To the Editor:

Just got to read Alexandra Jacobs’ review of my book The Price of Privilege [“Our Gilded Youth in Crisis! Ennui and Grade-Grubbing,” Aug. 14]. It was very well written, and the Lego metaphor made me laugh. But in fairness, Ms. Jacobs left out the most important part of the book, and that is the fact that it is research-based. Walking away from the review, one has the notion that I’m a “warm and genuinely concerned person” who uses too much psych terminology and has a tendency towards “poesy.” Whether that’s accurate or not (well, I certainly do think I’m a nice person), it says nothing about the facts I’ve presented.

If this book were just about my experience or even the county of Marin, in my opinion, it would be narrow at best, self-indulgent at worst. But Ms. Jacobs neglected to mention that this book is really the outcome of many years of research, much of it by one of the most respected researchers in the country.

It would seem to me, stylistic issues aside, that the significant difference between Alexandra Robbins’ The Overachievers, also reviewed, and my own is that one is about several kids and the other is about thousands. I would suggest there is a world of difference in the conclusions one can draw from these two samples.

Madeline Levine

San Francisco

Al, Is That You?

To the Editor:

Steve Kornacki is so on the money with Joe Lieberman [“Lieberman’s Precarious Fate Makes D.C. Democrats Sweat,” Aug. 14]. And the visual of the acceptance speech of Ned Lamont with Al Sharpton in the background will not go unnoticed.

Ellen Steinberg

Short Hills, N.J.

Fringe Cancer Treatments Go Unresearched

To the Editor:

I just read Ron Rosenbaum’s article about Starchild Abraham Cherrix [“Starchild Abraham: His Trip to Tijuana for Chemo-Refusal,” The Edgy Enthusiast, Aug. 7]. It is a good discussion of the ethics involved, which are complex. I’d like to encourage you to err on the side of libertarian instincts in this matter. I have been a nurse since 1985 and accompanied my father, a medical researcher, to Mexico for cancer care. That was his well-researched choice.

Having just studied the phenomenon of the Tijuana clinics myself for my thesis topic in graduate school, I felt moved to respond to Mr. Rosenbaum’s assessment of the science behind the treatments offered there as “bogus.” Interestingly enough, some treatments, such as photopheresis, that are just now becoming available in the U.S., were available in Mexico first. Others are being studied here but are not widely available, such as insulin-potentiation therapy and low-dose chemotherapy. Some treatments, such as Hoxsey’s formula, have not been formally studied for economic reasons.

Hoxsey refused to allow his formula to be patented because his father, who used it before him, told him he must always make it available to people who could not pay as well as people who could. (Read Kenny Ausubel’s When Healing Becomes a Crime.) The A.M.A. spent a lot of effort and time in court to shut Hoxsey down, but it always turned out that he had healed some relative of a key player in the court battle.

Ralph Moss has an excellent assessment of the current status of cancer-treatment centers in Tijuana. It is really worth reading and is available on his Web site. (I have no affiliation with him.)

And Mr. Rosenbaum is very right to say that these treatments, such as Hoxsey, are not well researched. The problem is that there is not enough research done on treatments that are not patentable. The price for F.D.A. approval is so high that only big pharmaceutical companies can afford to navigate it, and even for them it is necessary to have a large, sustained market at the other end of the process in order to be considered profitable. This rules out any de-escalation in health-care prices, as well as completely ignoring a huge wealth of potentially health-enhancing, currently existing technologies. It’s a lose-lose situation.

The finance of health care is a huge and growing issue. There is no such thing as a “free market” in health care, and this is a problem for those of us who are less than appreciative of efforts by the government to protect us from ourselves. Not only is the science of medicine poorly understood by the layperson, cutting-edge science is also not well incorporated by the medical community, who struggle to keep up within their own fields and are burdened by a byzantine reimbursement system. And the economics of health care are positively Machiavellian in nature.

It is a very difficult subject to tackle within the context of guiding the judgment of someone on the cusp of adulthood. I appreciate Mr. Rosenbaum’s discussion of it. Thank you!

Alicia Bright, M.S.N., R.N.

San Rafael, Calif.

And one that brings back to me a memorably strange moment in Tijuana, in one of the questionable “cancer cure” clinics clustered below the border beyond the (U.S.) law. A moment when I took a swig of the mysterious “Hoxsey tonic,” the elusive “cancer cure” elixir that is at the heart of the “Starchild” controversy.

The case involves a 16-year-old Virginia boy with the legal name Starchild Abraham Cherrix. (He now goes by the name Abraham.)

Diagnosed with Hodgkin’s disease at 15, he went through a three-month round of chemotherapy that left him ravaged and, alas, did not prevent an apparent reappearance of the cancer less than a year later.

Thus began the conflict: His doctors ordered another round of chemo, but with the support of his parents, young Abraham has asserted the right to refuse the ravages of a treatment modality that had failed before—and to pursue his own course, which has been described as a combination of a no-sugar diet and trips to Tijuana to be treated at the Hoxsey clinic down there. The place where I once tasted (as a reporter, not a patient) the banned-in-the-U.S.A. tonic.

In any case, a social worker reported the chemo-refusal situation to the authorities, and a Virginia judge initially ruled that Abraham must be forced to follow his doctors’ orders and undergo a second round of chemo whether he wanted to or not—and the parents must give up a share of custody of their child to the social-services department. Which raised all sorts of moral, ethical and civil-libertarian issues. Especially because his age, 16, put him in a legally ambiguous borderline temporal realm.

Opponents of the juvenile death penalty, for instance, argue that 16-year-olds should be considered “juveniles,” not adults—as persons not fully responsible enough to be executed for a murder committed at that age because they’re not capable of making a fully responsible “adult choice” to kill. On the other hand, pro-choice opponents of “parental notification” abortion laws argue that 16-year-olds should be considered adults, at least enough to be given the right to make abortion-related decisions without parental interference.

The Cherrix family appealed the first court decision, which might have meant Abraham would have to be strapped down and injected with drugs against his will. Then a second judge stayed that order until a trial, now scheduled to begin Aug. 16. Young Cherrix has expressed his feelings this way to the Associated Press: “I’ll fight until I do die. I’m not going to let it go. I would rather die healthy and strong and in my house than die in a hospital bed, bedridden and unable to even open my eyes.”

It’s a moving and heartfelt plea, but a problematic one as well. My instinct to support young Cherrix on libertarian grounds is undermined by the not quite fully developed thought process this statement suggests.

Is the choice he faces really the one he poses? Does one die from cancer (or any illness) when one is “healthy and strong”? Or is the fact that he feels good now deceiving him? Is he thinking like an “adult” or like a “juvenile” who needs advice and protection? Of course, the thought processes of many adults are not necessarily “fully developed,” but that’s not because of their age.

Is Abraham capable of making a rational choice? Does the state have the responsibility or the right to step in and make what it thinks is the rational choice? (Especially when states are not notable for their record of “rational choice.”)

Complicating things further is the debate over the efficacy of chemo in such a case. Some cite an 80 percent five-year survival rate with Hodgkin’s when treated with chemotherapy, but it’s not clear if those optimistic stats hold up if the first round of chemo fails, as it did with young Cherrix.

And what if it were 80 percent? At what point, at what percent should a family, should a 16-year-old, have the right to make a decision about the odds, the risks and the consequences of an “alternative” medical course of action on their own? Does he have the right to decide the quality of his life, even if it means hastening his death? And what should we think about the alternatives, as practiced by the “cancer cure” clinics of Tijuana, that the Cherrixes have chosen?

An Excursion to the Clinics of Tijuana

The clinic that left the most lasting, creepy impression on me was the deluxe clinic near Ensenada, down the Pacific coast from Tijuana on a cliff overlooking the Pacific surf, a cliff that had once been the site, so we were told, of an Aztec human-sacrifice ritual. With its mysterioso sinister vibe, this clinic couldn’t help but recall to me the sleazy rich “rehab” clinic in The Long Goodbye, Raymond Chandler’s most brilliant L.A. noir.

It was the clinic where the actor Steve McQueen spent his last days in the futile hope for a cure for his mesothelioma, one of the most incurable cancers. And the trip took place shortly after the death of Abraham’s forerunner, a child named Chad. Chad was about 3 then, and it was his parents’ decision to go the Tijuana route, choosing a clinic known for its then-faddish “laetrile” treatments for Chad’s leukemia.

The episode first raised the still-unresolved question of whether the state or the family has the right to make medical choices for children, and the whole issue was clouded by disputes over the cause of Chad’s death that arose not long after he died in Tijuana. Death seemed to be stalking these clinics and their “alternative cures.”

And yet, earlier in the day, the carful of cancer patients I was traveling with—I was doing a story which can be found reprinted in The Secret Parts of Fortune—had a different experience in Tijuana itself. In shabby clinics cheek-by-jowl with auto theft/repair junkyards and in grand, deluxe, ocean-side playas, we had fascinating talks with some of the patients. We hit the historic Tijuana clinic hotspots, among them the Hoxsey clinic, a kind of relic of a charismatic “healer,” Harry Hoxsey, who in the first half of the last century peddled a mysterious “tonic” in clinics in 17 states before he was driven by the law beneath the border.

At the time I visited the clinic, it was being run by Hoxsey’s original nurse, a kindly-seeming woman who gave one particularly impoverished member of the carful of cancer patients I was traveling with a bottle of the tonic gratis. When I ventured that I’d like a taste, she poured out a little from a large brown bottle into a paper cup. It tasted like gnarly cough syrup. The problem with the Hoxsey tonic is that there has been a running dispute over its actual composition and thus, to my knowledge, there have been no clinical trials of its value. Indeed, in one of the paradoxes I found in the below-the-border realm, “value” is something these remedies are endowed with by the patients rather than vice versa.

Later, we went to the Gerson clinic, run by the daughter of a German Jewish doctor, Max
Gerson, a key character in the John Gunther memoir of his son’s cancer, Death Be Not Proud. Gerson believed in a strict regimen of liver juice and coffee enemas (brand extension for Starbucks?). And we went to the prosperous laetrile clinic where Abraham’s forerunner Chad and his parents futilely sought “alternative” treatment.

What was fascinating was that at each clinic, we found patients who testified to being “cured.” It was anecdotal (although some provided before-and-after X-rays). For all we know, they could have been ringers paid by the clinics to sit in waiting rooms and offer false hope. But it didn’t seem that way. There were enough people in the clinics whose stories about being given up by orthodox doctors and finding new life below the border rang true to give one pause.

I’ve evolved a theory of the below-the-border “cancer cure” clinics, which is that the science, almost without exception, is bogus—but that the cancer patient’s decision to make the break with orthodoxy, to cross the border (a border that is not just geographic but psychological), to take control of one’s destiny and place one’s faith in a cure (however baseless its science), in the psychogenic power of hope (even false hope), might have had some hyped-up placebo effect in making a difference in the lives of those who went that route.

A “false-hope cure”? Well, as I’d put it, “false hope springs eternal,” and there’s growing evidence for the power of the placebo effect.

One can have disdain for the pseudo-scientific, holistic nonsense peddled by the false-hope clinics, but if someone gets to live a little longer by virtue of the false hope/placebo dynamic, should one deny them that chance? Especially in cases of cancers where round after round of ravaging chemotherapy hasn’t offered any hope at all?

So where does that leave Starchild Abraham Cherrix, his parents, the courts, the social workers, his doctors? I just don’t feel I know enough to know. Libertarian instincts and scientific rationalism are generally on the same side, except here strict libertarianism requires a defense of the right to hold false, even self-destructive beliefs. Here libertarianism and scientific rationalism, empathy and efficacy, seem to be in conflict.

You make the call.

Don't really expect us to post to The Real Estate till July 5, unless one of us gets drunk and decides to ruminate on the pleasures of listening to Herb Alpert and Tijuana Brass while sitting on a porch upstate, or in Maine, or in Matewan, drinking Fog Cutters.

We'll be back with intern Max Abelson's Morning Read stylings earlier than you on July 5, so don't count us out for long. And keep writing and calling. We love all of you crankpipes!

- Tom McGeveran

Albert Teitelbaum, a retired furrier and ex-convict, filed a $20 million lawsuit in the Federal District Court in Los Angeles on May 20.

"Ten for invasion of privacy," said Charles Morgan, the lawyer for Mr. Teitelbaum. "And 10 for the libel."

The lawsuit targets Condé Nast Publications, since the Condé Nast-owned GQ magazine was the original publisher of the James Ellroy work in question.

It's safe to assume that no writer or publishing company wants to hear from Mr. Morgan, a $400-an-hour attorney who practices libel law out of San Francisco. After all, in his last high-stakes libel gambit, Mr. Morgan represented psychoanalyst Jeffrey Masson against writer Janet Malcolm and The New Yorker . Mr. Morgan, 78, battled for 12 years on behalf of his client, through a deadlocked jury and a retrial, before losing the final appeal in 1997.

His new client, Mr. Teitelbaum, now lives in Oregon, but was apparently once a bit player in the postwar Los Angeles that has so captured Mr. Ellroy's imagination. He was the owner of Teitelbaum Furs on Rodeo Drive, "a fairly well-known business in Beverly Hills at that time," conceded his lawyer. But Mr. Teitelbaum claims that Mr. Ellroy did not get his facts right when he described scenes and incidents purported to be taken from his life.

Mr. Ellroy's technique is to mix factual events and actual characters-people like Frank Sinatra and Sammy Davis Jr.-with the stuff of his own fevered brain. It's an old technique, dating back to Defoe and now used by writers as disparate as E.L. Doctorow, Don DeLillo and Kurt Andersen.

It seems that, usually, the real-life characters who populate Mr. Ellroy's books and stories are 100 percent libelproof because they are (1) public figures and (2) dead. Mr. Teitelbaum, however, was never famous, and, at the age of 84, he is very much alive.

He's a major character in the Ellroy novella, Tijuana, Mon Amour , that GQ ran in two parts across its February and March 1999 issues. Like Mr. Ellroy's best-known work, L.A. Confidential , this one is narrated by Danny Getchell, the editor of the (fictional) gossip magazine, Hush-Hush .

In Tijuana, Mon Amour , Getchell tells a murky whodunit tale about a mobbed-up Frank Sinatra ("Sex-sational Sinatra-the thrill-seeking Three-Way King," as he's called in the novella) and his addiction to ménages à trois . Mr. Ellroy's Sinatra gets involved with a lady singer named Linda Lansing, who desperately wants to be a star. In the story, she also serves as the "model and pitchwoman" for Teitelbaum Furs. And Al Teitelbaum ends up caught "buck naked" in photos with Linda Lansing and another woman, Barbara Graham, a real-life human being who was executed on June 3, 1955, for murder-a fact mentioned frequently in Tijuana, Mon Amour .

Later in the story, Mr. Teitelbaum ("the furtive furrier") is "broke," so he stages "a fake fur heist to get some insurance money." The heist of Tijuana, Mon Amour -which Mr. Ellroy manages to set up in such a way that it involves Sammy Davis Jr. and a syringe full of LSD-takes place on the same date, Dec. 27, 1955, on which the real-life Mr. Teitelbaum committed the crime involving a false insurance claim that sent him to jail. As part of the fictional plan, Linda Lansing was to sell the furs-"fence" them, in the Ellroy lingo-south of the border.

In the May 20 lawsuit, Mr. Teitelbaum asserted that he "has never met either Barbara Graham or Linda Lansing, has never lain in a bed with either or both of those women; has never been photographed with either or both or those women; has never used any woman by the name of Linda Lansing to advertise his furs, nor has he ever engaged in any arrangement to have his furs transported to any 'fence' for stolen furs … nor was he 'broke' at that time."

Mr. Morgan-who won a ruling by the U.S. Supreme Court early on in the Malcolm case, setting down that misquotation can be libelous-elaborated in an interview: "There are basically two issues. They've got him in bed with Barbara Graham, who was executed for murder here, so she was a real person, and Linda Lansing, who we don't know if she was real or not. Which is totally false and outrageous, really. They have him broke and sending her down to fence furs in Tijuana. None of which ever happened. And none of which anyone ever said happened."

But Mr. Teitelbaum was no saint: In 1956, he was convicted of conspiracy to commit grand theft, attempted grand theft and the presentation of a false insurance claim. He spent six months in Los Angeles County Jail. Since then, his court papers insist, Mr. Teitelbaum "has lived a quiet life avoiding notoriety." His lawyer said he "had grandchildren who didn't even know about it. It was really very devastating to him. He has lived an exemplary life since then … He's 84. He didn't need this at the end of his life."

Mr. Cooper said he couldn't talk about the suit. "We don't comment on cases in litigation," said Condé Nast spokesman Maurie Perl. Mr. Ellroy didn't return a voice mail message. Mr. Morgan wouldn't give his client over for an interview.

Mr. Ellroy and GQ first learned of Mr. Teitelbaum's displeasure on Feb. 17, when Mr. Morgan put in his call to Condé Nast. The lawyer said he wanted his client's name expunged from the upcoming March installment of Tijuana, Mon Amour and he wanted an apology, too. But by that time it was too late.

Now, many writers of Mr. Ellroy's stature have heard that kind of talk from angry lawyers-but it's hard to laugh it off when it comes from the man who took Ms. Malcolm and The New Yorker to the mat.

The same day of Mr. Morgan's phone call, GQ editor Art Cooper threw a little party for the author at Joe's Pub on Lafayette Street. They were toasting Mr. Ellroy's new book, Crime Wave (Vintage Crime), which is made up entirely of pieces that ran first in GQ … including Tijuana, Mon Amour . (The book publisher was not named in Mr. Teitelbaum's lawsuit.) Given the phone call from Mr. Morgan, Mr. Ellroy did not look to be in much of a partying mood. In fact, guests noted that he did not work the room much, and they spotted him talking solemnly with Mr. Cooper by the stairway at the end of the bar.

Copies of Crime Wave were on display at the party. The copyright page of the book dutifully noted that Tijuana, Mon Amour and several other stories were a "works of fiction" wherein "names, characters, businesses, places and incidents in those stories are the product of the author's imagination or used fictitiously."

In his introduction to Crime Wave , Mr. Cooper praised Mr. Ellroy's use of a star-studded "band of merry miscreants" in his stories, including Lana Turner, Oscar Levant and Rock Hudson. "There is a raunchy ring of verisimilitude, a truly bizarre believability, to the way Ellroy makes them behave," he wrote.

Which is where the problem begins.