Mickey Nardo: Tangled up in Life
Mickey Nardo died yesterday.
I got to visit with him and his wife Sharon on the phone a short while before he got involved with Jo Le Noury, Jon Jureidini, Melissa Raven, Catalin Tufanaru, Elia Abi-Jaoude and me Restoring Study 329 in 2013. It was one of those moments – I can still remember exactly where I was sitting when I made the phone-call. Sharon had just come back from Cuba. He and she felt like intensely private people. Until very recently, very few people knew who 1boringoldman was – not even Ben Carey of the New York Times. It was difficult getting a photograph of Mickey for the Restoring Study 329 website.
Its surprising the moment stands out so clearly, given several phone calls since – some of them fraught, and nearly 1500 emails between July 2013 and December 2016.
I was watching a program on Tom Waits last night and some combination of the gravelly voice of Tom Waits and my impression of what Philip Marlowe might have been like hints at what it was like talking to Mickey. The blogs certainly sang with a lyricism Tom Waits would have enjoyed and tracking things to their source felt like a metier designed by someone for Mickey.
Here is a brief account of his career chiseled out of him for the Restoring Study 329 site. What strikes me most is his interest in the tangles people end up in. This certainly is a theme that ran through his blog.
I can add one little bit of detail. He mentions being in the Air Force. He and Sharon were based in Britain for at least part of this. At one point when the RIAT struggle with BMJ over publication got very intense he was willing to come over to meet Fiona Godlee – in part because it would have given himself and Sharon a chance to revisit old memories.
First career
I went to medical school as a mathematician planning a research career. I did an Internal Medicine Residency and a NIH Immunologu Fellowship. My planned post-doc was interrupted by a three year required stint in the Air Force. To my great surprise, I loved being a practicing doctor. It wasn’t the diseases. It was the tangles that the patients struggled with that I found so compelling.
Second career
I changed gears and returned to a psychiatry residency at Emory University, and started psychoanalytic training. After training, I became the Residency Training Director. In the mid-1980s, a new chairman arrived and there was a major changeover to a biomedical department.
This time, I didn’t change gears, but psychiatry did. I resigned my tenured position and went into practice as a psychodynamic psychotherapist. I continued to teach in the psychoanalytic program and the college, but had little connection with the psychiatry department. In 2003, I retired, leaving Atlanta for the Georgia mountains, the end of a rewarding career.
Third career
After 5 years, I began to work some as a volunteer in a local charity clinic, and was absolutely horrified at the peculiar polypharmacy the patients were being given. About that time, Senator Grassley began to investigate a number of prominent psychiatrists for unreported industry income and other conflicts of interest – one being the chairman of the department I was affiliated with, Dr. Charles Nemeroff.
I began to read up on the psychopharmacology literature and couldn’t believe what I found. I had been oblivious to the gross invasion of academic psychiatry by the pharmaceutical industry, cloistered in my psychotherapy practice. I had already been a blogger, but the more I learned, the more the blog [1boringoldman.com] turned towards the dreadful state of affairs in psychiatry.
I started meeting others who were as alarmed as I was becoming. I polished up my old statistical skills from years before and I began to vet clinical trials and to read and write about all of the deceitful science. Along the way, I began to correspond with Allen Jones, the TMAP whistle-blower [Texas Medical Algorithm Program], and ultimately my wife and I spent a week in Austin Texas attending that trial. Sitting in the courtroom listening to the testimony, I realized how incredibly corrupt the whole scene had become. It made it all very real for me and I haven’t looked back since.
Along the way, I had looked into Paxil Study 329, but in August 2012, I happened onto the raw data that had finally been posted on the Internet, and I took a stab at analyzing it on the blog. I submitted my findings to the JAACAP [Journal of the American Academy of Child and Adolescent Psychiatry, publisher of the study] requesting a retraction [to no avail].
When a RIAT team [Restoring Abandoned and Invisible Trials] was being formed to reanalyze and republish that study, I jumped at the chance to be on the team.
Share this:
Very, very few people have touched me like Mickey Nardo.
Following his humour, insight, determination to seek out what he could, where he could.
He was such a nice man.
When Abby first put up the post about Mickey being in hospital, I thought I wouldn’t intrude on the families private affairs. I read all 93 posts from all his admirers and thought, Mickey won’t go, he just won’t – too many just love him.
I also thought this almost sounds like an obituary, but, Mickey is still here.
I hope Sharon and Abby realise what a sad loss it is for us, too and send prayers to them both for Mickey.
Thank you, David, for this very nice remembrance of Mickey.
I am sorry you have lost a dear colleague and friend who was always there for you.
Shedding a tear, now, for the delightful Mickey.
Without 1BOM life won’t quite be the same again
A really good and honest man, so much fun, every day, no one will take his place..
All love to Sharon and Abby and familyxxx
Thanks for the reference to Abby, Annie – I was simply being fed by Twitter about 1BOM blog posts. Going on to the blog, in that way, did not show any problems whatsoever so it came as a total shock to me. Having read your comment, I went and saw Abby’s posts there. Her idea of compiling the blog posts into a book will be such a worthwhile memorial to her father.
I was stunned to read of Mickey Nardo’s death. No more ‘1boringoldman’ blogs to read is a shame – not that I fully understood the detailed aspects of his investigations I must admit! From the parts which I could understand, it was obvious that he was a caring, thoughtful individual – to whom people mattered. A person, it seemed, who could not help but return to his supporting role even in his retirement – a person, I would imagine, who felt he was here for the good of others above his own needs. As I read his blog, I often imagined him sitting in one of the rocking chairs in the photo which headed his blog page, deep in thought about his concern of the day. I feel that he feared that the US’s mental health issues were not going to fare too well under Trump’s presidency but I have no doubt that, had he lived, he would have done his utmost to reveal to his followers as much as he possibly could. Never was the label ‘boring’ as far from the truth as in his case. I’m sure he’ll be sadly missed by very many, worldwide but the greatest gap will, of course, be left in his family. Thank you for sharing the news with us as I’m sure many of us would wonder about the absence of news on his blog as time passes.
OMG! this is so sad, I really loved reading his posts and I even liked trying to work out his graphs. I am so very saddened to hear this. I will always remember him for his blog and work on Study 329.
RIP Dr Nardo you will be greatly missed by many of us online worldwide and thank you for all the hard work you have done for us in bringing out the truth.
My condolences also to his family.
I feel so sad ….. it was through my email contact with Mickey Nardo (at the very beginning of ‘my journey’ about psych drug harms (after a 1BOM blog came up in my google search on Seroquel) that I learnt about the existence of our very own David Healy and these blogs which really were a life saver for me, because otherwise I may well still be following ‘doctors orders’ which were that I would need medication for life and thus would have faced, no doubt, a premature death.
(I was diagnosed with bi-polar 2 when it is so clear to me, knowing what I know now, that I suffered iatrogenic SSRI induced Akathisia which led to being prescribed even nastier antipsychotics)
So I feel I owe Mickey an awful lot and will be eternally grateful to him for signposting me to DH and a whole new world of TRUTH about prescribed meds.
I am now very well, meds free, happy and SO very grateful to Mickey, and of course, David, for letting the truth be known.
God Bless, Mickey and many condolences to his family …..
PS. I can’t wait for the book based on 1boringoldman that Abby, his daughter is promising
Sincere condolences.
Mickey was one of the good ones, a compassionate man who tried to right many wrongs.
His work shall be just part of his legacy.
This is very sad news indeed.
RIP, Sir.
Abby Nardo, Mickey’s daughter, has put up a memorial post on his blog, and good wishes are flowing in. Anyone who wants to add their thoughts can do so here:
http://1boringoldman.com/index.php/2017/02/20/goodnight-mickey/
I can’t imagine what it’s like for her to try and say goodnight to her Boring Old Man. I feel sorry for everyone on the Study 329 team who got the privilege of working so hard with him and striking a blow for truth together. I even feel sorry for myself and all his other fans on the RxISK team. Surely I can’t be the only one who daydreamed of hitchhiking down to Stone Mountain or wherever, one of these days, and meeting Dr. Mickey.
And my heart goes out to all his patients at the free clinic. Some of whom had their lives changed for the better, and all of whom got heard. Wow.
As valuable as Mickey’s analysis was of the fraud running rampant through psychiatry, and his careful statistical lock-picking to let the truth stick its nose out … what I will really miss is his Tales from the Free Clinic. Abby will be endeavoring to pull together the best of Mickey’s blog posts for a book, and I hope she starts there…
Goodnight, Mickey
Help Remember My Old Man
Posted on Wednesday 22 February 2017
You are all invited to share your memories of my father and his work. I have created a site for such purposes.
http://1boringoldman.com/index.php/2017/02/22/help-remember-my-old-man/
Mickey Nardo was anything but a “boring old man.” He did much to battle the forces of sophistry operating comfortably within medicine. I will miss him and his insightful blogs.
Professor Mickey Nardo
‘He smiled’ ….. 🙂
Howard Morland
February 23, 2017 | 9:03 AM
Mickey Nardo’s Academic Promotion
The late Dr. John Michael “Mickey” Nardo (aka 1boringoldman) retired from Emory Medical School several years ago, becoming a Clinical/Adjunct Professor of Psychiatry Emeritus. He had spent more time practicing psychiatry than publishing, so he retired one publication shy of Full Professor.
His retirement hobby of blogging on medical issues led to a re-examination of Study 329, a clinical drug trial famous enough to have its own Wikipedia article. It was a four-year (1994-1998) clinical trial of the anti-depressant drug paroxetine (marketed as Paxil or Seroxat) which has been on the market since 1992, earning many billions of dollars for GlaxoSmithKline.
The purpose of Study 329 was to test it on teenagers. The test has been controversial since the beginning, but it was published in the Journal of the American Academy of Child and Adolescent Psychiatry in a way that suggested it was safe and effective for teenagers. Mickey and his six co-authors took another look at the data collected for Study 329 and concluded it was no more effective than a placebo, plus it increased the risk of suicide. Their critique was published in the British Medical Journal in September 2015: “Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence,” cited as: BMJ 2015;351:h4320.
Followers of this blog will already know these details. I will let his daughter Abby take it from here, via Facebook.
“Dad was a professor at Emory for years. He was called a Clinical Professor, but the title of Full Professor was only awarded to those who had either made a significant contribution to the field or who had published significant works. Last year, Dad was asked to submit to become a full professor because of his publication in the British Journal of Medicine in 2015. He submitted and was expecting a whole lot of bureaucracy on the road to getting this title. On February 9 around 10 pm, my mother received a call from Emory School of Medicine. They had expedited his application after learning of his illness, and they awarded him full professorship! Gail told him about this tonight during “lucid time,” and he smiled. I know his ‘1boringoldman’ gang will be so pleased about that bit of news.”
https://study329.org/rewrite-team/
This was an enormous task and All Credit to Professor Nardo and ‘Gang’
https://en.wikipedia.org/wiki/Study_329
It is profoundly sad to read this wonderful tribute to such an outstanding, ethical, humble and gifted doctor.
We need so many more like him.
We cannot afford to loose people as sincere and courageous as Mickey Nardo.
The wise and gentle face of Professor, Doctor Nardo in the above picture conveys a man of great compassion, intellect and courage.
Many who write here in an attempt to come to terms with their experience of loss, injury, abuse and unrelenting cruelty have seen “the other face” of psychiatrists.
Expressions and features which powerfully convey arrogance, and contempt for patients. Expressions embedded in those faces where abuse of power disguises unforgivable ignorance of pharmacology, pharmacodynamics, pharmacogenetics and toxicology.
Mickey Nardo was a doctor who I understand was also an advocate for his patients and an advocate for all who became vulnerable to psychiatry’s own drug dependence.
A dependence on casually prescribing profoundly dangerous and damaging drugs on a long term basis.
Drugs about which their “knowledge” is limited entirely to that which has been indoctrinated by the absolute command and control of Continuing Medical Education (CME) process by psychotropic drug manufacturers.
Perhaps a key consideration now is how do we who comment here carry forward this man’s vital work and commitment?
Is it time for us to again throw down the gauntlet to each other and consider how we can move onwards from supporting each other to alerting the “yet to be injured”?
If so we must proceed effectively, honestly and in a way which does not allow our knowledge and experience of prescription drug toxicity, its harms and its deaths, to be dismissed as if we are fanatics.
I wish that I knew the best way forward, but I can conceptualise a multi-facetted campaign.
My current preference (as a starting point) would be to identify and publicise every
Royal College CME programme “updating” doctors and prescribers “Mental Health” training as a deceptive and coercive pharma-marketing exercise.
Evidently – CME’s only raison d’être?
If potential recipients of prescriptions for psychoactive drugs were not only aware of the serious ADRs, but also were aware that their doctor had just attended a course sponsored by, for example Lundbeck (a current situation for GPs) – they may view the dangers that face them in sufficient depth to make an informed decision on taking prescribed psychoactive medication.
With reference to the Judas Goat dilemma:
I trained and became accredited as a GP before spending the rest of my professional life as a hospital based specialist physician.
In the former, we were superbly trained to listen to our patients, to respect their thoughts and opinions, and to develop the best communication skills we could muster.
I believe that these abilities still exist in general practice and that this discipline continues to attract trainees who are happy to relate to their patients as “equals-of-different-experience”.
Whilst detrimental and destructive central politics have served to suppress this aspiration, it remains a basic tenet of medicine as practiced by family doctors.
Family doctors have been deceived by psychiatry to an extent from which it may be difficult to retain patient confidence.
Dr Nardo, and his colleagues, began to expose this deception and the corruption which underlies it.
I believe that whilst this process may be slow, it is now unstoppable.
My specialist training was understandably dominated by investigation, diagnosis, management and publication.
I am so pleased that vocational training for general practice taught me to listen first.
Where does this fit into carrying forward Mickey Nardo’s vital work?
I gave my own GP the BMJ Reconstruction of Study 329. Similarly the paediatric Citalopram reconstruction. I have provided publications to increase awareness of akathisia.
I have been listened to and afforded courtesy and consideration.
I believe this approach would be dismissed with contempt were I unwise enough to ask those psychiatrists who so terribly injured our own lost soul, to consider such valuable and informative documents.
So, my tribute to Dr, Nardo and those brave men and women who remain in the RIAT-team is to endeavour to expand awareness within primary care of the fastidiously prepared and meticulously presented 329-research and related, subsequent endeavours.
This must continue until a comprehensive acceptance and awareness of the current tragedy is finally achieved by all of our efforts.
Tim.
Tangled Up in Life..
“This is closer to a war than a negotiation”
pharmagossip Retweeted
DES Daughter @DES_Journal 16 hr
Back to 2014 and to the engaged debate between @BenGoldacre and @DrDavidHealy http://wp.me/p1zQ5v-2Nj #AllTrials #ClinicalTrials #GSK
https://twitter.com/DES_Journal/status/835595399402520577/photo/1
1boringoldman says:
May 29, 2014 at 12:14 am
Over recent years, there has been a growing awareness that the data in pharmaceutical clinical trials has been routinely manipulated, and that we often can’t trust what we read in our journals about either efficacy or adverse effects. There’s a building consensus that there’s a space between the actual raw results and the public presentation that has been a devil’s playground and that the only solution is make it totally transparent. Goldacre’s AllTrials Movement, Godlee’s BMJ, the Cochrane Collaboration with Chalmers and Goetche, Healy’s efforts and RxISK, Doshi and Jefferson’s RIAT project, and many others have come at the problem from different angles trying to set things right. And the decision of the European Medicines Agency to implement a broad data transparency policy was an exciting step in the right direction.
Throughout this process, the pharmaceutical industry has erected roadblocks to data transparency at every turn. The suit by AbbVie against the EMA, the current attack mounted against Dr. Godlee, the article posted right now on the PhRMA site on intellectual property rights [http://www.phrma.org/innovation/intellectual-property], are just a few examples of industry’s attempts to undermine full data transparency. Even the concessions they’ve made are suspect. I’m on a RIAT team currently using the “remote desktop” interface provided by GSK for our project. The data is there, but the interface is so constricted that it severely limits anyone trying to do a thorough analysis of the information. I can’t see how it protects confidentiality or trade secrets. It just makes checking the data much harder than it needs to be. So I’ve come to see it as just another obstruction, nothing more. The recent turnaround in the EMA policy with a movement to view-on-screen-only access is a major setback – making the task of vetting clinical trials un-necessarily difficult.
I can see no reason for industry to have a seat at the table in the negotiations about data transparency at all. The misuse of their current ownership of the data, the record of the level of corruption in reporting, the number of negative studies with-held, the soft-pedaling of adverse effects, all point to what happens when they are allowed to control the data.
The only pertinent issues are the true efficacy of the drugs and an accurate reporting of the adverse effects. The economic health of the current pharmaceutical industry is, in my mind, an immaterial point, as is whether they join AllTrials or not. If the standards required to guarantee the integrity of our pharmacopeia are prohibitive to our current system, then our system needs to change – not our standards. So as to the argument in the comments in this post above, I have nothing but respect for all parties represented and all of their efforts. But when it comes to the involvement of industry in deciding where we’re headed on this issue, I agree with BMJ editor Dr. Fiona Godlee who said that they have an “irreducible conflict.” In my mind, their track record is ample proof that they aren’t responsible players and should be viewed with the highest index of suspicion they’ve earned. This is closer to a war than a negotiation. The task of evaluating the efficacy and safety of medications is an essential obligation of the medical scientific community to our patients – a bottom line. It’s irrational to move that line because of the economic needs of any commercial sector. If that impedes research into new treatments, that simply means we have to rethink how we do medical research.
Untangled…Awww..
https://www.flickr.com/photos/abbyladybug/11909617325/in/album-72157680587682755/
1 Not So Boring Obituary
Posted on Tuesday 28 February 2017
Published in The Atlanta Journal-Constitution on Feb. 28, 2017
http://1boringoldman.com/index.php/2017/02/28/1-not-so-boring-obituary/
Mickey Nardo Memorial Gathering
http://1boringoldman.com/index.php/2017/03/14/will-we-meet-any-of-you-this-saturday/
Mickey Memorial Video
http://1boringoldman.com/index.php/2017/03/22/mickey-memorial-video/
Mickey Nardo was a most excellent human being and doctor.