A Skeptical Response

Occasionally, the NZ Skeptics receive correspondence from members of the general public. Recently, Chairentity Vicki Hyde took the time to reply to one of these. Portions of the original letter are indented.

Dear Margaret

Thank you for your comments, though it’s sad to see that you believe the general stereotype of skeptic:

The mere term ‘skeptic’ is enough to conjure (oops, not a word skeptics like, I’m sure) up an image of a cynical, dogmatic person, afraid to step outside the realms of their small, unen-lightened world.

“Conjure” would actually be a very suitable term used in skeptical circles, as we have many magicians as members, as well as teachers, homemakers, researchers, a broad sweep of humanity. There are very few who fit the stereotype you have assumed, as about the only thing we have in common is the desire to actually step outside the realm and find out what makes us what we are, what encourages us to think how we do and to respond the way we do to the world around us.

About the only type of person we don’t have in the skeptical ranks are fundamentalist dogmatics, as they are taught to never question authority, and skeptics, by their very nature always ask questions and, in many cases, accept that there are some things we will never have the answers for.

I imagine that Rande, who was featured on a programme about homoeopathy on TV1 last night is typical of the average “skeptic” who desperately goes around trying to “debunk” anything that is not “clinically proven in a scientifically controlled experiment”.

No, not debunking, but investigating — most of us don’t like the term “debunk”, as it implies a biased viewpoint to start with, but the media does persist in using it.

We always try to investigate with an open mind and with the knowledge that everyone is fallible, we are all able to be fooled or biased. And that when extraordinary claims are made, it should involve an extraordinary level of proof.

Randi was asked in because magicians have a very clear professional understanding of how people can be mistaken or hood-winked, whether intentionally or accidentally.

Scientists, however, work in an environment of collegial honesty, which makes them more vulnerable, in some respects, to deception or assumptions. That’s one of the reasons why science encourages investigation, repeated observation, independent corroboration and all the other aspects that help us to differentiate between what we think we know and what we know, to try to eliminate our own biases, prejudices and assumptions in learning about the world.

I wonder if you skeptics ever experience a ‘hunch’ or a ‘gut feeling’ or, dare I say it, intuition … I imagine not — I mean, how can you prove it?

Yes we do. I had a long interview with a reporter this year about the nature of intuition. Sadly the editor wanted to hear only about “just so” intuition anecdotes, rather than the interesting story of why humans feel so strongly about intuition, how it has proven useful to us and why we have such difficulty remembering when it doesn’t work.

I think that intuition is the capacity for apparently making reasonably accurate predictions about the near future based on a combination of both definable and, for the most part, indefinable factors. We’ve all experienced those times when we “just know” something and, when we’re proved right, that’s an immensely powerful reinforcing factor for a belief in intuition or psychic abilities or whatever you think such an experience is based upon.

Humans are, after all, a pattern-seeking animal — we look for patterns in the stars and try and find meaning in them; we analyse our dreams; we try and find cause-and-effect in all manner of connections.

What we humans don’t do, is readily recall the experiences which provide counter-examples to the belief in causal relationships or intuition. We don’t bother thinking “gee, I felt something bad was going to happen today and nothing did!” Instead we look for confirmation of our beliefs — “gee I felt something bad was going to happen today, and look, a week later, I had a car crash!”

However, in our enthusiasm to over-simplify and gain control over our destiny, we have often taken such things too far — that star up there makes the Nile flood (bzzt, wrong!); bleeding a patient will rebalance their humours (bzzt, wrong!); that person is inferior to me because they are a different gender/race/religion/skin colour (bzzt, very wrong!).

There are hundreds and hundreds of people whose flashes of intuition or desperate hopes or even sheer bloody hard work, did not succeed, but you don’t hear about them, they don’t have the compelling story, they don’t get the column-centimetres in the glossy magazines.

Which demonstrates another key psychological point — one strong personal example will always far outweigh collective experience and general statistics.

As in, “my child got a bad reaction to immunisation which means yours will too” generates a much more powerful response in parents than millions and millions of non-affected children in some faceless study. And you see that in operation on Holmes every time the immunisation debate heats up…

I have had, on at least four occasions over the past 20 years, very strong feelings that my father had died or something had happened to him. Once I even rang him in the middle of the night from Japan, where I was living, just to check that he was OK, the feeling was so strong. I was wrong all four times. And the week he did die, I had no inkling at all, much to my sorrow.

I once had an incredibly vivid dream that my second son Perry fell off a bridge into a fast-flowing river. Very, very vivid dream — wind blowing, sharp streetlight shining on the water, his face disappearing beneath the muddy swirls, a terrible gut-churning wrench. Still makes me shudder even six years later. But he was just a toddler in my dream and he’s well past that now, at nine years old. And no, he’s never fallen off a bridge.

Now I am very conscious of the importance of counter-examples, so I have made a point of remembering those times when I have had strong feelings or dreams that haven’t panned out so I can say honestly that we do have such feelings and sometimes they are wrong.

But if my father had had problems within a week or so of any of those times I had worried about him, I could easily claim it as “proof” that intuition works…

Part of it comes down to an understanding of the statistics of coincidence. If I had continued to have dire warnings of my Dad’s imminent demise, then odds-on I would have had one some time close to the point he did die.

Thank goodness the majority of the world is comprised of thinking, feeling, spiritual beings who are intelligent and open minded enough to realise that life is comprised of such complex, multi faceted components which make up our universe and which no scientist or skeptic could possibly begin to understand or prove in a laboratory.

I’d agree with you with the first part — skeptics are incurable optimists and we’d love to believe that the majority of the world is comprised as you describe. It may be that you are confusing skepticism with scientism; the latter is the dogmatic view that science explains everything. Ironically enough, very few real scientists subscribe to it, although the stereotypes assume that they do…

As regards the second assertion, I don’t think any scientist or skeptic worth their salt would suggest that all things are explicable or provable in a lab. We recognise the need for humility in the face of the universe’s complexity, but we also appreciate that some of the complexity can be known better and appreciated in all its glory, if we but ask questions.

As a medievalist, I know that the stars were once regarded (at least in the Judaeo-Christian West) as bright points of light fixed in an immoveable globe of crystal. As a keen amateur astronomer, I know that the universe is much more complicated than that. I would say that the later knowledge is no less beautiful, fascinating and uplifting than the former view, and all the more powerful for being based in reality and shared with millions of others regardless of their culture or world view.

I see you skeptics are making submissions regarding complementary health in New Zealand. Don’t waste your time… Natural medicine is the fastest-growing industry in the world and will continue to be …

Yes, we know it is very popular, which is why it is important to be sure that it is both safe and effective — we can ask no less of anything which we use as medicines, regardless of whether it is herbal or industrial in origin. Anything less is not only potentially dangerous but also ethically unacceptable.

We don’t allow used-car salesmen to make unsubstatiated claims about their vehicles or sell unroadworthy ones (or if they do, we prosecute them). Our health, and the health of our children deserves no less scrutiny.

We recognise that medically useful things have come from chance discoveries, which is why it is important to keep an open mind. What we need to do is ensure that any practice or product we use is safer and more effective than whatever we currently have. That’s the gist of our Complementary and Alternative Medicine (CAM) submission — have you read it? (You can see it online at the Skeptics website, as we believe in open, transparent communication.)

Oh by the way, did you know that 80% of pharmaceutical drugs have no proven efficacy.

I’m not sure where your figure comes from, but certainly there is far too much useage and far too little scientific underpinning for many widely used products. That awareness has led the push for reexamining what drugs we use, how effective they are and whether there are better alternatives.

That’s why you’ll find skeptical groups as equally vocal about the over-prescribing of antibiotics as they are cautious about the claims for mega-vitamin dosages.

It’s why we often point out that a good two-thirds (if not more) of what ails us will get better within three days, regardless of whether you visit a GP or a homeopath.

It’s why we support evidence-based medicine which looks at safety and efficacy issues, critically examing our own assumptions about long-held medical beliefs. We know, for example, by looking at the evidence, that earache in children is best left alone and monitored, rather than treated with antibiotics. We know, by looking at the evidence, that episiotomies for childbirth aren’t warranted in the vast majority of cases, and have been pleased to see their use drop significantly.

We wouldn’t know these things if we didn’t stop to ask questions, to assess the evidence. And, if we are going to hand over our money or our lives to any kind of medical practitioner, surely it makes sense to ensure that they know what they are doing?

…and that 13,000 New Zealanders a year die from the side effects of medically prescribed drugs. Now that is a worry and something you skeptics would be far better off being skeptical about…

That’s an astonishing figure if you stop to think about it (which, after all, is all that skeptics ask people to do…). Where does it come from?

Lessee, that’s half of all deaths in New Zealand annually (I’m using the figures from the 1995 NZ Yearbook, which is the most recent one I have to hand, but I don’t think the figures have changed that much; it cites 26,437 deaths in total).

I guess if you assume that everyone who has cancer or heart disease or cerebrovascular disease died purely as a result of their medication (which assumes they were on medication in the first place), then you’d get somewhere near the figure you quote. But I don’t really think that that is a valid assumption, do you?

Given the type of disease and the likely demographics, then it wouldn’t be unsurprising to have a large number on medication, but the mere fact of that would not be enough to warrant the assertion that it was the drugs wot did it! While we can be critical about regulatory systems, medical practice, the public health system etc, a death rate of that size solely attributable to side effects from medicine would be Big News.

I don’t think that the aspirin my Dad was taking for his heart disease killed him, for example — he died because his heart finally stopped working. And, in fact, I believe that it may well have given him an additional 15 years he would not have had otherwise (the time between his first heart attack and his final), given the evidence for aspirin’s use in heart problems.

We can only find out whether there is a causal relationship between things by examining case after case after case, hence the importance of evidence and record keeping.

We’d encourage CAM practitioners to be involved in this (and some of the best are), not only to help their clients but also to help a better understanding of health issues and responses themselves.

My apologies for the length of this response, Margaret, but the issues you raise are not simple ones, and there are no simple answers. I hope you’ve taken the time to read this far — it’s a sad irony that we often find it’s those who are involved in alternative viewpoints who are not willing to hear other views or reconsider their beliefs. I guess that’s the nature of humanity, but one always lives in the hope of encouraging others to think more deeply — that’s what the NZ Skeptics are all about.

Sincerely
Vicki Hyde
Chair-entity

Hokum Locum

Cellulite – Just a Euphemism for Fat

Cellulite is the term used by women’s magazines to describe dimpled fat. It has no scientific or anatomical validity and it is simply ordinary fatty tissue that assumes a waffled appearance because fibrous tissue prevents the skin from fully expanding in areas where fatty tissue accumulates. This has been confirmed by a study where biopsies of fat and cellulite were microscopically indistinguishable by pathologists who were blinded as to the samples’ origin. Calling fat “cellulite” is part of the modern trend to seeking alternatives to the (unpalatable) truth, in this case an adipose euphemism.

The latest treatment for Cellulite involves a machine called Cellu-M6. It is described as having “even been approved by the strict Amer-ican Food and Drugs Administration”. I checked the FDA website and although I could not find the machine specifically mentioned it did refer to a “Dermosonic Non-Invasive Subdermal Therapy System”, presumably using ultra-sonic stimulation of the skin. The FDA “approval” is nothing of the sort, merely an acknowledgement that the machine is similar to others already on the market. There is nothing in the FDA response indicating any approval or endorsement of the device beyond noting that it “temporarily reduces the appearance of cellulite”.

Given that about half of the New Zealand population are obese, and roughly half of these are women, this makes for a huge and lucrative market. The Cellu-M6 machine is described as “breaking down the cellulite, toxins and abnormal water build-up are expelled and the increased blood flow stimulates enzymes which encourage fat cells to break down.” Journalists sometimes inadvertently get close to the truth and the article states in part “While it seems almost too good to be true…” Well, yes, it is.

With all worthless treatments it is essential to get the punters to do something for themselves, which in itself is actually effective, for example: “You’ll still need to do some work. Walking, exercise and watching what you eat.” The most well-motivated customers will be the ones who actually do exercise and lose weight. They will be thrilled with the results, happy with the cost and completely oblivious as to the real reason for their loss of cellulite (weight).
New Idea 4/1/03

Cannabis

For various legislative and historical reasons, cannabis use is illegal in New Zealand. My feeling is, why legalise cannabis when we already have so much suffering from the abuse of tobacco and alcohol? Nevertheless, on the medical evidence available, moderate indulgence in cannabis has little ill effect on health. Cannabis has been studied for possible use in various medical conditions but there are problems with drug delivery as most researchers feel that it is unacceptable to administer it through smoking and oral bioavailability is variable.

A recent Lancet study of patients with multiple sclerosis found that cannabis had no measurable effect on muscle stiffness or jerkiness. The patients, however, stated, “it had reduced their symptoms and improved their mobility.” I went to the Lancet website and there are problems with this study. Fifty percent of the placebo wing of the trial claimed benefit and because of the psychoactive effect of the cannabis, subjects knew whether they were taking cannabis or placebo. I have written before on the problems of clinical trials becoming “unblinded” through this effect. The researchers should have used an ‘active’ placebo, something that mimicked the effects of cannabis. It appears that researchers still lack an understanding of this process. Perhaps they should call in James Randi to help them?

Despite the lack of evidence for the medical use of cannabis, “a wealthy Christchurch businessman caught growing cannabis has escaped without a conviction after convincing a High Court judge that he used it medically.”

I can just see future headlines at the next sitting of the Dargaville Court: “Unemployed Maori youth of no fixed abode acquitted of growing cannabis after convincing the Judge he used it for a medical condition”. Yeah, right.

But wait! The businessman, we are told, suffered from a painful bowel condition diagnosed as “pyloric sphincter”. That explains everything. We all have a pyloric sphincter. It is a thickened muscular valve at the outlet of the stomach.

All of us can now smoke cannabis with a clear conscience (write or email me for a medical certificate, but only if you are rich, say $5000 per certificate will be fine).
Dominion Post, 8/11/03, 14/12/03

Veterinary Homeopathy

I don’t normally concern myself in this area although I did recently correspond with the Veterinary Council and their policy over alternative medicine is very similar to that of the Medical Council with Doctors.

The Press (18/11/03) carried an article, which I thought was unintentionally very funny. A trainer was fined for injecting a horse with a homeopathic remedy. It was further reported, “another horse injected with it had won, been swabbed and tested negative in the past.”

Of course it tested negative! Homeopathic solutions are water and this simple fact seems to have completely escaped notice by the Judicial Control Authority. I thought I would have a bit of fun by writing to them and pointing this out so will keep you posted.

The homeopathic remedy was “Vetradyne” and was easily found by Google. A 50ml bottle costs $215 but I was unable to find its composition, or any given therapeutic indication, apart from the cryptic comment “no claims made.” It was also detailed as being for “oral” use only so it does seem strange that it was given by injection. An inquiry of the website was no more forthcoming over composition or dilution factor.

Counsellors

Every time something unpleasant happens we hear the dreaded phrase “counselling has been arranged.” Can we do anything to stop this clichéd response?

Following the illegal viewing of pornography at a school, pupils have been offered counselling. What’s wrong with today’s teachers? Can’t they handle a situation like this in a reasonable and intelligent manner? It seems that our population are willing to hand over all responsibility whenever they can. Is it because they lack confidence or is this a deliberate social policy on the part of the government? It’s certainly consistent with Government policies that encourage dependency and allow hundreds of thousands of people to indefinitely remain on welfare payments.
Dominion Post 27/8/03

Badly Behaved Children

Readers will know my attitude towards the socially engineered fad diagnosis of attention deficit hyperactivity disorder (ADHD). ADHD is treated with methylphenidate (Ritalin) and there was a 17% increase in prescriptions over the past year. The drug is being sold by parents on the black market. This does not surprise me but readers may be surprised to know that most street drugs are sourced from legal prescriptions. There are doctors in every part of New Zealand who over-prescribe a wide range of psychoactive drugs, which are then sold.

To paraphrase a well-known psychiatrist: “any behaviour of a child can be consistent with ADHD.” We must act now and add Ritalin to the drinking water. This will have the dual benefit of removing the need for parents to discipline their children and of destroying the illicit drug trade. The whole population will be happy, well behaved and in no need of counselling.
Marlborough Express 1/12/03

Multiple Chemical Sensitivity

This is a pseudoscientific diagnosis where people develop a fixed illness belief about chemical exposures. It is increasingly becoming an employment issue and is a classic example of psychosomatic illness. In a typical case, a radiographer is reported as needing a face mask before leaving home because “when I have a new dose of chemicals I become unreasonably upset about anything and everything, and become ill and extremely tired, plus a host of other physical effects.” Such patients have been studied by Staudenmayer (Environmental Illness: Myth and Reality). He tested 20 patients complaining of universal sensitivity to multiple chemicals and found that “the patients’ appraisals were no different from chance performance” (ibid. p. 99). In other words, the patients’ beliefs were disproved. There is an urgent need for such testing to be available in Australasia, otherwise there will be an increasing number of these spurious claims, misattributed to employment conditions.
Marlborough Express 10/10/2003

Newsfront

Dying is Bad for Business

An Auckland law firm was going to court late last year (Dominion Post, November 1) to block the opening of a funeral parlour opposite it. Death (or dealing with it) offends against the ancient Chinese art of feng shui. Contact with death can lead to bad luck and negative energy could flow from the funeral parlour into the law firm. The firm was concerned it would lose its Asian clients if the parlour opened. The parlour, meantime, said it had been granted resource consent. Haven’t heard the outcome yet…

Ringing in new changes

And while on the subject of feng shui, here’s a tip for Telecom. Feng shui specialist Honey Lim says the company should relaunch its new logo in February to capture the powerful energy of a new age in the feng shui calendar. In the Dominion Post (November 26) Ms Lim says she approves of Telecom’s new logo, which is in harmony with feng shui. Telecom spent $140,000 on the logo, and will be happy to learn its green and blue squares underpinning the yellow rectangle have good karma. Ms Lim says the old one featuring three coloured spears stabbing the company name, which told her that, “despite the company’s own colourful and innovative efforts, their initiatives were hurting themselves more than spurring them forward.” She reckons they really should relaunch themselves in the New Year — an act which would generate “awesome feng shui”… . February 4 marks the beginning of ‘period 8’ in the feng shui calendar, a period of new energy. And in order to benefit from it, people or organisations need to undertake renewal or change after that date. Now there’s an idea…

ET – Wait a Tick

The mayor of a Brazilian town says he had cancelled a planned landing by aliens during an important soccer match last year (The Press, November 24). Elcio Berti said he cancelled the landing of the alien spaceship because he was worried they may abduct one of the Brazillian footballers. Berti, the mayor of Bocaiuva do Sul, claims to be in regular touch with aliens and is preparing a UFO landing pad for them in town.

“Con” Man Speaks Out

It was good to see Australian skeptic Richard Lead in the Dominion Post (September 22) following our conference last year. In a small article the “professional cynic” explained how he has tackled cons, from the Nigerian scam to property investment.

“I was living in Samoa in 1994 when I first saw the Nigerian scams. I used to attend a businessmen’s lunch and would pass the letters around and we would have a good laugh. I later found one of the guys had got taken for $90,000.”

This and similar scams, he said, work by the “Concorde fallacy” — the only chance you have of getting back the money you’ve already invested is to put in more. “They just keep sucking you in and the losses keep getting bigger and bigger. I used to say ‘how could people be so stupid?’. I don’t say that any more. I’ve seen it happen so often.”

He told the paper the hardest part of the job was dealing with people who had lost life savings, something he was not equipped to deal with. “Nothing in my accountant’s training prepared me for people with tears in their eyes because they’ve lost everything.”

The best way to avoid being taken in was to exercise common sense and carefully evaluate everything. “…if it sounds too good to be true, it usually is.”

Not a Prayer of a Chance

The biggest scientific experiment on prayer has failed to find any evidence that it helps to heal the sick.

Doctors in the US said that heart patients who were prayed for by groups of stranger recovered from surgery at the same rate as those who were not (Dominion Post, October 17).

The three-year study led by cardiologists from Duke University Medical Centre in North Carolina, involved 750 patients in nine hospitals and 12 prayer groups around the world.

The prayer groups included American Christian mothers, nuns, Sufi Muslims, Buddhist monks in Nepal and English doctors and students in Manchester. Prayers were emailed to Jerusalem and placed in the Wailing Wall.

Earlier, less extensive, research had suggested prayer could have a beneficial effect.

The news brought swift reactions. The Bishop of Durham, Tom Wright, said “Prayer is not a penny-in-the-slot machine. You can’t just put in a coin and get out a chocolate. This is like setting an exam for God to see if God will pass it or not.”

Red Tape for Health Pills

The Herald reports (December 8) that the $200 million-a-year health supplements business is up in arms over a Government plan to join with Australia to regulate the industry.

Under this plan, all dietary supplements and alternative remedies would be classified as pharmaceuticals and regulated through a new transtasman agency.

New Zealand has about 10,000 complementary and alternative health practitioners. Health Minister Annette King said the move was about quality, public safety and standards. “We require standards about the food we sell… we require standards for pharmaceuticals and medical devices. And one of the hard lessons I learned last year was that the public demanded standards and regulations for complementary healthcare.”

Opponents say New Zealand will lose control of decision-making to Australia, Kiwi dietary supplements firms will be hurt, and customers will have less choice.

Green MP Sue Kedgley and NZ First MP Pita Paraone are upset the Government is including alternative medicines and supplements before the health select committee report is out.

“Slimming Water” the Latest Fad

Forget about cutting out carbs on Atkins or replacing meals with a milkshake — the latest dieting phenomenon to hit the shelves is bottled water which claims to help people lose weight (Rotorua Daily Post, January 13).

Contrex is being marketed as Britain’s first “cosmetic water”, on the basis that it works as a slimming aid. Nestle, its maker, claims that the mineral water contains natural sources of calcium and magnesium which can eliminate toxins, fight fatigue and help people stay in shape. The calcium can also increase the body’s metabolism and improve weight loss, according to Nestle.

Health experts dismissed the idea of a “diet water” as ridiculous. Amanda Wynne of the British Dietetic Association said: “Drinking water will not make you slim, even if it is fortified with calcium and magnesium. It just doesn’t work that way.”

Despite this criticism, industry insiders are predicting that so-called “aquaceuticals” will be the boom dieting products of 2004. The fad started in Japan and hit America last year, with several brands planned for launch in Britain this year.

A spokeswoman for Nestle said, “It is selling like hot cakes. Contrex has been sold in France for years and women there call it the slimming water. You get the minerals you need without putting on weight.”

Other aquaceuticals to go on sale recently include Blue Water, which costs an incredible £11 a litre and claims to improve skin conditions and general wellbeing. It has been developed by an Austrian naturalist, Johann Grander, who says he “removed the negative memories from water and transferred beneficial energy patterns to it”.

Some fans say they feel better simply by sleeping next to a glass of Blue Water at night. Other products have celebrity endorsements, such as the Kabbalah Mountain Spring Water favoured by Madonna. It claims to have been transformed into a “living” water through modern technology and the wisdom of ancient texts used by the Cabbala, a Jewish mysticism.

Lakeland Willow has also been launched as an aquaceutical in the UK. According to its marketing blurb, it contains salicin, a natural painkilling substance found in willow bark.

Should You Sue Your Doctor?

Increased litigation will do nothing to reduce the rate of medical misadventure

In a recent decision the Privy Council has ruled that a New Zealand patient dissatisfied with a diagnosis can take legal action against the doctor responsible. Without commenting on any individual case, surely such actions must make doctors more careful and overall will improve the standard of medical treatment?

Not so; litigation in medical matters has had a disastrous effect overseas. New Zealand has been largely protected by the Accident Compensation scheme (with all its faults), so many people here do not realise what a terrible step is being contemplated. In particular medical litigation will make medicine more expensive. The US has in many ways an excellent medical system, with one major flaw; it hosts a whole branch of the legal profession as a parasite. Thus it is enormously expensive, and so unaffordable for many people.

I recommend an article originally published by the New Yorker in 1999 and reprinted in The Best American Science Writing 2000 (ed. James Gleick): When Doctors Make Mistakes, by Atul Gawande. This is partly an account of how the author made a medical error and of why errors occur, but explains how litigation does nothing to improve a medical system. It also contains a lot of interesting data.

It was estimated that in the US around 120 000 patients die each year, at least partly because of errors during medical care. In November 1999 (after the publication of this article) the National Academy of Sciences reported that medical errors caused between 44 000 and 98 000 deaths per year.

A 1995 study on hospital drug administration found that an error occurred about once per admission. Although nearly all were minor and did not cause a problem, about 1 per cent had serious consequences. In New York State another review of 30 000 admissions found that nearly 4 per cent suffered complications from treatment that prolonged their hospital stay, resulted in disability, or caused death.

Thus errors in the USA are not rare, but would they be more frequent without the threat of litigation? The evidence suggests not and it contains some surprises. Some in the legal profession have claimed that their role is to find and expel incompetent and dangerous doctors. However most surgeons are sued at least once in their careers. Repeat offenders are not the problem, practically all make some mistakes. A study on the perpetrators of medical error found no group of dangerous doctors. Instead errors were normally distributed across the profession. This implies a single population so it is pointless to look for a subset that could be eliminated to leave behind a better performing profession.

It is hardly surprising that litigation fails to reduce medical error rates when one sees how it is applied. In the US only 2 per cent of patients who received sub-standard care ever sued, while only a small minority of those who did sue had actually been the victim of sub-standard care. Many of those who sued successfully, were not actually victims. It was found that the chances of a patient winning a suit depended primarily on how poor the outcome was, regardless of whether the outcome was caused by error or negligence.

The sums awarded as compensation are often huge; but even if a surgeon wins and so pays no compensation, his/her legal costs are still enormous. Thus doctors must carry enough insurance to cover these possibilities. Even the best surgeon must prepare for the worst as he or she can expect to be sued at least once in a career. The insurance premiums are naturally very high, and of course these must be covered by the fees charged.

Closer to home in Australia there has recently been a crisis in the medical profession, with groups of surgeons threatening to cease work unless some Government action was taken. The problem grew with ever-increasing sums being awarded to successful litigants. Surgeons in particular were required to take out ever-larger insurance policies. A relatively small insurance company offered cut rate policies — but a few cases with very high awards against medical staff showed that they had miscalculated; they had set their premiums far too low. The financial collapse of this company and then the insolvency of a very large insurance company resulted in a number of medical staff being without any insurance cover. The new policies being offered them involved premiums far higher than those they had been paying. Their professional fees were too low to allow them to meet these extra charges.

The Government had to take emergency measures to ensure that surgery could continue. This example from just across the Tasman shows clearly how medical litigation has a dramatic effect on the cost of medical services.

Some recent actions suggest that people in New Zealand are already aware of the dangers they might face. In the far North, long-standing obstetrical practices were suddenly stopped resulting in public protest. But members of a hospital board may feel they could be held liable if procedures they had allowed, resulted in misadventure. In the same district, obstetricians had allowed anaesthetic procedures by midwives after a telephone consultation; this was also stopped. Perhaps they could be liable for any unfortunate result. One can hardly blame medical staff — to be held liable for one’s own action taken in good faith is bad enough; to be held liable for somebody else’s mistake is a dreadful possibility.

In his essay Atul Gawande identifies how medical misadventures can be reduced. This is done not by targeting individuals but by targeting practices. One lesson is that small hospitals are the least safe — something which is known to be the case in New Zealand but has never been properly explained to the public.

The major lesson is that everybody makes mistakes at times; the system must be organised to make it more difficult to make mistakes, and to ensure that the consequences of mistakes are made as benign as is possible. Forcing medical staff to be defensive, so that they will not admit error for fear of horrendous legal consequences is the very worst method for tackling the problem of medical misadventure.

Claytons Vaccines, Claytons Protection

This article was originally presented on National Radio’s Sunday Supplement

Be wary of “the health professional you see most often”. In some cases be afraid, be very afraid.

Why? Well in some cases, the advice you get from your friendly pharmacist could be deadly.

I try to ignore the herbs of dubious quality, the effusive claims for magnetic bracelets, the offers to feel my feet to see what ails me – all those things which seem a core part of pharmacy stock and trade. I do wonder about the business and medical ethics. After all, what’s worse – a pharmacist who apparently can’t distinguish between tested, regulated medicines and the hope and hokum variety; or the pharmacist who does know and doesn’t care because such stuff sells?

But the whole sorry state of that industry took a chilling turn recently with the report of an Auckland pharmacy selling a homeopathic meningococcal vaccine.

Many homeopaths would argue that the 300-year-old practice of diluting substances into infinitesimal amounts is akin to taking a vaccine. “Like cures like” as they say. What they don’t say is that the massive dilutions they use would require you to drink almost 8,000 gallons of homeopathic solution to get just one molecule of any medicinal substance involved.

You can pay a hefty price for this diluted water, but you can pay a much bigger price if you use it in place of stuff that actually works.

The Council of the Faculty of Homeopathy, the registered organisation for UK doctors qualified in homeopathy, recommends immunisation with conventional vaccines. As GPs, they know you ignore real vaccination at your peril. It’s a pertinent warning here when we’re considering a large-scale vaccination programme against meningitis.

Small wonder that the head of our Health Ministry’s meningococcal vaccine strategy was concerned about the sale of homeopathic vaccines, warning in a Herald article that it could give people a false sense of security.

However, I think the real false sense of security comes from the hopeful notion that we have some legislative protection from purveyors of such patently misleading products. There’s no protection under the Medicines Act it seems, for the Health Ministry’s compliance team leader Peter Pratt noted in the same Herald item that such preparations are permissible so long as they were “sufficiently diluted”.

Yet it’s the dilution that make this approach to vaccination so dubious in the first place, and not just to the skeptical. Alternative practitioner and homeopath Dr Dominik Marsiello states unequivocally that “there is no such thing as a homeopathic vaccine”. He goes on to acknowledge that “homeopathic remedies are too dilute to stimulate an immune response and confer immunity. There is no basis, historically or scientifically, for such a practice.”

Yet we have bottles of water labelled “meningococcal vaccine” and “hepatitis B vaccine” in our pharmacies, sold by health professionals, as a protection against these terrible diseases. Some apologists have said that “vaccine” in this case actually means “immune booster”. But “vaccine” has a specific meaning – it’s something which confers immunity through the production of antibodies. This is an easily testable claim, but apparently not one our Ministry of Health considers worth bothering about.

I shouldn’t be too surprised. After all, last time concerns were raised about a comparable product, our Commerce Commission – the organisation charged with protecting us from fraudulent claims – passed the buck to the Ministry of Health, saying it was a health issue. The health ministry, in turn, washed its hands of the business saying that “water is not a medicine”, thus it had nothing to do with them.

Contrast this with the activities of the Australian Competition and Consumer Commission, their state Health Care Complaints Commissions, their Fair Trading Ministers, and the Australian Therapeutic Goods Administration. They are taking an increasing interest in those areas where bogus medicines, fraudulent claims and consumer rights intersect. The TGA took a very dim view of having a fake vaccine on the Australian market, banning it and warning consumers. And the New South Wales Fair Trading Minister referred to the earlier incident where people were paying a 400,000 percent mark-up on a small bottle of water as “a New Age spin on an old-fashioned rip-off”.

Strong words, but ones which need to be said, and said loudly. I know of one New Zealand baby dead of meningitis because homeopathic treatment was chosen over real medicine. I don’t want to see any more. I just wish our Health Ministry felt the same.

Alternatives to Evidence Based Medicine

Alternatives to Evidence Based Medicine

I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as “making the same mistakes with increasing confidence over an impressive number of years.” New Zealand Medical Journal Vol 113 No 1122 p479

Homeopathy Flunks

It’s most unusual to see published trials showing that homeopathy is ineffective. The common term for this is “publication bias” where trials tend to be published only when they show something positive. One of the authors is GT Lewith, a long time apologist for homeopathy and that makes it even more remarkable. Should we give them one of our awards?

A double blind, randomised trial evaluated the efficacy of homeopathic immunotherapy on lung function. The conclusion: homeopathic immunotherapy is not effective in the treatment of patients with asthma. BMJ 2002;324:520-3

An accompanying editorial comments: “we believe that new trials of homeopathic medicines against placebo are no longer a research priority.”

All responsible health professionals must ensure that homeopathy is never funded by the health system. It would be grossly irresponsible to waste public money on “dilutions of grandeur”.

Ministerial Advisory Committee on Complimentary and Alternative Medicine (MACCAH)

Have a look at their Website: www.newhealth.govt.nz/MACCAH/. I have been visiting from time to time in keen anticipation of the result of their deliberations and to see what quackery will be introduced into our failing health system. The committee comprises a sociologist (chairperson), iridologist, doctor of medicine, naturopath, acupuncturist, paediatric nurse (and massage therapist), and teacher. The iridologist is David Holden who organised the International Iridology and Sclerology Conference that I mentioned in an earlier column.

Certain members of the committee have asterisks alongside their names as a reflection of a possible conflict of interest. Readers will recall that our organisation was unsuccessful in getting any skeptics on this committee. Would such a putative member have warranted an especially large asterisk?

There is a similar committee in the USA. It has become a scandal that the National Institute of Health (NIH) has distributed (wasted?) hundreds of millions of dollars on testing what Americans refer to as CAM, or complimentary and alternative medicine. They spent $1 million testing “magnet therapy”. The majority of the studies have been inconclusive and have led to the need for more tests. This has tended to give such quackery a spurious degree of acceptability. As critics point out, how many studies have been published showing that CAM doesn’t work? Read a very good critique of this area at www.washingtonmonthly.com/features/2001/0204.mooney.html

It is quite clear, given the US experience, that the MACCAH will produce nothing of any value and furthermore I predict that they will never publish a single article stating that any CAM modality is useless. I sincerely hope to be proved wrong.

Laying on of Hands

Every doctor of medicine knows the importance of properly examining patients even when they do not expect to find anything wrong. The act of touching people in a therapeutic context carries a very powerful placebo effect. This is a legitimate part of the "art" of medicine and when coupled with good communication leads to a good outcome. This effect is sometimes referred to as the “laying on of hands”, itself derived from the concept of mediated divine healing. For example, the King’s touch was supposed to cure scrofula, a cutaneous form of tuberculosis.

The extreme version of this is the absurd delusion of therapeutic touch where the patient is not actually touched but their energy fields are "corrected". Don’t laugh; this is part of mainstream nursing at Wellington Hospital!

The laying on of hands effect explains the apparent success of many physical treatment modalities such as osteopathy and chiropractic. They all do exceptionally well out of ACC-provided funding and it is no wonder that a recent provider survey found a high level of satisfaction from chiropractors (79%) and physiotherapists (76%). I once asked an ACC Colleague why they funded quackery such as osteopathy and chiropractic and his reply was that ACC didn’t care about anything except getting people back to work. Applying that logic I could set up a military consultancy (Boot Camp Rehabilitation Inc) and get people back to work by threatening them with military-style discipline.

Here is an extract from an advertisement from my local paper: "cranial osteopathy for babies and children to help with poor sleeping patterns, restlessness, crying and poor concentration". This quackery involves allegedly manipulating the bones of the skull to regulate the flow of cerebrospinal fluid. It is complete and utter nonsense that relies for its effect on the touching, a plausible patter and a gullible consumer.

ACC News October 2001 Issue 39

Bye, Bye, Bivalve

Trials of green-lipped mussel extract have been stopped after it was found that “the extract didn’t work.” (Marlborough Express March 11, 2002). Green-lipped mussel extract was marketed in NZ as Lyprinol and more than $1 million of the product was sold after it was claimed that it was a cure for cancer. Successful prosecutions were taken against those responsible for the scam.

The media frenzy showed that journalists had learned nothing from the Milan Brych affair.

I feed our cat (Gilgamesh) on green-lipped mussels, and as well as a lustrous coat he has shown no sign of developing cancer. I rest my case. In order to satisfy the most sceptical of journalists I enclose this picture as proof as he and Claire read the Lyprinol story.

Healthy Options

This is the title of a magazine that contains some of the most nonsensical rubbish I have ever seen. The editor is the woman responsible for promoting the Hoxsey quackery in Tauranga, which led to dozens of desperate cancer suffers taking one-way trips to Mexico to receive treatment. Tauranga travel agents made a killing in every sense of the word. This magazine should be read by all Skeptics in order to get a taste of what could be inflicted on the health system by the MACCAH. One ray of hope however – they mentioned www.quackwatch.com and stated that “this leads the public to believe that natural medicines are a fraud.” Well-enough said!

Possum Peppering

Is this delusion never going to go away? How many trials does it take to show that burnt possum testicles do not deter possums from eating vegetation sprinkled with said preparation? The Green party are already a bit of a joke and this latest nonsense makes me wonder whether they have all been partaking of ganja while worshipping with Nachos Tandoori. However, there is more to this than meets the eye, or testicle. I tried sprinkling some of a late relative’s ashes around our garden and I haven’t seen the mother-in-law for months. I rest my case. It must also be horribly lonely for all of those people living downwind of a crematorium – they never get any visitors at all!

Dummy pills just the trick

Dummy pills just the trick

The best paper in New Zealand (Waikato Times, May 6 – and it’s got nothing to do with the fact that I work there) reports that depressed patients tricked into thinking they are being treated have undergone healing brain changes.

The discovery is “conclusive proof of the power of the ‘placebo effect’ – the mind-over-body influence of believing that a drug will work.”

Scientists at the University of Texas, San Antonio say patients given a dummy pill experienced brain changes remarkably like those attained by taking Prozac.

World’s biggest ghost hunt

Hertfordshire’s Dr Richard Wiseman involved 250 volunteers and an array of hi-tech equipment in what became the world’s biggest ghost hunt, according to the Guinness Book of World Records.

The Evening Post (March 3) says despite a number of creepy tales from volunteers, no definite proof of the supernatural was found during the experiment conducted in Edinburgh early last year. Wiseman said it was truly fascinating but “…none of the stories convinced me ghosts exist … I used to be a magician and I saw how easily people could be tricked.”

The tour guide who worked in the underground vaults of the 18th Century chamber, was in no doubt of the presence of ghosts, the paper said. These included a little boy, a dog and “the spectre of a nasty man who whispers obscenities in people’s ears.

“He has foul, stinky breath and he’s really horrible … The vaults … have been closed for 180 years so I think all that paranormal energy has been bottled up and is only just now being released.”

Maybe the tour guide needs Scooby Doo to deal with the wee doggie.

Measles epidemic hits anti-vaccine town

A measles epidemic involving 700 children that ravaged a small German town is being blamed on two homeopathic doctors who denounced the MMR vaccine, says the Dominion on March 7.

Debate on the merits of the vaccine is reaching fever pitch and 30 children had been admitted to hospital where there were fears there could be deaths.

On one side are “alternative health enthusiasts” who dominate Coburg, an affluent Bavarian town. Two of the town’s seven child health doctors fiercely oppose MMR. And then there are the public health experts, who “accuse a ‘nest’ of militant anti-MMR activists … of putting children’s lives in danger.”

Germany, the paper reports, is becoming famous as a world leader in “exporting measles”, according to leading specialists.

Dr Helmut Weiss, head of the state health office in Colburg, said the stronghold of the epidemic was the Waldorf School.

He’s at it again

And the Evening Post (April 13) informs us that psychic Uri Geller is to look for the site of the battle featured in the movie Braveheart.

The “paranormal expert” has been called in by historian John Walker, to try to pinpoint the exact location of the Battle of Falkirk which was fought between King Edward I of England and William Wallace, in 1298. The location has been lost, and no bodies or artefacts ever found.

Mr Walker stumbled on to Uri Geller while on the internet one evening, and read how he’d helped discover the location of a wrecked submarine. Since, he said, conventional methods to discover the graves of the combatants had failed, “… we need to try the unconventional.”

And Mr Geller said the battle was mysterious. “…the fact that very little was found could mean they have not been looking in the right place for the site.”

As they say, watch this space. And, by the way, William Wallace was not a homespun-wearing, oatmeal-eating fighting man of the glens as depicted in that movie, but grew up in a genteel manor house where he probably had very good table manners. So there.

Forum

False Memory re Subs?

In the latest NZ Skeptic, beside the chair-entity’s report, there is a false history of subscriptions. From written records: the sub was $10 for ’86 to ’88, then $20 for ’89 to ’91 and $25 since. The new $40 rate follows the third increase since starting. I would hate to think the Skeptics allow false statements to go uncorrected.

Al Dennard

Two views of the World Trade Centre Attack

  1. From Editorial in Skeptical Inquirer Jan/Feb, 2002.
    Brian Farha, a professor of education at Oklahoma City University and member of CSICOP’s astrology subcommittee, wrote to me to propose we run a Forum column with this introduction: “Following are detailed summaries of documented psychic predictions-to this author’s knowledge-regarding the September 11, 2001, terrorist attack on America.” That would be followed by a blank page.

  2. From the newsletter of the American Society for Psychical Research, Dec, 2001.
    Through our website, we have initiated a survey of precognitive experiences specifically related to the terrorist attack.

Submitted without comment by Bernard Howard

More Brickbats for Glen Fiddich

Some years ago, returning from the Continent, the in-flight duty-free catalog offered Glen Fiddich and Glen Morangie. I ordered the Glen Morangie. It was bad enough to be told that they were out of stock, without being patronized by the salesgirl (“air-stewardess”) insisting on showing me what a Glen Fiddich bottle looks like. Very nice, so could I have a Glen Fiddich bottle refilled with Glen Morangie whisky! As for Wilson’s, (See Beer and Skittles, Issue 61) well I shan’t be surprised if it doesn’t taste as good as Glen Morangie, but will be disappointed if it doesn’t taste better than Glen Fiddich.

Kris Howard, Scotland

Organic Figures

In Philippa Stevenson’s note Report Debunks Organic Benefits (NZ Skeptic 61) she quotes from the NZ Herald that 10 million hectares in organic farming round the world yield $50 billion worth of produce, or about $5000 per hectare (NZ dairy farmers would expect to exceed this), while 44 million hectares in transgenic crops, mostly in the US, yield produce worth $7.5 billion, or $167 per hectare.

I would have expected that Philippa, or any other good skeptic, or the editor of NZ Skeptic, would have been skeptical about these figures and checked their credibility. Or are skeptics, so zealous not to be gulled by claims of the paranormal, quite gullible about claims of the normal?

Pat Palmer

Philippa Stevenson is a Herald reporter and not a member of the NZ Skeptics. The article was reprinted as it originally appeared in the NZ Herald. ed.

Children and Quackery

Pippa MacKay’s Bravo Award-winning item When Children are the Victims of Quackery made sad reading. Yet it is merely another reflection of a country that is losing its collective marbles. Volumes could be written about the reasons for this creeping looniness, but surely chapter one, volume one would have to be ‘our politically correct times’.

An encounter recently with the mother of a 4 year old has put me in a pessimistic frame of mind. The mother is a registered nurse, ie a ‘caregiver’, the 4 year old is her son – a lively, articulate and energetic boy, filled with inquisitiveness, brimming with energy and apparently desperate to be at school learning about the world. The boy is such a handful that a child psychologist has diagnosed him as an ADHD patient and recommended Ritalin for him. The mother is tired, but doubtful regarding Ritalin, yet remains tempted by such a trite and convenient diagnosis. I am treating the mother, who coincidentally swears by arnica ointment and enjoys reading the Women’s Weekly’s clairvoyant’s page.

It seems we are surrounded by the paradox of people who listen to the local clairvoyant with respect, and self-medicate with homeopathy yet have post-graduate education. Similarly I have spoken to anxious parents (and grandparents) about Ritalin, and heard enough to believe that Ritalin is being administered to children (almost always boys) who seem to be more energetic, more inquisitive and more assertive than their teachers or caregivers can deal with.

There can be nothing more horrific than child abuse, and God knows we have seen such abuse aplenty – but shouldn’t we be directing the sceptical searchlight towards the institutionalised child abuse prescribed and condoned in the name of ADHD.

Mike Houlding

Chair-entity’s Report 2001

Not a Bad Start to the Millennium

I’m pleased to welcome you officially to the 21st century, which I suspect will need Skeptics every bit as much as the last century, judging by the general level of activity over the past year.

Last November, I was delighted to be able to attend the World Convention of card-carrying Skeptics held in Sydney. I came away thinking we could produce just as illuminating and charming a bunch of speakers, so don’t be surprised if a couple of years from now you hear recommendations that we bid for a World Con in New Zealand.

Early in January we got a week’s notice to submit nominations for the Minister of Health’s Advisory Committee on Complementary and Alternative Medicines. Six months later we heard that yours truly hadn’t made it, and neither had nominations from a whole host of medical bodies of one form or another. The Committee is very strongly biased in favour of CAM practitioners and we await their first pronouncements with interest and — perhaps justifiably — a certain degree of apprehension. However, we do look forward to working with the group established by Dr Graham Sharpe which is to focus on the role of such therapies.

The website development approved in principle by last year’s AGM progressed with a hiss and a roar, and we now have a home at http://skeptics.org.nz. It’s proven very useful for me, as I can immediately access the vast bulk of material we’ve produced in the past decade or so, so I can have everything at my fingertips when I get rung up by journalists looking for information on the Kaimanawa Wall or whatever.

The website has also proven its utility with the conference in providing access to the registration form and programme for those electronically inclined. It also means you are now only a click away from a membership form when you’re talking to someone who really should join… I have some ideas for increasing the site’s usefulness still further which we’ll discuss later, such as information on the video library, dead tree library and a possible news alert service.

Contacts with the media have continued throughout the year, with the New Zealand Herald going so far as to track me down in Timaru Hospital for a comment on aromatherapy. We’ve worked with other organisations – providing the Royal Astronomical Society with ammunition showing the Moon landing wasn’t a hoax (they suspected as much), finding anthropological experts able to counter the notion of visiting Numidians in ancient Aotearoa, setting the legal wolves of Warner Brothers and some other large corporations onto a scam infringing their trademarks, and sharing information and ideas with the skeptical community overseas.

As always, your committee has been active in their ideas, suggestions and help, and I thank them and all those involved in the conference organisation for helping make our candle shine in the dark.

Best regards,

Vicki Hyde

Chair-entity, NZCSICOP Inc. 2001 Chair

Maxicrop, Mormons and Mediaeval Horror Stories

It wasn’t a dark and stormy night but a gaggle of skeptics got together recently to listen to ghost stories in Hamilton. Professional story teller Andrew Wright sent shivers down the groups’ skeptical spines as they listened to his rendition of one of the oldest known horror stories, Lord Fox, a BlueBeard variation.

The occasion was the Skeptics’ annual conference and I’m told founder member Bernard Howard’s opening talk the next morning on the changes seen in the Twentieth Century set the mood nicely for the material that followed. I missed this, due to being glued to the registration desk but look forward to reading it – we will run some of the addresses in coming issues. Another one I missed was John Welch talking about Gulf War Syndrome — which we have in this issue (see opposite). John also enthralled delegates with his demonstration of an antique black box Amazing Electrical Device.

An interesting session in the afternoon was held with representatives from the offices of the Commissioner for Children and the Health and Disability Commissioner. Perhaps the most disturbing aspect to come out of this was that the standard of treatment given by alternative practitioners is assessed only relative to standards set in that field. So an iridologist’s work is only compared with that of other iridologists (see Pippa MacKay’s article).

Nick Kim gave two very different presentations, one featuring his wonderful cartoons, and a more sobering piece on forensic science. He showed you can be convicted, in a British court, just for handling a banknote that has passed through the hands of a bomb maker.

Mike Clear, as well as warming the crowd up on Friday night, presented his findings on the intrusion of alternative therapies into the world of cats, dogs and chickens. Then followed two talks which, for me, were the highlights of the conference. Waikato University history lecturer Raymond Richards spoke about his experiences following a lecture he gave in 1998 and subsequent years on the Mormon church. Following complaints from the Mormon community, the university entertained charges of harassment against him. In a similar vein, former Agresearch scientist Doug Edmeades spoke of his involvement in the long-running Maxicrop case and the way in which commercial pressures impact on science.

During the conference a TV2 film crew did some filming for a documentary, Do You Believe In the Paranormal, which screened recently. “Madame Vicki” did a wonderful palm reading job and Denis Dutton (whose skeptical view of the Greenhouse Effect was another conference highlight) inserted pithy remarks at strategic moments. You can get a copy from the Skeptics video library and it’s well worth a view.

Annette's signature

Hokum Locum

The Women’s Weekly and Other Medical Journals

Dr John Welch goes eyeball to eyeball with the iridologists, and takes a look at some famous faces

Chiropractic Treatment of Infertility

During idle moments I read medical journals such as the Australian Women’s Weekly. In this case the issue was March 1999 and I really must speak to the Librarian about the disgracefully outdated journals currently held by the medical library.

Following extensive investigations for infertility, our reporter consulted Dr Naomi Perry, an Adelaide chiropractor, who “was doing revolutionary work treating women with infertility by manipulating their spines.” The chiropractor discovered that “Concepta” (not her real name) had a spinal curvature (scoliosis). This is hardly surprising since chiropractors diagnose this disorder in 100% of their patients, it being a central tenet of the chiropractic theory of subluxations. After four months of manipulation a pregnancy was confirmed. If the writer had stood on her head for two hours every night , a pregnancy would have eventually occurred since this event is a function of time for most couples.

Gypsies have the greatest success in predicting pregnancy. This is because they have crystal balls and can see it coming.

The White Stuff?

I was disappointed to miss the International Iridiology & Sclerology Conference held recently in Auckland. Iridologists have now discovered new secrets of divination using the sclera (white of the eye). This immediately reminded me of Ken Ring’s demonstration of “reading” elbows, knees or any part of the body for that matter. As far as iridology is concerned it doesn’t matter whether the iris, sclera, eyelid or the nostril are “examined”. Given a gullible customer, iridologists can spout any old rubbish and they will be believed. Nevertheless, there were some inspirational papers: “Pupillary ruff phenomena in the iris” presented by a senior iridology lecturer at the South Pacific College of Natural Therapies, and “Emotional resistance patterns in the sclera” by a US visitor whose qualifications included a ND (doctor of naturopathy) and a PhD from the University of Wakula Springs, the same one attended by Tarzan. The rather alarming claim is made that “it (iridology) is poised to become mainstream within this decade in many countries like NZ”.

Given the composition of the Health Minister’s committee on alternative medicine, this is a distinct and unwelcome possibility.

Health Secrets of Your Face

Each of the five elements which form the basis of acupuncture-earth, fire, water, wood and metal-have a corresponding face shape which tells the analyst about a person’s talents, personality and potential health problems. Kate Winslet sought the help of a facial analyst when she needed to shed 25 kg of weight gained during her pregnancy. For her “wood” face she was told to “prune” back on sugar, wheat and dairy products. The diet worked so well she not only shed some ugly fat but got rid of her husband…

The face is viewed as a map with different areas representing parts of the body. For example, the forehead represents the bladder and the area between the eyes relates to the spleen and gall bladder. Never be tempted therefore, to squeeze any pimples in this area!

Catherine Zeta-Jones has a “metal-type” face that doubtless describes her attraction to Michael Douglas who is certainly “well-metalled”.

New Zealand Woman’s Weekly 15 October 2001

US cancer institute funds trials of complementary therapy

The Gonzalez regime is a program of dietary modification, supplements and “detoxification” using coffee enemas. The supplements include animal glandular extracts, vitamins, trace minerals, papaya and magnesium citrate. Gonzalez has based his treatment on pseudoscience and anecdotal evidence of success has seen US$1.4 million dollars wasted on a formal clinical trial. I predict that the treatment will be a complete failure but this will not deter Dr Gonzalez from continuing to promote this worthless treatment. Neither will this deter gullible individuals from wasting money on this fraud. Rectal coffee could well be dangerous as the following account will demonstrate.

British Medical Journal Vol 320 24 June 2001 p1690

Fatal heart attack from a health food product

A woman collapsed and died soon after drinking a “natural” health drink containing guarana and ginseng. She had a faulty heart valve as well as a history of palpitations and had been warned to avoid caffeine, which is a heart stimulant. Her blood caffeine level was 19mg/L, the equivalent of drinking about 20 cups of coffee. The caffeine concentration in the drink was 60 times greater than levels found in cola drinks. Guarana seeds contain about 5 percent caffeine.

Medical Journal of Australia 174:520-1, 21 May 2001

Dangerous Chinese Medicines

Traditional Chinese medicines are basically placebos and when they do seem to work it is largely due to the illegal insertion of potent western medicines such as steroids. They can also contain mercury and arsenic, as well as toxic herbs and even banned animal species.

An Indonesian man was brought to a Hospital emergency department and was found to be confused due to a low blood sugar. After an injection of glucose he recovered and was able to tell his medical attendants that he was taking a Chinese remedy called “Zhen Qi”. The label on the bottle listed the ingredients as ginseng, pearl, ram’s horn, bark and “frog extract”. Gas chromatography revealed that the mixture also contained glibenclamide, a potent oral hypoglycaemic agent used for treating diabetes!

For once I join with naturopaths, homeopaths and alternative health practitioners everywhere, in condemning this cynical attempt to make sure harmless and ineffective quack remedies actually work by the inclusion of dangerous but effective drugs.

British Medical Journal Vol 323 6 Oct 2001 p702, p770

Hokum Locum

Recently returned from a posting in Saudi Arabia and now suffering from a cold and a bleeding nose, John Welch continues his column on medical matters.

Dilutions of Grandeur

As a Fellow of the Royal NZ College of General Practitioners (it came in the cornflakes) I receive a regular copy of their journal, the NZ Family Physician. There are some good contributions but I find it irritating to see reviews of homeopathy studies appearing in what should be a serious and scientifically based journal. In Vol 27 Issue 5, a study is reviewed in which mice were given nux vomica 30c, 200c and 1000c. 30c means that the “active” substance has been diluted 10 to the power 30 times. A mole of a substance contains about 10 to the power 24 atoms (Avogadro’s number) and this means that the 10-30 dilution is extremely unlikely to contain any active material. This is the main failing point of homeopathy, which depends on faith and the placebo effect. In the study reviewed a positive finding was made that mice treated with various dilutions of nux vomica, and then challenged with ethanol, regained their righting reflex more quickly. Such a result is a delusion.

I would add from my perspective: “The abuse of science will cause discomfort for many scientists.”

Integrated Medicine?

The same issue contains an article which should not have been published as it is a commercial for the use of Vega (read “vaguer” and you are on the right track) testing. There is no place for this unscientific rubbish to be practised by any medical practitioner and it is a matter of regret that the Medical Council do not have the power to ban the use of such machines. I have written before on the subject of this quackery and at the last Auckland Conference Dr David Cole gave an excellent presentation on the evolution of “black-boxes” which allegedly test “biofields”. The article frequently uses the following words and expressions (with my translations):

  • Biofield = imaginary energy aura which can only be detected by trained observers
  • Paradigm shift = more of a lurch into another dimension of foolishness
  • Energy based Quantum Physics = the author is ignorant of any physics
  • Dramatically improve = an excellent placebo effect was obtained

A double-blind randomised study of Vega-testing published in the BMJ (Vol 322, 20 Jan p131) concluded predictably: “Electrodermal testing cannot be used to diagnose environmental allergies.”

Re-birthing Backfires

Because a young girl was having trouble bonding with her adoptive mother, a couple of loony therapists decided she had a “reactive attachment disorder” and decided that a spot of rebirthing was in order. This unfortunately went tragically wrong when the girl suffocated inside the sheet which had been wound around her. This is a graphic reminder of the sometimes appalling outcomes associated with the activities of the lunatic fringe. It need not actively cause death as in this case, but can cause death by neglect when effective measures are denied such as in the Liam Holloway case.
(Sunday Star Times 22/4/01)

Aromatherapy Flunks

Subjects had their reaction times tested with and without the benefit of essential oils sprinkled onto surgical masks they were wearing. I will quote directly from the article: “The essential oils appeared to make no difference to reaction times, but the volunteers who rated the oils highly showed small improvements in their reaction times.” (Presumably not a significant difference).

“Dr Richard Tonkin, president of the Research Council for Complementary Medicine, said the power of suggestion was a big factor in all medicine.”

I would only add that the power of suggestion is the main factor in all complemetary medicine.
(The Dominion, 20 April)

Teething, Feeding, Wind and Worms

One of the problems of an aging population is that there are too many “old wives” promulgating myths about childhood illness. Twenty-five years ago, my old Professor of Paediatrics, Fred Shannon, gave a lecture to us with the above title, and observed among other things, that wind was a meteorological phenomenon. He must have been ahead of his time because Australian researchers found no link between ill-health and teething in a cohort of infants over the period of 6-24 months of age. It is obvious that chance events such as a minor illness will occur when a tooth is erupting and a folk myth is soon created. When death certification began in the UK in the early 1800s, as many as 4000 deaths annually were attributed to “teething”. As Fred Shannon observed: “teething causes teeth”. I certainly found this to be true with my own series (N=2 daughters) of cases.
(Pediatrics 2000;106:1374-9)

Head-drilling again?

I have mentioned this subject before but thought it to be an uncommon procedure. In the US (where else?) two men pleaded guilty to practising medicine without a licence after drilling a hole in the head of a woman’s skull in order to “restore her childhood buoyancy”. Now I have been doing quite a bit of swimming lately and I am very sure that a hole in the head would not help my bouyancy at all!

It’s about time!

At a medicolegal conference reported in Doctor 14/3/2001, Fiona McCrimmon called for the Ministry of Health to act against the manufacturers of complementary medicines where misleading claims are made. Pharmacies are full of such products which are not registered and are only lawful if they do not make any therapeutic claims. Ms McCrimmon went on to observe: “It is a challenge to find a flyer (for complementary therapies) that complies with the law.”