Chapter Sixteen
“H-A-N-O-V-E-R, and I work for the Centers for Disease Control and Prevention.”
“And Dr. Hanover, please explain exactly what your job entails.”
“My job is to verify that the correct procedures have been done by the submitting laboratory and that the suspect microbe – be it a bacterium or virus or fungus or parasite – has passed all the tests and qualifies to be called the causal agent of an infectious disease.”
“Dr. Hanover, were you on that job in 1984 when the virus now called HIV was labeled as the cause of AIDS?”
It was a stupid question, actually. Dr. Hanover, a striking woman in her early thirties, couldn’t possibly have even been in high school in 1984.
“No. My job is relatively new, and was probably created as a result of this whole AIDS-HIV debacle. But I sure wish I had been there.”
“Why is that?”
“Because I would never have let it happen.”
“Why not?”
“Because HIV does not meet the test of Koch's Postulates and therefore cannot be the cause of AIDS, pure and simple.”
“Are you sure of that?”
“Mr. Messick, I know my job, and I don't care what anyone says,” she states, looking directly at Dr. Gallo. “HIV cannot cause AIDS.”
“Why not?”
“First of all, the most striking thing to me is that no one has ever demonstrated HIV infection, even in a single case, using the accepted medical definition of the word. ‘Infection’ implies a large amount of virus, or microbe, and a high level of biochemical activity. If there were HIV ‘infection,’ there would be what's known as ‘viremia.’ The blood would be teeming with whole, infectious viruses – hundreds of thousands to millions of them in every milliliter of blood. But with HIV, any attempts to purify it and then photograph it using standard techniques have been total failures.”
Messick looks at the defense table. “Perhaps Dr. Gallo wants to change the definition of ‘infection’ at the same time he changes Koch's Postulates.”
Crawley is incensed. “Ob-jec-tion!”
“Sustained. The jury will disregard Mr. Messick's last comment.”
“Dr. Hanover, let's get back to where we were. You were adamant that HIV cannot be the cause of AIDS.”
“Yes. In addition to what I just said, HIV fails to meet three out of four of Koch's Postulates, and for something to be deemed a causal agent, it must meet all four.”
“Can you run through the failures very briefly for us?”
“Well, HIV is not found in every case of AIDS, nor in every stage of the disease. It therefore flunks Koch's Postulate Number One. It does not create AIDS if injected into another healthy body, and therefore flunks Postulate Number Three. And since it can't reproduce AIDS in Number Three, Postulate Number Four is impossible to perform. A flunk there, too.”
“And what about Postulate Number Two?”
“Technically, it passes Number Two, since it can be reproduced in a laboratory culture. But the fact that it grows side by side with healthy T cells – the very cells this virus is supposed to destroy with a vengeance – is very strange, I must say.”
“Dr. Hanover, did you hear the testimony from your fellow worker at the CDC, Mr. Harrison, that there are over 4,600 AIDS cases on record, and perhaps more than 10,000 cases, with no evidence of HIV, either the virus itself or the HIV antibodies? And also the testimony that we only tested a fraction of AIDS patients for the presence of HIV in two of the major cities involved at the height of this epidemic?”
“Yes, I heard that. Those were not the best days at the CDC, Mr. Messick. We’ve tried to change things since then.”
“All well and good, Dr. Hanover. But if you had 10,000 cases of tuberculosis and no tuberculosis bacterium anywhere to be found, what would you think?”
“I'd think either that there was a misdiagnosis – that it wasn't tuberculosis to begin with – or that, if it were tuberculosis, we must have the wrong cause since we can't find the specific bacterium.”
“And what if you had 10,000 cases of polio without the polio virus?”
“Same answer, Mr. Messick.”
“And if you had 10,000 cases of smallpox but no smallpox virus present?”
“Wrong diagnosis or wrong cause. There's no way around it.”
“And if you had 100 cases rather than 10,000?”
“It wouldn't matter, Mr. Messick. If I found just one case, it would send me back to the lab to verify my diagnosis or to look for a different cause.”
“What if you suggested otherwise to your peers?”
“I'd be the laughing stock of the profession. Does it sound logical to you that you could have an infectious disease without having the cause in your body?”
“So, Dr. Hanover, if there are thousands of cases of AIDS where there was no HIV present – whether it’s 4,000 cases or 10,000 cases – what is your conclusion?”
“As I said, there is no doubt in my mind that it is impossible for the virus called HIV to cause AIDS.”
“Then can you tell me, Dr. Hanover, why the CDC hasn’t, or won’t, stand up and tell the world the truth – that a mistake was made, that HIV cannot be the cause of AIDS – and let science get on with the process of finding out what is the correct cause, and therefore the proper treatment?”
Dr. Hanover looks at Messick like he is nuts. “Mr. Messick, you’ve obviously never been involved in government, or politics. That’s simply not a possibility, believe me. After twenty-five years...are you kidding?”
“I don’t understand, Dr. Hanover. Hundreds, even thousands of lives are still being affected today by the continuation of this…mistake. Why not set the record straight?”
“Have you ever heard the United States government admit it made a mistake in the Vietnam War, or the war in Iraq? It’s not going to happen, Mr. Messick. Wake up!”
“But isn’t that exactly what you’re doing right now, finally telling the truth on live TV, to millions of people?”
“Yes, it is.”
“So isn’t your presence here in this courtroom today an admission by the CDC that they made a mistake?”
“Maybe, maybe not. It’ll depend on what happens when I leave here.”
“Meaning?”
“Meaning that if I don’t have a job in a month, Mr. Messick, you’ll know that the CDC will have disavowed my testimony and is sticking to their old story.”
“But weren’t you given permission by the CDC to testify?”
“Yes, I was. But I have a feeling they simply couldn’t figure out what to do, so they sent me and will figure it out later, based on what happens in this trial. I’m hopeful that the ‘new’ Centers for Disease Control and Prevention will live up to my expectations of honesty and openness with the public. If they don’t, I wouldn’t want to work for them anyway, and my firing will be welcome.”
“Thank you, Dr. Hanover.”
Messick looks depressed, even though he had just scored a huge victory with Hanover’s testimony. As he slumps down in his chair, Crawley gets up out of his.
“Dr. Hanover, let’s not be so quick to say a mistake was made here. Let’s talk again about Koch’s Postulates. Don't you think, Dr. Hanover, no matter what field we want to talk about, that some set of criteria written down over a hundred years ago has gotten pretty stale and ought to be replaced, or at least updated, especially in the field of medical research, considering the giant steps we’ve taken in technology during that time?”
“That depends, Mr. Crawley. The Ten Commandments are a lot older than that and don't necessarily need changing, now do they?”
The courtroom laughs, bringing down the gavel from Judge Watts.
“But Dr. Hanover, we're not talking about God, here. We're talking about a very human Dr. Robert Koch who came up with these postulates. And we're also talking about gigantic changes in medical procedures, medical technology, research capabilities. Won't you admit that Koch's Postulates are no
t the last word these days in determining causality?”
“No, I won't admit that, Mr. Crawley. In fact, I think it's pretty arrogant to even suggest that. Koch's Postulates not only make a lot of common sense, but they also work, as well today as they did 100 years ago. If you can show me something better, please do. What would you like to replace them with, Mr. Crawley?”
“Well, I'm not the scientific expert here, but if Dr. Gallo – who is a world-recognized expert in his field – suggests that Koch's Postulates are archaic, then I'm sure he knows what he's talking about.”
“Well, I don’t know that I agree with you on that point, but I’d be happy to listen while Dr. Gallo tells me what he wants to take the place of Koch's Postulates, because we have to have some criteria, Mr. Crawley. We have to have something that gives us a system to determine causality. And I haven't found anything better than Koch's Postulates, to this day.”
“So, Dr. Hanover, you're saying that even though it is totally obvious from all the research that HIV causes AIDS, had you been on this job back then, you would have thrown all that evidence out if it didn't meet one of Koch's Postulates? You would have deprived so many thousands of people from treatment over the last twenty-five years because you would refuse to acknowledge the role of HIV, simply because of some set of arbitrary rules from one-hundred years ago – from the dark ages of medical research?”
“I'm not sure what research or evidence you’re speaking of to support HIV as the cause of AIDS, Mr. Crawley. I've heard a lot about it, but I've never seen that research or that evidence. All I'm saying is that if you throw out Koch's Postulates, what are we left with? Anybody, anytime they wanted, could stand up, for example…” and she again looks directly at Dr. Gallo at the defense table, “…at a press conference, and say that this virus caused that disease, and no one would be able to question it or test it or prove it. Medicine would be in chaos, Mr. Crawley, chaos.”
Crawley decides to give up. “I have no further questions.”
“Mr. Messick, re-direct?”
“No, Your Honor.”
“Then it is three-twenty-five on a Friday afternoon. This court stands in recess until nine a.m. Monday morning.”
Pandemonium isn’t even close to the right word.