Honesty is the best policy

As I write this, I am convalescing following an important (albeit minor) but painful diagnostic procedure.  There is no need to go into detail save to mention it is now apparent to me, that despite several thousand years of perceived wisdom it is, after all, possible to pass an object which feels roughly the size of a camel through something roughly the size of the eye of a needle providing sufficient lubrication is employed.

To distract myself from these delicate proceedings I began to dwell on the events and the reasoning that had led up to this day, the final stage in the investigation of this particular medical problem.  Making decisions about medical matters is not easy.  There are strong emotions to contend with - fear of the unknown, fear of pain, worry about family and friends.  There is denial; would I prefer not to know the full picture, just in case it’s something serious?  Also anger; I still consider myself young (don’t we all?), what have I done to deserve this, it’s not fair?

Fortunately my doctor was all you would hope for; extremely pleasant as well as knowledgeable and professional.  He was obviously experienced in this area of medicine and in dealing with this type of (not so patient) patient.  Aware of my worries he took time to explain carefully what was going to happen, the risks involved and the benefits to be gained in the way of good diagnostic information.  He was able to give me an idea of how I might feel during the procedure based on first hand reports he had had from previous patients undergoing the same thing.  He was also able to call on scientific studies to give an idea of the suitability of other routes of inquiry open to me.  From studies in larger patient groups he was able to advise that more invasive means of investigation probably weren’t called for at this stage given the risk of complications and the likelihood that, since all other tests had so far proved normal, little extra would be learned.

He explained, between my nervous interruptions, about the drugs that would be used.  Local anaesthetic with its familiar, predictable mode of action, well understood by those who use it and supported by decades of research allowing scientists to modify and improve the drug to give better pain relief and a varying duration of action, depending on requirements.  Antibiotics too, since their discovery in the 1930’s have been studied in sub-microscopic detail and classified, catalogued, refined and improved upon resulting in the saving of uncountable millions of lives in the few decades they have been around.  Pain killers also have come a long way since their beginnings as willow bark infusion taken through pursed lips to treat a headache.  Thanks to diligent research they are now more effective yet safer than ever before.

Of course it is the way of the world that most useful things in life have drawbacks as well as benefits.  Take mobile phones for example.  They save lives in disaster situations but when you’re next to a person ostentatiously broadcasting the more inane half of their high decibel conversation they are a complete pain and if used inappropriately, such as when driving a car, can be lethal.  In minor medical procedures such as mine the “risks” are equally minor; some pain or discomfort, the possibility of a little bleeding, all of which would be expected to resolve of their own accord within a day or two.  In other cases however where the stakes are higher the risks of treatment may be proportionately increased too.  This is the so called risk-benefit analysis which is core to any sensible decision in modern medicine and surgery.

Crucial to such an analysis is a full and honest understanding of how medicines and surgical procedures work and of all their actions on the body, not just the desirable ones we are hoping for.  The key word here for me is “honest”.  We live in a fast moving technological world containing many wonders which only a few decades ago would have seemed almost magical and some wonders which to many people, myself included, appear magical right now.  But they aren’t magic, they are made possible by an understanding of the way the world works and how the things in it from galaxies to quarks interact.  There is so much to know we can’t all understand everything, that is to be expected and it’s why, sometimes, we have to rely on experts who we can trust.  I haven’t a clue how the computer I am typing on at this moment works but I know that somewhere there is someone who does and what’s more could explain how and demonstrate it to me (and hopefully ignore my vacant look and silly questions).

Similarly in medicine, both human and veterinary, advancing technology means that today we are able to do things which, only 20 years ago would have been prohibitively expensive or dangerous if not downright impossible.

It behoves us though to be honest with ourselves about this technology from which we all benefit.  There is no place for head in the sand denial.  Problems such as side effects won’t go away if ignored; these inevitable if uncomfortable facts need to be recognised and dealt with in a mature and realistic way.  In short we need to admit that some breaking of eggs will be required when making omelettes.  Flat denial is of little consolation to Humpty Dumpty as you approach casually, whisk in hand, mouthing platitudes about the nutritional benefits of your finest cherry tomato and mozzarella frittata.  Humpty Dumpty would in fact be very well advised to run a mile from such advice.  Similarly we should all be extremely suspicious of anyone promising us something for nothing in any area, particularly medicine.  If something sounds too good to be true, whether it’s a “Humpty-friendly” omelette or a side effect free miracle cure, it probably is.  You don't get something for nothing in this life, particularly in the world of medicine and anyone who tries to convince you otherwise is at best labouring under a delusion and at worst, lying.

There is nothing more important than honesty when it comes to making health decisions for those family members who show us unconditional trust and who know we will act on their behalf and do what is best for them; our pets.  It is they who make being a pet “owner” such a special and difficult privilege and it is to them, for their trust and loyalty, that these writings are dedicated.

Miasms - I'm preparing for enlightenment

Miasms as Practical Tools: A Homeopathic Approach to Chronic Disease - the book is on its way - John Saxton's magnum opus. Can't wait! Having forked out large amounts of spondooliks on this apologia for the power of invisible & otherwise undetectible energies on health and well being I'm looking forward to reading it; to be fair, he rarely disappoints.

John Saxton BVetMed, MRCVS is also a VetFFHom, which is to say a fellow of the faculty of veterinary homeopaths and a CertIAVH - your guess is as good as mine on that last one. He has previously stated that pet booster vaccinations are a fraud and that vets who give these vaccinations (myself included) are fraudsters while on the other hand believing that his practice of radionics where diagnosis and cure are effected by hand waving and communing with a black box with some wires in is entirely genuine, above board and completely trustworthy. He was a founder member of the august British Association of Veterinary Homeopaths and the first veterinary surgeon to hold the office of President of the Faculty of Homoeopaths, so who am I, a mere allopath, to argue.

Laughter is the best medicine

So, Radovan Karadzic, alleged war criminal and concentration camp enthusiast has been arrested, posing as an alternative healer.

According to the BBC Mr Karadzic (or rather his alter ego Dragan Dabic) was a pleasant, long haired, bearded gentleman given to wearing black and entertaining the clients of the Madhouse Bar which he frequented by singing while playing the traditional one stringed Serbian gusle. He had a girlfriend, grandchildren and was cultured, tolerant and polite, according to a friend.

He wrote for a health magazine during his 10 year undercover life and earned his money from practicing alternative medicine claiming to be an expert in “human quantum energy”. He ran his own web-site and gave lectures, billing himself as a "researcher in the fields of psychology and bio-energy" at which he would distribute business cards.

His pseudonym probably came from a civilian man, a construction worker killed, along with 12,000 others, by Karadzic’s forces during the siege of Sarajevo in 1993. As Radovan Karadzic he stands accused of war crimes and genocide, particularly the 1995 massacre at Srebrenica when 7,500 innocent Muslim men and youths were massacred by pro-Serbian forces. He is also charged with unlawfully deporting civilians based on national or religious identity and destroying homes, business and sacred sites. It was during Karadzic’s reign of terror the phrase “ethnic cleansing” was coined to describe the activities of those he commanded.

The subject of Karadzic’s arrest came up recently during a discussion with fellow sceptics and inevitably there was some, fairly heated, debate (this is sceptics we’re talking about after all). Some felt a strong sense of comic irony in the fact of a brutal mass murderer turned kindly healer, others felt such levity was ill placed, particularly since on occasions there have been examples of people masquerading as conventional health care workers which is certainly not a subject for humour, so why should a similar situation involving an alternative practitioner be amusing. In my view this is missing the point and this story is funny on several levels, the brutal nature of the subject not withstanding. I believe we are allowed to laugh in this instance.

To many sceptics the concept, under any circumstances of a 'fraudulent' alternative practitioner is funny. The idea that some people may be able to talk to the dead while others just pretend or that some people are genuinely channelling the spirit of a long dead North American Indian shaman or a dolphin while others are making it up is hilarious. The possibility that some homeopathic sugar tablets work whereas others don't is truly laughable. All these things are bogus, any effects existing purely subjectively in the minds of practitioners and proponents. There is no way of policing such people. How can there be such a thing as a fraud when none of it works anyway?

In the case of someone acting as a bogus vet, doctor or nurse the situation is most definitely not funny in any way shape or form. This is someone using real medicine as a cover to prey on weak and vulnerable people for their personal gratification. The possibility of causing patients harm whether through ignorance or intent is real. Drugs have real effects and can cause real harm. Someone going to a channeller is no more likely to be harmed by one who is 'bogus' than by one who is 'real'; someone given 'fake' sugar pills by a bogus homeopath can rest assured that the effect will be identical to that which they would get from the 'real' thing. Someone given drugs by a bogus doctor on the other hand is much more likely to come to harm than when treated appropriately by a real doctor.

There is a difference between CAM and real medicine when it comes to fraud. The two modalities do not have equal standing or deserve equal respect and gravity. A 'fraudulent' CAM practitioner is a joke and will be laughed at, a fraudulent doctor is a criminal and will be locked up.

When talking with alternative practitioners there is often an air of smugness about them. In their view, as a rule, it is they are the enlightened ones. They portray themselves as caring, hands-on, intuitive, holistic, empathic - always with the implication that science based practitioners are none of these things and, furthermore are cold, clinical, hurried and detached, seeing patients as diseases, not individuals. Having been personally exposed to this type of bigotry for years, hearing that a genocidal maniac had joined the ranks of the touchy-feely, caring-sharing alt med brigade is wonderfully ironic and, I am afraid, extremely funny.

This is sick, graveyard humour and this man is a monster but it is humour nevertheless and it certainly doesn't mean that a sceptic caught smirking at this news item believes that all alt med practitioners are mass murderers. It's human nature and I make no apologies for it.

As a sceptic pal said, “it's too bad it wasn't an herbalist posing as a genocidal maniac. That would have been funnier”!