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Sex abuse article missing content?

I’ve just been reading my Summer 2012 edition of New Zealand Skeptic, but I think there is a piece missing from my version.

On page 15-17 there is an article by Gordon Waugh that is missing both a chunk of text and his references. There is clearly a gap between the first section which ends with “it caused mental injury” and the next which starts with “Do sexually assaulted people exhibit …”. In the later section he talks at length about the lack of a defined ‘syndrome’ caused by sexual abuses. This doesn’t make any sense unless there is a paragraph on why the ‘mental injury’ should be a ‘syndrome’ in order to be real. There’s no specific ‘falling off a ladder’ syndrome, either, but I wouldn’t argue that that means people aren’t injured in falls. Without Mr Waugh’s explanation of why he is using this narrow definition of ‘mental injury’ his argument becomes ridiculous.

I’m also concerned that his references have been lost. He talks about what counsellors believe and think, but the survey or research that backs this up is missing. I find it hard to believe an author calling for ACC to demand testable evidence in relation to sexual abuse cases would fail to provide the evidence to back up his own assertions. He also talks only about counsellors, and I assume that the section of his article that deals with what it means to be an ACC registered counsellor is also missing. Without it, it looks as though anybody can can set themselves up and start referring patients for claims. This is obviously absurd and without the missing section Mr Waugh’s credibility takes a serious knock.

Perhaps these could be printed alongside part two of this article, which I assume will be covering the legislative aspects. Mr Waugh refers twice to laws that are being broken, but never actually sets out which statutes these are. He also calls for the criminalisation of ACC claims that fail to provide “proper evidence” of sexual abuse and I assume he will talk more about how “proper evidence” is defined and how it would be collected. And how its collection will be consistent with the evidence required by other types of injury.

Renee Maunder

Peppering is back

Not possums … rabbits!

I was horrified to see a Country Calendar this morning (made in 2011) where the increase in rabbits was being discussed. One of the farmers said he had been told to shoot a rabbit, skin it, burn the skin, and scatter the ash in order to have the desired effect. He just hoped the rabbits would go elsewhere! He admitted his other farmer friends were doubtful but were waiting to see what happened. He said he was four weeks into the trial but that positive results might not show up until at least six weeks.

Well, this might work if he shot lots of rabbits to get the skins to burn … shooting would remove a few.

Else I have this mental picture of hundreds of little bunnies all sitting in Easter baskets and madly paddling away back to England…

Louette McInnes
Christchurch

Deconstructing Sex Abuse Industry Claims

ACC’s best-practice guidelines for identifying cases of sexual abuse are not credible.

Twenty years ago, New Zealand had a mere handful of people who claimed to be ‘counsellors’. Now they number in their thousands. The phrase, “victims were offered counselling”, has become commonplace, yet the only practical intervention they can make is to talk.

How did we suddenly produce so many wise folk who can provide counselling and therapy to so many? Is counselling science-based or evidence-free ideology? What did we do before we had counsellors?

Despite lofty claims of being trained health professionals, counselling is not registered under the Health Practitioners Competence Assurance Act 2003. Nor is it regulated by Government or any public process. It requires no specific or mandatory training, public examination, knowledge or skills. Selling counselling services to the public can be done by anyone, without control or accountability, much like psychics, spirit guides and mediums.

My particular concern here is sex abuse counselling, the industry it spawned and the part ACC plays. An ACC press release of 16 October 2009 advised that “[b]y law, ACC can only accept sensitive claims from those diagnosed with a mental injury resulting from the sexual abuse they’ve suffered.” There are two parts to this; firstly, sexual abuse must have occurred, and secondly, it caused a mental injury.

A Sexual Abuse Syndrome?

Do sexually assaulted people exhibit predictable behavioural characteristics that can accurately be profiled? The term ‘syndrome’ is defined in the New Shorter Oxford English Dictionary as a “group of symptoms or pathological signs which consistently occur together, especially with an (originally) unknown cause”. There is yet no reliable scientific evidence that sexual abuse is a cause of any specific psychiatric, psychological or behavioural condition. Reactions to sexual abuse are generally idiosyncratic and therefore unpredictable.

The existence of a sexual abuse syndrome would mean the “(originally( unknown cause” could be determined from client behaviour alone. Police would have a field day! No such syndrome has yet been identified, making it impossible to properly conclude from client behaviour alone whether a sexual abuse event was experienced.

Science – and evidence-based diagnosis – should always precede treatment decisions and methods. To ensure correct treatment is given to sexual abuse victims, it is also necessary to define what behaviours are not indicative of sexual abuse, but that has not been achieved. If the possibility of sexual crimes arise, then it is essential to find the facts from other forms of evidence.

Counselling

A recent president of the NZ Association of Counsellors declared that counsellors are not ideologically driven people – they are trained health professionals with high ethical standards who are not required to investigate crimes. Sexual abuse is a serious crime. But counsellors lack the skills, resources or authority to conduct external investigation of client claims.

To help it survive and grow, the industry created ideological myths and beliefs about abuse, amongst others, the fantasies of recovered memories, multiple personality disorder and satanic ritual abuse, and then invented scores of ‘counselling modalities’ to treat the claimed effects.

Counsellors believe that sexual abuse can be detected, confirmed or diagnosed from client behaviour.They created extensive lists of ‘effects’ and believe that clients presenting with a ‘cluster’of these ‘effects’ must have been sexually abused. In reality, the causes of those ‘effects’ are myriad. Test it for yourself – how many causes of (eg) ‘depression’ can you name?

The three glaring flaws in most sex abuse counselling cases are a lack of credible evidence that the client was in fact sexually abused, inability of counsellors to separate the effects of sexual abuse (if any) from the effects of other trauma in the client’s life, and a penchant to make treatment decisions on the basis that inevitable detrimental consequences arise from sexual abuse.

To them, allegations of abuse are proof of abuse, but absent externally corroborated evidence or other reliable markers of sexual abuse, a counsellor cannot know whether a client was in fact abused.

ACC’s Best-Practice Guidelines

There is much misguided and ill-informed thinking underscoring this vexed topic, as shown by ACC’s document Sexual Abuse and Mental Injury: Practice Guidelines for Aotearoa New Zealand, March 2008 (generally called the Massey Guidelines(.

It was developed for ACC by a research team from Massey University’s School of Psychology (Turitea Campus( and purports to describe best-practice guidelines for professionals from all disciplines providing therapeutic services to people who have experienced sexual abuse.

ACC’s October 2009 press release said, “[t]hese guidelines represent a significant landmark in the treatment of mental injury resulting from sexual abuse, because they’re developed by New Zealanders for New Zealanders; are evidence-based; and the product of four years’ extensive research and consultation.”

The Massey Guidelines declare that over 700 effects of sexual abuse have been identified, which are believed by counsellors to be reliable indicators of sexual abuse. The document states :

“No single effect can be seen as a trustworthy indicator of sexual abuse. Since effects never occur in isolation, it is useful to consider them in terms of what effects are more likely to co-occur.”

‘Effects’ present as ‘clusters’. If ‘pairs of effects’ had been specified, it would mean sets of two. However, the term ‘clusters’ means a group of three or more.

How skilled would counsellors need to be, to be able to determine retrospectively from ‘clusters of effects’ whether the client experienced sexual abuse? A reliable test would be to calculate the permutations to establish how big the task might be.

In the Massey Guidelines, no required order of choice of any single ‘effect’ is evident, and repeatability of any item is allowed (for example,’depression’ could appear in none, any, many or all clusters(. Under these conditions, the permutation formula to calculate the number of clusters is nPr, where n = 700 and r = 3, 4, 5…x, depending on how many effects make up a ‘cluster’.

Suppose any four effects are simultaneously presented as a cluster, then r = 4. The number of different ‘clusters’ able to be presented by a single client, and which the counsellor must be able to recognise, is therefore 7004 raised to the power of 4. That is, 238,047,385,800 possible clusters.

Full knowledge and awareness of that vast number of clusters is beyond ordinary human capacity. Counsellors would also need the ability, resources and authority to externally investigate each cluster and its individual components to ensure – before making treatment decisions – that the sole causewas in fact sexual abuse and not some other event or trauma in the client’s life.

The Guidelines say that for practical purposes in writing the document, the number of effects was conveniently reduced to 200! The number of possible clusters is consequently reduced. With just 200 effects presented in random clusters of four, a mere 1,552,438,800 clusters could exist.

Belief in the utility and reliability of these ‘clusters’ allows counsellors to assert that virtually any human behaviour is caused directly by sexual abuse, and conveniently removes the need for any other form of evidence of abuse.

Debate about the sex abuse industry is one about belief vs evidence. ACC supports the quaint notion of 700 ‘effects’ and believes mental injury is caused by sexual abuse which can be diagnosed from client behaviour alone. But no syndrome yet exists. Besides, counsellors and ACC fail to demand testable evidence of claimed sexual abuse.

I conclude the sex abuse industry is an ideological house of cards, based on myth, assumption and belief, and that ACC and sex abuse counsellors fail to meet legislative obligations. Moreover, every sexual abuse claim submitted to ACC without proper evidence of abuse and mental injury, constitutes a case of improperly using a document to obtain money, services and/or advantage.

Gordon Waugh is a retired Air Force officer with over 30 years of electronics engineering experience. He was a foundation and executive member of Casualties Of Sexual Allegations (COSA), a national organisation dedicated to helping men and their families damaged by false allegations of sexual abuse.

Pseudoscience for profit

Proponents of alternative therapies often throw around charges of vested interest when challenged. But often their own interests don’t bear scrutiny.

As this is the first of what I hope will be a regular column in the NZ Skeptic, I thought I would take the opportunity to tell you all a little bit about who I am and what has motivated me to write this column (besides David twisting my arm…). I am a research scientist with two obsessions: bioluminescence (the production of light by living organisms – think glow worms and fireflies), and nasty microbes. I feel immensely privileged to have made a career out of combining these two passions: in a nutshell, I make bacteria glow in the dark for a living.

After many years working in the UK, I was awarded a fellowship from the Health Research Council of New Zealand and relocated to the University of Auckland. Shortly after arriving in Auckland I joined Skeptics in the Pub and a fellow skeptic lent me a copy of Trick or Treatment. This fantastic book, written by Dr Simon Singh and Prof Edzard Ernst, reviews the evidence for the effectiveness of complementary and alternative medicine. I’m sure I don’t need to tell this audience that despite very little evidence for their success, these treatments are widely used.

In the final chapter, Singh and Ernst list some reasons why this might be. Surprisingly, scientists are on their list. Singh and Ernst argue that alternative health practitioners are highly vocal and many of their claims go unchallenged. They believe scientists have a responsibility to make their voices heard too. I found Singh and Ernst’s call to arms inspirational and took up blogging and writing letters to the editor as a result.

A very rich source of ire comes from a free monthly 150-page glossy A4 advertising magazine called the Ponsonby News, distributed to over 16,000 homes and businesses in Auckland. The Ponsonby News has a couple of ‘health correspondents’: John Appleton, who has a website selling vitamin and other supplements, and ‘Dr’ Ajit, an Ayurvedic practitioner with a couple of spas in Auckland. For those unfamiliar with Ayurvedic ‘medicine’, it is a system of traditional medicine that originated in India. Mr Ajit’s column is usually pretty funny, like urging people with hay fever not to eat stodgy food in winter for fear it will clog them up.

But John Appleton’s column usually worries me. A couple of months ago, he was inspired by an article he read in the Listener assessing the risks and benefits of hormone replacement therapy, which advised readers to avoid the internet and talk to their doctors instead. Unsurprisingly, Mr Appleton was somewhat horrified by this suggestion having “found the internet to be a fabulous resource” for researching topics like hormone replacement therapy.

Indeed, what he went on to write about was ‘bio-identical’ hormones which he implied are a safe and effective alternative to hormone replacement therapy. I wrote a letter to the editor to point out that the benefits of ‘bio-identical’ hormones were at best overhyped and at worst pseudoscientific nonsense1, which prompted a reply both through his column and in person. In it, I was accused of being part of the medical establishment, locked away in my ivory tower, only interested in “science for profit”, unlike those in the complementary and alternative medicine field, who he believes are doing “science for people”. He has since sent me an envelope full of reading material to show me just how bad evidence-based medicine is.

It was really interesting to read the propaganda material which has shaped Mr Appleton’s views on evidence-based medicine and the medical establishment. Needless to say, they are all non-peer reviewed articles posted on natural health websites.

I found one article in particular quite fascinating, as it trumpeted Andrew Wakefield, the disgraced gastroenterologist who insists there is a link between autism and the measles-mumps-rubella (MMR) vaccination. As a microbiologist, I am very familiar with Wakefield’s work, which is just plain old bad science (see NZ Skeptic 100). But Wakefield continues to be held up as a shining example of how a good doctor trying to do the best for his patients has been vilified by the medical establishment. If this kind of material is what Mr Appleton is using as his evidence base then I’m definitely alarmed!

I am left contemplating Mr Appleton’s concept of “science for profit” versus “science for people”. I have never thought of myself as doing science for profit. True, I make a decent living being a scientist but it is nothing like the money I imagine some of those involved in alternative medicine make. It is worrying that the alternative health field has successfully propagated the belief that it is purely motivated by improving people’s health and wellbeing, completely glossing over the fact that it is an extremely lucrative industry.

Indeed, one of the pieces of evidence that Mr Appleton used to back up the claims he made about ‘bio-identical’ hormones was a review paper written by a medical doctor called Kent Holtorf and published in an obscure peer-reviewed journal. Interestingly, Dr Holtorf declared no conflicts of interest despite the fact that he is founder of the Holtorf Medical Group which has offered ‘bio-identical’ hormone therapy for over 10 years. Science for people? More like ‘pseudoscience for profit’, if you ask me.

1‘Bio-identical’ was a phrase coined to describe plant-derived molecules believed to be identical to human hormones. No evidence has ever been presented to verify this. Many of the conventional treatments include similar plant-derived molecules. The difference is that the conventional therapies have been studied over many years so doctors know what the side effects and risks associated with them are. There is no evidence that ‘bio-identical’ hormones are safer or more effective; it is likely they have the same side effects and risks. As for it being pseudoscience, ‘bio-identical’ hormone treatment often involves blood or saliva testing to determine which hormones are deficient and hence tailoring treatment to the individual. While this sounds like a good idea, there is no scientific basis or indeed evidence that such a strategy is useful or relevant. In fact, hormone levels in the blood and saliva vary from day to day and are unlikely to reflect the actual biological activity in specific tissues.

The Unfortunate Experiment: Revisiting the Cartwright Report

This article is a response to ‘Truth is the daughter of time, and not of authority’: Aspects of the Cartwright Affair by Martin Wallace, NZ Skeptic 96.

The Cartwright Inquiry1 was held after the publication of “An Unfortunate Experiment at National Women’s” in Metro magazine in June 1987. The events leading up to the publication of the article and the findings of the subsequent inquiry have been contested ever since.

The inquiry heard from 67 witnesses, many doctors, 84 patients and relatives, and four nurses. In addition, 1200 patient records were reviewed, with 226 used as exhibits. The final report released in August 1988 has had a long-lasting impact. It recommended many changes in the practice of medicine and research, including measures designed to protect patients’ rights and a national cervical screening programme. These have since been implemented. The Medical Council announced in 1990 that four doctors were to face disciplinary charges resulting from the inquiry’s findings of disgraceful conduct and conduct unbecoming a medical practitioner. Charges against Dr Herbert Green were dropped due to ill health.

The report of the Committee of Inquiry has withstood many challenges, including judicial reviews and many articles alleging its findings to be flawed. Yet there have been allegations of a miscarriage of justice, charges of a witch-hunt, even a feminist conspiracy.

Where does this leave Dr McIndoe and others who had mounting concerns for so many years? Why did so many women develop cancer? In this article I will explore the findings of the Cartwright Inquiry, its context, the research and the criticisms, and attempt to find a more nuanced understanding of the “unfortunate experiment” and its ongoing effects. Page numbers in parentheses refer to pages in the Cartwright Report. CIN3 and CIS are interchangeable terms for a lesion of the cervical epithelium which can be a precursor to invasive cancer.

The Findings of the Inquiry

The report found that Green, rather than developing a hypothesis, aimed to prove a point (p 21) that even at the time was known not to be the case. A 1961 compilation of studies from Paris, Copenhagen, Stockholm, Warsaw, and New York showed CIS progressed to invasive cancer in 28.3 percent of cases (p 23). As at 1958 the official policy was “… treatment of carcinoma of the cervix Stage 0, [CIS] should be adequate cone biopsy … provided the immediate follow-up is negative and … the pathologist is satisfied that the cone biopsy has included all the carcinomatous tissue” (p 26). Standard treatment of the time involved excising all affected tissue and the ‘conservative’ treatment of conisation was in use well prior to 1966.

Green’s initial proposal stated “… It is considered that the time has come to diagnose and treat by lesser procedures than hitherto, a selected group of patients with positive (A3-A5) smears. Including the four 1965 cases, there are at present under clinical, colposcopic, and cytological observation, 8 patients who have not had a cone or ring biopsy. All of these continue to have positive smears in which there is no clinical or colposcopic evidence of invasive cancer”… The minutes then record that “… Professor Green said his aim was to attempt to prove that carcinoma-in-situ (CIS) is not a premalignant disease”… (p 22). This appeared to come about because of concern about unnecessarily extensive surgery for CIS between 1949 and 1962. During this period, some centres were beginning to use cone biopsy as effective treatment; however there were limitations to its use (p 27).

There were some questions over whether the work was a research project. The inquiry concluded this was the case and that a research protocol, however flawed, was put in place (p 69). Green published in peer-reviewed journals on his hypothesis and findings. By 1969, three cases of invasive disease had occurred in patients with positive cytology monitored for more than a year, and this should have made it clear that following patients with persistent CIS was unsafe (p 52).

Green then explained those patients by concluding that they’d had invasive cancer that was missed at the outset. The report contends this was dangerous to the patients as it demonstrated that the proposal was incapable of testing the hypothesis. These patients were reclassified by Green and the patients removed from the study (p 55). In addition, patients over the age of 35 were included in the research in breach of the protocol vp 49).

There were many subsequent issues, including lack of patient consent (p 136). Patients also had to return for repeated tests and other invasive procedures, often receiving general anaesthetics in the process (p 42-49). A collection of cervices from foetuses and stillborn infants and another of baby uteri in wax were collected by Green for research which was later abandoned. This did not appear to comply with the Human Tissue Act (1964) as no consent was obtained from the parents of the stillborn infants (p 141).

As part of an earlier 1963 trial to test whether abnormal cytology in women later developing CIS or invasive cancer was present at birth (pp 34 & 140), 2,244 new-born babies had their vaginas swabbed without formal consent from the parents (there was a decision to abandon this trial soon after it started but this wasn’t communicated to nursing staff until 1966).

Procedures such as vaginal examinations and IUD insertions/removals on hysterectomy cases were performed by students without patient knowledge or consent while they were under anaesthetic (p 172). There was a further study on carcinoma of the cervix treatment, where patients either had radiotherapy alone or hysterectomy and radiation (p 170). The method of randomisation was by coin toss.

The Research

The idea that patients were divided into two experimental groups arose from McIndoe et al (1984)2. The patients were divided retrospectively into two groups which overlapped strongly but not completely with groups defined by Green, that he called “special series”. In his 1969 paper, cited in the report (p 40-41) he stated: “The only way to settle the question as to what happens to carcinoma in situ is to follow adequately diagnosed but untreated lesions indefinitely … it is being attempted at NWH by means of 2 series of cases. (I) A group of 27 women … are being followed, without ‘treatment’, by clinical, colposcopic, and cytologic examination after initial histological diagnosis of carcinoma in situ … has been established by punch biopsy … (II) A group of 25 women who have had a hysterectomy (4 for cervical carcinoma in situ) and who now have histologically-proven vaginal carcinoma in situ, has been accumulated …” This was done semi-randomly, with cases presenting themselves fortuitously.

The outcome for the group of 25 who were included in the punch biopsy “special series” was summarised in the McIndoe et al (1984) paper. Nine out of 10 women who were monitored with continuing positive smears developed invasive cancer. Only one out of 15 women who had normal follow-up cytology later developed invasive cancer. While Coney and Bunkle may have made a mistake, it’s clear the judge didn’t. The report states: “Green’s 1966 proposal was not a randomised control trial, but it was experimental research combined with patient care” (p 63).

Green’s interpretation of the data in his 1974 paper is suspect, having concluded that the progression rate was 7-10/750 (0.9 to 1.3 percent) or 6/96 (6.3 percent) of ‘incompletely treated’ lesions (p 54). These were explained by suggesting that either invasive cancer was missed at the start, or over-diagnosed at the end. Dr Jordan (expert witness) deemed this interpretation incorrect as of the 750 cases, 96 had continuing positive cytology, meaning that the other 654 patients could be considered free of disease. Of that 96, 52 patients had not been assessed further, making it impossible to know whether or not this group already had unsuspected invasion. Of the 44 patients remaining with ongoing carcinoma in situ who had more investigations, seven were found with invasive carcinoma. The incidence of known progression was therefore 7/44 (16 percent), which approximates McIndoe et al (1984) findings. This means that the proportion of invasive cancer cases in those inadequately treated was much higher compared with those who had returned to negative cytology, even before any cases where slides were re-read and excluded are considered.

McIndoe et al (1984) covered the follow-up data for 948 patients with a histological diagnosis of CIS patients who had been followed for a minimum of five years; there was a further paper in 1986 regarding CIS of the vulva. The same method used by Dr Green to group women by cytology after diagnosis and treatment was used, but using the correct denominators and the original diagnosis. Patients who were diagnosed with invasive cancer within one year were excluded to avoid the possibility the cancer had been missed initially. The management was cone biopsy or amputation of the cervix in 673 patients, with 250 managed by hysterectomy. The only biopsies in 25 women were punch biopsy (11), wedge preceded by punch biopsy (7) and wedge biopsy alone (7). Twelve out of 817 (1.5 percent) of group 1 patients developed invasive cancer. Given the lengthy follow-up with negative cytology for group 1 patients, the authors concluded these represented the development of new carcinoma. There were marked differences in the completeness of excision between the two groups and the second group shows markedly different results, with 29/131 (22 percent or 24.8-fold higher chance) with positive cytology developing invasive cancer. At 10 years this was 18 percent rising to 36 percent after 20 years, irrespective of the initial management or histologic completeness of excision. This needs to be explained, as those figures strongly suggest the progression of CIS to invasion when it is and was a totally curable lesion. The answer is that a prospective investigation, as done by Green, has to establish that invasive disease is not present, while conserving affected tissue that is required for later study. The argument has been posed that women in the second group did get cone biopsies and hysterectomies. This ignores the fact that while many women were treated with various procedures, there was evidence of continuing disease, demonstrating that the intervention was inadequate. This was not followed up, posing a high risk of development of invasive disease.

This differs from group 1 patients, who were successfully treated at the outset. It’s pertinent to point out that the Cartwright Report did not rely on this study (or the Metro article) to reach its conclusions, but on review of patient records.

There have been two follow-up studies. McCredie et al (2008)3 examined medical records, cytology and histopathology for all women diagnosed with CIN3 between 1955 and 1976, whose treatment was reviewed by judicial inquiry. This paper gave a direct estimate of the rate of progression from CIN3 to invasive cancer. For 143 women that were managed by only punch or wedge biopsy the cumulative incidence was 31.3 percent at 30 years and 50.3 percent in a subgroup who had persistent disease at 24 months.

The cancer risk for 593 women who received adequate treatment and who were treated conventionally for recurrent disease was 0.7 percent at 30 years. These findings support McIndoe et al (1984) and extend the period of follow-up.

McCredie et al (2010)4, described the management and outcomes for women during the period 1965-74 and makes comparisons with women diagnosed 1955-64 and 1975-76. This showed that women diagnosed with CIN3 in 1965-74 were less likely to have treatment with curative intent (51 percent vs 95 percent and 85 percent), had more follow-up biopsies, were more likely to have positive cytology during follow-up and positive smears that were not followed by curative treatment within six months, as well as a higher risk of cancer of the cervix or vaginal vault.

Those women initially managed by punch or wedge biopsy alone in the period 1965-74 had a cancer risk 10 times higher that women treated with intention to cure. This was despite the 1955-64 group being largely unscreened, which would have delayed diagnosis. This study is important as it shows the medical experience of the women, where they were subjected to many interventions that were not meant to treat but rather to monitor.

Whistle blowing

Scientific misconduct happens, and for those trying to address it the risks are high. Brian Martin5 looked at several cases, and stated: “In each case it was hard to mobilize institutions to take action against prestigious figures. Formal procedures, even when invoked, were slow and often indecisive.”

McIndoe and others encountered similar difficulties and ultimately failed to get Green’s proposal reviewed. The concept of “clinical freedom” (p 127), where the doctor was the arbiter of the best course of action for the patient, was one major issue to emerge from the report. Colleagues tended to be very reluctant to intrude upon this, and this meant that the proposal could continue with little oversight or intervention. McIndoe had mounting concerns, particularly after 1969, which were disregarded or treated lightly.

These concerns were shared by pathologist-in-charge Dr McLean, and were raised internally with Medical Superintendent Dr Warren, who consulted with the Superintendent-in-Chief, Dr Moody and an internal working party set up to look at the issue in 1975. Twenty-nine cases that had developed invasive disease were referred to it; however only 13 were examined, and having set up its own terms of reference it only considered whether the protocol had been adhered to and disregarded concerns about patient safety (p 83).

The 1966 proposal effectively ceased when McIndoe withdrew colposcopic services and Green reverted to cone biopsy in most new cases (p 88), but it was never formally terminated. While Green himself did not take any steps to prevent the review of records by McIndoe and colleagues, Bonham did, and wrote a letter to the Medical Superintendent (p 92).

There are some important lessons to be learned from this, including that those with the authority to deal with the situation should make the best effort to achieve a balanced view of the situation and assess it fairly to allow the claimant a fair hearing.

Conclusions

The potential risks of Green’s proposal outweighed any benefits such as avoiding hysterectomy or cone biopsy. Invasive cancer could not be ruled out because there were poor safeguards against the risk of progression. This was unethical from the outset, regardless of the issue of informed consent. In addition, patients that developed invasive disease had their slides reclassified and were removed by Dr Green from the study. This would be considered research misconduct then and now as it manipulated the data.

It does not matter if the initial motivations were sincere; they ultimately fail on these points. This proposal had a very human cost. Moreover Green’s views had long-term effects, including influence on undergraduate and postgraduate medical students, and support for the attitude that cervical screening was not worthwhile. This ‘atypical’ viewpoint was also promoted in the scientific literature and in the press, creating confusion within the medical scene and with the public.

It can be incredibly hard to admit our failings and let go of old loyalties. In the aftermath of the report many doctors objected to cervical screening, ‘unworkable’ consent forms and the intrusion of lay committees on practice6. It’s true this had negative effects on the perception of doctors overall, particularly in regard to practices that were widespread in hospitals at the time, and there were times that unfair criticisms were aired. This impacted on the nursing profession as well, for nurses are meant to be patient advocates.

This was also about power. The really unfortunate thing is that medical responsibilities to patients are almost totally ignored in the midst of the argument, when they should be brought to the forefront. Likewise respect, justice and beneficence were lacking for the patients involved. No doctor raised concerns about the lack of consent, even though from the 1950s there was the growing expectation that this be sought, particularly with participants in research.

The Medical Association working party that examined this stated that it was “regrettable that the trial deteriorated scientifically and ethically and did not change as scientific knowledge advanced or as adverse results were observed”7. They found it deplorable that patients involved did not know they were part of a trial, and that it took a magazine article for it to be investigated.

Unfortunately, instead of addressing this and examining whether Dr Green made any errors or misinterpretations himself, the findings in McIndoe et al (1984) and other papers were not accepted. There is the unfortunate implication that, rather than there being mounting and valid concerns over decades, that Green was unfairly toppled and the resulting inquiry was a whitewash.

The report couldn’t have been written without the assistance of the medical community as expert witnesses and advisors. It’s not surprising that there would be loyalty for a colleague, but perhaps instead of attempting to rehabilitate Green it’s time McIndoe and his colleagues were vindicated. Morality did not totally fail and attempts were made to prevent patients being harmed8.

Acknowledgements: many thanks to Dr. Margaret McCredie of Otago University who assisted me with my research.

  1. The Cartwright Report: www.nsu.govt.nz/current-nsu-programmes/3233.asp
  2. W.A. Mcindoe; M.R. McLean; R.W. Jones; P.R. Mullins 1984: J. Am. Coll. Obst. 64(4).
  3. M.R.E. McCredie; K.J. Sharples; C. Paul; J. Baranyai; G. Medley; R.W. Jones; D.C. Skegg 2008: The Lancet Oncology DOI:10.1016/S1470-2045(08)70103-7
  4. M.R.E. McCredie; C. Paul; K.J. Sharples; J. Baranyai; G. Medley; D.C. Skegg; R.W. Jones 2010: A&NZ J. Obst. Gyn. DOI:10.1111/j.1479-828X.2010.01170.x
  5. B. Martin 1989: Thought and Action 5(2), 95-102.
  6. J. Manning (Ed.) 2009: The Cartwright Papers: Essays on the Cervical Cancer Inquiry 1987-88. Bridget Williams Books Ltd.
  7. L. Bryder 2009: A History of the “Unfortunate Experiment” at National Women’s Hospital. Auckland University Press.
  8. C. Paul 2000: BMJ 320, 499-503.

Hokum Locum

Poison for Profit

There is something rotten in the state of China, a country where greedy people are quite happy to poison their own citizens in the name of profit. Milk powder is assayed for protein content by detecting nitrogen levels. Melamine, being a nitrogen-rich compound, gives a return in this test which indicates for protein, so if you have a poor milk product or it has been watered down, melamine can be added to make the product look as if it is up to normal protein levels.

The Chinese have been down this path before when they used melamine in pet food and it caused similar problems with kidney stones.

They also have a history of adding effective western drugs such as Viagra and steroids to enhance useless herbal remedies.

Melamine is relatively non-toxic but is relatively insoluble so tends to precipitate out and form stones in any animal that has the ability to concentrate urine.

Some animals such as cats and dogs are at a higher risk than humans because their urine is acidic and melamine has a lower solubility in acid urine.

I recall a previous scandal in the Chinese health system where the chief culprit was convicted and immediately shot. Despite my reservations about capital punishment one is tempted to wish the same fate on the criminals who have visited so much illness and suffering on small children.

Herbal Remedies for long life?

Folk wisdom is often seen as being somehow superior to modern medicine. Inductive logic is frequently used as a justification for quaint belief, reasoning from the specific case to the general case. For example, Great Uncle Fred took arsenic every day and lived to be 100 so therefore…

A nutritionist found a book in her late mother’s attic and has used it on a website promoting folk remedies such as pepper for earache, plantain leaves for toothache and horseradish mixed with gin for premenstrual tension. (Just as an aside, do women have postmenstrual docility?)

www.howtolive100years.com/index.html

You can even download the book, How to Live 100 Years. The nutritionist recalled her father treating her for mumps -“he put boiled onions on my neck.” This sounds remarkably like the medieval philosophy known as the doctrine of signatures where it was believed that God provided a ‘signature’ to plants as a sign for what ailments they might be useful for. An onion resembles the swelling of the neck with mumps so according to this doctrine an onion is the appropriate cure.

Marlborough Express 16 July 2008

Quackupuncture

An article in the Australian Medical Journal ( 2007; 187:337- 341) claimed to show that acupuncture was an effective treatment for allergic rhinitis. This struck me as absurd and also drew a sharp criticism from Edzard Ernst, Professor of Complementary Medicine, University of Exeter. Ernst has experience of a wide variety of modalities such as acupuncture, spinal manipulation and homeopathy. Despite what you might expect of his appointment he has proved to be something of a gadfly for those who make claims about alternative medicine.

The study had a fatal flaw as outlined by Ernst. It was supposed to be a ‘randomised sham controlled trial’ as follows. Needles were inserted into acupuncture points and stimulated when ‘chi’ was elicited. Chi is the subjective sensation associated with the needling of an acupuncture point. In the sham group needles were inserted at non-acupuncture points, where according to acupuncture theory no chi would be experienced! Ernst commented: ‘Thus the intervention patients were experiencing chi, and the control patients were not. This means that neither the patients nor the therapist were blinded.’ (just as an aside, ‘ blinding’ could have been achieved with acupuncture needles – the ‘ King Lear’ trial).

Another study I came across had the grand title ‘Laser acupuncture in children with headache: A double blind, randomized, bicentre, placebo controlled trial.’ Some years ago, when I reviewed the literature on acupuncture, I found the most poorly designed trials were the ones claiming the greatest results. A similar trial claimed to show laser stimulation of acupuncture points produced a ‘dramatic’ relief of pain in patients with rheumatoid arthritis. Some more sceptical people repeated the study and obtained the same improvement even when the laser was switched off!

Ancient Wisdom

While in Australia recently I saved an article from the Sunday Telegraph (21 September).

It claimed that the overburdened Australian Health System is causing large numbers of people to seek out traditional Chinese remedies.

According to Dr Alan Bensoussan, ‘The Chinese have linked particular signs together, connecting not only physical symptoms, such as the colour of the tongue and the quality of the pulse on the wrist, but also their predominant emotions, to make a diagnosis.’ What happens if you have a consultation straight after eating a raspberry ice block?

The article contains the usual anecdotal reports. A woman with asthma claimed that repeated courses of antibiotics had failed to cure chest infections which aggravated her asthma. She was cured by a one-week course of some unspecified herb.

The majority of chest infections in asthmatics are in fact caused by viruses so I have no argument there. As to the herb: probably as effective as powdered fox lung, a traditional English remedy for asthma.

Another person complained that he got the flu despite being immunised and taking a course of antibiotics. He now takes regular doses of herbal medicine and no longer gets the flu.

Immunisation is not 100 percent effective and as we all know antibiotics are ineffective against viruses. I wish journalists would challenge people on these issues instead of promulgating myths about antibiotics.

An example is given of the difference ( East vs West) between traditional Chinese and western medicine.

Six patients are found to have peptic ulcers and are all treated the same way by western doctors, regardless of sex, age and emotional state.

The Chinese traditional medicine practitioner however, takes into account differences in build, pulse quality, complexion, tongue colour, moods, sleeping patterns and length of nostril hairs. (No, I made that last one up). Each patient is diagnosed with a different root ( unintentional pun here) cause for their ulcer, based on their unique clinical picture.

I deliberately highlighted the last bit because this sort of treatment requirement is often quoted as a reason why such traditional treatments cannot be subjected to traditional drug trials. In order to give a patient an individual treatment they cannot by definition be randomised into a clinical trial. This often quoted as the ‘ plea for special dispensation.’ The other argument used is: ‘ we know our treatments work so there must be something wrong with your trial.’

However, I am mindful of the fact, pointed out by Professor Sir John Scott at last year’s conference, that a great deal of traditional western treatments and practices have never been put to the test. This is true but at least modern medicine is based on plausible ideas derived from scientific study of anatomy, physiology and pathology.

Chinese traditional medicine is based on highly implausible beliefs that defy logic and common sense.

Hokum Locum

Selenium – Too Much of a Good Thing?

New Zealand soils are deficient in selenium and this can cause serious health problems for animals. A 500kg animal needs about 1mg selenium daily. There is no evidence that New Zealand adults need selenium supplements and this situation has been described as “a deficiency in search of a syndrome”.

A 52-year-old dairy farmer presented to her doctor with chronic aches and pains, lethargy, sore throat and painful swallowing. After some weeks of fruitless investigations she admitted to taking 0.5ml daily of a solution containing 5mg/ml of selenium, several times the recommended daily human dose. All of her symptoms disappeared once she stopped taking the supplement.

Despite the lack of proof for any deficiency syndrome in adults, local pharmacy leaflets stated “selenium is an essential trace element” and that “low levels of selenium are linked to a higher risk for cancer, cardiovascular disease, inflammatory diseases and other conditions associated with free radical damage, including premature ageing and cataract formation.”

It is quite clear that it would have been much safer for this woman to have taken a homeopathic selenium remedy and there would have been no risk at all of any toxicity from over dosage.
NZ Family Physician Vol 30 Number 6, Dec 2003

Animal Homeopathy

I know that homeopathy has been done to death but it crops up everywhere, even in the treatment of animals. People defend this delusion by claiming that the placebo effect does not work in animals, therefore any observed effect must be real. Any observed effect is clearly due to expectation on the part of the person administering the water, sorry, I mean the homeopathic remedy. An article in the Christchurch Press (March 12, 2004) described how Taranaki’s first qualified animal homeopath has gained an “advanced diploma of homeopathy”. She also has a BSc and it beggars belief that someone with that background can take up a pseudoscience such as homeopathy. This is what HL Mencken was referring to when he said: “How is it possible for a human brain to be divided into two insulated halves, one functioning normally, naturally, and even brilliantly, and the other capable of ghastly balderdash?”

I find it amusing reading such accounts because the clue to the belief system is usually contained in the article but is unrecognised. In this case the animals are described as “glowing with health in a way that suggests good feeding and love but their appearance is so striking it indicates there is another ingredient as well”. You guessed it — the other ingredient is homeopathy! It’s obvious that the animals’ condition is due to the “good feeding and love” and to claim otherwise is a delusion.

It would not in the least surprise me if the diploma of advanced homeopathy is NZQA approved.

Snake Oil Flunks for Snake Bite

Boonreung Bauchan was known in Thailand as the “Snake Man” and held a Guinness world record for spending seven days in a snake enclosure. The Mamba family of snakes are extremely venomous and when one of them bit him on the elbow he relied on a traditional herbal remedy and a shot of whisky. As we all know, herbal remedies are mostly placebos and should not be used for serious or life-threatening conditions and Boonreung is sadly no longer with us. Had he taken a proper antidote, his chances of survival would have been excellent.
Christchurch Press March 23, 2004

Counsellors

If you get up in the morning and find your letterbox has been vandalised, don’t worry, counselling is available to help with your distress and grief. (Dominion Post March 6, 2004).

Following September 11, an estimated 9000 grief counsellors turned up in New York and one hotel was booked out by a single group of 350 counsellors. This absurd behaviour is of course defended by the counselling “industry” despite the existence of research that shows that many of such interventions are actually harmful. Counsellors defend their behaviour by claiming that it cannot be scientifically tested. For example: “People working from the scientific model want to measure outcomes. A lot of people would say, ‘I feel better’, but that doesn’t fit a scientific model.”

Such claims should be treated with complete contempt. This sort of reasoning could be used to justify the implementation of all sorts of quackery because it makes people “feel better”.

To put it bluntly, counselling is a placebo therapy. Third-party funding ensures that an industry has been able to develop. This has disempowered people from learning to deal with personal trauma by simply talking to a friend or other family members.

Hair Analysis

Last year I spent some time working in Westport and noticed an advertisement for hair analysis. Hair analysis does have a scientific basis but it has been taken over by quacks who offer all sorts of ridiculous assessments. When I got home I wrote to the address and sent hair from my wife Claire and my oldest daughter Eve, under their own names, and some hair from “Russell”. “Russell” was actually my daughter’s dog, a wheaten terrier.

For $40 I received a detailed four-page handwritten report and after reading it I felt quite mean because the writer’s sincerity was obvious. I have sent a copy of the letter to the Editor but will summarise the main findings. I see no value in exposing the writer because the letter was written in good faith but note that sincerity and good faith can go hand in hand with gullibility and foolishness. His findings were as follows:

Claire needs natural estrogen — “raspberry leaf” two tabs daily. Wormwood — 5 drops in water daily. Bach flower remedies — “Mimulus, Rock Rose”. Conscious deep breathing — practise six times daily. There was also a recommendation to have “faith” and consider the Bahai religion for that reason.

Eve had a systemic yeast infection. Recommended treatment: nystatin, aloe vera juice, Blackmores chewable tablets, wheatgerm capsules, super strength kelp, rescue remedy (Homeopathic), extra progesterone in the form of “wild yam cream”.

Russell also had a systemic yeast infection, and iodine deficiency. Recommended treatment: nystatin (oral antifungal agent), self heal tincture — 50 drops twice daily, herbal B vitamins — six tabs daily, super strength kelp — three tabs daily. Repeat hair analysis in three months.

It is easy to see that such a “scatter gun” approach to treatment would be bound to work in a well-motivated believer. I did not inquire as to the method of hair analysis but this is unimportant because any diagnostic method will work provided it is plausible and the treatment offered is congruent with the particular belief system. The homeopathic vet would no doubt approve of Russell’s diagnosis and treatment.

Shockwaves for chronic heel pain

High energy sound waves are now being used to treat various conditions such as tennis elbow and other painful areas such as the heel, knee and shoulder. It is claimed that 60-70 per cent of patients will gain relief from the treatment.

The same technology (extra-corporeal shockwave therapy or ESWT) is used to disintegrate kidney stones.

In the case of kidney stones there is no need for a randomised controlled trial (RCT) because it is obvious when a large stone has been broken down into smaller pieces.

When treating various painful conditions with no such “marker”, one has to be much more cautious and this therapy is crying out for a randomised controlled trial with a placebo group who would receive treatment administered when neither the patient nor the technician were aware that the machine was actually switched off. I predict that when such trials are carried out, there will be no advantage over placebo.
NZ GP November 12, 2003

Hokum Locum

Confidence Based Medicine

This is restricted to surgeons.

British homeopath suspended

The British General Medical Council (GMC) has found family practitioner Michelle Langdon guilty of serious professional misconduct and banned her from practising for three months. According to press reports, Langdon had advised a couple that the gastrointestinal symptoms of their 11-month-old were caused by “geopathic stress patterns” beneath their home and then “dowsed” for a remedy by swinging a crystal attached to a chain over a book of herbal remedies. A hospital emergency department subsequently found that the child had gastroenteritis. The GMC also examined evidence that another patient had been prescribed an herbal remedy for a sore throat after the doctor dowsed for the treatment.
http://www.homeowatch.org/reg/langdon.html

Bi-Digital O-Ring Test

This is what got Dr Gorringe into trouble with the Medical Practitioners Disciplinary Tribunal (MPDT). This test is part of the pseudoscience known as kinesiology. Dr Gorringe got the patient to pinch the thumb and forefinger together and then attempted to separate them. By introducing several homeopathic substances into an electrical “circuit” he claimed to be able to demonstrate a weakness of pinch-strength caused by “paraquat poisoning” and other equally ridiculous diagnoses. Dr Gorringe refused an offer to test his diagnostic method. Several patients suffered illhealth as a result of Dr Gorringe’s diagnostic methods and treatments and he has been struck off the Medical Practitioners Register and ordered to pay more than $100,000 in costs.

The full judgment is at www.mpdt.org.nz under Recent Events. It runs to 142 pages but makes fascinating reading. I often wonder how anybody can go through several years at medical school and then fall victim to these foolish and unscientific sidelines. Gulp! I just remembered that I did — acupuncture and spinal manipulation — but I was protected from getting too excited and committed to these modalities by a natural curiosity about how they worked. After all, curiosity or thoughtfulness is what scepticism is all about. Once I looked at the evidence and learned the significance of the placebo effect, I ceased these practices.

Gulf War Syndrome — the Continuing Quest for Compensation

Despite all of the evidence showing that there is no such thing as Gulf War Syndrome (GWS), the alleged victims are now suing the various corporations that supplied Iraq’s chemical weapons programme. This is to be expected and follows the same pattern that has been followed over nuclear test veterans and those exposed to Agent Orange. GWS is in reality a “post-war” syndrome, formerly called war neurosis or shell shock. The symptoms are presented in a context appropriate to the conflict. In the case of GWS the alleged list of causes includes chemical poisoning, immunisations, pollution, depleted uranium. Every conceivable cause has been investigated and scientists, whose naivety is exceeded only by their ignorance of history, continue to clamour for research funds to investigate ever more ludicrous theories.

For an excellent account read Hystories, by Elaine Showalter, Columbia University Press, 1997.

I can also forward by email an electronic copy of a paper I presented to a Military Medicine Conference.
Gulf War Syndrome — A Historical Context, 8th Asia Pacific Military Medicine Conference, 3-8 May 1998, Auckland.

Chemical Phobia?

Firemen had to wear breathing apparatus to clean up a hydrogen peroxide spill. This “toxic chemical” was described as “fizzing and bubbling” as it “reacted with the asphalt”. Of course it was fizzing and bubbling! The hydrogen peroxide was breaking down and releasing “toxic” oxygen and water. These emotively worded reports foster ignorance and hysteria about common chemicals. I recall a similar piece of ignorant journalism where a toxic spill was revealed to be the chemical equivalent of rust!
Dominion Post 6/8/03

Bee Products (Pollen-ate?)

These are currently popular with that segment of the NZ population who would eat sheep dropping sandwiches if they were properly advertised as benefiting health. That reminds me of the cruel jibe by Dame Edna Everidge (aka Barry Humphries) that NZ was a country of 60 million sheep, 3 million of which think they are people.

An advertisement in the Sunday Star Times, (20 July) contains the claim that “BIO BEE” is “the only Potentiated Pollen available that uses Dr Kelly Duncan’s (former Dean of Science, Canterbury) patented potentiation process”. Refer http://www.biobee.co.nz

I duly visited the website and some of the claims made for this product appear suspiciously close to health claims. I would welcome readers’ opinions.

I subjected Dr Duncan to a “google” which produced a number of interesting hits including him being a party to a complaint to the Advertising Standards Complaints Board. www.asa.co.nz/decisions/FULL/Fd0106.rtf

[Chair-entity’s note: A concerned member has been forced to tout bee products as part of his media-related job. We now have a new information flyer examining the case for various bee products available as a PDF here]

Herbal Medicine

“Kentucky Fried Medicine” is such an easy target but can always be counted on to provide material for your correspondent. As we all know, most, if not all such preparations are completely useless. The latest ploy is to illegally include effective prescription medicines, particularly in the area of erectile dysfunction. (New Ethical Journal, July 2003) It is perfectly obvious to a consumer when a product has not worked for erectile dysfunction so it makes perfect sense to cheat by adding a drug that does work. Such fraud invites a stiff fine.

Hua Fo VIGORMAX was withdrawn in Canada when it was found to contain tadalafil, marketed as the legitimate drug “Cialis” in New Zealand.

Likewise in the US, a product called Viga was withdrawn because it contained sildenafil, marketed in New Zealand as “Viagra”.

One possible benefit of these frauds is at least the Chinese might stop trafficking in endangered animal species in the preparation of these products.

An American study of 443 Web sites (reported in Manawatu Evening Standard, 24 September) found that most Web sites marketed herbal remedies with misleading or unproven health claims that violate US Law. I suspect that there would be similar findings in any survey of such sites in New Zealand.

Newsfront

Biokinetic Horror Show

A Hamilton doctor is facing two charges of professional misconduct and one of disgraceful conduct after one of his patients was left looking “like something out of a horror movie”. The Marlborough Express (August 21) reports Yvonne Short had gone to Dr Richard Gorringe in 1998 looking for a cure for her skin problems.

She told a disciplinary tribunal in Hamilton Dr Gorringe promised to cure her within 12 weeks, but she ended up worse off.
“My hands were also swollen and painful… I would wake up in the morning and there would be skin on the bed and on the floor,” she said.
In her opening address, director of proceedings Morag McDowell told the tribunal Dr Gorringe’s alternative practice was not an issue. Instead, the prosecution was concerned with his diagnostic technique.

The next day (NZ Herald, September 22) Dr Gorringe demontrated this technique, known as Peak Muscle Resistance Testing. Using a fake patient, he showed how the patient placed his or her hand or arm on a square aluminium plate, which was part of a wired circuit.

In the other hand, the patient holds an aluminium rod, and touches dozens of small vials filled with various body tissues, chemicals, toxins and pathogens. If the patient’s arm flexes when they touch a certain toxin or body tissue vial, that shows what is wrong and where the problem lies.

Using this technique, Dr Gorringe diagnosed Yvonne Short as suffering from paraquat poisoning.

Expert witness Dr Richard Doehring told the tribunal the technique was not reliable, adding that muscle testing was without objective validation and confirms what the practitioner expects it to confirm.

He criticised as unethical Dr Gorringe’s practice of selling remedies from his own clinic and described his alternative practice as “cruelly exploitative, if not outright fraudulent.”

Hotline to Heaven

Bolivian visionary, evangelist and stigmatist Katya Rivas flew into Wellington briefly, and relayed a message from Jesus especially for the people of New Zealand. Since being visited by the Blessed Mother in 1993, Katya has reported numerous miracles. She has even converted sceptics to Catholicism – Aussie investigative journalist Mike Willessee interviewed her in 1999 for a Fox TV documentary and the former sceptic converted. It was he who invited her to Sydney, to help launch a new video he made on the miracle of the Eucharist. Contact magazine (September 5) had this as its lead article, spurring an unprecedented five copies submitted to Newsfront from members. Christ’s message, by the way: “We are already in a new country, a country which is ready to receive my mercy through love. Trust, it is important that you speak to the people and save souls that are precious to me. Happy are those who are docile to my voice and invitations.”

Letters to the editor resulted, essentially saying “Stigmata, potata!” – one pointed out that CSICOP’S Joe Nickell looked into the alleged stigmatisation and found they could not be authenticated. The show was so bad it even won Farce of the Week (see http://www.randi.org/jr/7-30-199.htm). Another said “A lot of Mike Willessee’s very sane friends and colleagues are deeply concerned about his health…”

Something to cry over

While on such things, the NZ Herald (September 23) reports the weeping virgin of Rockingham appears to have joined the long list of fakes that have plagued Christendom since splinters of the “true cross” carved out a market in the Middle Ages. (I wish I’d written that introduction -ed.) After examination, a secret cavity was found in the fibreglass statue which has enthralled thousands of the faithful at the industrial suburb south of Perth since rose-scented “tears” appeared in March. Following a pattern on the internet describing how to “amaze your friends and bring peasants to your door” the unknown creator reportedly put an oil-filled cavity in its head. It was then sold as a souvenir in Thailand eight years ago. Such are miracles.

Bad Vibes, Man

A Whakatane woman fears plans to build a periodic detention centre next to her shop will wreak havoc on her business, the Dominion Post (26 July) reports. “I sell crystals, can you imagine the negative energy that will come from over there,” said Gerry Tobin, who plies her trade next to the proposed Commerce St site. On the other hand, we wonder whether the positive vibrations from her wares will have a beneficial effect on the prisoners?

It’s your hair they’re after

Consumer Affairs Ministry senior adviser Pamela Rogers is one person keeping tabs on scams (Dominion Post, September 11 – yes, there were other news items that day). She says the “ickiest” one she’s seen was from clairvoyant Liv Hansen who would map out your financial future in return for $30 and a clipping of your hair.

Similar scams included Master Charli Chan’s amazing golden dragon egg and Maria Duval’s cardboard talisman, priced between $50 and $80.

Variations on the Nigerian scam include pleas from Zimbabwean “Edward Mulete” to help disperse his murdered farmer father’s $46 million estate, and a man claiming to be the late King of Nepal’s lawyer looking to offload $67 million squirreled away by the king’s son and killer, Prince Dipendra.

The ministry has also seen a recent upsurge in “El Gordo” lottery scams, in which people are sent a letter or e-mail saying they had won money in a lottery, but needed to send a cheque or provide credit card details to pay $50 to claim their prize. Ms Rogers said people still sent money despite knowing they had not entered such lotteries.

Sceptic sees stars

Independent film-maker Bart Sibril surprised Buzz Aldrin, one of the first astronauts to walk on the moon – and saw stars for his efforts. The man-described as a “sceptic”-maintains the moon landings were faked in the Nevada desert. He was with a Japanese film team and ambushed the astronaut outside a Beverly Hills hotel, reports The Press (September 21). “I walked up to him on the sidewalk and put a Bible up to him and asked him to swear on the Bible that he actually walked on the moon,” said Sibril, who has confronted Aldrin twice before. “He refused to do it, so I told him he was a thief to take money for giving an interview on something he didn’t do. That’s when he hit me …”

Looking For Love

Keiko, the whale from Free Willy, has told an “animal interpreter” that he is lonely and looking for love. He also has an itchy back. Astrid Moe, who claims to have had a “lengthy telepathic dialogue” with Keiko, says the whale is looking for his other half and that he feels stuck between two worlds, reports the Star-Times (September 15). “He told me that his back was very itchy and that was when I saw an emitting device near his dorsal fin. That’s probably what he was talking about.” Rocket science.