MOVING BEYOND SIMPLICTY TOWARD THE RIGHT ANSWERS

I often say that neither science nor law (my field) should be inscrutable. But for scientific writing (or legal writing for that matter) to be understandable to lay people, it must make sense. Dr. Martha Herbert, a pediatric neurologist, makes sense when she speaks or writes. She is never one to overstate the case; indeed, she was one of the researchers who asked to have her name removed from a Generation Rescue advertisement lest her work be touted as definitive proof of a mercury-autism connection.

Dr. Hebert’s article, Autism: A Brain Disorder, or a Disorder That Affects the Brain?(link to pdf here), does not break any new ground, but it does clarify where we are and, more importantly, where we should be going. In the piece, Dr. Herbert convincingly suggests that the scientific evidence now supports a departure from a “strongly genetic, brain-based” model of autism in favor of a “genetically influenced, systemic” model. Her model seeks exploration of the interplay between brain connectivity issues and biological factors. Somatic symptoms that some call “comorbidities” are hypothesized to “be integrally related to what have been considered ‘core’ or defining symptoms, and both are likely to derive from the same or related underlying pathophysiology.”

It is important to note that Dr. Herbert does not specifically identify mercury as the biological factor triggering the genetic predisposition. Rather, her article references “heterogeneous” biological underpinnings. That certainly matches my own opinion that autism is not dependent on thimerosal exposure, but thimerosal exposure may be a trigger or contribute to the development of autism. Autism, again in my opinion, predated the introduction of thimerosal into vaccines, but the expansion of the vaccine schedule and the use of thimerosal are the primary factors in the skyrocketing numbers of diagnosed autism. In other words, the fact that the development of autism in an individual does not mean it is not primarily responsible for the current epidemic (oh dear, there I go using the “E” word again).

For a while now, those of us who believe that vaccines played a role in our children’s autism have been split into three basic camps. (This is a gross overgeneralization given the various permutations on the hypotheses, but I am culling it to three to keep this post manageable.)

First is the group that believes thimerosal exposure to be the cause of autism, a view which is sometimes oversimplified into an equation of autism = mercury poisoning. Those who doubt the vaccine connection (i.e., those that proclaim autism is totally genetic and that the unprecedented increase in diagnosed cases is due wholly to broadened diagnostic criteria and increased awareness) tend to lump anyone who disagrees with them into either this category or into some vague classification of “anti-vaxers.” Although admittedly controversial and not universally accepted, laboratory testing often indicates that mercury may not be properly excreted by some autistic children.

The second group focuses more on the effects of MMR vaccinations and the development of enterocolitis. The connection is easy enough to make given the gastro-intestinal problems many autistic children have. Like the thimerosal hypothesis, there are laboratory findings ⎯ again controversial and not universally accepted ⎯ to suggest that live viruses are causing problems in these children.

The third group, which I would place myself in, sees validity in both the thimerosal and MMR hypotheses, but don’t believe either can give a full answer in isolation. The key to understanding is to classify autism ⎯ at least the form of autism we see in our children ⎯ as an autoimmune disorder. Although there is a genetic predisposition underlying everything, the actual autoimmune process in most children might start with mercury poisoning from thimerosal-laden shots (see the recent study from the M.I.N.D. Institute). With the immune system damaged by the mercury, it becomes understandable how attenuated live viruses, particularly those given in combination and simultaneously with thimerosal-containing vaccines (e.g., my son received the MMR, polio, and DTP shots all in one visit to the pediatrician) can not only fail to create an immunity, but might also cause the kind of biological damage of which Dr. Herbert writes.

As we learn more and more, this third hypothesis is getting more attention beyond the scientific community. Witness the new articles in Dan Olmsted’s excellent and thought-provoking “Age of Autism” series for UPI. Like all of his articles, Mr. Olmsted is very careful to avoid representing his writing as scientific, but the questions he raises cannot be ignored. His recent series entitled “Pox” (see here and here) examines some of the results of a Merck-sponsored trial of the “ProQuad” vaccine. The ProQuad combines the MMR with a vaccine for chicken pox. Some of the children on whom the vaccine has been tested, have developed autism. The common thread among the children, other than they all reside in the area of Olympia, Washington, where the trials occurred, is that they all have a family history in which relatives had problems with chicken pox (e.g., multiple cases of the disease or the subsequent development of shingles) that might suggest a susceptible immune system.

It may yet turn out that mercury is the only problem, or that the MMR is the only problem, or that vaccines are not involved at all and it is all genetics. It would be far easier to believe any of those scenarios than to look at a multiplicity of possible environmental triggers acting on genetic predisposition. Most of us, however, would rather reach the right answer. Dr. Herbert’s model provides a framework for finding the right answer. And an answer that points to autoimune processes makes sense.

IT’S SO REASSURING (NOT)

As Patrick Sullivan, Jr. recently reported at the Pat Sullivan Blog, the FDA, after years of stonewalling, agreed to conduct hearings on the neurotoxicity from mercury-containing dental amalgams. When I read that, my first reaction was that their decision was probably already made, but I wondered if maybe I was just becoming a bit too jaded by the duck-and-cover tactics used by government regulators. Could this be a genuine attempt to determine the truth, one way or the other? Now it appears that my initial skepticism may have been well-placed.

This week, the Associated Press reported that two separate studies were released that indicate amalgams are safe. Perhaps it’s just a coincidence, but what are the odds that the FDA would reverse their position on holding hearings shortly before two ⎯ not one, but two ⎯ reports are released that would tend to vindicate the agency’s long-standing position?

It’s worth noting that both studies were funded by the National Institute of Dental and Craniofacial Research, which is part of the National Institutes of Health (the same people that brought us the Institute of Medicine).

Of course, the timing of the studies and the hearings do not necessarily show a problem. What if the studies are correct, and amalgams really pose no danger? The answer to that obviously depends on the methodology used in the studies. For example, do the researchers take into account any differences between patients with intact fillings and those whose amalgams may have cracked (and yes, that does happen)?

I have not yet read the reports themselves, but the AP story gives a few clues as to the value of these studies. The leader of one of the studies, Dr. Sonja McKinlay of the New England Research Institutes, noted that “while the study revealed children with the mercury fillings had higher mercury levels in their urine, there was no evidence they had a higher incidence of kidney damage.” Was kidney damage the only problem they looked at?

We know that the other study, focusing on children in Portugal, supposedly looked for neurological problems, but how rigorous were the criteria?

The most telling indication lies in the following excerpt from the AP article:

Neither study examined autism. Dr. David Bellinger, an author of the New England study, said that autism so rare that it wouldn’t be expected to be found among the number of children studied. Also, any children with autism would have been eliminated from the study, as would other children with prior neurological disorders.

So let’s get this straight. In order to determine the risk of neurotoxicty, a study is going to ignore the prime suspect in the constellation of possible adverse reactions. That’s like conducting a study to determine of there are adverse autoimmune problems that might result from cigarette use, but excluding lung cancer and emphysema.

Even if the researchers excluded only pre-existing cases of autism from their work, they have missed the opportunity to determine whether exposure to mercury from amalgams might exacerbate autistic dysfunction. But maybe that was the point.

I plan to read these studies in the not-too-distant future, and I will amend this in the comments or in a new post if I am doing the researchers any great injustice. I have seen, however, a commentary by Dr. Herbert Needleman, apparently printed in JAMA, which points out a few of the problems with the studies, including the fact that there is no provision for measuring the impact on children with a genetic predisposition to mercury toxicity. Sound familiar?

Thanks to Mary and her sharp eyes for pointing me in the right direction on all this.

PAUL OFFIT: THE DISINGENUOUS SALESMAN

Many writers have “muses,” people who inspire us to write even when we think we have run out of things to say. In a rather demented way, my muse is Paul Offit, the Chief of Infectious Diseases at Children’s Hospital of Philadelphia. I would really like to ignore him, but any time he opens his mouth, he says something that cries out for comment.

Friday morning, C-Span 2 aired a live panel discussion at the conservative American Enterprise Institute featuring Dr. Offit. (The video of the forum may be viewed here.) The subject of the forum was Dr. Offit’s book, The Cutter Incident. Although I admit to not having actually read the book lest I do anything to further enrich Dr. O (perhaps if I see it at a rummage sale . . .), I previously have discussed the deficiencies of his thesis, which one does not need to read the book to understand given the author’s proclivity for self-promotion.

In short, Paul Offit believes that a health-care crisis arose out of an incident in the 1950s after an early polio vaccine, manufactured by Cutter Laboratories, not only failed to prevent polio in certain patients, but actually caused the patients to contract the disease. As is known to happen in America, even the America of the fifties, lawsuits resulted, and at least one case uniquely resulted in the imposition of liability without a showing of negligence on Cutter’s part.

In the paranoid view of Dr. Offit, that verdict against Cutter resulted in a scare among pharmaceutical companies who jumped out of the vaccine business in fear of the legal profession. In a previous post, I took a stab at explaining how the legal developments occurring after the Cutter verdict do not support an exodus from vaccine manufacturing. If there are less manufacturers in the vaccine business, it is far more likely to be the result of other market forces, particularly the consolidation of the industry. But Dr. Offit has never been one to let logic get in the way of selling his bill of goods.

And what is Dr. O selling? He wants to effect a wholesale change in public policy concerning vaccine injuries. In short, he is not satisfied with the present state of affairs in which the federal vaccine court acts as a speed bump on the way to seeking compensation for vaccine-related injuries. He doesn’t even want vaccine-court decisions to come from the special masters that now judge the cases. Dr. Offit wants a whole new decision-making process in which the question of liability is made solely by scientific and medical specialists (i.e., industry insiders). There would be no recourse to the ordinary court system. After all, in Paul Offit’s opinion, most of us are just too simple-minded to understand science.

There was nothing new about what Dr. O was selling this time, but he did pull a couple of new sales tools out of his sample case. His theme has always been fear, and primarily fear of the legal profession in particular. In his presentation before the American Enterprise Institute, Offit used two visual aids that say much about his pandering.

First, Dr. O wanted to make sure we all understood how evil the Cutter suits were to begin with, and the best means of illustrating that was to demonize the architect of the legal strategy. The plainitffs’ legal team had been led by the self-proclaimed “King of Torts,” Melvin Belli. As a self-respecting defense lawyer, I was not a big fan of Mr. Belli, but Offit’s ham-handed attempt to damn the message by damning the messenger was too much for even me. He decided to show a photograph of Mr. Belli. He could have chosen from hundreds of pictures of one of the most-photographed lawyers of all time, and many of the images from his later life would have depicted Belli’s flamboyant nature. But those would have made the lawyer appear clownish rather than evil, and evil was what Dr. O wanted to convey. So he showed a picture of Belli taken during one of his relatively rare forays into criminal law: his representation of Jack Ruby. The implicit message was that great harm was done to a noble cause by the defender of murderers.

The other visual aid Dr. O used was the recent full-page ad placed in USA Today, on behalf of Put Children First. Never mind that the ad criticized the CDC’s apparent stonewalling of the truth about a connection between thimerosal and the autism epidemic, rather than directly attacked the vaccine manufacturers. In Dr. Offit’s opinion, the ad could only have one purpose: poisoning the minds of any potential jurors in suits against vaccine manufacturers. (That opinion ignores the fact that the voir dire process in a jury trial would help to eliminate anyone who formed an opinion by reading an ad.) What was the basis for Offit’s opinion? Well it was obvious to Dr. O: the ad was placed by the same advertising agency that once worked with plaintiffs’ lawyers in breast-implant litigation. Puhleeze!!! Any good advertising agency is going to have a wide variety of clients. And some agencies are going to specialize in public-interest ads. That does not mean that every client they have will be allied. What one must look at is the identity of who is paying for the ad. In this case, it was J.B. Handley, who has not filed suit in either a district court or the vaccine court. He has no stake at all in any litigation.

In selling his goods, Dr. Offit relies on irrational fear rather than the inconvenient (for him) truth. But the fear he’s using is not the fear he really has. I suspect Dr. O is not so much afraid that the legal system won’t do the right thing as he is afraid that justice will actually be done.

I’m afraid too. I’m afraid that some people actually seem to be buying Paul Offit’s bill of goods.

WE SHALL NOT BE MOVED

I wasn’t physically present at the Mercury Generation Rally in Washington last week, but a friend sent photographs from the event to let me know what I missed.

The estimates I’ve seen for the number of participants ranged from a couple of hundred to a thousand. I’m not too concerned over the numbers. It is enough to know that for every person there at the capitol, there were many, many others who could not be there for one reason or another. There are a lot of us out here, and we’re not going away any time soon.

We’re speaking through a lot of different groups and a lot of different media (including blogs). To be sure, we don’t speak for all autistics or parents of all autistic children. Some feel we’re creating a diversion from what they see as the real issues of autism. Some feel we’re advocating a waste of national resources. Some feel that by talking in terms of “cure,” we create an image of autistics as being unworthy of respect or love. I don’t believe that’s the intent or the result, but obviously some feel that to be the case. Those who disagree with us are entitled to their opinions and feelings, and I will not fault them for airing their opinions and feelings in any appropriate way they see fit. But know this; there are a lot of us out here, and we’re not going away any time soon.

That is not to say that we ⎯ that is, those of us who either marched in Washington or wished we had ⎯ all have the exact same opinions and goals. We certainly don’t agree on the efficacy of any one intervention, although most of our favorite interventions fall under the umbrella of biomedical protocols. Some of us think mercury is the only problem. Some of us think mercury is a large component of a complex problem. Some of us want to preserve legal rights. Some of us care less about who can sue whom, and just want someone to tell us the truth. As for me, I think the question of how we, as a society, should apportion the cost of our mistakes can wait. The important first step is to find a definitive answer. As we look for that answer, keep in mind that there are a lot of us out here, and we’re not going away any time soon.

What if that answer shows we’re wrong? Then we look for new solutions in the answer that emerges. I don’t think, however, that we’re wrong. Everything I’ve seen in the last couple of years tells me we’re on the right track. I recall visiting relatives living in tobacco country as a boy. I can still hear my father’s cousin, who operated a wholesale business for tobacco products, railing about those litigation-seeking agitators who were trying to draw a connection between cigarettes and cancer. He could cite lots of impressive studies that “disproved” the connection, but we came to find out those studies were dictated more by interests than science. In the autism controversies, both sides claim that it’s the other guys using “tobacco science.” It says a lot to me that only one side says the debate is over. That side needs to be reminded that there are a lot of us out here, and we’re not going away any time soon.

I didn’t think it could happen, but the rhetoric is getting harsher than ever these days. People on both sides ⎯ better to say all sides ⎯ of the debate are getting frustrated. And there are certainly vocal persons on both sides who seem to delight in provoking controversy. I may wince when some things are said, but I can only control what I say. As a whole, we are people of good will. Nevertheless, we cannot and will not forget what has happened to our children. Yes, there are a lot of us out here, and we’re not going away any time soon.

We shall not, we shall not be moved.
We shall not, we shall not be move.
Just like a tree that’s standing by the water,
We shall not be moved.

We shall not, we shall not be moved.
We shall not, we shall not be moved.
We’re fighting for our children,
We shall not be moved.

A VERY GOOD DAY INDEED

I have had good days, and I have had bad days. Although I certainly made mistakes in my life, there are more than enough right things I’ve done to make up for them. The smartest thing I have ever done happened 11 years ago tonight.

On April 8, 1995, I somehow got Sym Andrea Cusimano, the most amazing woman I’ve ever met, to marry me.

Not too shabby, Rankin, not too shabby.

GROUNDHOG DAY IN APRIL

There has been much action on the scientific, political and media fronts in the ongoing debate over the connection between vaccines and the autism epidemic (and, yes, I will continue to use that word). First, was all the news out of the M.I.N.D. Institute, including the announcement of the Autism Phenome Project, and the release of a study showing damage to the immune system from thimerosal exposure. Then, we had the letter by eight members of Congress, led by Senator Joe Lieberman, calling upon the National Institute of Environmental Health Sciences to take a new look at the hypothetical link. Last week, at a press briefing that included Dan Olmstead and David Kirby, Representative Carolyn Maloney announced her legislative efforts to mandate further studies. And this week will see the Generation Mercury March and a DAN! Conference in Washington.

That much activity just naturally has to make for a collective case of the jitters among those who have a vested interest in denying any link between vaccines and autism. Their reaction was predictable.

A letter was addressed to the individual members of Congress by 22 organizations, pleading that there be no legislative restrictions on the use of thimerosal in vaccines. The groups’ rationale was open fear. Some people might interpret a ban on mercury in vaccines as being an admission that there is a problem, or that “vaccine safety oversight is inadequate.” Well, duh!

The 22 organizations declared that they “stand behind the enormous amount of scientific evidence that shows no link exists between thimerosal in vaccines and the development of autism.” Perhaps if they said they believe the research does not support a link, I could call their position a legitimate disagreement with the growing body of evidence of a link. But to say there is an “enormous amount” of evidence against a link is laughable. The 2004 IOM report cited the Verstraeten study, which even in its post-Simpsonwood version was labeled “neutral” by its author. The other evidence relied upon by the IOM committee consisted of foreign studies in which the level of exposure was less than the United States, and at least one Danish study changed the criteria for its pre-thimerosal-removal and post-thimerosal-removal cadres. Have I missed some startling revelation of the last year or so?

The other sign that the powers that be are worried is the resort to their favorite tactic. They trot out Dr. Paul Offit to let everyone know that no attention should be paid to the man behind the curtain. Just like Punxsutawney Phil, Dr. O emerges from his safe area, sees the shadow of bad news on the horizon, and then speaks reassuringly to those who don’t live with the issue every day. Just like Phil’s weather forecast, however, any similarity between Dr. Offit’s pronouncements and reality is purely coincidental. And just like the movie, Groundhog Day, in which Bill Murray lives the same day again and again, what we’re hearing from Dr. Offit is pretty much the same thing we’ve heard him say before.

“Every Child by Two,” an organization dedicated to promoting childhood immunization (this was one of the 22 organizations sending the letter to Congress), hosted a teleconference with Dr. Offit for the media. In her introduction, Amy Pisani, the Executive Director of Every Child By Two, noted that the purpose of the conference was “to discuss vaccine safety and legislation that’s being introduced in many states to ban the use of thimerosal in vaccines.” Of Dr. Offit, Ms. Pisani remarked that “he has the uncanny ability to make sense of the abundant research that’s been conducted around the world to disprove allegations that the preservative thimerosal that is in some vaccines ever caused autism in children.” That was an interesting introduction inasmuch as the bulk of actual autism research was barely mentioned.

The closest thing to a surprise in the teleconference was Dr. Offit’s admission that environmental insults may trigger autism in genetically predisposed children. In particular, he mentioned studies based on mothers taking thalidomide or being exposed to rubella, both insults having to occur early in pregnancy. To refute the connection between mercury and autism, however, Dr. Offit cited a study reportedly indicating that Rhogam use in pregnancy does not increase the odds of developing autism. According to Dr. Offit, that study was presented in March 2005 in Chicago at the American College of Genetics annual meeting. I must admit that I am unfamiliar with such a study, and if it was ever published, it is not readily accessible through a pubmed search. There is certainly evidence to suggest the contrary conclusion.

But the main rationale cited by Dr. Offit was, as usual, the same epidemiological studies on which the IOM report was based. He calls the results “clear and consistent and reproducible.” Apparently, Dr. Offit still labors under the misconception that the European studies, based on different levels of exposure than the United States experience, somehow reproduce and validate the “neutral” results of the Verstraeten study.

In the teleconference, Dr. Offit points to levels of mercury in the environment apart from vaccinations, and implies that an infant is more in danger of mercury poisoning from breastfeeding than from receiving a flu shot. He bases that argument not only on the volume of mercury involved (ignoring the fact that injection is a far more efficient means of introducing mercury than digestion), but also on thimerosal containing ethylmercury “a form of mercury which will be excreted much more quickly.” When a reporter later asked about the Burbacher studies, which demonstrate that ethylmercury is as dangerous ⎯ if not more so ⎯ than methylmercury, Dr. Offit moved the subject back to script with the aplomb of a presidential candidate at a debate: “again, I think ⎯ I mean, I think that ⎯ you know, there’s nothing as strong, frankly, as the epidemiologic studies.” As usual, Dr. Offit did not wander far from his comfort zone. There was no real discussion of any studies that might point to conclusions he won’t like.

Paul Offit is now taking the show on the road. On April 11th, he will be the featured speaker at a seminar in Jacksonville, Florida, entitled Vaccines and Autism: The Provider’s Role in Communicating Vaccine Safety. Soon we will have lots of Offit clones all telling us that there is nothing to worry about, and we should trust people who must be lots smarter than the rest of us. Interestingly, there is no fee for attending the seminar, but that can be explained by the acknowledged “commercial support” for the program from GlaxoSmithKline, Merck & Co., Inc., Sanofi Pasteur, and Wyeth Vaccines. At least those sponsors were up front about their interest in presenting the program; Dr. Offit reports that he has “no relevant commercial relationships to disclose.”

Punxsutawney Phil seems to be a genial fellow who can entertain a crowd. But I wouldn’t want to place my faith in his forecasting skills. Is it any wonder that Punxsutawney Phil and Paul Offit both come to us from the great state of Pennsylvania? Hey, wait a second . . . isn’t Dr. Offit from somewhere around Gladwyne, Pennsylvania? Could it be???

Before I close this one out, I just wanted to extend best wishes to all who will be at the rally and the DAN! conference in Washington. While at the conference, keep an eye out for my spouse, Sym, and go say “hi.” And if you see her on Saturday, remind her to call home and wish her husband a happy anniversary.

22 (MAKE THAT 25) GOOD REASONS TO LOVE NEW ORLEANS MUSIC

I was staring to formulate a new post on autism controversies, etc., but it’s been just too pretty a day, and I’m still having those Jazzfest thoughts. Then a friend of ours emailed asking for musical suggestions for a party with a New Orleans theme. It got me thinking about what songs I would burn onto a mix if I was throwing the party. Here, in alphabetical order, is a pretty good, but certainly non-exhaustive, sampling of New Orleans classics.

All These Things ⎯ Art Neville
Art is the eldest of the famous brothers (and the father of television journalist Arthel Neville). His career spans close to fifty years, and would have been considered complete if he had never cut another record after “All These Things.” It’s a great slow-dance love song.

Big Chief ⎯ Professor Longhair
Henry Roeland Byrd a/k/a Professor Longhair was called “the Bach of Rock,” partly because of the intricacy of his piano playing, and partly because of the influence he had on what developed into rock-n-roll. He pioneered a rhumba-flavored blues style of piano playing that came to shape the New Orleans style. “Big Chief” is one of many songs that echoes the chants of the Mardi Gras Indians, groups of African Americans who take to the streets on Fat Tuesday morning in elaborate costumes. Greta versions of this song were also released by Dr. John and the subdudes.

Burgundy Street Blues ⎯ George Lewis
I’m not including very much traditional jazz on this list, mainly because it would lengthen it by at least a hundred tunes to include just the essentials. But this little-known gem is just too good to omit. George Lewis was, in my humble opinion, the greatest clarinet player New Orleans ever produced. “Burgundy Street Blues” was one of the few tunes he actually wrote. It has a bittersweet feel to it; you just can’t help but close your eyes and smile wistfully while listening to it.

Cissy Strut ⎯ The Meters
The original Meters consisted of Art Neville on keyboards, Leo Nocentelli on guitar, the incomparable George Porter, Jr. on bass, and the irrepressible Zigaboo Modeliste on drums. They served as the house band at legendary Sea-Saint Studios, where they backed up the likes of Dr. John, Robert Palmer, and Paul McCartney. They also cut some amazing albums of their own. Most of the early records were instrumentals, including this classic that redefined the meaning of “funk.” After years of legal disputes and petty squabbling that kept them apart, the original four Meters regrouped for last year’s Jazzfest. They had so much fun, they did some more dates, and they are back on the jazzfest schedule for the end of this month.

Fiyo on th’ Byo (Fire on the Bayou) ⎯ The Neville Brothers
This tune was originally recorded by the Meters, during a period when Cyrill Neville was part of the group. When Art and Cyrill left the Meters, they formed the now-legendary act with their brothers Charles and Aaron. This is one of the Meters’ tunes that made it into the new group’s catalog, and the Nevillized version is nothing short of amazing.

Gonzo ⎯ James Booker
Before the weird blue Muppet, and even before anyone decided to give the name to Hunter S. Thompson, James Carroll Booker, III was Gonzo. He took Professor Longhair’s syncopated rhythms and took music to places no musician had gone before or has gone since. Among the odder chapters of his life story was that this genius who was known to disobey a few laws in his life, took the young son of the local district attorney under his wing, and showed him a thing or two on piano. A few cynics thought Booker was using the kid as his get-out-jail-free card, but it turns out the kid had a few chops and Booker seemed to genuinely like him. The kid was a 12-year old Harry Connick, Jr., who seems to have found some measure of success. It is ironic that Booker, who was known as “the piano prince of New Orleans,” recorded his best known song, “Gonzo,” on organ.

Hey Pocky Way ⎯ The Meters
This classic vocal track from the Meters is adapted from a Mardi Gras Indian chant. The Neville Brothers also perform this song, but the Meters’ version is definitive Fat Tuesday funk.

Iko Iko ⎯ Dr. John
This is another one that started out as an Indian chant. It is the mark of pride in new Orleanians that we actually understand the lyrics to this one. A better known version was released by the Dixie Cups, but the doctor’s recording can’t be beat.


I’m Walkin’ ⎯ Fats Domino
When Hurricane Katrina bore down on New Orleans, one of the stubborn folks who refused to leave was Antoine “Fats” Domino. His rescue from his Ninth Ward house made headlines, and resulted in a collective sigh of relief around the world. He’s not only playing at this year’s Jazzfest, he’s on the poster. A lot of his songs could have made this list, but I chose my favorite.

It’s Raining ⎯ Irma Thomas
Irma Thomas is rightfully called the “soul queen of New Orleans.” She makes any song sound good. This is a classic tune of having the blues in the rain.

Lipstick Traces ⎯ Benny Spellman
This was the only nationally known hit by Spellman, affine New Orleans singer. The song’s imagry shows why Allen Toussaint is so revered among songwriters:

Lipstick Traces
On a cigarette
Every memory of you
Lingers yet

Mardi Gras in New Orleans ⎯ Professor Longhair
This is a rollicking good time of a song with incredible piano work and the world’s funkiest whistling.

Mother in Law ⎯ Ernie K-Doe
Ernest Kador was a unique character who was born to entertain. It’s hard to say he had a great voice, but every song he sang was infused with personality. His best known song was another Allen Toussaint gem, with references to the stereotypical mother-in-law having been “sent from down below.” For anyone who has had a mother-in-law who “thinks her advice is a contribution, but if she would leave would be a solution,” this song is an anthem. In his last marriage, ol’ Ernie finally found a mother-in-law he loved, but he never talked about the ones who came before. I can relate.

St. James Infirmary ⎯ Louis Armstrong
It seems odd to only have one song by Satchmo on the list, but it’s another case of keeping it manageable. “St. James Infirmary,” also known as “The Gambler’s Blues” was a New Orleans variant in “The Unfortunate Rake” cycle of folk songs (okay, that’s a bit more information than you really wanted). Armstrong recorded it at the peak of his career, and he’s at his best on both trumpet and vocals.

Such a Night ⎯ Dr. John
Mac Rebennack’s most commercially successful album was ‘Right Place, Wrong Time,” on which he was backed up by the Meters. Of all the great songs on the album, “Such a Night” is standing the test of time quite well. It’s hard not to crack a little smile at the rationalization of the refrain: “If I don’t do it, y’know somebody else will.”

‘Taint it the Truth ⎯ Ernie K-Doe
Another great performance from K-Doe, in one of those “she’s left me” songs.

Time Is On My Side ⎯ Irma Thomas
Most people are familiar with this song as being one of the early hits of the Rolling Stones. Ms. Thomas recorded the original, and her vocal puts Mick to shame.

Tipitina ⎯ Professor Longhair
Never has random nonsense sounded so good. Dancing to this is as much fun as is humanly possible. The famous New Orleans nightclub, Tipitina’s, is named after this song, and a statue of the professor stands in the neutral ground (“median” for you yankees) of adjacent Napoleon Avenue.

Tell It Like It Is ⎯ Aaron Neville
Is there anyone out there that really hasn’t heard this one?

Who Shot the Lala ⎯ Oliver Morgan
Before Sym and I got married, one of our more memorable dates was to see the legendary Tommy Ridgley (who we eventually hired to play our wedding) perform at a suburban club. Sitting in for a set was none other than the great Oliver Morgan. As it turned out, we were one of only two couples in the place, but Tommy and Oliver didn’t seem to care. They put on a great show. I will never forget seeing Oliver Morgan look down from the stage to the dance floor where I was twirling my Sym around, and he asked “You love that woman, boy?” I surely do Mr. Morgan. “Who Shot the Lala” is Oliver Morgan’s best-known song, and is, without doubt, the world’s most fun song about a killing.

Workin’ in a Coal Mine ⎯ Lee Dorsey
This was reworked in the ‘80s by Devo, but it just wasn’t the same. It’s yet another Allen Toussaint song, and has the absolute greatest bass line of all time.

You Can Have My Husband (But Please Don’t Mess With My Man) ⎯ Irma Thomas
When you get right down to it, the name pretty much says it all.

There it is, a short list of songs that can turn any party into a N’Awlins second line. But there’s a lot more where those came from. Anyone with internet access can get a free lesson in New Orleans every day by listening in on the world’s greatest radio station. So c’mon, everybody get funky!

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Addendum:

After posting this, I realized I left off three of the great ones.

Barefootin’ ⎯ Robert Parker
This has to be one of the greatest dance songs of all time.

Ooh Poo Pah Doo ⎯ Jessie Hill
Another bit of irresistible nonsense.

You Talk Too Much ⎯ Joe Jones
And really, haven’t we all wanted to say that to someone sometime. Some people say something similar in the comments to this blog on a regular basis.

So now we have a full 25 songs on our New Orleans list. NOW GET FUNKY!