Hokum Locum

Drink your way to good health

Don’t scoff. A magazine as authoritative as Woman’s Day reports a case where a woman treated her breast cancer by drinking her own urine. Following a mammogram and ultrasound examination the patient reports: “I was introduced to a surgeon who said I needed to have both my breasts removed right away.” This is complete nonsense as no surgeon would ever perform a bilateral mastectomy without a tissue sample confirming the diagnosis. It is quite clear that she never had cancer at all, but a condition colloquially known as lumpy breasts or benign fibrocystic breast disease.

Such people are a godsend for cancer quacks. There’s nothing easier than curing somebody who was never ill in the first place. In fact, that’s the whole basis of ‘alternative medicine’.

I googled the subject of urine drinking and there are a surprising number of articles on the subject. My favourite was a reference to the Koryak tribe of Siberia who used to get stoned by consuming the fly agaric toadstool, Amanita muscaria. The hallucinogens are excreted in the urine and as the account goes: “those who cannot afford the fairly high price (of the fungi) drink the urine of those who have eaten it, whereupon they become intoxicated.” (Wasson, quoted in Murder, Magic and Medicine, by John Mann)

Hyperbaric Oxygen-I don’t think so!

A local clinic offers “Hyperbaric Oxygen Therapy” at a cost of $60-$110. The pamphlet says:

“A cleanse with intraceuticals products first followed by a deep exfoliation. Oxygen Therapy applied with serums suitable to skin condition – a relaxing soothing treatment incorporating lymphathic (sic) drainage for a complete rejuvenation/brightening or reduction of fine lines. Also treats acne, rosacea, eczema and open pores-super hydrates. Complimentary home care product if a course of six treatments (weekly) booked.”

This clearly constitutes false advertising as well as an affront to grammar and spelling. Hyperbaric oxygen means oxygen under pressure and this requires either a pressurised mask or a chamber which can be pressurised. I have contacted the Commerce Commission over this false claim and I will keep you posted.

Cancer Diversions

A friend has been unlucky enough to develop bowel cancer last year and then go down with breast cancer this year. She has faced up to all of this with equanimity. Another acquaintance of mine, a doctor, has been diagnosed with a form of cancer which is likely to be terminal. This person is now on a vegetarian diet with no alcohol and is described by friends as “doing very well.”

It’s hard to imagine the fear and horror of being diagnosed with cancer. It leads to all sorts of irrational thinking, even by doctors. If I ever got cancer I would take up smoking again, use hard drugs, drink as much as I liked and indulge myself in dangerous sports. Go out with a bang, not a whimper! Such a strategy could well see cancer cells shrinking against an onslaught of nasty substances.

“Magical” thinking about cancer extends to psychological issues. An Australian study comprehensively debunked the idea that mental attitude has anything to do with beating cancer. For example, women who were preoccupied about their cancer were more likely to get a relapse. The researchers found that such women had the worst tumors-they were anxious and preoccupied for a reason! This sort of analysis is at the heart of skepticism – looking at the facts and coming up with the most likely explanation-not some horribly deprivational diet that denies people meat, wine and what little enjoyment of life they have left.

The chief executive of the Cancer Council Australia, Professor Ian Olver said that he had been involved with a smaller study with lung cancer and had reached a similar conclusion. Marlborough Express 4 June

Bogus Body Enhancer

Winston and Sylvia Gallot were ordered to pay $632,500 and $130,000 costs after being convicted of breaching the Fair Trading Act. Their weight loss product, Body Enhancer, was described by the judge as being ineffective. The High Court dismissed the quacks’ appeal but reduced the fines to $394,500.

Never mind, the couple must be laughing all the way to the bank as it was estimated that about $5 million of the product had been sold. If you google the offending product there is a wealth of material to review. I particularly enjoyed the Judge’s descriptions as follows:

“Mr Gallot was described as a man of considerable intelligence, style and charm, but he was exposed as ‘calculatedly dishonest’ and blamed everyone but himself.”

Judge Moore referred to a “succession of blatant untruths” by Mrs Gallot in trying to launch Body Enhancer in Britain.’

Marlborough Express 30 May

Another useless product

The Commerce Commission successfully prosecuted another useless product which claimed to “melt away fat and cellulite.” A judge said anyone who purchased Celluslim wasted their money.

The company had claimed that the product “had been scientifically tested by a fictitious doctor at the fictitious Saint Alto Research Centre in Switzerland.” When their useless product ran out they merely substituted honey, garlic and apple cider vinegar pills.

Marlborough Express 30 May

Amalgam again

A local dentist missed out on a health contract because of his opposition to dental amalgam. The amalgam debate has raged for decades and has parallels with the pure water crackpots who oppose fluoridation. Amalgam is a stable compound that is not ideal but it is the most cost effective agent at present. When something better comes along it will be superseded. I have a mouth full of amalgam fillings-a legacy of growing up without fluoridation. My mother gave fluoride tablets to the remaining four siblings who all have perfect teeth. People who elect to have their amalgam fillings removed expose themselves to a great deal of mercury which is released during destruction of their fillings. Those of us who sensibly live with our existing amalgam fillings can rest assured that our major mercury exposure comes from fish and chips.

Marlborough Express 25 March

Body Talk

I will have to rethink my theory that “wacky ideas are promoted by people who are bald and have beards”. After rubbishing body talk in an earlier column I was stunned to see that this ludicrous nonsense has arrived in Blenheim. Get this-straight from the reporter:

“I lie down on the consultation table and she holds my hand loosely over my stomach. A series of yes or no questions are asked and she lifts my hand in a circular motion each time, sensing resistance or acceptance of the question. It’s when she picks up on a positive response; she places my hand over my sternum and then taps me several times on the head, then taps me on my heart zone.”

The reporter accidentally stumbles across the mechanism when reporting: “It bears a resemblance to the ‘laying on of hands’ popular among some born again Christian groups.”

This whole mélange of hocus pocus is of course a placebo. It is staggering that such nonsense can gain credence and it beggars belief that a newspaper should even bother reporting it. How ridiculous does something have to be before an editor would reject it?

Saturday Express 24 May

Hokum Locum

Yet another military syndrome


I imagine that most people joining the Armed Forces would expect the likelihood of a posting to an area of conflict. I know I did. I spent six months in Iraq between the two Gulf Wars. I admit that it was stressful but it was also one of the most exciting and interesting experiences that I have ever had. But that’s another story.

It appears however, that many would prefer a safe posting at home, typing memoranda or serving tea in the mess. The only risks from these activities are RSI or perhaps a minor burn from slopping the tea. When military personnel are posted to an area of conflict this comes as a shock. Compensation is fortunately available. It appears that shell shock and post traumatic stress disorder are passé. The new ‘buzz diagnosis’ is MTBI, or ‘mild traumatic brain injury’.

The cause is blast from roadside bombs and this can lead to “memory loss, depression and anxiety”. The US has instituted a screening programme for those returning from active service and they estimate as many as 20 percent may be at risk of MTBI. The UK MOD remains skeptical and is quoted as saying: “It is a very complex area. We have no way of knowing whether (the US assessment) is accurate because there is a level of dispute as to what constitutes MTBI.” You could apply the same logic to stories of alien abduction.

Skeptics could note that the diagnosis is largely subjective but should be alarmed that therapists such as Kit Malia are poised to cash in: “If the American figures are correct, this is massive, absolutely massive.” More work for the army of counsellors.

As the saying goes, war is hell. Many returned servicemen will tell you that and they fervently wish for an end to all conflict. Instead of pursuing this aim, we continue to send young men and women to various hell-holes and wonder why they fall apart. It is hardly surprising that they choose to fall apart in culturally acceptable ways with diagnoses such as GWS, PTSD and now MTBI. Screening programmes, websites and a telephone help line will ensure that those suffering from MTBI are suitably coached into supplying the right symptoms of this disorder.

When I read about these daft syndromes, I often think of my late father who experienced combat as an infantryman in World War Two. He came home, resumed his career and the only disability he had was spinal tuberculosis, contracted in Japan while serving with the occupation forces. The only compensation was the opportunity for resuming academic studies. Perhaps we could retrospectively label this ‘mild tubercular back injury’.

Today’s military personnel are not conscripted. They have a choice. I say, take the money and accept the consequences. Let’s either call an end to absurd diagnoses such as MTBI, or have the moral courage to eschew warfare and refuse to send our men and women on such missions.

The Guardian Weekly Vol 177 No 20 p11

Sensory Processing Disorder

Some children become upset when confronted with new sounds or places. They scream and misbehave. This behaviour is set to become yet another disorder of childhood-‘Sensory Processing Disorder’. Advocates are pressing the American Psychiatric Association to include this condition in its manual of mental disorders. Sound familiar?

Therapists have already set up clinics to deal with this new ‘disease’. One such clinic is Paediatric Potentials, where children experience play therapy including a spandex cocoon that can calm them. The condition was studied in the 1960s by a psychologist who called it ‘Sensory Integration Dysfunction’.

This has all the hallmarks of a fad diagnosis. The symptoms and signs of the condition are completely subjective. The condition relies on interpreting extremes of behaviour as being pathological. Physician enthusiasts are recruited to popularise the condition. Pressure is put on the relevant authorities to endorse it. This is precisely the path that led to the diagnostic labels of PTSD and ADHD. It appears that some academics are incapable of understanding normal human behaviour.

I’m still waiting for alien abduction to follow the same pathway to recognition. It’s just as valid as Sensory Processing Disorder.

Marlborough Express 15 November 2007

Are your children reaching their full potential?

So reads the advertisement from a local pharmacy. Perhaps this is the solution to SPD? For only $20 you can get 60 capsules of ‘Clever Kids Omega 3’. This product has been designed to “help support brain development and learning ability, including concentration, memory and problem solving, and may assist in the temporary relief of mild anxiety and irritability.”

This is the perfect product for families where parents are too busy to have time to interact with their children. If anybody could be bothered to test this useless product, I predict it will have no advantage over placebo.

Ritalin Substitute

Pharmac, the Government’s drug buying agency, is constantly looking at saving money on our huge national drug bill. Ritalin (methylphenidate) has been supplanted by a cheaper generic equivalent, Rubifen, which is one million dollars a year cheaper. Methylphenidate is used in the treatment of ADHD, another fad diagnosis like SPD. Parents remain unconvinced and many are demanding a switch back to Ritalin. This is typical of placebo dependence where people become convinced that the new small yellow pill is somehow inferior to their familiar big red pill. Given that ADHD is an entirely subjective disorder it is not surprising that there is a subjective obsession over the familiar drug versus a generic equivalent.

While I’m on the subject of useless products …

Red Bull OD

An Australian man drank eight Red Bull energy drinks in five hours and suffered a cardiac arrest while competing in a motocross event. This equated to a caffeine intake of 400mg which is close to the toxicity level for an average adult. The label warned against consuming more than one to two cans or bottles of the product per day. The victim was quoted as saying he drank four Red Bull drinks per day because “With the work I do I don’t have a lot of time to eat.” On the day of his acute illness he suffered a cardiac arrest and required defibrillation. He admitted to consuming eight Red Bull drinks over a five-hour period as follows: “It was to get a bit of a buzz and keep down my reaction times.”

It is difficult to feel sympathy for such moronic behaviour. Red Bull is a useless and unnecessary product which has been successfully marketed for idiots. While I’m on this topic how about …

Cold medicines

The US Food and Drug Administration (FDA) commissioned some outside experts to advise on medicines used by parents to treat their children’s coughs and colds. The conclusion was that products such as cough suppressants do not work and may cause side effects in young children. I recall that Consumer has reported on these products and the evidence is that they are not worth the money. This is the familiar placebo effect at work.

Hokum Locum

Skull manipulation takes a lot of ‘training’

Cranial osteopathy is based on the notion that the bones of the skull can be manipulated. Even doctors have been taken in by this nonsense. The following account is by a registered medical practitioner, Dr Putative (not his real name).

The craniosacral movement is a rhythmical expansion of the skull and meninges around the cerebrospinal fluid. “It is a very subtle small amplitude excursion which is palpable with careful trained hands.” (So there, all you Skeptics: if-like me-you can’t feel it, you lack training.)

“The bones of the skull open and close rather like a flower opening to the sun.”
“It must be emphasised the movement is very subtle and can only be felt after considerable practice.”

The article goes on to claim that cranial osteopathy can successfully treat colic, a blocked nose, Bell’s palsy, and facial asymmetry in infants. I wish it could cure terminal gullibility! When doctors involve themselves with such nonsense, it always reminds me of HL Mencken’s criticism of an American gynecologist who believed in the literal truth of the story about Jonah in the belly of the whale. I can’t remember the exact words but it goes something like this: “How is it possible for the human brain to be divided into two halves? One capable of brilliant thought and the other complete balderdash!”

This quote could also apply to Dr John E Mack. (In 2004 he died after being hit by a car.) He collected a group of fantasy-prone individuals whom he gradually came to believe had been abducted by aliens. Harvard was furious; some of his colleagues started a movement, Knife the Mack, but Mack became very wealthy from his book about these patients. He basically argued that because psychiatry can’t explain such matters the accounts must be true. Wrong. It is well known that certain fantasy-prone individuals experience vivid dreams (hypnagogic) at certain stages of sleep.

Iridology

This absurd nonsense has now become part of mainstream pharmacy. Commercial pressures and PHARMAC, the government drug buying agency, have squeezed profits and many pharmacies stock a wide range of unproven and ridiculous pro-ducts. One local pharmacy has a range of such items which is larger than the OTC section.

Another local pharmacy advertised it was going to have an in-store iridologist for the day. The iridologist was described as having a Bachelor Degree in Health Science. (BHSc) It is little wonder that universities continue to oppose the granting of such degrees by various polytechnic institutions.

Chinese Frauds and Dangerous Products

The Chinese are already recognised as an international threat in regard to traffic in endangered species (eg tigers and bears) as well as promoting ‘traditional products’ which are adulterated with Western drugs such as steroids and Viagra.

A Chinese-made toothpaste (Excel) was withdrawn from sale in New Zealand when it was found to contain diethylene glycol, normally found as antifreeze in the radiator of your vehicle. Hmmm, could be useful when brushing your teeth in Antarctica.

It appears that Chinese doctors can be as venal and corrupt as their herbal industry. Reporters posing as patients produced urine samples which were actually green tea. The diagnosis made was urinary infection and the prescribed treatment cost $40. One reporter re-submitted the same sample and received the same diagnosis. At least the quacks were consistent. These frauds are to be expected in a poor country where doctors are underpaid.

Some NZ Doctors perpetrate similar frauds by using ‘black box’ devices and other unproven treatments. These frauds are not to be expected in a country where doctors are both well paid and well educated!

Dominion Post 24 March
BMJ 9 June 2007 Volume 334 p1183

The Culture of Complaint

In his book, From Paralysis to Fatigue, Edward Shorter predicted that the next era of medicine would revolve around psychosomatic medicine. This also encompasses a culture of complaint which sees a whining populace avoiding responsibility for their own actions by finding someone else to blame for their misfortune.

There is a new vaccine (Gardasil) against human papilloma virus (HPV). HPV is the main risk factor for cervical cancer in women. Following vaccination at a school, about 25 girls presented to the sick bay with headache, nausea and dizziness. The media had a field day while more sensible people correctly diagnosed ‘mass sociogenic illness’ which is a polite way of saying ‘mass hysteria’. There is an excellent account online at www.crikey.com.au/Politics/20070528-Schoolgirls-have-mass-sociogenic-illness-but-Neil-Mitchell-needs-the-smelling-salts.html

There is a huge and fascinating published literature on mass hysteria. A constant feature is the rejection of this label by people involved in the incident. People do not like to accept that they have been victims of their own panic. It’s much better to believe in a mysterious vapour or poison. My favorite mass hysteria story concerned a kitchen which was evacuated due to a bad smell causing symptomatic illness. It was traced to a rotten onion in a cupboard!

In the case of the Gardasil story, the media beat-up wiped $A1 billion off the market value of the drug company.

Marlborough Express 26 April

Physiotherapy

Some time ago I roamed the internet looking for evidence supporting the efficacy of physiotherapy. I was interested in its scientific basis. I looked in vain. There are a few trials which showed certain practices were either useless or even dangerous.

I recently received a report from a specialist which included the following gem:

“I do not think that there is any specific medical contraindication to his undergoing whatever rigorous physiotherapy programme is planned for him, although by the same token I am not all that enthusiastic about physiotherapy in these situations: my opinion is that physiotherapy simply helps to pass the time and I cannot really understand what good it is meant to be doing. However…that..opinion does not sit comfortably with the ACC’s and patient’s enthusiasm for having their bodies tweaked and pummeled at great expense in the name of ‘rehabilitation’.”

The phrase “great expense” is important. There are so many treatment providers with their snouts in the ACC trough that treatment costs have become excessive. These treatment providers have developed a beneficiary mentality and whenever ACC attempts to control or restrict treatment practices there are indignant protests.

ACC reforms mean that patients can go to a treatment provider and register a claim and have treatment. If they need time off work this can only be provided by a doctor. The ‘gate keeper’ function of the doctor has been lost. I heard of two recent examples of how people can be harmed by this practice.

An osteopath gave a maximal number of treatments to a patient who was eventually diagnosed as having a complete rupture of the rotator cuff muscles of the shoulder. Osteopathic treatment is completely useless for this injury. In fact there is no published evidence showing that it works for any injury.

In the other case a 15-year-old child was treated by a physiotherapist for some time for a sore leg and was eventually diagnosed with bone cancer.

Steiner Preschools: More taxpayer-funded loopiness

Rudolf Steiner kindergartens look set to cash in on free early childhood education initiatives.

The plan of Education Minister Steve Maharey to provide 20 hours of free early childhood education reminds us that New Zealand has a wide variety of preschools, based on diverse philosophies. Perhaps the weirdest is Waldorf-Steiner schooling, which was founded by the loopy Austrian, Rudolf Steiner (1861-1925).

Hundreds of schools and even more kindergartens in scores of countries follow Steiner’s system. Established in 1950, the Hastings Rudolf Steiner School and Kindergarten was the first Waldorf centre of education in New Zealand. The Federation of Rudolf Steiner Waldorf Schools was formed as an incorporated society in 1988 and lobbies the government. Today, the country has 10 Steiner-Waldorf schools or school initiatives and almost 40 Waldorf kindergarten groups. The Government gave most of them money from you and me even before Maharey’s scheme started.

The education they offer is based on the notions of Rudolf Steiner, the founder of anthroposophy. He believed humanity is living in the post-Atlantis period, which started with the sinking of Atlantis in 7227 BC. After the current European-American epoch ends in the year 3573, humans will regain the psychic powers they had before the time of the ancient Greeks. Steiner claimed to be the earthly ambassador of the world-encompassing spirit of our time, St Michael. According to Steiner, a hierarchy of angels and archangels influence earthly developments. Seven leading archangels take turns to guide the evolution of humanity for 354 years at a time. St Michael’s stint as “time spirit” started in late November 1879, and Steiner declared that he himself had accepted the mission of being the Michaelic Initiate, to help guide the spiritual life of the Western World. This was an event of world historic importance that took place unnoticed. Anthroposophists regard Steiner with awe and reverence. They are as gullible as Mormons.

Anthroposophy can involve bizarre behaviour. For example, some anthroposophists sit alone or in groups to read to departed souls in order to form links from our sense-perceptible world to the “so-called dead”. They claim to receive messages of “Thank you”. Some anthroposophists ask questions of Steiner himself. Occasionally statements are circulated that allegedly came from him. The feeling that such a message evokes of loosening one’s being from the physical body is a sign that the communication is genuine.

Steiner devoted time to many interests, including education, poetry, architecture, jewellery design, astrology, biodynamic agriculture, reincarnation, karma, medicine and the creation of what he called a new art, eurythmy (mime and movement). All these topics he treated in spiritual terms. Eurythmy, for example, is supposed to manifest spiritual states of being, calling upon influences from past lives and preparing for future lives.

The benefits of anthroposophical medicine are wildly exaggerated. The pricey Helios Therapeutic Retreat in Hawkes Bay sells eurythmy, massage, music and art therapy. Although perhaps nice, these pursuits will not cure any diseases. Patients who need a loan to meet the thousands of dollars in fees are referred to a finance company in Napier. In 1921 Steiner himself started a business called Weleda that has spread internationally, selling useless ‘natural’ medicines with a spiritual approach. Waldorf schools have a reputation for opposing childhood vaccinations.

Waldorf kindergartens are based on the belief that there is a spiritual side to all of life. They focus on free play, art and craft, fairy stories, myths, eurythmy, and circle time for festivals such as Michaelmas. Waldorf teachers use the ancient idea of four temperaments (choleric, phlegmatic, melancholic and sanguine) to categorise children. They might seat pupils in the classroom according to their supposed type. The Steiner approach is sometimes called racist. He believed that souls pass through stages, including racial stages, with African races being lower than Asian races and European races being the highest form. Steiner education stresses fantasy and dreaminess, which anthroposophists associate with spontaneous clairvoyance. Other quirks of the system include teaching reading late and the banning of computers until high school. Television, radio and recorded music are excluded. While this approach can stimulate imaginations, it also is based on false and nutty ideas. I wonder how many New Age people and followers of alternative healers were handicapped in grasping reality because they went to a Steiner school.

Zetetic Astronomy and other madness


In the 21st century, there are still people who believe the Earth is flat.

Mad people are among us. Reading letters to the editor and discussing issues at universities can be frustrating exercises because some people are oblivious to facts and reason. Some odd people, including radical postmodernists, are proudly hostile to science and empirical evidence. They say there are no facts, only perceptions. They describe scientific method as a mere ploy, used by elites to claim falsely that they are in sole possession of knowledge. Views that are based on empirical evidence supposedly are products of a paradigm that is no more valid than any other way of arriving at a belief.

Academics, who are reputed to have great intellects, can flaunt lunacy. I once heard a paper on religious history where the speaker tried to justify her weird conclusions by saying, “Of course, there are nonrational ways of knowing.” A university dean once urged me not to contradict the fanciful claim of the Mormon Church that a lost tribe of Israel settled America; Latter Day Saints have their own paradigm, which we must respect, she said. Another academic insisted that I should be charged with harassment if I told a group of Polynesian students that their culture’s belief in a flat earth is false.

It is hard to believe that some first-world people think the world is flat. After all, belief in a flat earth is so ridiculous that it is sometimes used in debates as an obvious example of pseudoscience or dogmatic thinking. Yet, apparently some Polynesian people are Flat Earthers, and the internet includes sites devoted to promoting this theory. There is no way of knowing how many of these sites, if any, are genuine. Given the lunacy on show in letters to the editor and universities, however, it would not be surprising if some of the writers are sincere.

Trying to follow the reasoning of Flat Earthers is instructive for Skeptics because it shows us what we are up against. Years ago, I came across a couple of books that astounded me because their authors were so immovable. One book was written by a Catholic who had an answer to every accusation ever hurled at his religion. No matter what the objection — the cruelty of the Inquisition, papal collusion with Nazism, the corrupt selling of indulgences — he staunchly made the case that the Catholic Church was God’s true church. The other book was a course in selling life insurance. No matter what objection the prospective customer raised, the book gave the insurance agent a model answer. For example, if the potential buyer objected that he could not afford insurance, the salesman was to tell him that he could not afford not to have insurance. Chiropractors take a similar line. No matter what the symptom, a regular crack of the back is the recommended treatment.

Today’s Flat Earthers sustain a line of argument that was started in the mid-nineteenth century by the English inventor, Samuel Birley Rowbotham (1816-1884). Starting with a pamphlet in 1849, he developed his ideas over three decades into a 430-page book, Earth Not a Globe, which he published under the pseudonym Parallax. Rowbotham insisted that the Earth is flat, with the North Pole at its centre. The land is surrounded by a waste of ice and snow, bordered by a huge, circular cliff of ice. The Sun, the Moon and the planets — in fact, all celestial bodies — also are flat. The Sun and Moon, each about 50km in diameter, circle the Earth and are only several hundred kilometres above us. Each functions as a spotlight, with the sun radiating hot light, the moon sending out cold light. Because they are spotlights, they give out light over only a limited area at a time, thus explaining why some parts of the Earth are dark when others are in light. Rowbotham called his model Zetetic Astronomy.

He was a tenacious debater, and modern followers of Rowbotham continue his practice of never being stuck for an answer. Doesn’t Nasa have photos to prove the Earth is a sphere? No, Nasa is part of a conspiracy; the photos are fakes, made by computers.

How do satellites orbit the Earth? They don’t. Satellite signals come from radio towers.

What about gravity? Well, the Earth is accelerating upward, as is every celestial body. This movement produces the effect known as gravity.

Debating Flat Earthers is a waste of time. So, I suggest, is arguing with Creationists, New Agers and other mad people. Their crazy minds are set. Our efforts will be most fruitful when we aim at educating people who are open to sensible ideas. Thankfully, that includes most of the population.

Hokum Locum

Members of the Royal Society and other eminent doctors have written to every hospital in the UK urging them not to suggest anything but evidence-based medicine to their patients (Guardian Weekly Vol 174 No 23). This was a timely reminder given that Prince Charles had just been urging the World Health Assembly to promote alternative medicine. The letter writers reminded people that alternative and complementary medicine needs to be evaluated on the same criteria as conventional medicine. This was precisely the same argument most of us took when making submissions to MACCAH.

Continue reading

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Debunking debriefing

It has become a cliché that whenever something bad happens, a horde of counsellors descend on the survivors to make their lives a misery. It’s true. Counselling does make you more sick compared to doing nothing.

A child is run over and killed. Instead of teachers and parents rallying around and doing what they have done for hundreds of years, ‘professionals’ are now called in to make things worse. In a study, survivors were randomly allocated to “emotional ventilation debriefing” (whatever that is), educational debriefing or nothing and were followed up at two weeks, six weeks and six months. The only difference in outcome was that at six months the first group had significantly more emotional distress.

Not only are these forms of counselling useless they are harmful and the relevant authorities should face up to this by not inflicting it on people. People have always coped with death and disaster and feelings naturally settle with time. Ordinary people underestimate their own ability to just be there for their friends and family and support them. No fancy talk is necessary. bjp.rcpsych.org/cgi/content/abstract/189/2/150

More on Placebos

It can easily be argued that the history of complementary and alternative medicine (CAM) is intimately involved with the history of the placebo effect. The placebo effect is also intimately involved with the practice of medicine although attempts are made to control for it.

The placebo effect is poorly understood, even by doctors, and if you interview specialists they generally discount the placebo effect in their own specialty and attribute it to their colleagues in other specialties. Orthopaedic surgery is rife with placebo procedures such as arthroscopic washout of arthritic knees. At least two good trials have shown that it is worthless yet orthopaedic surgeons continue to inflict this useless procedure on their patients. I confronted one such specialist and he argued that “in my experience it makes the knee feel better.” This is the typical feeble appeal to authority which is the lowest and most contemptible form of evidence. This refusal to accept the evidence is not unusual and in the past other placebo operations have been performed for years until such time as there is a critical mass of peers crying stop.

With respect to homeopathy, there are wide variations in the results of placebo controlled trials because, as someone put it, not all placebos are equal. One wag suggested that “double strength placebos” were needed.

In an interesting study subjects were given placebo analgesia and subjected to painful stimuli. The painful stimuli were then surreptitiously reduced to make the analgesia appear even more effective. This enhanced learned response lasted up to seven days and the authors concluded that this effect “may explain the large variability of the placebo responses that is found in many studies.”

My conclusion from all of this is that my own profession fails to use the placebo effect in a positive way. It is viewed instead as a nuisance to be controlled or minimised. The CAM industry has shown no such reluctance and the placebo effect is behind most of these treatments. Perhaps this explains the public fascination with quackery?

www.chaser.com.au/index.php?option=com_content&task=view&id=1182&Itemid=26

Medical Journal of Australia Vol 179 18 Aug 2003

Pain Vol 24 Issues 1-2, Sep 2005 Pg126-133

Traditional Chinese Medicine (TCM)

Advocates of TCM argue that it cannot be evaluated by clinical trials because TCM has a different philosophical basis to western medicine. This is a typical argument known as the ‘plea for special dispensation’ and is a hallmark of quackery.

TCM evolved in China in the same manner as western medicine under the teachings of Galen. Authoritative teachings were gospel and anyone who dissented was criticised. In many respects this process has some of the features of a religion where beliefs are more important than scientific facts.

Galen solved the problem of the circulation of the blood by proposing that blood got from one side of the heart to the other through tiny pores in the heart. No one was ever able to demonstrate these pores but it was taken as fact. When Harvey described what actually happened in the circulation of the blood (ie arteries to capillaries to veins and back again) based on his anatomical studies he was treated as a heretic. TCM is a placebo-based philosophy and every time there is a scandal such as herbs adulterated with western drugs, for example Viagra and steroids, this strengthens the argument that such products and practices should be banned as being consumer fraud.

Occupational Health Delusions

Unhappy people in boring jobs can escape their stressful situation by attributing some mythical illness to the workplace. This entitles them to compensation from ACC. Many such people become extremely litigious and unpleasant if there is any suggestion that their illness is psychosomatic. Complaints and symptoms are out of all proportion to any evidence of an actual injury.

A recurring theme in the occupational health literature is the statement that “psychological factors might be important.” There is seldom any suggestion that a condition has nothing to do with work. Conditions such as railway spine and miners’ nystagmus were compensated when we now know that these conditions were a delusion, a folie a deux between plaintiffs and their gullible doctors.

Sick building syndrome (SBS) is a modern example of this delusional thinking. I recall an earlier study where symptoms bore no relationship with building ventilation. This experiment involved varying the ventilation rate without the workers’ knowledge. If the air was being changed at a very high rate there should have been a corresponding drop in symptoms.

Another recent study has found “symptoms of SBS are more strongly associated with job demands, workload, social stressors, and support at work than with the physical environment.” Occupational and Environmental Medicine 2006;63:283-289

More on Goji Juice

I revisited the goji juice site www.best-goji-juice.com and decided to investigate Dr Earl Mindell. He has a legitimate Bachelor’s degree from the University of North Dakota and a PhD from a diploma mill, the University of Beverly Hills. Quackwatch has some good information about his vitamin industry and the goji juice industry is a good example of multilevel marketing similar to Amway. Has anybody tried the stuff? I would be interested to hear.

The ideal marriage?

Consider an iridologist married to a reflexologist. The iridologist can look into her partner’s eyes and tell him what’s wrong with his feet. The reflexologist can look at her feet and tell her what’s wrong with her eyes. Many thanks to whoever it was who passed that on at the conference and thanks to Dr Keith Davidson for passing on a half page advertisement devoted to reflexology from the Christchurch Press, 26 September. It’s clearly a growth industry with their own website www.reflexology.org.nz. You can train at a reflexology school or even gain a diploma from the Canterbury College of Natural Medicine.

Hokum Locum

Liquor still quicker

There is little doubt there are criminals who are prepared to drug women in order to sexually assault them. History records the commonest drug used was chloral hydrate in an alcoholic drink (Mickey Finn). The modern equivalent is rohypnol, a drug discontinued in New Zealand owing to its abuse potential. However, as Ogden Nash observed “liquor is quicker” and alcohol remains the most likely cause of incapacity leading to unwanted sexual activity.

There has been recent publicity alleging ‘drink spiking’ but a remarkable dearth of evidence to support these allegations. Invoking the law of parsimony, if women drink a lot of alcohol it is more likely that they were drunk rather than drugged by some additional chemical. This has been my experience in clinical practice. I was working in a hospital emergency department and a woman brought in her daughter who alleged she had been drugged during an evening out. They requested a blood test. I ordered a drug screen as well as an alcohol level. The time was 3pm the day after her night out. The drug screen was negative; however, the young woman’s blood alcohol was still 112 mg/100ml blood. The legal limit for driving is 80mg/100ml blood. I leave it to readers to do the maths but I suggest she must have been seriously intoxicated the night before!

The current hysteria about ‘date rape’ is a smoke screen to cover up serious alcohol abuse by many young people.

From the Journals

Bromelain, an aqueous extract of the pineapple plant, is widely sold as a natural organic anti-inflammatory agent. The results of a randomised controlled trial cast doubt on claims that it is an effective treatment for osteoarthritis. Although the trial was too small to be definitive, there was no benefit over placebo (Quarterly Journal of Medicine 2006, 99: 841-50).

High blood pressure features in a randomised controlled trial of acupuncture appropriately named SHARP (Stop Hypertension with the Acupuncture Research Program). Despite the promise suggested by case reports and small observational studies, active acupuncture was no better than invasive sham acupuncture at reducing systolic or diastolic blood pressure in 192 patients with untreated blood pressure (Hypertension 2006, 48: 838-45).

A New Zealand doctor has been given a grant of $5000 to continue her research into the treatment of autism. Her alternative methods involve dietary manipulations. In one case, “within a week of having colours and preservatives removed from his diet”, Dr Gullible (not her real name) claimed the subject had a vocabulary of 200 words. Well then, within a few more months he will have conquered the Concise Oxford Dictionary! Dietary manipulations involve a change in management and attention and it is this which is responsible for any observed improvements. These are placebo interventions (NZ Doctor, 15 November 2005).

Fat Lazy Teenagers

Claims have been made that overweight adolescents should have surgery. Some of these fatties have weighed in at 150-200kg. They can be seen in any shopping mall, usually eating a bag of chips and clutching a bottle of soft drink. The parents, usually the mother, are also obese and the situation is not a disease but one of child abuse. The standard of reporting and medical insight is pitiful. A report in the Christchurch Press (23-24 December, 2006) claimed that a possible cause of obesity was hyperinsulinaemia, an excessive production of insulin. Obese people who develop diabetes do have hyperinsulinaemia but this is caused by their obesity, not the other way round. The obesity causes an insulin resistance at the cellular level and the pancreas responds by cranking up its production of insulin.

After surgery, one teenager lost 80kg and is now training to be a chef! I think there needs to be a great deal more informed debate before the health system starts funding this sort of surgery.

Occupational Health-Disease of the month

The history of occupational medicine is full of examples of absurd complaints being linked to the workplace. For example, pain syndromes in women who are only typing a few words per minute (refer Dr Yolande Lucire’s book: RSI Belief and Desire).

The latest medical construct is ‘acoustic shock’ seen in call centre workers. Seven hundred employees have reached out-of-court settlements in the UK with a payout of three million pounds. A further 300 cases are pending. It pays to have an employer with deep pockets. An article in the Guardian Weekly (24 November, 2006) advises that “acoustic shock is caused by exposure to a sudden increase in noise, but people who are already anxious or under stress appear to be particularly prone to it.”

Note the careful wording. The ‘disease’ is not created in normal people but in those who are naturally “anxious or under stress”. These words are designed to obscure the fact that this is not an occupational disease but an attempt to attribute personal angst to the workplace.

Although not given to crystal ball gazing, I predict that this condition will next appear in Australia closely followed by New Zealand. Furthermore, I predict that the condition will remain unheard of in India, the origin of most call centre calls, since there is no compensation available.

The next time you are disturbed by a call centre while eating dinner, yell loudly down the phone and tell the caller to make a claim for ‘acoustic shock’.

Sickie Busters

Fraudulent absenteeism is just as common across the Tasman as it is here. Absenteeism costs Australian industries an estimated $7 billion dollars per year. Rates are around 3.5 percent but this figure can double with-you guessed it-call centres! These must be the people who are away from work while consulting their advisors about their claim for ‘acoustic shock’.

Some savvy people have set up a business (Direct Health Solutions) and they check up on people taking a sickie. Client absenteeism has been reduced by one third and for every dollar spent there have been gains of $12 saved in terms of productivity.

A DHS Nurse reports “you can always tell people throwing a sickie, because very often they haven’t decided what’s wrong with them”.

Sunday Telegraph Australia, 12 November 2006

Selenium Poisoning

A 75-year-old man had a blood test which showed an elevated prostate specific antigen (PSA). He became concerned about prostate cancer. The article does not say whether there was a suspicion of prostate cancer or whether the PSA test was done as a ‘check’. Prostate cancer is certainly common in males of this age, being found incidentally at autopsy in 40 percent of those over the age of 75 years. A screening ‘check’ of PSA cannot be defended in this case because a male diagnosed with prostate cancer at the age of 75 years is more likely to die from some other cause (ie with the disease rather than from it).

The patient visited one of “287,000 sites discussing the use of selenium in prevention and treatment of prostate cancer” and “was able to purchase 200g of sodium selenite powder without adequate instructions.” Three to four hours after ingesting 10g of the powder he presented to an emergency department, acutely unwell, and subsequently died of acute selenium toxicity.

The authors comment: “This case highlights the risks associated with failure to critically evaluate Internet material and exposed the myth that natural therapies are inherently safe”.

Medical Journal of Australia 2006, 185 (7): 388-389

Defrauding the dying


Mexican cancer clinics continue to do a roaring trade, despite their poor track record.

When civil rights leader Martin Luther King was assassinated in 1968, the world lost a voice for decency and truth. The death of his widow earlier this year, however, was attended by greed and lies. The family of Coretta Scott King rushed her to Hospital Santa Monica at Rosarito Beach, Mexico, on 26 January. She died five days later. The underlying cause of her death was ovarian cancer. King’s death in one of alternative medicine’s dodgiest facilities highlights a relationship between quacks and Mexicans that is evil.

Hospital Santa Monica is located near crashing surf, 25 kilometres south of San Diego. The climate there may be the best in the world, consistently pleasant. Cruise ships call at beach resorts along the coast, unloading passengers who like the sunshine and the cheap peso. The region also has about 20 alternative medical clinics for desperate patients, almost all from the United States. Coretta Scott King was barely alive when she arrived in Mexico, but like the tourists, she had money. She was one of perhaps 10,000 paying US citizens who check into some Mexican clinic every year. Mexican locals and authorities welcome money from both the tourists and the sick.

Sadly, Hospital Santa Monica and the dozens of similar facilities sell patients only false hope. Kurt W Donsbach founded the Rosarito Beach facility. “The major patient clientele is comprised of cancer patients who have been told that there is no more hope, all traditional therapies having failed,” he boasts on his website. Donsbach claims to use “wholistic” techniques to treat the “whole” person; body, mind and spirit. He repeats the usual twaddle favoured by quacks: about how orthodox doctors treat only symptoms, not the disease; about detoxing the body and boosting the immune system; about avoiding standard treatments because they make cancer worse. Hospital Santa Monica offers “a very eclectic approach,” he says, including ultraviolet blood purification, mag-ray lamps, hydrogen peroxide solutions dripped into veins, ozone gas blown into the colon, a microwave hyperthermia machine (with a rectal probe), induced hypoglycemia by administering insulin, shark cartilage, a Rife frequency generator machine (remember Liam Williams-Holloway?), magnet therapy and other nonsense. Deluded groups such as the so-called Cancer Control Society, based in Pasadena, California, run trips to such Mexican clinics, taking thousands of cancer patients there for useless treatment.

Donsbach fails to reveal on his website that he has a criminal record but no medical degree. Born in 1933, he graduated in 1957 from a chiropractic college in Oregon. By the late 1960s he was running a health-food store in California, selling supplements that he said treated cancer. Throughout the 1970s and 1980s, he was repeatedly in legal trouble for practising medicine without a licence, selling unapproved drugs and related wrongs. In 1979 he founded a correspondence school – the nonaccredited Donsbach University – that awarded bogus degrees in nutrition, and he sold his own supplements. Officials in New York said the products were useless and sued him. Under pressure in the US, Donsbach started the Mexican clinic in 1983. In 1996 he pleaded guilty to charges of smuggling $250,000 worth of unapproved, adulterated or misbranded medicines from Mexico into the US. Sentenced to prison, he avoided serving time by plea bargaining. In other words, Kurt W Donsbach’s life has been devoted to a range of health-related scams.

The Mexican medical clinics are a blot on the page of human history, but they continue to exist because they attract money. Mexico is a very corrupt country, and bribes and fraud allow unconscionable activity to thrive there. Mexican officials claim they can investigate the facilities only if there are complaints, which are rare because the clinics usually treat non-Mexicans and do not advertise in Mexico. Sometimes clinics get shut down, but they re-open. A week after Coretta Scott King died, the Mexican government closed Hospital Santa Monica, saying it lacked authority to carry out some of its treatments and that several of its unconventional practices put patients at high risk. Patients from the US, Canada, Australia and Italy were at the facility when it was closed. Interviewed by the Los Angeles Times, Donsbach was shameless. He blamed the closure on the US medical establishment and predicted that his clinic would reopen soon: “The moment they close down a clinic, they open it up very quickly, the same place, same people.” Immoral quacks and their allies continue to fleece the dying.