Whipped Cream Difficulties

Dr. Donald Pinkel, big damn hero, has passed away at 95.

About 23 years ago, I was watching some sort of special on PBS. I don’t remember the title, but as I recall, they were talking about developments during the 20th century. One of the things they spent a lot of time on was the story of childhood leukemia.

Acute lymphocytic leukemia, a type of cancer that overwhelms the body with misshapen white blood cells, was once the No. 1 killer of children in the United States between the ages of 3 and 15, causing about 2,000 deaths a year. It had a 96 percent fatality rate — and doctors say that number might have been low, because the remaining 4 percent of cases were probably misdiagnoses.

There were drugs that could push leukemia into temporary remission. Emphasis on the “temporary”. It always came back.

Dr. Pinkel combined multiple chemotherapy drugs to drive the disease into remission. Then, when the patients were healthy enough, he and his team bombarded their skulls with radiation and injected drugs directly into their spinal columns, attacking places where Dr. Pinkel suspected the cancer was hiding during remission.
This would go one for months, even years. Children would lose their hair, their appetites. Some died. But by 1968 Dr. Pinkel’s regimen, which he called Total Therapy, was achieving remarkable results: Out of 31 patients in one study, 20 were in complete remission after three and a half years.
A decade later, after continued refinements to the protocol, the five-year survival rate was up to 80 percent. Today, still using Dr. Pinkel’s framework, it is 94 percent.

I realize we’re talking 60 years of scientific advancement here. But to me, this is still an amazing story. Turning things around from “everybody dies” to (almost) “everybody lives”. And going from zero to 80% in sixteen years?

Beyond that, Dr. Pinkel also helped build St. Jude.

One day in 1961 Dr. Pinkel got a call asking if he would be interested in a job as the head of St. Jude. During a period of emotional and professional distress, Mr. Thomas, the hospital’s founder, had prayed to St. Jude, the patron saint of lost causes, for help. When he recovered, he decided to build a hospital to help children in similarly dire straits.
Dr. Pinkel was tired of the cold, wet Buffalo winters, but he wasn’t sure about the offer: Memphis was a segregated Southern city, and many in the medical community said Mr. Thomas’s status as a television comedian made it hard to take the idea seriously.
Still, he met with several members of the hospital board and came away impressed. They, like him, believed in focusing their efforts on childhood cancer, and they agreed that the hospital should be need-blind, and that both its staff and its patient population should be completely desegregated.
Dr. Pinkel drove to Memphis in his Volkswagen Beetle, arriving to find a hole in the ground where the hospital would one day be. He made himself an integral part of the planning process, insisting, among other things, that the hospital have integrated bathrooms.
He also insisted on as much common space as possible, including a single cafeteria for all —- doctors, scientists and administrators — to encourage creative cross-pollination. He also opened the cafeteria to patients and their families, to give staff members a visual reminder of their collective mission.
“It was a civil rights culture,” Jackie Dulle, one of his first executive assistants, said in a phone interview. “He wanted everyone to be equal.”

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Dr. Pinkel and his team found early success with his Total Therapy approach but kept the results unpublished until the late 1960s, to ensure that the data was solid. Still, when he did publicize his findings, he was met with skepticism, even derision; other doctors said he was cruel to give patients and their families hope in the face of what everyone knew was an incurable disease.
But after he invited a few of his most prominent critics to visit the hospital, they changed their tune; one of them, Alvin Mauer of Cincinnati Children’s Hospital, took over as the president of St. Jude when Dr. Pinkel left.

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He won most of the major awards given in the medical field. In 2017 St. Jude named its new research tower after him, a testament to his persistence in the face of what everyone else said was an impossible task.

Luc Montagnier, one of the discoverers of the human immunodeficiency virus.

It’s complicated.

The discovery of H.I.V. began in Paris on Jan. 3, 1983. That was the day that Dr. Montagnier (pronounced mon-tan-YAY), who directed the Viral Oncology Unit at the Pasteur Institute, received a piece of lymph node that had been removed from a 33-year-old man with AIDS.

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From this sample Dr. Montagnier’s team spotted the culprit, a retrovirus that had never been seen before. They named it L.A.V., for lymphadenopathy associated virus.
The Pasteur scientists, including Dr. Françoise Barré-Sinoussi, who later shared the Nobel with Dr. Montagnier, reported their landmark finding in the May 20, 1983, issue of the journal Science, concluding that further studies were necessary to prove L.A.V. caused AIDS.
The following year, the laboratory run by the American researcher Dr. Robert Gallo at the National Institutes of Health, published four articles in one issue of Science confirming the link between a retrovirus and AIDS. Dr. Gallo called his virus H.T.L.V.-III. There was some initial confusion as to whether the Montagnier team and the Gallo team had found the same virus or two different ones.
When the two samples were found to have come from the same patient, scientists questioned whether Dr. Gallo had accidentally or deliberately got the virus from the Pasteur Institute.
And what had once been camaraderie between those two leading scientists exploded into a global public feud, spilling out of scientific circles into the mainstream press. Arguments over the true discoverer and patent rights stunned a public that, for the most part, had been shielded from the fierce rivalries, petty jealousies and colossal egos in the research community that can disrupt scientific progress.

There was a lawsuit: an out-of-court settlement was mediated by Jonas Salk.

Dr. Montagnier and Dr. Gallo shared many prestigious awards, among them the 1986 Albert Lasker Medical Research Award, which honored Dr. Montagnier for discovering the virus and Dr. Gallo for linking it to AIDS. And in 2002 they appeared to have resolved their rivalry when they announced that they would work together to develop an AIDS vaccine. Then came the announcement of the 2008 Nobel Prize for Medicine or Physiology.
Dr. Gallo had long been credited with linking H.I.V. to AIDS, but the Nobel Committee for Physiology or Medicine singled out its discoverers, not him, in awarding half the prize jointly to Dr. Montagnier and Dr. Barré-Sinoussi. (The other half was awarded to Dr. Harald zur Hausen of Germany “for his discovery of human papilloma viruses causing cervical cancer.”)

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In his acceptance speech, contrary to the views of other AIDS experts, Dr. Montagnier said he believed that H.I.V. relied on other factors to spark full-blown disease. “H.I.V. ,” he said, “is the main cause, but could also be helped by accomplices.” He was referring to other infections, perhaps from bacteria, and a weakened immune system.

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After his work with H.I.V., Dr. Montagnier veered into nontraditional experiments, shocking and infuriating many colleagues. One experiment, published in 2009 in a journal he founded, claimed that DNA emitted electromagnetic radiation. He suggested that some bacterial DNA continued to emit signals long after an infection had been cleared.

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Last May, he added fuel to the spread of false information about Covid-19 vaccines by claiming, in a French video, that vaccine programs were an “unacceptable mistake” because, he said, vaccines could cause viral variants.
And in January, in an opinion article in The Wall Street Journal written with the Yale law professor Jed Rubenfeld, he criticized President Biden’s vaccine mandates. The authors said it was “irrational, legally indefensible and contrary to the public interest for the government to mandate vaccines absent any evidence that the vaccines are effective in stopping the spread of the pathogen.”