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Response to another attack on homeopathy

January 30, 2008 by bobleckridge

Sunday 13th January, the Sunday Times in Scotland published an attack on homeopathy by one of their journalists, Joan McAlpine. (Sorry I can’t put a link in cos the Sunday Times doesn’t bother to put their Scotland-only articles on their website) The “stimulus” for the article was a written answer to a question in the Scottish Parliament which showed the cost of GP prescriptions for homeopathic medicines in Scotland. There was nothing really new in the attack – same old arguments really – but what bothered me most about it was the headline describing homeopathy as a “sick fantasy”, the claim that homeopathy was “dangerous” and the dismissal of patients’ reports as being just about feeling better (the implication being they were not really better).

The paper published an edited version of my letter on Sunday 20th but I thought I’d just put the full letter here for you to read.

Dear Madam

£250,000 spent last year by the Scottish NHS for “alternative” drugs? What an outrageously small amount! In the same year the Scottish NHS drugs footed a £1 billion pound bill to the drug companies for prescribed medicines. Yet, 90% of all drugs only work in 30 – 50% of the people who take them. Deaths from homeopathic medicines in the whole of the UK in 2006? Nil. Deaths from prescribed drugs? 1013 reported (over 10,000 estimated). Cost of Adverse Drug Reactions to homeopathic medicines? Nil. And to prescribed drugs? About £500 million a year.
Let’s be clear. Human beings are not machines. What works for one person may not work for the next. Health care needs to be diverse. We need more research into non-drug, non-surgical treatment options and we need to make more available on the NHS inexpensive, safer treatments, such as homeopathy which two out of three patients report is of benefit to them. And while we are at it, Joan McAlpine, let’s stop the arrogance of dismissing the relief of human suffering as “sick fantasy”. If someone says their pain has gone, it has. Prove it hasn’t! If someone says their depression has lifted, it has. It’s time to start putting patients first. At Glasgow Homeopathic Hospital we are, like all good doctors everywhere, successful because we listen to patients and believe what they tell us. We could do with more of that on the NHS.

yours faithfully

Dr R W Leckridge

Posted in from the consulting room, health | 18 Comments »

When you look at something from another angle, it completely changes

January 29, 2008 by bobleckridge

I just came across this ad. It’s clever.

Watch it right through. Then watch it again.

Posted in creativity, from the viewing room | 1 Comment »

Happiness the Confucian way

January 28, 2008 by bobleckridge

Psyblog has a good post about happiness from the perspective of Confucian teaching in the light of modern discoveries. I was particularly attracted to the quote by Confucius at the start of the post –

“The one who would be in constant happiness must frequently change.”

I’ve often said that one guaranteed “fact of life” is that everything constantly changes. Nothing stays the same. There’s an old story told of a ruler asking for a speech which he could use in ALL situations, and several of his philosophers and teachers taking on the task and failing, until finally, one man gives him the speech which works in all situations (another version of this story involves King Solomon looking for a ring which will relieve his suffering which he fears will go on forever, and he is given a ring with a few words carved into it) What was the speech? Same as the words in King Solomon’s ring –

THIS TOO SHALL PASS

That’s a recognition of the reality of constant change. Japanese culture holds transience in much greater esteem than many other cultures. That’s partly why they greet the blossoming of the cherry trees every Spring with such enthusiasm. (if you’re ever in Japan in the Spring you’ll see thousands of people out photographing the cherry blossom and photos of the earliest blossom will appear on the front pages of the national newspapers). To be in touch with the cycles of the seasons and to celebrate the changes between them can bring great pleasure.

A fundamental characteristic of a complex adaptive system (CAS) is that it constantly changes, constantly adapts.

The first two lessons in the Psyblog post are “Invest in intimate ties” and “Embrace society”. Both of these emphasise the importance of engagement – along with adaptation, one of the key characteristics of a healthy CAS.

The other lessons are interesting too, including “have fun” and “educate yourself” – both of which are about creativity and growth – the third of the characteristics of a healthy CAS.

Posted in from the consulting room, from the reading room, health, life, psychology | 5 Comments »

Healing trees – Cinchona

January 27, 2008 by bobleckridge

In an earlier post I wrote about significant trees and said I’d tell a couple of healing tree stories. Here’s one of them.

The Cinchona Tree is famous in the history of medicine. It’s a member of the Rubiaceae family (the same family of plants which coffee comes from). Actually there are 25 different species of Cinchona trees, and the one in question is “Cinchona officinalis“, which is native to Peru. Here’s the story –

The wife of the Viceroy of Peru, the Countess of Chinchon, fell sick with a high fever shortly after arriving from Europe in 1630. The local Spanish Jesuit priests had been taught to treat fevers by the indigenous Peruvian people. They used a preparation of the bark of the Cinchona tree. So, they treated the Countess with this and saved her life. It’s most likely that the fever she suffered was malaria, and we now know that the Peruvian tree bark contained a lot of “quinine”, which is still a staple treatment for malaria.  Whether or not, the Countess of Chinchon ever really did get sick and was successfully treated with the bark of this tree will never be known but most historians think it is a myth.

Whatever the truth of the matter, the key players in the discovery of this tree’s power to cure malaria and the spread of that knowledge is down to the Jesuits. It was a Jesuit apothecary in Peru who heard about the local use of this bark to stop “shivers” in fevers and knowing the severity of the “shivers” in malaria he decided to try it out on sufferers with spectacular results. The Jesuits brought the bark back to Spain and Italy, where it became known as the “Jesuits’ powder“. It’s interesting that aligning the medicine so definitely with the Jesuits led to it being a highly controversial and contested form of medicine for decades. The Protestants were none too keen to accept a Catholic medicine! However, it was successful in case after case of fever, and it was produced, cultivated and distributed worldwide by the Jesuits.

The story of the discovery of quinine is beautifully told in “The Miraculous Fever-Tree” by Fiammetta Rocco (ISBN 0-00-257202-8). It’s a great read and brilliantly researched. In her book she gives many examples of the enormous impact of malaria on events in world history showing how both the disease itself, then, later, the successful treatment of the disease with this drug, probably determined the course of history on a number of occasions.

This “fever tree” is also a key part of the origin of a whole therapeutic practice. Dr Samuel Hahnemann, 1755 – 1843, a German doctor, was translating Cullen’s Materia Medica (the guide to medicines prescribed by doctors at that time) and he read of Peruvian Tree Bark (Jesuit’s powder) as a treatment for “Swamp fever” (malaria). Cullen said it worked by being an astringent (it dried the body up) and Hahnemann wondered if that was true, so he prepared some and took it himself to study its effects. Much to his surprise he developed all the symptoms of a patient with Swamp Fever. This was his discovery of the principle of “like cures like” which led to the creation of a therapy known as homeopathy.

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Think before we act? Turns out we don’t……and that’s the truthiness

January 26, 2008 by bobleckridge

How do you think the brain and body work together? A lot of people reckon we figure out what we want to do first, then our brain moves into a kind of second phase and make the body do what we’ve decided we want to do. Seems logical, huh?

Well, it turns out it’s not like that. Here’s an interesting study which shows that the brain and the body work at the same time, not brain first, body later! A group of psychology researchers asked people (yes, college students again….you have to watch out for those psychology studies, they mostly use college students as their guinea pigs, and do you think college students are typical?), sorry, lost the thread a bit there, they asked people questions and observed what movements their arms made on the way to either the “no” or the “yes” buttons on the computer. They found that in response to the more ambiguous questions the students’ arms moved more between the buttons, than they did on straight forward questions. What that means is that they could be seen to dither a bit before answering the ambiguous questions. Their arms and brains were working together – simultaneously. It gets more interesting……..they dithered more towards “yes” when answering a “no” question than towards “no” when answering a “yes” question, suggesting that people have a general bias towards assuming a statement being true.

These dynamic data showed that participant arm movements had lower velocity and curved more toward the alternative response box during ‘no’ responses than during ‘yes’ responses—suggesting that we experience a general bias toward assuming statements are true,” the authors explained.

The authors conclude that this shows we lean towards “truthiness”.

You know, I’d never seen that word before, but when you go searching on the net about it you can find LOADS. Start here at wikipedia. The word seems to have been made up by, or at least given a specific, new definition by comedian Stephen Colbert. Here’s his explanation –

Truthiness is tearing apart our country, and I don’t mean the argument over who came up with the word…It used to be, everyone was entitled to their own opinion, but not their own facts. But that’s not the case anymore. Facts matter not at all. Perception is everything. It’s certainty. People love the President because he’s certain of his choices as a leader, even if the facts that back him up don’t seem to exist. It’s the fact that he’s certain that is very appealing to a certain section of the country. I really feel a dichotomy in the American populace. What is important? What you want to be true, or what is true?…

Truthiness is ‘What I say is right, and [nothing] anyone else says could possibly be true.’ It’s not only that I feel it to be true, but that I feel it to be true. There’s not only an emotional quality, but there’s a selfish quality.

What lies behind this, as he highlights, is that old need for certainty. Human beings don’t handle doubt very well. There’s a strong tendency to seek certainty and when that is applied to beliefs (whether religious or scientific) it leads to that statement in the above quote – ‘What I say is right, and [nothing] anyone else says could possibly be true.’Don’t know about you, but I prefer to find a way to deal with doubt. It’s more real. Truthiness doesn’t leave much room for dialogue.

Posted in from the reading room, psychology | 5 Comments »

Laughter and smiling…..two great medicines

January 25, 2008 by bobleckridge

Dr Tom Bibey’s blog is worth reading. He’s the kind of family doctor I like. He recently posted about laughter and I thought I’d post this just for him and his good wife. Hope you enjoy it!

While you’re here, and if you feel you need something to cheer yourself up try

this superb piece of video-editing or

this great mime.

Posted in from the viewing room, humour, life, video | 5 Comments »

Burns Day. A Man’s a man, for a’ that

January 25, 2008 by bobleckridge

It’s Burns Night. Robert Burns. Another of my local heroes. Well, not  Stirling man, but a Scot.

I think it’s good to have at least one poet as a hero!

Robert Burns

Here’s a voice thread of me reading Burns.

Posted in creativity | 4 Comments »

Blogger’s Code of Conduct

January 24, 2008 by bobleckridge

Science bloggers meeting at the North Carolina Science Blogging Conference have been debating the need for a code of conduct. You may have come across some pretty offensive and aggressive commenting from science bloggers – I know I have! (See my Commenting Policy bottom right). I think it’s a great idea. O’Reilly and others have developed a blogger’s code of conduct.

Here’s the first draft –

We celebrate the blogosphere because it embraces frank and open conversation. But frankness does not have to mean lack of civility. We present this Blogger Code of Conduct in hopes that it helps create a culture that encourages both personal expression and constructive conversation.

1. We take responsibility for our own words and for the comments we allow on our blog.

We are committed to the “Civility Enforced” standard: we will not post unacceptable content, and we’ll delete comments that contain it.

We define unacceptable content as anything included or linked to that:
– is being used to abuse, harass, stalk, or threaten others
– is libelous, knowingly false, ad-hominem, or misrepresents another person,
– infringes upon a copyright or trademark
– violates an obligation of confidentiality
– violates the privacy of others

We define and determine what is “unacceptable content” on a case-by-case basis, and our definitions are not limited to this list. If we delete a comment or link, we will say so and explain why. [We reserve the right to change these standards at any time with no notice.]

2. We won’t say anything online that we wouldn’t say in person.

3. We connect privately before we respond publicly.

When we encounter conflicts and misrepresentation in the blogosphere, we make every effort to talk privately and directly to the person(s) involved–or find an intermediary who can do so–before we publish any posts or comments about the issue.

4. When we believe someone is unfairly attacking another, we take action.

When someone who is publishing comments or blog postings that are offensive, we’ll tell them so (privately, if possible–see above) and ask them to publicly make amends.
If those published comments could be construed as a threat, and the perpetrator doesn’t withdraw them and apologize, we will cooperate with law enforcement to protect the target of the threat.

5. We do not allow anonymous comments.

We require commenters to supply a valid email address before they can post, though we allow commenters to identify themselves with an alias, rather than their real name.

6. We ignore the trolls.

We prefer not to respond to nasty comments about us or our blog, as long as they don’t veer into abuse or libel. We believe that feeding the trolls only encourages them–“Never wrestle with a pig. You both get dirty, but the pig likes it.” Ignoring public attacks is often the best way to contain them.

What do you think? Anything in that draft you wouldn’t agree with?

Posted in science | 4 Comments »

Drugs work best when diet and lifestyle is good

January 23, 2008 by bobleckridge

This rather technical study has suggested one of the reasons why drugs work better in some people than they do in others is down to the rest of that person’s life.

We’ve known for a long time that most drugs don’t do what they are designed to do for many of the people who take them. This is not just drugs like painkillers which are trying to modify a subjective experience, but even drugs whose effects are mainly objective right down at cell level, like anti-cancer drugs.

Some researchers are pursuing a genetic explanation for this and a whole new area known as pharmacogenomics has arisen with the hope of combining genetic testing with prescribing so that a particular drug can be chosen in the light of the patient’s genetic make-up which may make them more responsive to the drug in question.

This study is interesting because it looks to an environmental explanation instead and shows that diet and lifestyle strongly influence the effects of particular drugs.

As always, we’ll find that both explanations are partly right and partly wrong. The trick will be to understand how to use these discoveries in the best interests of patients.

Posted in health | Leave a Comment »

Happy Birthday Biopsychosocial! Pardon?

January 22, 2008 by bobleckridge

The Biopsychosocial approach to health is thirty years old this month. The what? Yeah, I bet it doesn’t mean much to you, does it? And that’s pretty amazing really. It shows how tenaciously orthodoxy clings to its old models. The dominant model in Western Medicine is the “biomedical” one, which seeks a biomolecular explanation for all illness. This is a materialistic and a reductionist understanding of illness. In fact, proponents deny the very reality of any illness which cannot be explained by molecular, physical changes in a body.

Thirty years ago, George Engel proposed the term “biopsychosocial” as an alternative mode of understanding. Essentially this approach considered that “the study of every disease must include the individual, his/her body and his/her surrounding environment as essential components of the total system.” It situated the individual in the inextricable contexts of his or her life. It proposed that the way to understand illness required a holistic understanding of a person, with every single person being different and unique. It was an argument against reductionism and for insights gained from understandings of the links and influences which exist within our living networks. More than that, it opened the door for psychosomatic medicine – the joining back together of the body and the mind, for so long considered as separate, almost vaguely related entities. There’s an awful lot of illness which is not explainable from a disease focussed approach. We can’t really reduce individual illness experience to a set of physical entities or lesions. And the other side of the coin is that Engel’s approach demanded a holistic understanding of health. From this perspective health is so much more than the mere absence of disease.

So why hasn’t it become the dominant model? And why do we still consider most illnesses as physical entities which we call diseases which can be treated with surgery to remove the lesions and drugs to fight the disorder?

Well, Engel himself gave us the explanation in advance. He said

… nothing will change unless or until those who control resources have the wisdom to venture off the beaten path of exclusive reliance on biomedicine as the only approach to health care

Those who control the resources still like to consider the world as made up of physical, separate objects; still think of disease as an entity to be fought and expelled. We have a better scientific explanation now but it’s still a long way from being the dominant model.

Posted in from the consulting room, health | 2 Comments »

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