Abby here. So very sorry that the site was down for about a week. I have been communicating with Bluehost support every day since last Wednesday trying to get things repaired. Thank you for your patience, and please let me know if you notice the site isn’t working. I wasn’t kidding about keeping this site up.
When John M (Mickey) Nardo, whom you may know better as the author of this 1 Boring Old Man blog, died on 19 February 2017, the loss was felt around the globe.
Mickey’s contributions to the field of psychiatry are renowned, from outstanding patient-centred care, to rigorous analysis of clinical trial data relating to psychiatric drugs, to incisive dissection of fake science. Anyone familiar with Mickey’s work will know of his passion to ensure that evidence is analysed and reported accurately, with particular care given to recommendations around potential benefits and harms.
Mickey was a great friend to us at the Critical and Ethical Mental Health research group (CEMH), part of the Robinson Research Institute at the University of Adelaide in Australia. He helped lead our RIAT (Restoring Invisible and Abandoned Trials) reanalysis of the infamous Study 329 of paroxetine (Paxil) for adolescent depression. This work resulted in a prestigious publication in the British Medical Journal (BMJ).
Mickey is survived by his wife Sharon, his daughter Abby and son-in-law Christian, his ‘semi-adopted’ daughter Caitlin, and his sister Anna. His family support the creation of the John M. Nardo Postdoctoral Fellowship here at the University of Adelaide to best honour Mickey’s memory.
Our goal is to establish the position for two years in the first instance. Through the Fellowship, CEMH will be able to provide valuable and accurate information about the benefits and harms of psychiatric medications for adolescents. This research will help health professionals make better decisions about how to respond to people with mental health problems. And crucially, it will help to improve the integrity of future research.
We have secured funding from the newly established RIAT Support Centre at the University of Maryland. Part of this grant, along with donations already received, will cover the Fellowship for the first year, when the Fellow’s main focus will be on restoring the influential and controversial Treatment of Adolescents with Depression Study (TADS).
We seek further funding to support the recruitment of a strong John M Nardo Fellow on a 2-year appointment. Please join us in donating. The University of Adelaide (UA) uses the British Schools and Universities Foundation to allow overseas donors to claim a tax deduction in their support of the University.
For American-based donors wishing to support the John M Nardo Postdoctoral Fellowship, they can either:
We believe Mickey would find this a fitting tribute.
Warm regards,
Sharon and Abby Nardo, and Jon Jureidini (Child Psychiatrist, and Research Leader, CEMH)
Mickey Memorial Gathering
Emory Brain Health Center, Atlanta GA
March 18, 2016
0:00 Caitlin Way
07:57 Gail Anderson and Ed Anderson
17:39 Micah Lipscomb
23:19 Carl Sissom
29.38 Anna Nardo
35:13 Jack Senterfitt
45:12 Sammye Brown
54:00 Abby Nardo
01:05:55 Proud Mary
If you come, please introduce yourself to me and Mom. We look like this:
(We each created our own Simpsons character several years ago.)
Published in The Atlanta Journal-Constitution on Feb. 28, 2017
John M. Nardo, MD, Born December 3, 1941 in Chattanooga, TN, died February 19, 2017.
John Michael Nardo, MD (known as Mickey) was the rare physician who excelled in patient care, medical education, and research. Born in 1941 to John and Nita Nardo, Mickey attended McCallie School and City High School. After attending the University of Tennessee, he initially expected to pursue a medical career in research, completing an NIH fellowship in Immunology and Rheumatology during an internal medicine residency in Memphis. However, his experience as an internist at Lakenheath Air Force base in England convinced him that he enjoyed working directly with patients and wished to have more time and skills to help them. So he decided to pursue a second residency in psychiatry in 1974 at Emory University. In 1976, he began psychoanalytic training at Columbia University in New York. After three years as Medical Director of the Grady Memorial Hospital psychiatric emergency room, he joined the faculty at Emory University Department of Psychiatry and assumed the position of Director of Residency Training. Later, he opted for private practice, serving Atlanta as a psychiatrist and psychoanalyst for more than thirty years. Anyone lucky enough to have been his patient received superb care. Anyone lucky enough to have been his colleague appreciated Mickey’s gift for turning complex concepts into memorable vignettes. For decades, Mickey taught for the Atlanta Psychoanalytic Society and the Georgia Psychiatric Association. He was an active faculty member in Emory’s Psychiatry Residency Training and a pillar of the Psychoanalytic Institute.
In 2003, after a successful career as “Dr. Nardo,” Mickey “retired” in order to build barns and a house with two close friends, to create maps and a web site for the Mountain Stewards Trail Tree Project, and to blog about politics. In 2007, when he joined the Good Samaritan Clinic in Jasper, GA as a volunteer physician, he began to see first hand the problems of current psychiatric drug promotion. He quickly educated himself about the drugs that he had used only sparingly in his private practice. As a result of these observations, the focus of his blogging turned to exposing the problems in the pharmaceutical industry, especially the distortion of clinical trial reports. This work culminated in a “Highly Cited Paper” that he co-authored in the British Medical Journal in September 2015. After a lengthy struggle to obtain the original patient-level data used in a key article on a popular psychotropic drug, Mickey rigorously reanalyzed the data in order to demonstrate that the study’s claims of the drug’s effectiveness in children were false. In December 2016, on his 75th birthday, Mickey said, “I never thought I’d make my most important contributions to the field of medicine at this time in my life.” In January 2017, Emory School of Medicine promoted Dr. Nardo to Adjunct Professor of Psychiatry in recognition of his devoted service to psychiatry at Emory and in Atlanta and of his internationally recognized research.
Although Mickey spent his life trying not to be special, he was one of a kind. He had an epic sense of play and could sit for hours entertaining children with legos, clay, or toothpicks. And his neighbors all knew him as a consummate barbecue pit master. Mickey is survived by his wife of 50 years, Sharon Nardo; his daughter Abby Nardo, a psychologist in Raleigh, NC; his son-in-law Christian Karkow, an adjunct professor of design; his semi-adopted daughter of 30 years, Caitlin Way, Associate Director of Development at the Alliance Theatre in Atlanta; and his sister Anna Nardo, LSU emerita professor of literature, now living in Evanston, IL. A memorial gathering will be held in Atlanta at 2pm on March 18th at the Emory Brain Health Center (12 Executive Park NE). In lieu of flowers, please donate to one of the following three groups in the name of Mickey Nardo: Foundation for Integrity and Responsibility in Medicine (http://firmfound.org) 16 Cutler St, Suite; All Trials (http://www.alltrials.net); and Lown Institute (https://lowninstitute.org).
In lieu of flowers, Mickey’s family would appreciate it if you would donate to these groups:
You are all invited to share your memories of my father and his work. I have created a site for such purposes.
Dad died just before midnight last night. Every end-of-life choice made was his, and knowing that gives Mom, Caitlin, and I a lot of peace. The only sadness (not really a regret, since we did all we could to make this happen), was that Dad could not make it back home to die. He was just too sick.
Because Dad was on a trach, he could not speak in the last days of his life, and his hands were too swollen and weak to be able to type. Despite those limitations, we worked out how to communicate surprisingly well. I let Dad know that I would like to turn his blog into a book. He really liked that idea. Given the size of his blog and the amount of quoted information included herein, this will not be a quick project, but it is one to which I am committed. I have already begun to make inquiries. I told Dad that Barney Carroll seemed to me to be a good person to consult with about this project, and he wholeheartedly agreed. I may post here from time to time as I work on this project. I really want to honor him and serve this community to the best of my ability.
You have meant so very much to my Dad. He’s had this whole new career as a retiree, and I thank all of you for that. I know he’s really made a difference in the field, and I am so proud of him. I am the admin for this blog, so if anyone has a burning need to post something here, please let me know, and I can post it as a main topic with the title “Guest Post: John Doe.”
There will be a large memorial gathering in Atlanta soonish. It won’t be immediate because Dad is so beloved by so many people that we expect a large crowd. We would love to have some of you in that crowd if you are able. This is probably several weeks out, but keep that in mind. We want you to know that you are welcome.
Dad was recently working on a Change.org petition. One favor you could do for him and for us is to read and sign it. I have a feeling you will all love it, and Barney says Dad created the graphic of the two ostriches with their heads in the sand.
Stop False Reporting of Drug Benefits & Harms by Making FDA & NIH Work Together
So much love to all of you. Abby
Abby here. I’m Mickey’s daughter and luckily, I am Dad’s admin, so I’m able to log in and post. My husband and I traveled to Georgia Wednesday afternoon because my father has been admitted to the ICU. He has severe pneumonia, COPD, and renal failure. Yesterday he was intubated and sedated and he remains in that condition. It’s taken me about 36 hours to realize that we haven’t yet contacted the people with whom he communicates the most! There aren’t many updates to give since right now, their primary aim is to treat this pneumonia so he’s sedated (and luckily, stable). I’m willing to take the risk of him being very annoyed with me for “outing” him in this way since I know you all are so engaged with him and will begin to wonder why your very chatty friend has suddenly gone quiet. Dad doesn’t ever like to be special, but as you all have probably worked out by now, he’s pretty amazing. And right now, he’s pretty sick. I can say he’s in very good hands. Mom and I are very impressed with the staff at the hospital.
This will probably embarrass him, but here’s a photo I took of him a few years ago. Feel free to share your thoughts in the comments. Mom and I will check them later today. Doctors make rounds in the ER between 10 and 12, so we may know more later today.
REGULATORY AFFAIRS PROFESSIONALS SOCIETYBy Zachary Brennan31 January 2017In a sign of what’s to come for the US Food and Drug Administration [FDA], President Donald Trump told pharmaceutical company CEOs Tuesday that his administration will be “cutting regulations at a level no one has ever seen before.” The comments, which came before the meeting with CEOs from industry group PhRMA, Merck, Novartis, Johnson & Johnson, Celgene and others, Trump said in terms of the drug approval process: “We’re also going to be streamlining the process, so that from your standpoint, when you have a drug you can actually get it approved, instead of waiting for many, many years."
He also called for significantly lower drug prices and again for better negotiations on drug prices between Medicare and companies. “We’re going to get the approval process much faster,” he repeated, noting that “one thing that’s always disturbed me is that you come up with a new drug for a patient that’s terminal and FDA says you can’t have this drug used on this patient and patient will be dead… we don’t know if drug works or doesn’t work, but the patient’s not going to live for more than 4 weeks.”
The comments on terminal patients seemed to be a reference to what FDA calls compassionate use or expanded access, and as FDA has sped up that process, experts have noted that the difficulty for many of these terminal patients, who have either run out of treatment options or didn’t have any to begin with, is not getting FDA to sign-off on the use of an investigational drug [FDA approves more than 99% of all expanded access requests it receives] but in getting the companies running the clinical trials to allow new patients to enter trials.
FDA Cuts
“Instead of it being 9,000 pages, it’ll be 100 pages,” Trump said, perhaps in reference to FDA’s rulemakings, guidance and other regulations. He also offered a one-liner about companies not getting their products or their manufacturing plants approved in the US that drew laughter from the group. Between 75% and 80% of all FDA regulations will be eliminated, he added, before commenting on a lack of foreign regulations without any specifics. “It’s very unfair what other countries are doing to us, a lot of that has to do with regulation,” Trump said. “Other countries have no regulation and you go there for that reason.”
But as others have noted, no matter where a drug is manufactured, companies have to follow US laws and regulations in order for that drug to enter the US market, which is still the biggest market for pharmaceuticals in the world. As far as his choice for FDA commissioner, Trump said an announcement is coming soon. PhRMA CEO Stephen Ubl called the meeting positive and productive and said Trump’s agenda on taxes, trade and regulation could create 350,000 US jobs over 10 years for the biopharmaceutical industry.