. Koinis to sign the exemption form for their children?

I think you already have the answer, after a fashion, from AoA:

“This could easily be a scam by the authorities to check up on the patients.”

There’s a great deal of paranoia among the antivax — or at least there certainly was during my few years at MDC — about being “entered into databases,” put simply. I think this would be “I-CARE” in Illinois, but as with most parts of the state’s Web sites,* this one is not responding for me at the moment.

*I spent an hour today just trying to request a new insurance card from the state, only to be led around in circles and discover that logins “time out” after 30 seconds in some of the bowels of the system.

“There’s a great deal of paranoia among the antivax”

Didja realize that V.K. (Van Koinis’ initials) also stands for “Vaccination Kills”?

It’s like a message from the spirit world. 🙁

@ Dangerous Bacon

When a doctor kills himself, whether an altie fundie or an anti-disease fundie, it always compounds into a serious matter: If the issues are not of an excessively personal nature, it’s usually tied to what he did, witnessed or could not do in the scope of his profession.

So: Wible? A nutcase? Or doing work than no one else does, however imperfectly?

Here’s a doctor suicide I took much interest in when reading about it:

It’s not because the MD is a quack that a doctor’s suicide should not be taken seriously. Taboos are fun only up to a certain point.

Did those quotes come from a newspaper? The syntax is dreadful and hard to read at all in places The sheriff seems kindly but not a terribly bright bulb.

So now people are avoiding blood draws (or fussing about them) for kids? Oh my…those snowflakes are lucky I’m not their Mom. I had stoic children perhaps, except for one, but by god, she got her shots and her blood drawn when called for. She wailed at the time but makes no claims of trauma or abuse today, (she’s 50–I had them very young). : ))

Two of my boys never let out a peep when getting stitches–actually they watched and were interested.

Such a strange case. Let us know if anything comes of the investigation.

@ brainmetterz

“She wailed at the time but makes no claims of trauma”

How much did you got her punched by others to get her blood drawn? At which age did you consider it OK for her to choose her own doctor on her own?

Answers to these questions may explain why she made no claim of abuse. And even if she believed she’d been abused, she wouldn’t necessarily complain to you, nor anyone else. Things do not work that way.

@ JP

I wasn’t making any judgement on brainmatterz. I’m just saying that making judgements on this is not inherently straightforward.

Luckily, the vast majority of people do not feel irredeemably abused by medical interventions. Whether they should is an entirely different matter.

Kids can withstand a lot. Way more than adults can.

“You know, when you’re little, you have more endurance than God is ever to grant you again. Children are man at his strongest. They abide.” — Rachel Cooper – The Night of the Hunter.

Again, why wouldn’t such parents simply ask Dr. Koinis to sign the exemption form for their children?

For school sure, but as mentioned previously, anti-vaxxers are an odd lot prone to paranoia. Intentionally falsified records could have been for camps or travel or just to keep “The Man” off their backs if/when the kid went to the hospital. This speculation is dependent upon in what direction the medical records were altered. I hope there is follow up on this; that’s a lot of children affected by this.

I would think that if he were faking vaccinations at the request of parents that it would come out at some point. His name would have been passed around the usual places.

@ Christine Rose

It doesn’t seem he was doing it for that purpose. It’s more like a true believer keeping a secret to himself.

He apparently was known for allowing parents to be selective with shots. He may have faked some records for some parents for particular purposes. One possible situation could be where one parent wants the child vaccinated and the other parent does not.

What is far more intriguing is why he felt guilt over this. After all he was a homeopath and they are often virulently anti-vaccine to the point where anything goes to stop children having vaccinations. I am wondering whether something happened to one of his patients that might have tripped an already troubled person over the edge. It is a strange thing to put in a suicide note even given most suicide notes are really the person committing suicide justifying their choice and not necessarily based on reality.

even given most suicide notes are really the person committing suicide justifying their choice and not necessarily based on reality

Oh, Jesus, I don’t have the energy to jigger up the canonical Scanners clip.

@ F68.10

Off topic. I mentioned the WHO studies on various nations health care system. You can actually download them for free. The 2004 of France can be found in French at:

A more recent one from 2015 can be found at:

@ Joel Harrison

Thanks for the reading material. I will have a look at it. But, more generally, Joel, I am not saying the french system is bad. Statistics prove that something is done correctly overall, and surely there are lessons for other countries, as access to healthcare is rather easy. But to stay on the topic of medical institutions, there are serious management issues on many levels, and a big one of them is that the whole system is centered around public hospitals. That system is cracking and the crisis is now open in the news. So there are basically two choices, that are in essence “ideological” in the french context.

First choice: pour more public money in and keep the system centralized around public hospitals.

Second choice: think harder and accept that the hospital is not the place where everything should be treated. And maybe change one thing or two (like integrating doctors into the management of hospitals instead of leaving it completely managed by bureaucrats formed at the EHESP).

If you want to get down to the ground and onto operational issues, I’d advise reading a bunch of articles from Laurent Vercoustre:

Towards the privatization of the hospital?

Granted, the situation is nowhere like in the US. But what is fascinating about France is how the system can and does function with such a centralized top-down mentality. Public servants (because doctors in hospitals are basically just that) are the engineer of their own suffering, and they compensate the shortcomings of the system by doubling down on dedication while being underpaid. And making their dedication known through strikes. That’s very french, and I’m not happy about it.

@ F68.10

This is my last post on French health care. I’ve other things to do.

First, the French system is quite complex, at the tertiary and quartenary levels, where the most complicated procedures are carried out, e.g., heart transplants, lung transplants, burn centers, are PUBLIC regional hospitals. Stats for them are quite good, especially given the complexities, seriousness of the cases they take. Then at the lower levels are public hospitals, non-profit hospitals, and for-profit hospitals. On the whole, the small for-profit hospitals take the less serious cases. Given they compete with non-profit and public, given the regulations and oversight, they do fine. When one looks at statistics on outcomes, one has to take into consideration the complexity and seriousness of cases. In the U.S., for instance, when comparing non-profits to for-profit hospitals, the for-profits have significantly higher morbidity and mortality. In fact, with kidney dialysis, studies find for-profits have up to five times the morbidity and mortality. To make the max profits they hire the smaller staffs, etc. A while back the State of California tried to pass a law to require better staffing, etc. which was defeated by the for-profit company spending more than $100 million to defeat it.

The universal non-profit single-payer health care system that I have supported for over 30 years for the U.S. will be mainly free-standing non-profit hospitals; but will include minimum requirements for staffing, etc. and strong oversight.

I should point out that the Veterans Administration Hospitals system, which is a public system, over and over gets the highest ratings for continuity and quality of care. The adverse publicity has not dealt mainly with care; but getting into the system. For instance, an ex-soldier who did three tours of duty in Afghanistan and Iraq was denied with claim he had a pre-existing condition, which, obviously didn’t stop him from serving honorably. Also, some VA regions lied about length of time on waiting lists to become patients. Once in the system, on the whole, they get excellent care.

The article by Vercoustre is one man’s opinion. And the idea that the problem with health care in France is because doctors don’t control the system is problematic. Having both lived in Canada and studied problems with their system, one of the main problems is that doctors have too much power, too much independence. I could give long references lists backing all of the above; but I’m tired.

Vercoustre has his blog; but as you have seen on Respectful Insolence, in the U.S. we have doctor groups, e.g., Association of American Physicians and Surgeons (AAPS) that think no one should regulate them at all.

I’ve look at international data, individual health care systems, etc. for over 40 years and lived in five different nations. While, actually socialized medicine in Sweden maintains high standards, in France, U.S., etc. probably a single-payer with non-profits and good oversight would work best. But also a restriction on number of tertiary and quartenary hospitals. In U.S. when coronary bypasses started, many small hospitals began doing them with much higher morbidity and mortality. A few Centers of Excellence is best where staff have experience. In addition, the smaller, especially for-profits operating on patients who probably didn’t need the surgery. One for-profit conducted over 1,000 bypass operations of totally health hearts, resulting in some deaths and disabilities, the they were finally caught.

But as I pointed out, though France rated best system in world numerous times, because of having dozen primary insurance companies, and more secondary insurance companies, and the complexity of your system, monies wasted on excess administrative bureacracies could go to increasing doctor’s incomes and other aspects of medical care.

@ Joel

Yes, do not answer on this topic. You have other things to do.

But I wish to correct a statement you made:

“The article by Vercoustre is one man’s opinion. And the idea that the problem with health care in France is because doctors don’t control the system is problematic.”

He’s not saying that the should control the system. He’s saying that they are having no input, and that they haven’t grown a backbone to be able to engage in fruitful with the bureaucrats. Who do not care anyway.

It’s nothing like the AAPS.

And it’s not the only problem he points to.

But yes, let’s close the discussion.

Heh. I saw that.

More seriously, anti-vaxxers and woo-meisters continue to use legal threats to silence critics, AS I’ve recounted, Null and his legal eagles have targeted Wikipedia, Wikimedia and sceptics like Orac, Dr Novella and Prof Reiss, demanding FOIA material from those who work for state based universities and generally waving their hands**.

IANAL but I doubt that these suits or threats will go very far ( past suits cast at Wikipedia and a blogger failed miserably)
HOWEVER they do accomplish something:
— they may intimidate sceptics and make them more careful about speaking up when they reads balderdash and malfeasance created by woo-meisters who aren’t honest about their credentials, accomplishments and “science”.
— lawyers cost money and not everyone has it.
— dealing with nonsense like this eats up time and causes distress: sceptics, wishing to avoid the trouble, may silence themselves. That’s the point: shut down criticism so woo can flow unimpeded and lead to profit.

HOWEVER the sheer amount of articles/ letters ( Over 70!) accumulating at PRN leads me to believe that they are quite scared of what sceptics’ criticism can do to their business and reputation.

** Orac’s lawyer asks that they show exactly how his writing defames them

I left out an additional factor:
these suits are meant to influence woo believers so that alties can cast themselves as victims who are truthful:
if you lied about your credentials and career would you sue someone for saying so? But they do anyway.
It keeps followers within the fold.

In other anti-vax news…

— AoA is calling for people from other states( in New England, NY) to show up at Connecticut’s state capitol next Wednesday to protest the proposed elimination of the religious exemption.
If this were truly a popular, widespread belief, why would they need people from other jurisdictions there?

— Kim Rossi ( @ KimRossi1111) has been asked to stop tweeting/ blocked at #actually autistic because she isn’t autistic. She maintains that she is her daughters’ voices who can’t tweet. She refuses to understand that that isn’t the point of the hashtag.

— Del Bigtree ( @ HighWire talk) “broadcasts” live from Anarchopulco, a rather expensive ( I checked) convention of conspiracy mongering in Acapulco. The other speakers are so far down the rabbit hole that even I never heard of them!

— Mike Adams & Co ( Natural News) are too obsessed with the corona virus and China to do much about anti-vax

Kim Rossi’s arrogance nicely sums up antivaxxers, doesn’t it? Thinking they are more important that the autistic people they claim to champion.

@Julian, what drives me nuts is that they want it both ways for their argument. Autism impacts ~1 in 63 people when they want “shocking” numbers to scare people, but a huge percentage of those people don’t count when they want to scare people with what autism means for an individual.

Right. If you look at recent data, much of the increase from diagnostic change is in the higher functioning end- that is, probably people who weren’t counted in past decades. There was a study in the UK that searched for older autists and found them at a rate similar to figures for children today.
My SO had a co-worker ( and his brother) and has a relative ( born in the 1930s/ 40s and 1960s, respectively) who would most likely be categorised as ASD if they had been born later. I had two boys in my primary school class who might have been so as well- one’s a physicist, the other is a small business owner.

Anti-vaxxers like to focus upon the severely affected because talking about people who have less variation from the norm negates their horror stories. One of their tropes is that vaccines “destroy” children’s minds – people like Julian are not a good argument for that- he certainly can write, reason and joke better than most of their chief spokes models.

@Julian, what drives me nuts is that they want it both ways for their argument. Autism impacts ~1 in 63 people when they want “shocking” numbers to scare people, but a huge percentage of those people don’t count when they want to scare people with what autism means for an individual.

An excellent point that bears repeating.

Having made my opinion about long-distance diagnosis known elsewhere on this blog, I want to point out that suicidology must be the ultimate form of it.

@ Old Rockin’ Dave

Suicide screening is bogus, and anyway, doctors are so whimsical when it comes to suicide that they’ll jump in practice on any confirmation bias they fancy just to vindicate their point. With this underlying idea that no matter what, care is always a Good Thing ®.

However, if I want to be honest, I must admit that the so-called Integrated Motivational-Volitional (IMV) Model of Suicidal Behaviour is theoretically promising.

Theoretically promising… In practice, it will remain a fuckfest of psychological projections where people will be punched hard until they confess being suicidal. That’s how you make reality conform to theory.

Theoretically promising… In practice, it will remain a fuckfest of psychological projections where people will be punched hard until they confess being suicidal.

That’s certainly not my U.S.-ian experience; I get the PHQ-9 and, after having eight or so boxes ticked off, I’m asked about means and intent. It’s no grounds for a 72-hour hold. In fact, it’s extraordinarily difficult to get a hold for someone who clearly is a danger to him- or herself. The hospitalization situation is a whole ‘nother can of worms, at least in Illinois, where the legally prescribed option of “informal admission” no longer exists in practice.

@ Narad

“That’s certainly not my U.S.-ian experience; I get the PHQ-9 and, after having eight or so boxes ticked off, I’m asked about means and intent. It’s no grounds for a 72-hour hold. In fact, it’s extraordinarily difficult to get a hold for someone who clearly is a danger to him- or herself.”

Yeah, well it’s my experience, literally. Though I admit that it’s not the general case, even if I believe it would be very interesting to discuss the whole issue thoroughly, in detail. But hey, you’re being picky! What’s wrong with a teeny weeny bit of exaggeration when it comes to medical claims? Nothing, I’m told…

But I guess you’ve never been, as in the case of dear Ms. M. C., daughter of I. M., the offspring of a loony psychiatrist. She might have a few things to explain to you. The link is up there, in my reply to Dangerous Bacon, for your enjoyment, big boy. It might shed an illusion or two about your fantasy world where everything is perfect and Care Bears fight off the evil Cloud of Uncaring with ripples of magical hearts!

Yeah, well it’s my experience, literally. Though I admit that it’s not the general case, even if I believe it would be very interesting to discuss the whole issue thoroughly, in detail.

I have three decades’ personal experience in this matter, and I’m not going to provide PHI regarding whom or how.

@ Narad

PHI is not an acronym I’m familiar with. If you’re referring to some personal information, you already did give some on this blog at the beginning of last year. I have an excellent memory.

And three decades is not that “impressive” compared to the duration of medical nonsense in my family. As far as I can tell, that specific kind of medical nonsense goes roughly back as far in time to just after WW2. So sorry: Not impressed by merely three decades. And not interested in medical whinings seen through the eyes of a compassionate caretaker claiming vicarious trauma for a friend’s fate anyway. Been there, done it, seen it, fed up with it.

Moreover, do not make a category mistake by believing I am “moaning”. I’d never advise anyone to make that specific mistake: I’m decidedly not friendly anymore, to put it very mildly, and do not seek sympathy in whatever form. If you need proof of that, I can give you more.

@ JP

Yeah. Well I believe it’s time that he understood that he shouldn’t mess with me either.

I do not take prisoners.

@ Narad

What’s that supposed to mean?

IRL, I know I’m not a Tough Guy. Never wanted to be one anyway. But it just so happens that once in a while, you have people who never wanted to be violent who end up murdering healthcare workers. That happens.

I think it’s a bit more constructive to have a discussion on the IMV model of suicide. Which is the main point of this thread on suicidology started by Old’ Rockin Dave.

My only aim in being an Internet Tough Guy, is coercing people like you into a constructive discussion. For the real-life murderous intents, I’m keeping them under control myself, and I do not believe you’d be of any help in the matter. So keep your distances.

Washington state is incredibly atavistic with regard to all this stuff; it’s still One Flew Over the Cuckoo’s Nest out here.

If you ever find yourself stuck in some place in Yakima County, the public defenders really are quite good. Worth taking advantage of. (The counsel.)

@ JP

“Yeah, if somebody could explain that one to me, that would be great.”

Well, that’s easy. The Official Position is that this is Science.

Or I am having auditory hallucinations… but it’s quite weird that these auditory hallucinations occur only when doctors or nurses are talking to me.

I’m waiting for an aggionarmento, or at least a very serious discussion. And not a one on one discussion with threats of assault amid staggering amounts of bad faith and, what do they call it again?… Denial.

That kind of denial:

Yeah, I have a new advisor of sorts who has some info about what’s been going on. I don’t want to spill it here, publicly. For reasons.

Yeah, if somebody could explain that one to me, that would be great.

State hospitals are the worst, as frequent flyers well know: They’re the threat lever that gets people to sign in voluntarily, as no private hospital is going to spend money on litigating over involuntary commitment.

@ JP

“I don’t want to spill it here, publicly. For reasons.”

Ah… Dirty little secrets that should be kept within the family. I know how that feels.

You shouldn’t spill them here. The only realistic way to handle these kind of issues is to engineer or consolidate communication channels that break the wall of silence while keeping people’s ass out of the fire. A problem just as old as mankind. Or maybe even chimps.

@ Narad

“Regrettably, there’s no killfile installed here.”

You can ask Orac to ban me. I’m fine with that.

Meanwhile, let’s not talk to one another. Agreed? I’m tired of pointless skirmishes with stone deaf people.

Bjork? Yeah, that was me (one attempt or whatever). Sue me. I am a developer, after all.

Funny thing; Bjork was my friend Miles’ cat’s name, the friend who killed himself back in 2017.

@ Science Mom

“F68.10, I say this congenially that this is the point where you usually realise you are in that bad place and take a break or re-set.”

It’s been a very long time that I realized I’m in a very bad place. Thank you for realizing it too.

As for a break or a reset, I’d be quite happy to receive a shipment of Nembutal. That would make me cheer! And hopefully Narad and Panacea too!

Let’s cut the discussion here. It’s a pointless one.

@ JP

It’s been roughly 10 years I discovered I was screwed so badly by this situation. I had plenty of time to mature that thought. And gave ample opportunities to medical professionals to allow them to backtrack. In vain. Dogma, you know…

But you know, when you listen to the suicidologist, what’s left of these decisions are “a mixture of truth, guilt, fiction, fantasy, projection, denial, and often the written “causes” turn out to be very much not true (or they can be, but we cant tell!).”

Message received: Once considered a liar, always considered a liar, even after you die.

No one is therefore able to judge whether this is “rash” or not. I’m the only judge of that situation. Thank you Mr. Suicidologist for making that specific point cristal clear.

But I believe it would be more beneficial to this blog if we went back to the IMV model of suicide. I quite like it. It seems solid, and does seem to match what I have had time to observe over time. Would you mind if we get this discussion away from my personal issues, and back to the Science? I’m very much interested in it. What do you people think of the IMV model?

I just don’t want you to die, that’s all. I’ve tried more than once; one time you gave advice on here on how to do it (pretty painlessly, probably, something about unhooking a dryer and breathing the gas.)

I think we probably have really a lot in common. That’s all. Don’t hurt yourself.

@ JP

I do not care about myself: I am not a “moaner”. And I do not care whether or not I have things in common with anyone else. As to methods, yeah I can talk about them, but it’s off-topic. But if we could talk about the IMV model, I’d be more interested: The key point in the model, at least from my point of view is the concept of entrapment. For instance, what could Dr. Koinis feel entrapped about? I do not believe guilt alone could trigger his suicide, given that his views on vaccines had not changed. You need something else that is or feels unescapable, in my opinion. That’s why I’d really like to have a closer look at his suicide note: As suicide tends to be an information game in certain circumstances, specifically when entrapment is strong and enduring (in my opinion), I wonder what he tried to achieve with his suicide note. What he was trying to break out of.

If you are going to have somebody do an experiment about (what???), you really need to take into account handedness (I’m ambidextrous) and also linguistics and maiden names and so forth. Yeah.

And making the downloadable browser extension inescapable? What the actual…

Yeah. Somebody’s going to hear from their IRB.

Had me frantically pressing “escape” and “delete” trying to get out of the freaking thing.

Yeah. Not okay. Not even slightly.

First and most important: You cannot insult anyone into changing their opinions. If I had a dollar for every time that’s been proven true, I wouldn’t be on this blog. I’d be in my private personal nation, in a magnificent mansion equipped with hot and cold running harlots.
Second, my original point, before it wandered off into the weeds, was that diagnosing the dead is easy to do, especially since the subject can’t contradict you.
Third, and just an FYI for anyone who cares: In New York State, a 60-day involuntary commitment can be initiated by any two licensed MD, even a pathologist and a radiologist, and there are eleven parties that can request it; one of those parties can be “someone residing with the person.” It does have to stand up to an exam by a psychiatrist with admitting privileges in any hospital, as long as that psych is not one of the original two, but I can imagine all kinds of ways that can go wrong. The hospital can get a court order to extend the stay. Given the standard of judiciary in this state, I am morally certain things can easily go wrong here too.
The legal standard is “Involuntary – Two Physician Certificate (§9.27)
Standard: person has a mental illness for which care & treatment in a mental hospital is essential to his/her welfare; person’s judgment is too impaired for him/her to understand the need for such care and treatment; as a result of his/her mental illness, the person poses a substantial threat of harm to self or others.”
Obviously this can lead to all sorts of mischief, and often does.

Dr. Koinis was probably trying to do the right thing in his suicide note by telling people his records of vaccinations weren’t necessarily accurate. He felt he could inform people because wouldn’t be around to face the consequences.
That’s probably why he left that note, rather than as informing people about his reasons for killing himself.

The conspiracy theories over on AoA are getting bigger. While Erin Elizabeth hasn’t called it yet, over on AoA they have. Konis’ death could not have been suicide because it took them 24 days to find his body.

What? People don’t hide away when they are going to kill themselves? Perhaps someone should point out the suicide forest in Japan. At least this way his family didn’t find him dead in their own house.

@ Narad

You write: “no private hospital is going to spend money on litigating over involuntary commitment.”

Check out this New York Times article:

“Federal investigators, who spoke on condition of anonymity, said today that they had been looking into charges that National Medical had held patients who did not need psychiatric hospitalization against their will until their insurance coverage ran out. Many of these patients were covered under Medicaid, Medicare and the Civilian Health and Medical Program of the Uniformed Services. Some patients said doctors had referred them to National Medical’s psychiatric hospitals in exchange for kickbacks.”

One of the things they did was to offer evaluations of teenagers thought by their parents to have “problems.” They always found problems that required involuntary commitment and the “cure” coincided with when insurance ran out. Not exactly litigating over involuntary commitment; but . . .

By the way, NME changed their name to Tenet and a few years later one of their hospitals, Redding Medical in Northern California was found to have carried out coronary bypass operations on over 1,000 health hearts. Some died, others became disabled, and it was discovered that their cardiologist wasn’t even Board Certified. One of the patients they operate on had Gastric Esophogeal Reflux Disease.

@ Joel

““Federal investigators, who spoke on condition of anonymity, said today that they had been looking into charges that National Medical had held patients who did not need psychiatric hospitalization against their will until their insurance coverage ran out.”

That’s one of the reasons I like US private insurances: You just have to wait for your insurance coverage to run out to get out. Not so where I lived, where they keep pushing you into debt no matter what (Switzerland) or where that concern is simply irrelevant (France).

I do not mind being broke if I’m free from brainwashing. Money talks!

But that’s way too personal a reason to endorse the US system…

In my opinion, Dr. Van Koinis was educated pro-vaccine, practiced as a pro-vaccine physician, regressed into a vaccine hesitant physician, and left a final note expressing anguish and confusion in the spirit of a vaccine safety advocate.

Nothing….Well truthfully, I’d like you to ask the question in a friendly manner. Also, can you be more specific? Thanks!

MJD. why not take off your antivaccine-colored glasses for once. You have a right to your opinion, but I propound that the good doctor did himself in because the Martians stopped bringing him the many and varied Martian treats he had come to rely on. Your may be more likely to be correct (Occam’s razor and all that) but relying only on the information we have been given here, you are no more likely to prove your case than I am.
Until the dochniak can distimm the doshes of the dead, we can never be certain.

As much as I don’t agree with the antivax crowd over most things, I think they are partially right. I think Dr. Koinin who was opposed to vaccinations, gave them and had pangs of conscience. I don’t think there was any grand conspiracy behind his giving them accept basic business sense and competition. I think typically a parent would come in with a child who needed a vaccination for school/camp/whatever and the parent asked for vaccinations. If Dr. Koinin had refused or even lectured too hard, he risked losing not only the patient but also her siblings. You can’t blame Dr. Koinin for NOT letting money walk out the door.

You can’t blame Dr. Koinin for NOT letting money walk out the door.

I believe a few hundred books, religious, legal, fictional or of some other philosophical flavor, have precisely been written with the intent to blame people for choosing money over conscience or ethics.

“You can’t blame Dr. Koinin for NOT letting money walk out the door.”

We can therefore assume that you, too, are for sale. What’s your price to perform acts that you believe to be wrong?

@ rs

That’s not necessarily the case. You do not need to be a non-smoker to know that cigarettes are crap. Nor do you need to be a smoker to think that smoking can be a personal freedom issue. Basic point: You cannot infer the personal ethics of someone based on his moral judgements of others.

@ Athaic

There are times when it wise to choose money over conscience, personal ethics, or social opprobrium. But as I said, I do not believe money was Koinis’ main behavioral determinant. He indeed seemed to have considered other professional ventures in 1999, and did make choices when it came to money vs. medicine.

Additional information: when I was in college, there was a suspicion that I had “temporal lobe” epilepsy, but I didn’t have health insurance at the time, so I never got the “brain scan” thing. So it goes.

Yeah, I couldn’t think of the word at one point, I was pointing to my head and vaguely gesturing. So it goes! (As Kurt Vonnegut often wrote.)

“And what else is there to say after such a thing but ‘Poo-tee-weet?”

Cool old guy, Kurt. Lots of tragedy for him, as things went. Sad.

Eileen: “I think Dr. Koinin who was opposed to vaccinations, gave them and had pangs of conscience.”

I don’t know how you can believe this, given reports about what was in his suicide note. From the CBS news report quoted by Orac:

”“The note was very short. It was a note where he expressed a lot regret and the note was solely driven at the fact that he did things he regretted as far as the vaccinations,” said Cook County Sheriff Tom Dart. He added Koinis also expressed regret in doctoring records…

Dart said that the note mentioned a window spanning about 10 years in which he either doctored records or gave fake vaccinations…
“There seems to be an overarching depression that was driven by years of not vaccinating people properly. We were not able to nail it down any further,” Dart said. “That was the sole reason he gave for this.””

So, instead of regretting giving kids their vaccinations, it sounds instead like he felt highly guilty for NOT giving the shots.

Eileen: “You can’t blame Dr. Koinin for NOT letting money walk out the door.”

Even if your explanation was true, he would definitely have deserved blame and major penalties including the revoking of his license to practice medicine and potential fraud charges, if he took money under false pretenses and forged medical records to cover it up.

@ Dangerous Bacon

A suicide note is not necessarily truthful. Whatever he may have believed about vaccination, he intended to let people know what he wanted to make known. And it seemed that he did not want to make it known that he had changed his mind if ever he did. So it’s not necessarily a given that he felt guilty for not giving the shots per se. But he obviously wanted to make it known that he could not live with the consequences of his lie. He may even have believed both that he is right that vaccines are bad and also that he had done something wrong by putting his belief above both guidelines and parents’ wishes (which would be the right attitude). I do not believe you would have enough guilt to kill yourself only because a fair share of your patients are unvaccinated. However, a lie may be uncovered, and that is outside of his control. So he lived under the threat of having people discover he lied to them. That puts him under social pressure, and even if he was a True Believer to the end, doubts could have crept on him over time. Doubts you cannot escape, even if not noted down in a suicide note; and perhaps a few patients or patients’ families may have come up to him and share their share of confusion or even covert accusations. That could wear down someone significantly over time. It’s indeed difficult to get out of serious lies…

That’s the best shot I can make about reverse engineering his suicide note without going into deeper and speculative intricacies.

But as far as Eileen’s remark goes, that’s talking out of one’s ass. Or implying that there is a “conspiracy” to alter in the media the exact content of the suicide note. There may be inaccurate reports of the content of the note, but that’s as far as doubts on this matter may go without diving into the deep end of full-blown conspiracy theories.

Or Eileen’s remark may instead be describing how Dr Koinis initially started faking vaccinations. Which could make sense and even seems likely. (Except the money part, which is entirely speculative and doesn’t stack up to the fact that doctors are usually inclined to do what’s right first and foremost, which is the baseline one should start with before speculating).

So first round of guilt when vaccinating while disagreeing with vaccination. Then goes on faking vaccinations as an attempt to keep his conscience in one full piece. Then second round of guilt when he sees that his lie has consequences he cannot escape even in the form of threats or potentialities. Doubts then creep over him even he doesn’t admit to himself that he has them. Utterly confused man takes his life and focuses in his note on what he knows was wrong (lying) and not on what he could have been covertly confused about (vaccines good or bad?). I indeed do not believe one would admit bluntly being confused in a suicide note: it kinds of cuts off significance or credibility to the note and/or the act. Suicide can indeed also be about saving face in one way or another, either to oneself or to others.

Possible. My two cents.

Whatever he may have believed about vaccination, he intended to let people know what he wanted to make known.

Which was “not necessarily truthful.”

But he obviously wanted to make it known that he could not live with the consequences of his lie.

This has merit FWIW. I believe that he couldn’t live without being a doctor and what he had done would have ended his career. Simplified as I don’t doubt there was a lot going on in his belfry.

CBS2 Chicago has interviewed a parent of one of Koinis’ non-vaccinated patients.

“Linda’s son received 20 vaccinations between October 2014 and January 2016 – for chickenpox, mumps, polio, and other standard preventable diseases. They were all administered by Dr. Koinis himself.

Last week, Linda tested her son to see if there is evidence in his system of those shots. He got 20 shots, and CBS 2’s Tye asked Linda how many of them were legitimate vaccinations.

“Well, none as of today,” she said. “None.”

Linda said she was always in the room when her son received the vaccinations. What does she think Dr. Koinis was injecting him with?

“Well, considering there was something that was a liquid – I mean, I’m not a doctor – I would say saline, maybe like, or placebos that are nothing,” she said.”

Nevertheless this woman says she’s not angry with Koinis. She’s mad at sheriff’s investigators for not revealing results of their investigation sooner.

Oh My God. Those poor kids! Having to get their shots all over again!
Those poor parents, trying to do their best for their kids and having a trusted person lie to them and abuse their kids this way!

This is horrible.

Want to respond to Orac? Here's your chance. Leave a reply!

This site uses Akismet to reduce spam. Learn how your comment data is processed.