January 12 2012
David L Lewis: indignant abuse as complaints turn to nothing
Videos above: David Lewis denounces Brian Deer’s journalism as suspiciously good
In January 2012, David L Lewis, an American retired environmental microbiologist, filed what he represented as a complaint with three UK bodies concerning reports in the BMJ investigating Andrew Wakefield, the former doctor and vaccine research cheat. This is my (very long) response.
BY BRIAN DEER
I first learnt of this man David Lewis in June 2011, when I was told that he’d submitted an abusive attack on me to a small, US-based journal. His article ran to more than 30 pages and was derived from baseless allegations by the discredited former surgeon Andrew Wakefield. Lewis’s general thesis, which he set out in detail later, is that I’m part of a conspiracy with the pharmaceutical industry and government agencies to exact what he calls “retribution” on the purportedly innocent Wakefield. In the article, reference was made to the BMJ.
Get Deer’s book: The Doctor Who Fooled the World
In the article, Lewis held himself out to be “Director” of the “National Whistleblowers Center Research Misconduct Project”, and called himself a “research microbiologist” at the centre. I established that the “NWC” (whistleblowers.org) is a website operated by a firm of Washington employment lawyers, Kohn, Kohn and Colapinto, and shouldn’t be confused with the prestigious Government Accountability Project (whistleblower.org). Although, for all I know, it may do legitimate public interest work, it appears to me that the law firm operates the NWC much as drug companies have been known to operate associated bodies to reach out to potential customers. In this instance, the NWC may attract business, provide speaking, media and publishing credentials for the firm’s partners, and bestows the courageous aura of “whistleblower” upon clients in disputes with their employers. Unlike the GAP, the Kohn entity isn’t listed as a 501(c)(3) not-for-profit, and this renders aspects of its affairs opaque.
The “Research Misconduct Project” is Lewis, and he apparently obtained approval to announce this and designate himself as “Director” in December 2010, the month before he took up with Wakefield. Although he never contacted me, I found that he’d posted a suite of pages on the NWC website crammed with libellous abuse of me. Some of it was written in an oddly indignant tone. For example:
“We are talking about a reporter with no education or experience in medical practice of any kind… Now, it seems, the whole world is buying into this same ridiculous argument made by a reporter with no competence whatsoever in interpreting medical records of any kind. As a research microbiologist, I must say that this is completely insane.”
He falsely claimed not only that Wakefield had been “targeted for retribution”, but that Lewis had also been so targeted in what he suggested were wide-ranging conspiracies of uncanny similarity. He claimed:
“Most scientists have never been targeted for retribution by government, industry or academia. Usually, such treatment is reserved for researchers who gain public attention and directly threaten important government policies or corporate profits. To stop researchers who publish unwanted results, institutions have resorted to using false allegations of research misconduct as a weapon of choice. Scientists who are targeted in this manner suffer lifelong consequences, and the chilling effect it has on other scientists is profound. Few, if any, scientists are willing to step into the firing line of government or big industry and risk being martyred.”
He gives no alleged examples, other than Wakefield and himself. [2023 UPDATE: Even a decade later, Lewis had produced no further examples or activity by his pretend “project”]
Upon reading this material alleging that I was part of such activity, I promptly wrote to Stephen Kohn, who heads both the law firm and the website “center”. Shortly afterwards, most of Lewis’s material was taken down, although he continues to claim on his pages that he’s producing “a non-biased, objective review”.
This claim to objectivity is plainly false. Lewis’s attacks on me ooze with malice, and have been prepared in frank collaboration with Wakefield, who he met in Montego Bay, Jamaica, in January 2011. [See reply to Lewis at nature.com] Both men were invited and funded to attend a small meeting organised by anti-vaccine campaigners at a luxury villa resort. Video of the event suggests that perhaps three dozen people took part. Kohn and Lewis were among a literal handful of individuals present who aren’t well known for anti-vaccine activism, sometimes involving lucrative expert witness work on the US “vaccine court” circuit. Attendees were reimbursed by the “National Vaccine Information Center”, operated by one Barbara Fisher, who has worked with Wakefield since about 1996, and who likens him to Galileo.
Lewis and the EPA
On Lewis’s webpage, a lengthy “director’s story” outlined what I later found to be a misleading account of an extraordinarily arcane dispute between himself and the Environmental Protection Agency. For most of his career, Lewis, now 63, was an environmental microbiologist at the EPA’s lab in Athens, Georgia. In addition to his paid employment, he became active on the side as an expert witness, leading at one point to a complaint to the EPA from a private company that he’d turned his employment with the government agency “into a vehicle to support his private, paid expert witness work”. It may be recalled that one of my revelations about Wakefield was that he’d secretly received huge sums of undisclosed legal money to make a pre-agreed case against MMR, beginning years before his infamous 1998 Lancet paper was published. There was no connection between the pair’s cases, but it’s not hard to see that Lewis, and others whose minds have turned to fantastic conspiracies, might want to exploit one to fuel the other.
Lewis’s principal expertise is in the potential contamination of agricultural land by harmful sewage sludge. It appears that he was being paid by lawyers to make a case against a firm called Synagro [summary Synagro report on Lewis] – a company I’ve never before heard of, or had any dealings with. Complaints against Lewis included his alleged misuse of EPA credentials to further what was represented to be his private agenda. At some point, Lewis had himself declared a “whistleblower”. Despite its heroic-sounding quality, this is generally a technical legal issue in the US, often invoked in employment disputes. In fact, it appears that his “whistleblowing” was to make complaint against an employee of lower grade in a different section of the EPA, who took a contrary view over Lewis’s sewage sludge claims. Lewis then alleged that EPA had vicarious liability for this other employee’s conduct. Lewis signed a settlement agreement to leave the EPA, but when the date of its maturity arrived, he complained again. Lewis was represented in his dispute by Stephen Kohn, and generated increasingly long documents.
He made countless complaints which, as far as I can tell, were rejected. A relatively straightforward account of some of the matters is contained in a judgment in the US court of appeals dated February 2010, summarised online. This finally rejects his “whistleblower” complaints, after years of apparently futile rancour. Although I’ve not investigated his case, he appears to have made unfounded accusations against both his professional colleagues and his employer. Various investigations and hearings, all the way to the federal appeals court rejected his assertions. At one point, the dispute focussed on his submission of an article to the Lancet, the integrity of which was challenged by the other EPA scientist, who improperly showed it to outsiders. I believe that the paper was rejected. It will, of course, be recalled that the Wakefield issue centres on a paper in the Lancet.
In May and August 2011, while Lewis was hawking his attack on me, he lost two further cases in the federal appeals courts. To say that he has spent a great deal of his life filing complaints and appealing their rejection would appear to understate his activities for more than a decade.
One passage on his webpages, regarding himself, is, I think, particularly revealing:
“So far as UGA [University of Georgia, Athens] is concerned, the allegations remain officially unresolved ─ even though its Science Integrity Officer in charge of ruling on the research misconduct petition called the allegations a ‘witch-hunt’ and testified that she never believed them.”
Lewis’s dispute with the EPA, I believe, casts light on the mindset behind his campaign against me, his abuse of the BMJ and its editor Dr Fiona Godlee, and now his 167 pages of accusations and materials sent to University College London, the UK Research Integrity Office, and the Higher Education Funding Council for England. It appears that he has identified these bodies from reading the BMJ and that he knows, or ought to know, that none have jurisdiction over the journal. But he evidently feels compelled to make complaint and to take it somewhere. So I’m now obliged to generate this lengthy, time-consuming, document.
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On 9 January 2012, a website operated on behalf of Wakefield issued an online paid-for press release of Lewis’s complete allegations, dated 8 January, which he had placed online for this purpose. The press release offers a photograph of Lewis and is headed:
“Whistleblower Scientist Accuses British Medical Journal of Institutional Research Misconduct. Actions of BMJ Editor and Reporter ‘More Tabloid News than Science’ According to Dr. David Lewis, and ‘a Genuine Threat to Public Health’.”
This is the second time the two men have arranged for attacks on the BMJ and me to be issued as press releases. The previous occasion, on November 10 2011, was timed to coincide with what they expected to be the publication of Lewis’s allegations in the science journal Nature. That press release was headed:
“Ongoing Investigations by Dr. David Lewis Refute Fraud Findings in Dr. Andrew Wakefield Case. Well-known Whistleblower Calls for Withdrawal of British Medical Journal Article Alleging Fraud.”
Both press releases are confections devised by Wakefield and Lewis, plainly working together. In my view, Lewis’s January submission was intended for publicity purposes. The document, and Lewis’s conduct with it, weren’t any kind of bona fide complaint, or legitimate disclosure of public interest.
The Lewis document wasn’t published on Kohn’s site, but on that of another law firm which has previously published – on an identical format – Lewis’s claims regarding his alleged persecution over his sewage sludge activities. A statement makes clear that Lewis is engaged in a personal campaign:
“The views expressed in this document are my own, and have not been reviewed or approved by the National Whistleblowers Center.”
It appears that Lewis’s many disputes and complaints in the past have wasted much of what ought to have been a productive period in his life. I’ve no knowledge of the rights or wrongs of those conflicts, or whether he acted dishonestly with regard to his research on sewage sludge. It may well be that he has been traumatised by what has happened to him. Nevertheless, he’s responsible for his own conduct. It can’t be right that he seems intent on carrying on with me where he left off with the EPA. I believe that he needs counselling or other support, and in a letter to Kohn of June 2011, I set out my general analysis:
“It seems to me that we are witnessing the bizarre spectacle of Dr Lewis’s psychological transference through which he seeks to punish me as a surrogate for those who he feels have treated him unfairly in the past… Whether such a transference phenomenon goes back only a decade, or whether David Lewis was consumed with bitter grievance long before that, I can only at present guess and try to feel compassion for.”
Lewis’s submission to the BMJ
After an all-out campaign of abuse against me, Lewis changed tactics and sought to exonerate Wakefield with documents provided to him by the disgraced former surgeon. Wakefield was erased from the UK medical register in December 2010 and expelled by the Royal College of Pathologists in January 2011, as a result of proven charges of research dishonesty and the abuse of autistic children. These findings were handed down by a fitness to practise panel of the UK General Medical Council in May 2010.
The documents Lewis obtained from Wakefield were raw data “grading sheets” apparently prepared in 1997 by a consultant histopathologist working with Wakefield at the Royal Free medical school (now a unit of UCL), and also other sheets prepared by a trainee, Dr Andrew Anthony. These sheets recorded observations of bowel biopsies taken from children enrolled in Wakefield’s MMR vaccine research, commissioned by a firm of lawyers and published in the Lancet in February 1998.
The consultant was Dr, now Professor, Amar Dhillon, a co-author of Wakefield’s retracted 1998 Lancet paper. In his approach to the BMJ, Lewis contended that the BMJ and I alleged that Wakefield’s work was fraudulent because of mismatches (identified during the GMC proceedings) between the official reports on bowel biopsies issued by the Royal Free hospital pathology service, and descriptions of “histological findings” tabulated by Wakefield in the subsequent Lancet paper.
As a matter of fact, where the pathology service generally reported healthy biopsy samples from children in Wakefield’s 1998 Lancet research project, the resultant paper reported “non-specific colitis”. The paper, and subsequent statements by Wakefield, claimed the putative discovery of a new inflammatory bowel disease in autistic children. I reported and discussed this mismatch in a BMJ feature of April 2010 titled “Autistic enterocolitis under the microscope”.
These biopsy assessments, however, weren’t the basis upon which, in January 2011, the BMJ concluded that Wakefield’s MMR work was “an elaborate fraud”. The evidence we presented rested firmly on the GMC panel’s findings of research dishonesty, and was overwhelmingly related to Wakefield’s activities with regard to the admission of patients to the study, as well as the purported clinical histories and findings which lay behind a claim by Wakefield of a 14-day temporal link between the administration of MMR and the first “behavioural symptoms” of autism. We say this purported link was fraudulent.
In the 2010 report, I looked specifically at the bowel pathology, and set out what was said to have happened after the hospital pathology service reported largely normal findings from the children’s guts:
“‘It was decided that the senior consultant histopathologist with expertise in intestinal disease (Dr Dhillon) should review all biopsies from autistic children, and that pathology should be graded on a pro forma (or grading sheet) designed by him,’ Wakefield said last March, in a now suspended complaint to the UK Press Complaints Commission about one of my Sunday Times reports.”
I also set out some of the discussion of this matter at the GMC hearing, plus various issues arising from Wakefield’s explanation, and left the matter as a mystery. We didn’t then have the grading sheets, so there was no way of knowing whether, as Wakefield and others said, Dr Dhillon in the medical school found colitis where the hospital pathology service hadn’t. Dhillon declined to speak to me, so we didn’t know what the true position was. However, Wakefield’s claims about Dhillon’s then-undisclosed sheets would need to have been true if the Lancet paper’s “histological findings” (meaning findings under a microscope) were accurate.
But we just didn’t know.
Enter Lewis, who approached Dr Godlee in late August or early September 2011, after his manuscript was rejected by the small journal to which he’d submitted it. Much of the subsequent detail of events is dealt with below in my analysis of his accusations document of January 2012. But at the heart of the matter was Lewis’s presentation to the BMJ of what he and Wakefield said were copies of Dhillon’s grading sheets (supported by others, completed, after the Lancet paper was published, by the trainee, Dr Anthony).
The sheets gave scores for various inflammatory changes, and included a tick-box “non-specific”. Although it later transpired that not all of the sheets were completed by Dr Dhillon, Lewis argued that “non-specific” meant “non-specific colitis”, and that these were ticked in correspondence with the descriptions “non-specific colitis” in the Lancet. He deduced from this that what he characterised as our allegations of fraud against Wakefield were thus proven to be false. He goes on to allege that they were intentionally false.
Among other things, Lewis wrote to the BMJ:
“Dhillon’s grading sheets (Attachment 1) included boxes to check, which characterized various conditions that are widely recognized as different forms of colitis, including Crohn’s disease, ulcerative colitis (“UC”), and infectious, ischemic, and non-specific colitis. In one case (Child 7), Dhillon left the boxes blank, meaning none of these forms of colitis were present. For the remaining 11 children, he checked “non-specific.””
Dr Godlee sent me the sheets, and within perhaps six minutes it was clear to me that, notwithstanding both Wakefield’s and Lewis’s claims, the sheets overwhelmingly didn’t report colitis. My research in 2010 had given me some lay understanding of such matters, and it was clear to me that the scorings were almost all of observations which pathologists would assume to be physiologic. It also seemed to me that “non-specific” merely meant that findings weren’t specific to anything. As it happens, there’s no accepted entity called “non-specific colitis” and you’d be a long time looking for it in gastroenterology textbooks.
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I was surprised that Lewis appeared not to understand relatively elementary fundamentals of GI histopathology when he was representing himself to us as an expert. He evidently couldn’t, or, worse, wouldn’t, read the grading sheets and make sense of them. Within perhaps an hour, I advised Dr Godlee to promptly put the sheets out for expert review. I’m aware of perhaps seven experts who subsequently looked at them. All of them said what I’d said. The sheets largely noted observations of apparently healthy bowel mucosa, and the “non-specific” tick-box wasn’t meant to indicate a finding of colitis.
This was a significant development in the overall MMR story. Here were previously unseen raw data, explicitly invoked by Wakefield as evidence of colitis and of a putative “new inflammatory bowel disease” associated with autism and MMR, which he would later call “autistic enterocolitis”. This was pivotal material which helped to launch the MMR vaccine crisis. And yet the data didn’t show what Wakefield claimed. Nor did they square with what he and others had told the GMC panel, which took evidence under oath. We forthwith began preparing a further report in a BMJ series “Secrets of the MMR scare”, begun in January 2011, when, by coincidence, Lewis was in Montego Bay with Wakefield.
On 9 November, the BMJ published a package of materials. First was an editorial by Dr Godlee, then a news feature by me titled “Pathology reports solve ‘new bowel disease’ riddle”. This was followed by assessments of the grading sheets by two of the experts we consulted. Then came a letter by Lewis, arguing the case that Wakefield didn’t intend to mislead when he reported “non-specific colitis” as “histological findings”. The BMJ published the grading sheets, as supplied by Lewis, but further anonymised to conceal patient hospital numbers, so that readers could see for themselves whether or not what Lewis claimed was true.
Shortly after publication, Professor Dhillon issued a statement in which he confirmed that the “non-specific” tick-box wasn’t meant to indicate colitis, and that a finding of colitis requires both input from clinicians’ and the patient’s history, neither of which were available to him when he completed his sheets.
Our intent in publishing the November package wasn’t to make a fool of Lewis, or really to accomplish much at all with regard to him. Our motive was to bring forward, in the public interest, important new information: raw data from an area of Wakefield’s research where previously we’d none. However, I can understand that Lewis may have felt humiliated to be so publicly exposed as inept – and by a newspaper reporter, to boot. It’s noteworthy that in his 167-page complaint, he now raises no argument about the “non-specific” tick box, even though this was at the foundation of the case he brought to the BMJ and had hawked to other publications.
The Lewis accusations analysed
HEADING “MARKETING DRUGS WITH TABLOID SCIENCE”
DEER: The title is revealingly silly and insulting.
TEXT HEADED “COMMENTARY”
LEWIS: “Editors at the British Medical Journal (BMJ) and Brian Deer, a freelance reporter with no formal training in science or medicine…”
DEER: I’m an experienced investigative reporter with more than 25 years of contentious public interest journalism behind me, much of which has been in the field of medicine. I’ve won two British Press Awards for my investigations, including for my work on the Wakefield affair.
LEWIS: “… alleged that Andrew Wakefield fabricated the diagnosis of colitis in a 1998 Lancet study involving 12 children with autistic spectrum disorder (ASD).”
DEER: At the core of our problems in dealing with Lewis is that nowhere was such an allegation made in the BMJ. He repeatedly identifies my feature “Autistic enterocolitis under the microscope”, published in April 2010, but this simply doesn’t make such an allegation. Plain reading would make this clear.
Not only can I find no foundation for this fundamental of Lewis’s complaint (and I think I’d remember forming any view at that time that the histopathology reporting in the Lancet was fraudulent, as distinct from, say, wrong, misleading or incompetent), we consulted legal counsel, before and after publication, and expert peer-reviewers. We remain unable to identify any text inferring Wakefield’s intent with regard to histology reporting. I’ve similarly asked Nature to identify any such text, and they too have failed.
LEWIS: “In the study, some parents and physicians linked MMR vaccine to the children’s gastrointestinal problems and rapid regression into autism.”
DEER: This statement is noted. As a matter of fact, such “links” as were made followed approaches by Wakefield, who, the GMC panel heard, telephoned both parents and doctors to advance his views prior to the children’s evaluation by clinicians.
LEWIS: “In 2010, Deer alleged in the BMJ that Wakefield alone made up the diagnosis by misinterpreting grading sheets from pathologists A.P. Dhillon and A. Anthony, who reviewed the children’s colonic biopsy samples.”
DEER: I made no such allegation. My 2010 report couldn’t have offered any inference about grading sheets or their interpretation, as no such sheets were available.
LEWIS: “In the article, Deer wrote that, according to specialists, grading sheets ‘don’t generate clinical diagnoses such as colitis.’”
DEER: My statement is of fact, peer reviewed for the BMJ by gastrointestinal pathologists. Grading sheets (whether in histopathology or other areas of medicine) are research tools, not clinical instruments for patient diagnosis. The consultant pathologist, Dr Amar Dhillon, who completed sheets I reviewed with experts in November 2011 (“Pathology reports solve ‘new bowel disease’ riddle”) confirmed in a statement to the BMJ that grading sheets don’t generate clinical diagnoses. That’s what I’d said, and I was right. I must assume that Lewis doesn’t understand the meaning of “clinical”.
LEWIS: “Grading sheets I recovered from Wakefield’s files, however, show that Anthony wrote “colitis” in marginal notes on a number of his grading sheets.”
DEER: Andrew Anthony was an unaccredited trainee pathologist, and, oddly, was still a trainee eight years later. He was neither qualified nor authorised to set aside the diagnoses of consultant pathologists of the hospital pathology service, particularly since such diagnoses had been agreed with clinicians at weekly clinicopathological meetings.
The “number” Lewis alludes to, but doesn’t state, appears to be 5 of 56 sheets – of which 2 are plainly wrong because the sample reported isn’t from the colon. It appears possible that, in addition to his difficulty with “clinical”, Lewis doesn’t know or is unwilling to acknowledge the meaning of the word “colitis”. For example, on page 80 of his complaint, he notes what he represents as a finding by Anthony of “colitis” in small bowel (ileal) samples:
“There are actually two children in which he wrote some form of “chronic colitis” on his grading sheets. This includes the ileal biopsy for Child 5 (Slide 96-13543) where he wrote “mild chronic colitis.” For Child 6 (Slide 96-11992), he wrote “active chronic enteritis + colitis” for the ileal biopsy.”
Colitis, by definition, is inflammation of the colon (the large bowel), and can’t be reported in the ileum, where inflammation is enteritis, or, more specifically, ileitis. It’s hard to believe that both Anthony and Lewis could be so careless as not to spot this. Lewis also failed to take account of this when he wrongly deduced that Dr Dhillon’s “non-specific” tick-box on sheets reporting small bowel biopsies meant “non-specific colitis”.
Anthony’s (dated) evaluations were all performed after the paper was published, and hence can’t be the basis of what was reported in that paper. According to the Legal Services Commission, Anthony was paid £57,499 to support Wakefield’s claims in litigation, including by carrying out evaluations of biopsies. It appears that Anthony’s instructing solicitors may have not realised, or not cared, that he was a junior doctor and would be unable to give expert testimony in high court litigation.
LEWIS: “And, Dhillon included boxes to check for various diagnoses, such as Crohn’s disease and “UC” for ulcerative colitis.”
DEER: Dr Dhillon didn’t check any of these boxes.
LEWIS: “Consistent with the Lancet article, both pathologists found that only one child showed no evidence of inflammation.”
DEER: As reported in my heavily-referenced November 2011 report, and an accompanying expert commentary by a professor of gastrointestinal pathology, the normal, healthy, state of the colon is one of “controlled inflammation”. This is inextricably tied up with how it works. The question for pathologists is whether the inflammation is physiologic or pathological. Experts in this field, who the BMJ and I consulted, said that the grading sheets overwhelmingly show physiologic inflammation.
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In fact, the all-normal grading sheets for the child referred to was completed by the trainee, not the consultant.
LEWIS: “Last September, BMJ‘s chief editor, Fiona Godlee, rejected a commentary I wrote about Wakefield’s documents. In its place, she invited me to submit a Rapid Response, which I did.”
DEER: Noted.
LEWIS: “But, instead of admitting she had falsely accused Wakefield of making up the diagnosis of colitis…”
DEER: I believe that Dr Godlee made no such admission because she’d never made any such false accusation.
LEWIS: “… she and Deer simply cherry-picked the evidence to come up with a new theory involving “institutional research misconduct.”
DEER: Neither Dr Godlee or I came up with any “new theory”. Dr Godlee set out her general view of the institutional issues in a commentary dated 19 January 2011 titled, appropriately, “Institutional and editorial misconduct in the MMR scare”. This was many months before we’d ever heard of Lewis.
LEWIS: “The alleged fraudsters now include University College London (UCL) administrators, the Royal Free Hospital, and all 13 authors of the Lancet study.”
DEER: No such allegations were published in the BMJ.
LEWIS: “Their objective, according to an editorial and feature article Godlee and Deer published with my Rapid Response, was to create the MMR scare so that UCL could sell its own safer measles vaccine, diagnostic kits and ‘autism products’.”
DEER: Neither the editorial nor the feature article made any statement with regard to the objective alleged by Lewis.
The feature made no mention of any safer measles vaccine, diagnostic kits or autism products.
LEWIS: In her editorial, Godlee acknowledged “the BMJ Group receives funding from the two manufacturers of MMR vaccine, Merck and GSK.”
DEER: Among a great many sources of revenue, I believe this is correct.
LEWIS: “To support their new fraud theory, Godlee rewrote my Rapid Response, removing any evidence that undermined their allegations against Wakefield and others.”
DEER: Lewis’s rapid response was extensively re-written because it was false and defamatory. Legal advice was taken. Two peer reviewers rejected the submitted text. No changes had any effect in supporting any “fraud theory”, whether new or otherwise. Lewis approved the published text.
LEWIS: “Then, to prevent me from publishing this evidence on my NWC website, Deer filed a flurry of false allegations of ethical misconduct against me with the NWC.”
DEER: I wrote to the NWC because Lewis had published on its website false and defamatory allegations against me, accusing me of being party to a conspiracy to pursue “retribution” against Wakefield. He did so without ever putting his allegations to me, or of doing anything at all but agreeing his attack with Wakefield.
LEWIS: “Godlee ignored my protests over Deer’s behaviour; and some of his false and misleading characterizations of my professional credentials and current work appeared in her editorial and Deer’s feature article.”
DEER: Dr Godlee is responsible for what appears in the BMJ, and has no authority over any efforts I must make to defend my professional integrity. The alleged “misleading characterizations” are not particularised.
LEWIS: “When testifying before Parliament in 2011, Godlee agreed that peer-reviewed journals have become “the marketing arm of the pharmaceutical industry.”
DEER: That’s not quite what she said, but I’m sure we all get her point. Medical journals carry a great deal of pharmaceutical advertising and are a prime means by which industry communicates with prescribers. They carry a great deal of industry-sponsored research.
LEWIS: “Therefore, it shouldn’t surprise anyone if her fraud allegations turn out to be nothing more than a scheme to protect the BMJ‘s financial interests in companies marketing MMR vaccines.”
DEER: I think it would surprise a great many people. However, the infantile quality of this assertion rather showcases Lewis and his complaint.
LEWIS: “What’s so frightening about all of this, however, is that such a scheme requires that one of Great Britain’s leading medical journals utterly destroy the reputation of one of the world’s most prestigious academic institutions.”
DEER: I doubt whether the BMJ intends to “utterly destroy the reputation” of UCL, whether any “scheme” requires this, or whether the BMJ would be capable of such a feat should it harbour the aspiration.
TEXT HEADED “SUMMARY”
LEWIS: “In November 2011, Fiona Godlee, chief editor of the British Medical Journal (BMJ), and a reporter, Brian Deer, used newly discovered documents I obtained from Andrew Wakefield’s personal files to allege that University College London (UCL) may have committed ‘institutional research misconduct.’”
DEER: As indicated above, the “institutional misconduct” charge was made by Dr Godlee in January 2011 – 10 months previously, and before we’d ever heard of Lewis. The documents supplied by Wakefield to Lewis, and by Lewis to us, was in part an occasion for the BMJ to re-rehearse issues arising from the Wakefield affair with the addition of the fresh information. The core of the issues which the BMJ and I believe constitute institutional misconduct have nothing to do with histopathology. And, indeed, they are nothing to do with Lewis.
LEWIS: “The term, which I coined at the National Whistleblowers Center (NWC) in Washington, DC, refers to instances in which institutions, such as government agencies and universities, commit or support acts of research misconduct to protect government policies and industry practices.”
DEER: Lewis can use the expression as he wishes, and presumably so can Dr Godlee.
LEWIS: “According to Godlee, the misconduct may have involved UCL administrators, 13 scientists, and the Royal Free Hospital in London.”
DEER: Apart from 13 “scientists”, a number I don’t recognise regarding scientists in this context, this may be correct.
LEWIS: “It was all part of an elaborate scheme in which the Lancet study was intended to generate an MMR vaccine scare which, in turn, damaged vaccine sales by Merck and GlaxoSmithKline (GSK), which, in turn, opened up the market for UCL to sell safer vaccines, diagnostic kits and ‘autism products.’”
DEER: Lewis is in difficulty again over his understanding of intent. I’ve never expressed concern, or known of anyone else to express concern, over the vaccine sales of Merck or GSK. I couldn’t care less. In any event, percentage fluctuations in MMR vaccine sales over the years would be irrelevant to the named companies, aren’t consequential to their profits, and there has never been the slightest evidence of market sensitivity to the Wakefield scandal. If Lewis has evidence of such a motive being alleged, then I’m surprised he doesn’t identify the words complained of, or produce evidence.
The various products were meant to be sold by private companies of Wakefield’s, in which the Royal Free’s trading subsidiary was in negotiation to take a stake. This institutional conflict of interest was revealed in my second “Secrets of the MMR scare” report “How the vaccine crisis was meant to make money” in January 2011.
LEWIS: Godlee wrote that this scheme caused “enormous harm” to public health, and could reflect “the prevailing culture of Britain’s academic institutions.” In her editorial and other comments published in the BMJ, she called upon various oversight bodies to investigate, including Parliament, UK’s Research Integrity Office (UKRIO), the Higher Education Funding Council for England (HEFCE), and UCL’s Office of Provost.
DEER: I believe she did.
LEWIS: “In a previous version of their fraud scheme published in January 2011, and earlier in 2010, Godlee and Deer alleged that Wakefield alone faked the diagnosis of colitis to profit from a patent UCL filed on a ‘transfer factor’ he developed.”
DEER: As previously intimated, no article appeared in the BMJ in 2010 alleging that Wakefield “faked the diagnosis of colitis”, whether to “profit from a patent” or for any other purpose. I know of no connection between colitis and transfer factor. No such article appeared in 2011.
LEWIS: “Transfer factors are used to treat infections in immunocompromised patients who cannot be vaccinated with live vaccines, such as MMR vaccine.”
DEER: I’m unaware of any immunocompromised patient being treated with transfer factor on grounds that they cannot be vaccinated with live vaccines. Immunocompromised patients are generally protected by herd immunity, and this is an aim of vaccination policy.
LEWIS: “These were the first in a series of articles published by the BMJ in which Deer allegedly exposed ‘the frauds behind Wakefield’s research.’”
DEER: Noted.
LEWIS: “Copies of the pathologist grading sheets and other data from the 1998 study, which I obtained from Wakefield’s personal files, however, appear to show that the diagnosis was not fabricated.”
DEER: The documents Wakefield gave Lewis show nothing of the sort. They evidence that the claim in Table 1 of the Lancet paper of “histological findings” of colitis for 11 of 12 patients is false. Two consultant histopathologists are named in the paper. Both have separately denied making histological findings of colitis, and pathology reports or grading sheets confirm their statements.
LEWIS: “After rejecting a commentary I submitted to BMJ, which included evidence that the BMJ had wrongly accused Dr. Wakefield, Dr. Godlee invited me to resubmit the documents as a ‘Rapid Response.’”
DEER: As indicated, the rejections followed legal and peer-review advice.
LEWIS: “My report, which I have submitted to UCL, UKRIO and HEFCE, includes 72 emails exchanged between me and the BMJ‘s editors.”
DEER: I offer the recipients at UCL, UKRIO and HEFCE my sympathy.
LEWIS: “In my opinion, they clearly show that Dr. Godlee and others at the BMJ cherry-picked the evidence and rewrote my Rapid Response to support their new, wider fraud theory. Experts disagree on the clinical significance of the data. But, as a whole, the documents I provided clearly show that the diagnosis of colitis reported in the 1998 Lancet article was not fabricated. In addition, my report includes emails Brian Deer sent the NWC in which he demanded that evidence exonerating Dr. Wakefield, which the BMJ edited out of my Rapid Response, be removed from the NWC website.”
DEER: This paragraph is a pastiche of previous arguments.
“Apparent ‘cherry-picking’ of the evidence”
LEWIS: “To support their new fraud theory, Godlee, Deer, and the BMJ‘s lawyers engaged in the most reprehensible conduct I have ever witnessed involving any scientific journal. To paint a dark picture of institutional fraud at UCL, it is my opinion that they used the same tactics of which they accused Dr. Wakefield, and now UCL at large.”
DEER: There was no “new fraud theory”. Otherwise this paragraph appears emptily argumentative. If this is the “most reprehensible” conduct Lewis has ever witnessed “involving any scientific journal”, he must have had a sheltered career prior to his retirement. The allegation of “institutional fraud” is nowhere to be found in the BMJ.
LEWIS: “To begin with, they cherry-picked a treasure trove of hitherto unpublished evidence from Wakefield’s files, selecting the only set of documents they could possibly use to support their new fraud theory.”
DEER: Nothing was “cherry picked”. It took me, “with no formal training in medicine or science” approximately six minutes to realise that Dr Dhillon’s grading sheets reported overwhelmingly normal findings. I urged Dr Godlee to test my judgment by putting the documents out to peer review. This she did. All reviewers confirmed my impression.
Dr Dhillon’s sheets were raw data from his observations of biopsies which Wakefield claimed evidenced a “new inflammatory bowel disease”, and were hence of significant interest. This was the material which the GMC panel had been told was grounds for changing gut diagnoses from healthy to diseased. It was missing material from a consultant histopathologist. Nothing else from Lewis had anything remotely like the significance of these data.
LEWIS: “This was A.P. Dhillon’s grading sheets, in which I asked Dr. Wakefield to add the corresponding numbers used to identify the 12 Lancet children. It is evident from these grading sheets, which the BMJ uploaded on its website, that nowhere on them did Prof. Dhillon actually write out the word ‘colitis.’ He did, however, include a box labeled ‘UC’ to indicate a diagnosis of ulcerative colitis.”
DEER: Lewis’s complaint to the BMJ critically included his judgment that the words “non-specific” on the forms meant “non-specific colitis”, and that when Dr Dhillon ticked this, he was diagnosing bowel disease. Lewis has since abandoned this claim, not least, I suppose, because Dr Dhillon has denied it. Rather than apologise for his timewasting error, however, Lewis now changes tack and argues that there was a “box labelled ‘UC’ to indicate a diagnosis of ulcerative colitis.”
Lewis fails to state that Dr Dhillon did not tick any box labelled “UC”.
LEWIS: “Godlee’s own expert, Ingvar Bjarnason, a gastroenterologist at King’s College Hospital, London, however, told Nature that he believes Dhillon’s grading sheets ‘don’t clearly support charges that Wakefield deliberately misinterpreted the records.” “The data are subjective,’ he says, ‘It’s different to say it’s deliberate falsification.’”
DEER: Since nobody said that Wakefield “deliberately misinterpreted” the histopathology, Professor Bjarnason’s alleged remarks go nowhere. The reporter, briefed by Lewis, asked him a silly question and wrote down his answer. There’s no “however” involved, as per Lewis’s irrational non sequitur.
LEWIS: “To address my Rapid Response, Godlee devoted an editorial, two commentaries, and a feature article by Brian Deer arguing that what little evidence remains of biopsy slides that no longer exist does not support a diagnosis of colitis.”
DEER: The material published wasn’t “devoted” to the rapid response. The material analysed the raw data in Dr Dhillon’s grading sheets. The aim wasn’t to address Lewis’s opinions, which were irrelevant. He plainly couldn’t, or wouldn’t, understand the data he’d supplied to us. Were it not for his malevolent stance towards me, I would have discussed the grading sheets with him, and helped him to understand them. He plainly hadn’t taken expert advice, as I’d done. Possibly he has access to none. We’d important new information to illuminate the origins of the vaccine scare, and, in the public interest, we published it.
LEWIS: “But that’s not the issue.”
DEER: That’s precisely the issue. Do the data give credible grounds to claim a new bowel disease, or to report “colitis”, as Wakefield did when he launched the vaccine scare? The answer we published from five professors in the relevant specialties, who had never previously seen the data, was “no”. Subsequent to publication, when we put the sheets online, we’ve received not one complaint from any pathologist or gastroenterologist, or alternative interpretation to the one that took me less than six minutes to suspect was the position. Lewis himself doesn’t here challenge what I say in my November 2011 piece, or the expert assessments which accompanied it.
LEWIS: “The issue I raised in my Rapid Response, to which all of this effort was directed at overcoming, is whether Dr. Wakefield deliberately misinterpreted the grading sheets as Brian Deer claimed in his article entitled ‘Wakefield’s ‘autistic enterocolitis’ under a microscope.’”
DEER: This paragraph repeats previous arguments.
LEWIS: “What if there was no deception at UCL involving Wakefield’s research and any potential conflicts of interests its administrators and scientists may have had?”
DEER: A fitness to practise panel of the GMC, constituted under the Medical Act 1983 and comprising three doctors and two lay members, said there was deception by Wakefield at (what is now part of) UCL. The panel made findings (against a criminal standard of sureness) including of four counts of dishonesty over the research. Against that background, Lewis’s “what if?” speculation is of no interest.
LEWIS: “Could the BMJ ‘s conflicts of interest with manufacturers of the MMR vaccine have led to deceptions by the BMJ‘s editors and Brian Deer? Based on what transpired between BMJ‘s editors, Brian Deer, the NWC and me, I can now answer the last question. There is no doubt that BMJ‘s editors and Brian Deer appear to be deeply involved in creating an elaborate deception.”
DEER: Lewis has adduced no evidence upon which any rational person could base such a disgusting allegation.
“Godlee’s and Deer’s apparent deception”
LEWIS: “The documents I submitted to the BMJ, which Godlee chose not to publish, clearly demonstrate that neither Andrew Wakefield nor any of his coauthors “faked” the diagnosis of colitis.”
DEER: Repetition.
LEWIS: “For example, Godlee did not publish, or even mention, photomicrographs of the missing biopsy slides for 11 of the 12 children, which I provided to BMJ‘s editors.”
DEER: The editor of a journal can publish or not publish illustrations at their own discretion. In this case, neither Dr Godlee nor I could be sure of what we were looking at.
Nine micrographs were supplied by Lewis – a number contrasting with more than 60 biopsy specimens reported on in the grading sheets. These nine micrographs were handled, supplied, labelled and described by Wakefield, who has four GMC convictions for research dishonesty. Additionally, he published a falsely-described gastrointestinal image in a (now-retracted) 2000 paper in the American Journal of Gastroenterology. As further evidenced by the retraction of the Lancet paper, Wakefield can’t be relied upon to submit accurate material.
To evidence this credibility gap yet further: of the Dhillon grading sheets for 11 children supplied to us by Lewis, Wakefield managed to append incorrect labels in the cases of three patients. Child 3’s ileal sample was reported by Wakefield to be from the patient’s duodenum. Child 4’s sigmoid colon sample was reported by Wakefield to be from the patient’s rectum. And the ascending colon sample from Child 12 was reported by Wakefield to be from a different patient altogether. Despite his training in science, Lewis evidently failed to notice.
I don’t believe that any editor of any credible journal would publish micrographs supplied by Wakefield, or any other material from him reliant upon assumptions of his basic integrity and competence.
LEWIS: “In Deer’s article, “Wakefield’s ‘autistic enterocolitis’ under a microscope,” he referred to the missing biopsy slides as the ‘ultimate proof’ of whether Wakefield faked the diagnoses in Table 1 of the Lancet article.”
DEER: No I didn’t. The slides would be the ultimate proof of what was on the slides.
LEWIS: “The photomicrographs of the missing slides, which were taken by Dhillon and Anthony, clearly illustrate all of the architectural structures described in Table 1.”
DEER: No they don’t. And that assumes the micrographs are what Lewis says they are, for which we have no reliable evidence.
LEWIS: “All that remains in question is whether Wakefield took it upon himself to intentionally misinterpret this information to mean ‘colitis.’”
DEER: Correct.
LEWIS: “Nowhere is that question settled more clearly than in Anthony’s Power Point presentation, which I provided to BMJ‘s editors.”
DEER: The PowerPoint presentation is merely described as relating to a “series of slides circa 1998”. A PowerPoint from a third party couldn’t determine Wakefield’s intent. As indicated, Anthony wasn’t a qualified pathologist.
In his presentation of the PowerPoint material, Lewis says: “One patient’s name, which appeared on two slides, was converted to initials [AG] by David Lewis.” None of the 12 patients in the Lancet study have the initials AG.
Of eight patients identified by their initials in the PowerPoint, six weren’t included in the Lancet paper, further illustrating that Lewis can’t be relied upon to get things right.
Thus, contrary to Lewis, no such question is settled by any PowerPoint, nor could it be.
LEWIS: “In this well-illustrated presentation, which Godlee chose not to publish…”
DEER: I don’t think medical journals generally publish PowerPoint presentations, perhaps especially when they relate to the wrong patients, and were submitted and misinterpreted by an individual who didn’t create them.
LEWIS: “… Anthony carefully explains the basis he used to interpret the architectural features described in Table 1 of the Lancet article as colitis. Obviously, not all experts would agree with his interpretations. But still, they leave no doubt that Dr. Wakefield did not make up the diagnosis of colitis as Deer alleged when he put “Wakefield’s autistic enterocolitis” under a reporter’s microscope.”
DEER: As indicated, Anthony discusses a different group of patients. Examination of the PowerPoint slides, moreover, shows that they don’t present data, but are campaigning materials for Anthony’s work in litigation. For example, on the first slide referring to “routine pathology”:
“Important because difficult to promote and defend notion of a mild form of gut inflammation in autistic children if these were reported as normal here”
Far from exonerating Wakefield, such an observation might be seen as incriminating, as it suggests the researchers wanted to find a way around the normal results from the hospital pathology service.
LEWIS: “Finally, I provided the BMJ with the GMC’s copies of Anthony’s grading sheets, almost all of which were created in September 1998, seven months after the Lancet article was published. Several sheets were dated in October 2001.”
DEER: The provenance of the Anthony sheets isn’t established. In addition to Anthony’s junior doctor and trainee status, Lewis doesn’t seem to grasp that data generated after publication can’t be the data upon which the 1998 publication was based. This seems elementary. He may also not realise that, such is the nature of histological interpretation, a pathologist may report different observations from the same samples on separate occasions. They may also report different findings according to their motives.
Get Deer’s book: The Doctor Who Fooled the World
We’re aware that, after Dr Dhillon’s normal grading sheet findings, the grading sheet used for Wakefield’s legal project was redesigned so as to permit Dr Anthony to report normal bowel features (lymphoid follicles) as pathology.
LEWIS: “Throughout his grading sheets, Anthony noted the various architectural features discussed in his power point presentation. In his marginal notes, he scribbled “colitis” for at least six of the eleven children. In her editorial, Godlee stated: “Anthony concluded that some of the children had “mild” or in one case “active” chronic colitis.” But, because Anthony’s grading sheets were dated after the Lancet paper was published, she deemed them to be irrelevant and did not send them out for external review.”
DEER: This was one reason why they weren’t reviewed. Another was that, as indicated, Anthony was a trainee. Most importantly, Wakefield’s repeated position has been that it was Dr Dhillon’s assessments which were the basis for the Lancet paper’s “histological findings”. This is notwithstanding that the paper identifies four doctors, including himself, as having “assessed” the biopsies. Only two were consultant histopathologists: Dr Dhillon and Dr Susan Davies of the hospital pathology service.
LEWIS: “I also gave the BMJ copies of Prof. Dhillon’s and Dr. Anthony’s affidavits, which confirm that they reviewed the Lancet article before it was published.”
DEER: Only extracts from the statements were supplied to us. Large sections were missing. Dr Dhillon states that he can’t remember a draft of the paper, says he “did not write the histology section of the paper” and argues that others may have contributed findings to that section. Anthony states: “I can however confirm that as far as I recall I did not write, or have anything to do with the drafting of the table of Endoscopic and Histological findings which appears in the Lancet paper.”
Both I and the GMC established that the final Lancet paper was significantly different to the drafts, and that Wakefield alone was responsible for the final text.
LEWIS: “The children’s biopsy slides and Anthony’s grading sheets, which Dr. Wakefield used when he created Table 1 of the Lancet article, are perhaps the single most important pieces of evidence related to Brian Deer’s allegations.”
DEER: With reference to the trainee Anthony, this isn’t Wakefield’s position. His position was set out, for instance, in a 58-page complaint he lodged with the Press Complaints Commission against The Sunday Times in March 2009 (but which, despite my encouragement to the PCC to hear the complaint, he didn’t pursue):
“Dr. Dhillon’s diagnosis formed the basis for what was reported in the Lancet; long antedating Mr. Deer’s allegations. This process has in fact been described in the relevant medical literature (see below) and it was also presented in evidence by me in Mr. Deer’s presence to the GMC hearing (see below).”
I believe that a similar account occurs in a book Wakefield published.
LEWIS: “The slides, however, disappeared from Dhillon’s laboratory after the Lancet article was published; and the most relevant portion of Anthony’s grading sheets disappeared as well. None of this evidence was available to the GMC during its deliberations.”
DEER: This paragraph appears to be Lewis’s suppositions, or claims made to him by Wakefield. Lewis could have no direct knowledge of these matters.
LEWIS: “Fortunately, Dr. Wakefield’s personal files contained photomicrographs of all but one of the children’s biopsy slides, Anthony’s Power point presentation, and grading sheets that Anthony completed shortly after the Lancet article was published. These documents were available to the GMC through discovery.”
DEER: Repetition.
LEWIS: “They make it abundantly clear that Anthony – not Wakefield – took the lead in interpreting architectural features in the biopsy slides as evidence that most of the Lancet children’s biopsies exhibited signs of colitis.”
DEER: As indicated, this isn’t the position Wakefield advanced (under oath) at the GMC, nor in his complaint to the PCC, nor in his book. Nor do any of these materials make the truth of Lewis’s claims “abundantly clear”.
In a recent letter from me in the BMJ, I put forward the question of whether “autistic enterocolitis” and the paper claiming the discovery of a putative new inflammatory bowel disease, which helped trigger a global health alarm, could rest its “histological findings” on the judgment of one junior doctor. Dr Anthony, now a consultant at another hospital, hasn’t responded.
LEWIS: “Collectively, the documents described above establish beyond any reasonable doubt that the initial fraud theory that the BMJ published in 2010 is untrue.”
DEER: As indicated, the BMJ didn’t publish a “fraud theory” in 2010.
LEWIS: “Namely, Dr. Wakefield did not intentionally misinterpret the grading sheets provided by Prof. Dhillon and Dr. Anthony in order to fabricate the diagnosis of colitis reported in the Lancet study. This evidence compelled the BMJ to abandon its initial theory; but its editors made no admissions and gave no apologies. Instead, they cherry-picked Dhillon’s grading sheets to support a new fraud theory in which UCL administrators and all of the Lancet authors allegedly conspired to falsely diagnose colitis in children with autism to profit from an MMR vaccine scare.”
DEER: Repetition.
“Apparent suppression of evidence”
LEWIS: “Dr. Godlee gained my cooperation last September after rejecting a commentary in which I addressed all of the relevant evidence and discussed how it applied to the wide range of allegations of research fraud leveled against Dr. Wakefield by Brian Deer and the BMJ.”
DEER: Lewis didn’t address “all of the relevant evidence”, which would require a much larger document even than his complaint.
LEWIS: “The commentary, for example, addressed the issues of consecutive referral of the Lancet children, a grant from attorney Richard Barr, and UCL’s patent application related to Wakefield’s research.”
DEER: Lewis merely rehashes aspects of Wakefield’s claims, which were considered by the GMC panel during its 217 days of evidence, submissions and deliberations. Much of the material was trivially false, and I don’t believe Lewis has any special status to expect medical journals to publish his opinions.
LEWIS: “In its place, she offered to publish a Rapid Response to Deer’s article titled “Wakefield’s ‘autistic enterocolitis’ under a microscope,” and attach a revised commentary, photomicrographs of the missing slides, and the pathologists’ grading sheets.”
DEER: What is described appears to be routine editorial discussion.
LEWIS: “After obtaining my documents, BMJ‘s editors had them externally peer reviewed, and provided copies to Brian Deer.”
DEER: Although Lewis claims at his website that his letter was “peer reviewed”, the reviewers rejected Lewis’s assertions as absurd. One reviewer asked if Lewis was “mad”. I was delighted to receive copies of what were described by Wakefield and Lewis as Dr Dhillon’s sheets, although some turned out not to be signed by Dhillon.
LEWIS: “Based on the peer-reviews, which BMJ‘s editors would not provide to me, they rewrote my Rapid Response and dropped my attachments.”
DEER: As I understand it, amendments to contributions are commonplace, and they were agreed by Lewis.
LEWIS: “In our original agreement, Godlee agreed to publish my peer-reviewed letter as a Rapid Response to Deer’s article titled “Wakefield’s ‘autistic enterocolitis’ under a microscope.” But, after removing my comments concerning this article, she published my letter as a Rapid Response to a different article Deer wrote a year later entitled “How the case against the MMR vaccine was fixed.”
DEER: This appears to be conventional editorial processing. I get the impression that Lewis imagines he has some special right not only to access the BMJ’s editorial pages, but also to determine which pages.
LEWIS: “This change, which I never approved or was even informed about, completely diverted readers away from Deer’s 2010 article where he alleged that Wakefield made up the diagnosis of colitis in most of the Lancet children by misinterpreting the pathologists’ grading sheets. Addressing Deer’s error in this article was the crux of what my Rapid Response was all about.”
DEER: I can only comment that, in this case, perhaps Lewis might have been more diligent in reading the feature he purported to critique.
LEWIS: “In short, the BMJ removed any evidence I supplied that could undermine the reiteration of their previous allegations of research fraud against Dr. Wakefield, or the presentation of their new fraud theory of institutional research misconduct. In the end, my Rapid Response was so devoid of substance that the BMJ did not even link to it as related content in its editorial, feature article and commentaries published to address it.”
DEER: I understand it to be a matter of law that libellous allegations may not be published in the UK with impunity. Lewis’s allegation – that my 2010 feature falsely accused Wakefield of fraud over histopathology – is untrue and defamatory. Lewis agreed the text of his rapid response as published. If it was “devoid of substance”, the reason is that his allegations had no basis in fact.
LEWIS: “One of the documents I found in Dr. Wakefield’s files…”
DEER: Given the scale of the Wakefield affair, and the tens of thousands of pages of documentation involved, it’s unlikely that Lewis merely “found” this document, unless he took up residence at Wakefield’s home (which, I suppose, is possible).
LEWIS: “…was a 2006 report by the GMC’s expert pediatric gastroenterologist, Prof. Ian Booth. Booth compared routine pathology reports from the Royal Free Hospital with Table 1 of the Lancet article, which summarized Prof. Dhillon’s and Dr. Anthony’s blinded independent analysis of the children’s colonic biopsy slides. Based on mismatches between the two sets of records, Booth concluded that research fraud could not be ruled out.”
DEER: I’ve only seen an extract provided by Lewis from what I believe was one of several statements prepared by Booth for the GMC. This was posted by Lewis on his website page, last May or before, as purported evidence for an abusive attack on me. After the apparent intervention of Mr Kohn, it has been taken down.
LEWIS: “Booth did conclude that research fraud could not be ruled out.”
DEER: Correct.
LEWIS: “Booth offered no explanation in his report as to why he used routine pathology reports, rather than Prof. Dhillon’s and Dr. Anthony’s grading sheets, to check the accuracy of Table 1.”
DEER: I can’t speak for Booth, with whom I’ve never had contact. However, I’d surmise that Booth’s use of the hospital’s pathology service reports wasn’t for the purpose assumed by Lewis. It appears that Lewis, notwithstanding his collaboration with Wakefield, has a poor grasp of the GMC case.
Booth’s central task for the GMC was to give expert opinion on the justification for ileocolonoscopies which Wakefield and the then-professor of paediatric gastroenterology, John Walker-Smith, caused autistic children to undergo. Therefore, he looked at the children’s records, which included the reports of the hospital pathology service. Such reports are of exceptional clinical and legal status. They are printed, signed by two pathologists, and reviewed at weekly clinicopathological meetings. They aren’t like the tatty, sometimes unsigned and undated, scribbled sheets of Dr Dhillon and the trainee. It appears that Lewis may not be conversant with procedures for the reporting of histopathology in hospital settings.
Get Deer’s book: The Doctor Who Fooled the World
In the course of Booth’s review, he evidently noticed that the histology reported by the hospital’s pathologists was different to what was published in the Lancet – apparently a clinical case series. Indeed, sitting in the GMC hearing where the reports were repeatedly read aloud by counsel, I noticed this myself – and, of course, I’ve no formal training in science or medicine.
LEWIS: “But, in an email to me…”
DEER: Indicative of Lewis’s character and reminiscent of controversy at the EPA, he wrote to Booth in a misleading manner. Rather than making clear who he was and the purpose of his approach, Lewis wrote using an email address of the University of Georgia, and merely characterised himself as “Director, Research Misconduct Project”, as if he were an academic at a unit of the university. The text of his email was also deceptive.
LEWIS: “… he explained that the GMC’s solicitors specifically requested that he perform this analysis, and that it was used to prepare the GMC’s case against Wakefield and two of his coauthors. The GMC’s solicitors never introduced Booth’s report into evidence during the GMC’s hearings.”
DEER: Booth’s reports were supplied to all parties in the case, and he was examined and cross-examined on his evidence therein over the course of eight days. Repeat, eight days. I was present throughout.
LEWIS: “Several weeks before the GMC issued its findings, Deer published his article in the BMJ using the same analysis…”
DEER: I didn’t use “the same analysis”. I used material gathered, in a wholly conventional reporting manner, during the GMC proceedings. I would need to have been asleep not to spot that where the Lancet reported “colitis” and claimed a “unique disease process”, the hospital’s pathologists had reported healthy biopsies. However, I understand from Lewis’s website tirades against me, and from comments passed to me by a Nature reporter, that he fantasises that I was working in cahoots with Booth, or that both of us were being controlled by some undisclosed third party.
LEWIS: “… to accuse Dr. Wakefield of faking most of the Lancet children’s diagnoses.”
DEER: This would, again, be a reference to my 2010 feature, where no such accusation was made.
LEWIS: “In an editorial accompanying one of Deer’s multiple articles on the subject, Dr. Godlee and two other editors declared Dr. Wakefield’s research to be fraudulent.”
DEER: This would be some nine months later. The article upon which Dr Godlee comments was my long feature “How the case against the MMR vaccine was fixed”, published when Lewis was in Montego Bay. This article includes scant mention of histopathology, makes no suggestion of fraud with regard to histopathology, and includes no suggestion that Wakefield was responsible for the sole change in GI diagnosis which I report (and attribute to Walker-Smith).
LEWIS: “In these writings, BMJ‘s editors and Deer use the GMC hearings as a backdrop for their allegations of research fraud.”
DEER: The GMC case was not a “backdrop”. For a journalist, it was an extraordinary investigative tool, with the GMC empowered to seize and lay out in public medical records and other material (for example the hospital pathology reports), which would otherwise never have seen the light of day. It was also a statutory tribunal empowered by parliament and the courts to rule on allegations of serious professional misconduct by medical practitioners.
LEWIS: “Booth’s expert report and his email to me, however, show that the GMC’s solicitors carefully considered Booth’s analysis, which was later used by Deer.”
DEER: Booth’s analysis wasn’t “later used by Deer”.
LEWIS: “They stopped short of introducing it as evidence, or charging Wakefield and his coauthors with faking the diagnosis of colitis.”
DEER: I believe that the charges in the GMC case were finalised and served prior to Booth’s supplementary report. Booth’s supplementary was dated 8 November 2006. The GMC public inquiry began on 16 July 2007, with an indictment running to something like 80 pages. Had more charges been added, the case might have run for many more months, at greater cost, or failed entirely under the weight of the indictment. As it was, research dishonesty was proven, and it seems unlikely that any public purpose would have been served by proving it again. Wakefield could only be erased once, and he was.
LEWIS: “When Deer discovered Booth’s document posted on my NWC website in the Spring of 2011, he demanded that NWC director Stephen Kohn remove my documents.”
DEER: I wrote to Kohn regarding the gross abuse and libels posted by Lewis. I gratefully downloaded the extract from Booth’s report, which I’d never seen before. Evidently, a professor of paediatric gastroenterology had noticed the same anomalies as I’d spotted.
LEWIS: “Deer claimed he never communicated with Booth, and was unaware of Booth’s GMC report prior to seeing portions of it on my website.”
DEER: Correct.
LEWIS: “Deer’s claim of ignorance, however, has no bearing on whether the GMC’s solicitors were instrumental in getting Deer and the BMJ to use the same analysis they crafted for Booth.”
DEER: It would have been Booth who “crafted” his analysis for the solicitors, not, as Lewis states in his complaint, the other way round. This would be because Booth is a paediatric gastroenterologist and the solicitors are, well, solicitors. The GMC’s lawyers, or indeed anyone connected with the GMC, had no involvement in preparing, or prior knowledge of, any of my reports.
LEWIS: “Deer refused to explain to the NWC how he came up with the idea of investigating mismatches between the Royal Free Hospital’s routine pathology reports and the Lancet article.”
DEER: I’ve never refused to explain this. I received a creepy, anonymous email from his “NWC”, asked the sender to identify themselves and offered to phone them. They didn’t reply.
I “came up with the idea” because I was sitting in the GMC hearing room for many months. Leading counsel for all four of the parties read the pathology service reports aloud, perhaps four or five times for each of the patients’ cases considered. If Lewis had read the transcript, he’d know this. I’d also, of course, read the Lancet paper.
LEWIS: “Deer’s use of Booth’s analysis, whether knowingly or unknowingly, and the manner in which BMJ‘s editors rewrote my Rapid Response, raise questions as to who may have actually written Brian Deer’s articles published in the BMJ.”
DEER: This should be handwritten in green ink and cc’d not merely to UCL, UKRIO and HEFCE, but also to David Cameron and the Archbishop of Canterbury.
LEWIS: “The scientific and medical content of his articles are well beyond what any individual with no formal training in science or medicine would normally be able to write.”
DEER: I’m deeply indebted to David Lewis for his kind words regarding the quality of my journalism. It reassures me that perhaps, among all the tribulations of the last eight years, my labours in the public interest have not entirely been in vain.
LEWIS: “To prevent me from uploading my evidence on my NWC website, Deer sent misinformation concerning my professional credentials and association with Andrew Wakefield to the NWC, and included false allegations of ethical misconduct against me.”
DEER: As indicated, I made a complaint following my discovery last June of Lewis’s tirades against me – essentially accusing me of being part of a conspiracy to persecute Wakefield on behalf of the drug industry, government agencies and perhaps other shadowy powers. I did nothing to “prevent” him from doing anything. If Stephen Kohn wishes to publish grievous libels on his website, I can advise and act, but I can’t prevent. My guess is that Mr Kohn wants to act properly and to protect the reputation of his firm and ancillary entity. It seems that may even want to be fair.
LEWIS: “Dr. Godlee allowed this behavior to go unchecked even after learning that Deer’s allegations were apparently completely false.”
DEER: How I choose to defend my reputation and integrity isn’t subject to Dr Godlee’s approval, and anybody with common sense would know that. My allegations weren’t “completely false”.
LEWIS: “She even participated in Deer’s deceptions regarding my relevant professional credentials.”
DEER: This is uncertain as to its meaning.
LEWIS: “Without even asking me for a copy of my curriculum vitae, Deer suggested to the NWC that I have no relevant credentials with respect to the Lancet article in question.”
DEER: Lewis isn’t a gastroenterologist, nor a GI pathologist, which would be the only credentials relevant to the expert assessment of gut histopathology. Nor is he a medical doctor, nor even a clinical microbiologist. I find it hard to believe that any court would, in full knowledge, accept him as an expert in this highly specialist field. If he has been receiving payments to opine on human gut histopathology, I think he should give the money back.
Both Lewis’s failure to realise that Dr Dhillon’s grading sheets noted largely normal findings, and his inept claim that Dr Dhillon reported non-specific colitis, evidence Lewis’s lack of expertise in GI histopathology. These errors were at the heart of the complaints he demanded be published in the BMJ, but he has since dropped these embarrassments altogether.
LEWIS: “Then, when rewriting my Rapid Response, BMJ‘s editors inserted the following statement: “I am not qualified in medicine or histopathology”, which simply highlighted and amplified Deer’s misrepresentations of my professional credentials.”
DEER: That suggested statement, although accurate, wasn’t published.
LEWIS: “When I referred Dr. Godlee to my extensive credentials listed in my revised commentary she replaced the false statement…”
DEER: To say that Lewis isn’t qualified in medicine or histopathology isn’t a false statement.
LEWIS: “… and identified me as “an expert in clinical studies involving the collection and examination of colonic biopsy samples.”
DEER: This would be a misleading characterisation of Lewis’s credentials. He’s a retired environmental microbiologist, who previously specialised in sewage sludge contamination for the Environmental Protection Agency, from which he was involuntarily terminated in 2003.
LEWIS: “But, after deleting this commentary and editing down my Rapid Response, she described me in her editorial as “a self employed environmental microbiologist.” In his feature article, Deer described me as a ‘self employed American environmental microbiologist working with Wakefield.’”
DEER: Correct.
LEWIS: “I have not been employed as an environmental microbiologist, self or otherwise, since leaving the U.S. Environmental Protection Agency (EPA) in 2003. I live almost entirely on my federal retirement pension. For the past couple of decades, I have derived additional income as an expert witness in federal and state court cases involving the collection and examination of colonic biopsy samples. This is an area in which I have extensive professional credentials.”
DEER: I’d be interested to learn of any references to these cases, so as to establish Lewis’s involvement. I suspect that any claim by Lewis of expert status in bowel histopathology may usefully be investigated by counsel for those he gave evidence against, or counsel for any party which has paid him. The “collection” of colonic biopsies is a surgical procedure and their examination is a task for medical doctors with specialist training in histopathology.
Expert witness work is self-employment.
Lewis describes himself in his rapid response and correspondence with the BMJ as “Research microbiologist, National Whistleblowers Center”. He doesn’t describe himself as retired, and, as far as I know, has never represented himself in this manner prior to his present complaint.
LEWIS: “Since January 2011, I have worked full-time investigating Dr. Wakefield’s records on a voluntary basis, with no pay.”
DEER: In other words, Lewis isn’t just working “with” Wakefield, he’s working “for” Wakefield.
LEWIS: “I approached Dr. Wakefield in my capacity as director of the NWC’s research misconduct project to learn more about the BMJ‘s and Brian Deer’s allegations of research fraud.”
DEER: As indicated above, the NWC’s “research misconduct project” is Lewis. He started it in the month before the Montego Bay conference. It only has two cases on its webpages. One is Wakefield. The other is himself.
LEWIS: “He did not solicit my help. I requested copies of his court pleadings and other documents; he did not approach me and offer up any of his documents.”
DEER: Perhaps Lewis needs to consider for what purpose he was flown to Jamaica; why he’s now scheduled as a speaker at an upcoming autism conference operated by anti-vaccine campaigners; and why he put his accusations online with a press release before anybody could evaluate or respond to them.
LEWIS: “The misrepresentations Dr. Godlee and Mr. Deer published regarding my relationship with Dr. Wakefield and my current employment appear to be intentionally dishonest. More specifically, they appear to have intentionally misled the public as to the credibility of my conclusions concerning their allegations of research fraud against Dr. Wakefield.”
DEER: Lewis has no credible status, expertise or findings in these matters. He doesn’t need our help in respect of these deficiencies. He was plainly working with Wakefield, as evidenced by the material published on his webpages last May, and the paper he sought to get published at that time, prepared in collaboration with Wakefield, and published online with a press release. Lewis made not the slightest effort to raise the matters with me, but had already made up his mind.
LEWIS: “Finally, Dr. Godlee and the BMJ‘s lawyers appear to have attempted to get the NWC to intentionally violate UCL’s copyrights on the grading sheets after UCL would not give them permission to publish them. Godlee wrote: The advice from our lawyers is that the risk of any challenge from UCL in relation to publication of the grading sheets is infinitessimally small … and [UCL] would not, in my view, seek the adverse publicity that would follow if they were to take legal action.”
DEER: Dr Godlee appears to have responsibly sought to keep Lewis informed of the advice she’d received. I’d also comment, as a journalist, that the laws of copyright and confidence are subject to public interest tests. In the public interest, a publisher may breach both copyright and confidence without realistic expectation of sanction. The safety or otherwise of children by means of vaccination is a pre-eminent issue of public concern. UCL has raised no complaint.
LEWIS: “Dr. Godlee’s excuse for not obtaining informed consent before publishing the children’s medical records is even more disturbing. Admitting that the parents are more inclined to cooperate with Dr. Wakefield on such matters, Godlee wrote: “given (a) the fact that most of the families of the patients in question are known to be dedicated supporters of Andrew Wakefield and opponents of Brian Deer and his work and (b) the tenor of the articles that we were proposing to publish alongside David Lewis’s letter, we reasonably believed that even if we could establish contact with the patients or their families, we would not obtain consent.”
DEER: Similar public interest overrides apply. Moreover, the data was anonymised (and was derived from medical school research, not health care records). Guidance exists and was observed.
“Conclusions”
LEWIS: “Dr. Godlee’s apparent complicity with regard to Deer’s use of false allegations to prevent the NWC from publishing incriminating evidence of their wrongdoing, and her apparent unethical behavior regarding the matter of UCL’s copyrights and the publication of the children’s medical records, are particularly reprehensible. Moreover, the range and scale of misbehavior that I witnessed in the manner in which BMJ‘s editors and Brian Deer interacted with me and the NWC, respectively, are extraordinary.”
DEER: Lewis has substantiated nothing in this paragraph.
LEWIS: “I welcome UCL’s forthcoming investigation of the issues raised by the BMJ ‘s and Brian Deer’s many allegations, including their latest ones based on the documents I submitted.”
DEER: Me too.
LEWIS: “Hopefully, UCL and others will begin to view the BMJ‘s all-out assault on the embattled Lancet study for what it is. It is a vicious and malicious campaign aimed at punishing Dr.Wakefield, his coauthors, and their institutions for reporting the simple truth that some parents and physicians associate autism with the MMR vaccine.”
DEER: Although “vicious and malicious” has elegant assonance, Lewis ends his complaint much as he begins it: with no real understanding of the concept of “intent”.
There’s no “campaign”. My lengthy involvement has significantly been driven by Wakefield’s conduct (for example in causing me to be involved in two years of baseless litigation, and requiring me to write innumerable documents such as this one).
No criticism has been levelled by me, or by any person I know of, concerning anyone “reporting the simple truth”.
The GMC panel’s many findings of serious professional misconduct, including dishonesty, against Wakefield. These, and the important issues for public health, more than validate my investigation. That investigation, moreover, has been recognised by my peers in the form of a British Press Award. The judges, for the Society of Editors, described it as “a tremendous righting of a wrong”.
LEWIS: “This assault is being waged by a journal funded by the two leading manufacturers of the MMR vaccine…”
DEER: No assault has been waged, much less as evidenced in anything from Lewis. I believe the BMJ has a wide base of funding and a reputation for journalism critical of the pharmaceutical industry.
LEWIS: “… and a reporter who employs the despicable tactics of which he falsely accuses Dr. Wakefield.”
DEER: No “despicable tactics” have been identified anywhere in Lewis’s complaint.
The GMC panel’s 217-day hearing upheld all of the substantive issues raised in my journalism, as of the date the charges were laid. My work has been scrutinised by the editorial staff and legal advisers of three media groups: Times Newspapers, Channel 4 Television and the BMJ.
LEWIS: “Ostensibly, the BMJ‘s defamatory campaign against Dr. Wakefield and his coauthors serves to protect children around the world from money-grubbing scientists who, according to Godlee’s editorial, are causing great harm to public health. In reality, the ongoing attacks on Wakefield, his coauthors, and their institutions are a major contributing factor to growing numbers of parents and physicians resorting to alternative vaccine schedules. They feel that they cannot trust government agencies and scientific journals to tell the truth when it comes to vaccine safety.”
DEER: I see.
SECTION HEADED “ADDITIONAL DETAILS”
“Government connections”
DEER: No government connections are evidenced.
“From the beginning, attacks on Dr. Wakefield were a means to protect Government officials in the UK from being held accountable for their lack of proper oversight. In 1988, they approved an MMR vaccine containing live Urabe AM-9 mumps virus (Pluserix), which was withdrawn in 1992 after causing outbreaks of meningitis.”
DEER: Two brands, Pluserix and Immravax, were withdrawn in 1992. My first report was in 2004. I’m not really aware of any significant media coverage critical of Wakefield before that. The withdrawals had nothing to do with Wakefield, and there is presently contemplated litigation in the UK to the effect that his activities and causation theories denied alleged victims of Pluserix and Immravax side effects their chance of justice. I’m aware, however, that Lewis is rehashing a Wakefield script here which he evidently hasn’t checked.
“Dr. Wakefield’s dean, Prof. Arie Zuckerman, was the first to use ethics rules as a means to prevent Wakefield’s research from uncovering more problems with MMR vaccines. Zuckerman wrote to the British Medical Association’s Ethics Committee: “Clearly, [Dr. Wakefield’s research] could lead to a case against the Government.” Committee Chair Dr. E. M. Armstrong replied that delaying or declining to conduct research in the public interest on such grounds ‘does not appear to be a sound moral argument.’”
DEER: Now I’m confused. The BMA, the good guys here, publishes the BMJ, allegedly the bad guys. The rest is familiar material distributed by Wakefield. How it helps anyone, I’ve no idea.
LEWIS: “To bring down Dr. Wakefield and his coauthors, Brian Deer and Parliament Member Evan Harris met with Lancet‘s editors in February of 2004. Harris later cosponsored a Motion in Parliament blaming Dr. Wakefield for illnesses and deaths associated with preventable outbreaks of measles.”
DEER: I met with the Lancet’s editors, at their request, to put to them the findings of the first four months of my inquiries, which concerned the journal. This was my professional duty, and I was directed by my editors.
Dr Harris turned up under his own steam, which he does a lot in matters of public controversy. But I’m not sure what Dr Harris has to do with this complaint, other than that Wakefield’s supporters hate and routinely abuse him.
LEWIS: “Lancet‘s chief editor, Richard Horton, helped the UK’s General Medical Council (GMC)develop a strategy for prosecuting Dr. Wakefield and two of his coauthors. At a meeting with Horton, one of the Council’s regulators jotted down some possible lines of investigation and suggested Horton contact him directly. ‘He seemed keen to pursue Dr. Wakefield,’ Horton later remarked, ‘especially given ministerial interest.’”
DEER: Dr Horton did nothing to help the GMC develop any “strategy for prosecuting Dr Wakefield”. Horton was opposed to the prosecution, as I report in my third BMJ feature of January 2011, “The Lancet’s two days to bury bad news”.
Lewis selectively quotes from a book by Horton. The missing element of the passage is Horton pouring scorn on the GMC’s interest. I suspect that Lewis was given this wrong information by Wakefield as general filler material.
LEWIS: “The GMC issued its findings in 2010 and Deer summarized his accomplishments: ‘My investigation of the MMR issue exposed the frauds behind Wakefield’s research. Triggering the longest ever UK General Medical Council fitness to practise hearing and forcing the Lancet to retract the paper … it led to Dr. Wakefield and Walker-Smith being struck off the medical register.’”
DEER: Correct.
“The editing process”
LEWIS: “In the 72 emails exchanged between me and the BMJ ‘s editors, it became increasingly apparent that the BMJ had no intention of publishing the photomicrographs of the missing biopsy slides or any of the information in my commentary. At first, I thought that they just had very limited space available for addressing the issue. But, as the editing process drew to a close, that assumption proved wrong.”
DEER: Repetition.
LEWIS: “Dr. Godlee informed me that she was preparing two commentaries from outside experts, a feature article, and an editorial to give their side of the story. She never disclosed the fact that Deer was writing the feature article.”
DEER: Noted. I’ve not always been told about material for publication related to my contributions, and wouldn’t particularly expect it. This is unexceptional publishing behaviour.
LEWIS: “The strategy of BMJ‘s editors and lawyers seems clear. They strictly limited my presentation of any evidence that could undermine their allegations of research fraud against Dr. Wakefield.”
DEER: Repetition.
LEWIS: “To this end, Dr. Godlee had my Rapid Response, including the attachments, peer-reviewed by two outside experts. Then, following the peer-reviewers’ guidance, BMJ‘s editors reduced my Rapid Response from 5,000 to approximately 500 words containing mostly background information. I was allowed only four sentences at the end to state my views, which Dr. Godlee restricted to a single issue – histopathology. The insertion of Deer’s false claims regarding my professional credentials suggests that he was also involved, directly or indirectly, in editing my Rapid Response.”
DEER: Substantially repetition.
LEWIS: “Any effort on my part to include even a morsel of what was lost when my commentary was deleted met with resistance. For example, I tried to add just a few words referring to my view of the Lancet article as a whole.”
DEER: Possibly, Dr Godlee didn’t think her readers would care about Lewis’s views of “the Lancet article as a whole”. The paper was substantially repudiated by its authors in 2004, and fully retracted by the journal in February 2010. Lewis was saying nothing new and isn’t an authority on any relevant matter. Such is the prerogative of editors.
LEWIS: “Godlee responded: ‘We are able to go with your revision except for the phrase ‘or that the paper as a whole is deceptive’ since the grading sheets relate only to the histopathology and not to the Lancet paper as a whole.’”
DEER: That seems wise.
LEWIS: “At the last minute, the BMJ‘s lawyers removed the main content of the four sentences at the end of my letter in which I had been permitted to state my views. Dr. Godlee wrote:
“On closer reading of your letter we find that there are a few sentences that we cannot publish on legal advice. These are the sections that suggest that the BMJ’s claim that Andrew Wakefield committed fraud was based on the histopathology. This is not true. I have therefore had to edit the letter further, as you will see in the attached version, again with and without track changes. As well as deleting the necessary sections, I have tried to strengthen the letter in other small ways, by reinstating your “could” and by strengthening the final mention of Dr. Anthony’s grading sheets. I’m sorry to have to make these changes but this is the only basis on which I can offer publication of your letter in the BMJ. Please let me know if you are still happy to proceed. Best wishes, Fiona Godlee.”
DEER: As previously indicated, it’s unlawful to knowingly publish libellous material.
LEWIS: “I refused to do anything other than change a couple of words, and Dr. Godlee let it pass.”
DEER: In my experience, Dr Godlee is always reasonable.
LEWIS: “It appeared that the BMJ‘s intention all along was to discourage me to the point that I would eventually withdraw “my” Rapid Response (letter). I use quotation marks because the BMJ‘s editors reversed the roles editors normally have. In my case, they considered it their role to write my letter, and my role to suggest changes.”
DEER: Noted.
LEWIS: “The most unexpected surprise came when Dr. Godlee informed me that UCL holds copyrights on Prof. Dhillon’s and Dr. Anthony’s grading sheets, and would not grant permission for the BMJ to publish them. Dr. Godlee wanted me to post them on the NWC website; but I informed her that the NWC would not violate the copyright. Dr. Godlee forwarded my response to the BMJ‘s lawyers, who tried to convince the NWC that there was little risk of getting caught.”
DEER: Largely repetition, except that the BMJ’s lawyers wouldn’t, and didn’t, try to “convince” anyone about the “risk of getting caught”.
LEWIS: “Dr. Godlee explained [18]:
“The advice from our lawyers is that the risk of any challenge from UCL in relation to publication of the grading sheets is infinitessimally small and that if there was such a challenge, one could simply take the sheets down from the website. There is no suggestion of commercial exploitation of the forms in publishing them, or of commercial loss to UCL, and a strong claim to be publishing in the public interest, which further reduces the risks, as does the fact that UCL wants nothing to do with this and would not, in my view, seek the adverse publicity that would follow if they were to take legal action. If you decide not publish them, I will look again at whether we should do so, although we are launching our new website on the day of publication and I have promised the web team not to do anything complicated on that day.”
“For Dr. Godlee and the BMJ‘s lawyers to entice the NWC to intentionally violate UCL’s copyright suggests that the journal’s leadership apparently has lost its moral compass.”
DEER: This is a preposterous inference to draw from Dr Godlee’s helpful communication.
“Discussion”
LEWIS: “Faced with evidence that their allegations of research fraud against Dr. Wakefield are untrue…”
DEER: I’m unaware of such evidence.
LEWIS: “… Dr. Godlee and Brian Deer are now denying that they ever made such allegations in the first place.”
DEER: We’ve made no such denial. We denied that we alleged the histopathology results were fraudulent. We couldn’t at the time determine the intent behind the mismatches.
LEWIS: “Nature quotes Deer…”
DEER: Nature has never quoted me. However, I do have a letter in the 12 January 2012 issue, pointing out what dopes they were to get entangled with Lewis.
LEWIS: “… as claiming he ‘never accused Dr. Wakefield of fraud over his interpretation of pathology records.’”
DEER: Nature’s reporter said I said this.
LEWIS: “It is virtually inconceivable for Deer to take such a position after writing in the BMJ that Dr. Wakefield misinterpreted the pathologists’ grading sheets in order to fake the diagnosis of colitis…”
DEER: It may be “virtually inconceivable” to Lewis, but this is, indeed, my position. His relentless repetitions don’t make what he says true. No judgment was formed on Wakefield’s intent with regard to histopathology reporting at that time. That judgment has recently shifted somewhat, since Wakefield has heard Dhillon’s position, along with proper professional guidance published in the BMJ. He now knows his reporting of “histological findings” in the Lancet was wrong and yet he continues to assert them.
LEWIS: “and then boasting that he ‘exposed the frauds behind Wakefield’s research.’”
DEER: My statement was correct, and wasn’t boastful.
LEWIS: “Dr. Godlee was also quoted in Nature, saying: “the journal’s conclusion of fraud was not based on the pathology but on a number of discrepancies between the children’s records and the claims in the Lancet paper.”
DEER: Dr Godlee wasn’t quoted in Nature. The words are the reporter’s.
LEWIS: “The alleged research frauds put forth by Brian Deer, however, are largely based on interpretations of routine pathology reports by his unnamed experts, and Dr. Wakefield’s alleged misrepresentations of histopathology data in Table 1 of the Lancet article.”
DEER: No they aren’t.
LEWIS: “Dr. Godlee’s claim that the BMJ never accused Dr. Wakefield of fraud regarding pathology data is nonsense.”
DEER: We’re now almost at the end of Lewis’s allegations, which apparently have taken him nearly a year to assemble – working full time, he says – and nowhere has he identified the words complained of.
LEWIS: “BMJ‘s instructions to authors permit attachments to be included with a Rapid Response. And, in an email dated October 14, Dr. Godlee assured me that the BMJ would publish my “letter and other commentary on bmj.com” (Emphasis added). Editors incorporated numerous revisions in my commentary until Deputy Editor Tony Delamothe informed me on October 27 that it would not be included.”
DEER: This appears to be conventional editorial processing.
LEWIS: “The section of my commentary titled “Brian Deer’s other arguments” specifically dealt with Dr. Godlee’s specious defense. In it, I addressed a range of points upon which Brian Deer and the BMJ based their allegations of research fraud. BMJ‘s editors and lawyers eliminated approximately 90% of the text in the body of the Rapid Response I originally submitted to the BMJ. Then they deleted my attached commentary. BMJ‘s editors and lawyers, therefore, forced my Rapid Response to accommodate Dr. Godlee’s defense by making it appear that my only argument was over the grading sheets. To say the least, it was disingenuous for Dr. Godlee to only allow me to comment on the histopathologies described in the grading sheets, and then argue publicly that her fraud allegations are based on something else.”
DEER: I don’t really understand much of that.
LEWIS: “When Dr. Godlee called for a Parliamentary inquiry, she titled her editorial ‘Institutional Research Misconduct,’ a term she borrowed from the NWC website.”
DEER: As indicated, Dr Godlee wrote an item headlined “Institutional and editorial misconduct” about a year ago. But if Lewis feels that Dr Godlee ate his apple, then he might try to get over it.
LEWIS: “I coined the term to describe the type of research misconduct that occurs ‘when institutions, including federal agencies, corporations or academic institutions commit or support acts of research misconduct to protect their interests.’”
DEER: Lewis has so far failed to demonstrate any example.
LEWIS: “False allegations of research misconduct have become a weapon of choice when institutions suppress research that threatens their vested interests.”
DEER: If they are a “weapon of choice”, Lewis must surely have many examples. If he tells me what they are, I might investigate them.
LEWIS: “The BMJ‘s handling of Dr. Wakefield’s research and my efforts to correct the record may represent the first time that a prestigious scientific journal has ever taken the lead in an effort involving this form of research misconduct.”
DEER: Lewis asserts misconduct, but demonstrates none.
LEWIS: “Dr. Wakefield and his coauthors immediately came under attack for simply reporting that some of the children’s parents and physicians observed a temporal association between MMR vaccination and autism.”
DEER: No they didn’t. Taken at face value, the 1998 Lancet paper offered a potentially important observation, and it was treated as such at the time. However, it turned out that the project was dishonest, and the reported “temporal link” rigged. The authors themselves retracted their claim of this possible link in March 2004, and the paper was fully retracted by the journal in February 2010.
LEWIS: “The ongoing campaign by the BMJ and Brian Deer to completely destroy Dr. Wakefield’s career and reputation is contributing to a backlash among an increasing number of parents who witness their children developing severe illnesses concurrent with vaccinations. These reactions often increase in severity with subsequent vaccinations, and sometimes result in death. Parents and their sick children are being abandoned by the government agencies and the medical community. They are left to face a government-supported vaccine industry that does little to even monitor children who experience adverse reactions.”
DEER: I see.
LEWIS: “The ongoing campaign by Brian Deer and the BMJ to destroy Dr. Wakefield has undermined public confidence in the ability of the scientific community to resolve issues involving vaccine safety. This loss of confidence directly contributes to the current trend toward alternative vaccine schedules, which a growing number of parents and physicians see as their only hope. My experience with Deer and the BMJ only confirms what the public has always suspected. The BMJ‘s attacks on Dr. Wakefield have nothing to do with protecting science.”
DEER: I see.
LEWIS: “Dr. Godlee recently testified to Parliament: “Even on the peer-reviewed side of things, it has been said that the journals are the marketing arm of the pharmaceutical industry. That is not untrue.”
DEER: Repetition. Not exactly the words of a “pharma shill”, I’d suggest. Were Dr Godlee in cahoots with industry, I wouldn’t expect her to blow their cover in this way. But perhaps Lewis feels there’s some kind of double-agent thing going on here.
LEWIS: “Dr. Godlee’s complicity when Deer used false allegations to quash evidence is very revealing, especially given the involvement of other editors and the BMJ ‘s lawyers.
DEER: I don’t really understand that sentence.
LEWIS: “It appears that the BMJ as an institution is deep into the business of using false allegations of research misconduct to protect the funding it receives from Merck and GSK.”
DEER: It might appear that way to Lewis, but he produces no evidence for this offensive smear.
LEWIS: “If true, then the BMJ is, by my definition, has committed institutional research misconduct.”
DEER: The heart of Lewis’s indignant complaint appears to be that the BMJ didn’t publish allegations from him, notwithstanding that its editor knew his allegations to be false. These allegations have subsequently been proven to be false.
Even Lewis, in his 167-page complaint, makes no attempt to resurrect his central claim about Dr Dhillon’s alleged findings of non-specific colitis. Yet this is what Lewis brought to Dr Godlee in the first place as purported proof of Wakefield’s innocence.
I’m left struggling to summon a sense of compassion for Lewis. But he has taken up a great deal of my time, and also that of anybody who has felt obliged to digest this nonsense.
Brian Deer
10 January 2012
Postscript 2022: A decade later, Lewis’s purported entity, “The Research Misconduct Project,” had examined no cases of research misconduct beyond bleating denials on his own and Wakefield’s behalf, and otherwise apparently doing nothing at all. I deduce that Lewis is a charlatan and his “project” was a sham from the start.
If you’ve read this far, why not finish with a video, Wakefield threatens a whistleblower. Or read Brian Deer’s letter to Nature.
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