June 4th 2019

Several people have asked after my welfare as I have not updated this blog for some time. The answer is that I am okay. Thanks for your concern. There have been a few things going on, one of which I will be able to speak about – at some point in the future – that have been taking up inordinate amounts of my time.

I am also writing, but for some reason, every time I sit down to write a new blog my mind goes completely blank. A very difficult thing to explain. It is as if a million thoughts all gather and just mangle each other up. Things seem very clear when I am walking about, but the moment I try to get started – glomp.

I am not sure if this is what is called writer’s block. It cannot really be, because I am writing other things – such as another book. However, it is very frustrating. I did fear maybe that I have run out of things to say – but in truth each day sees a newspaper headline, or a medical research paper, that has me itching for the keyboard. How can there be so much nonsense written in the world?

So, instead I am writing this rambling nonsense, that is of very little interest to anyone I suspect, but it may get me started again. Re-set my brain into super-blog mode – if there is such a thing.

Because I still believe there is a need for voices to question the misleading rubbish   being churned out by people who claim to be scientists. Especially medical scientists, such as my great friends in Oxford who can write the most outrageous gibberish and get it published.

I have always liked to believe that science is a self-correcting system. Researchers can head of in the wrong direction for many years, decades even, but in the end the scientific truth will always catch up with them, tap them on the shoulder and make it very clear they are just being silly.

The days when there were special devices for blowing smoke up the rectum have faded from memory:

‘When an “apparently dead from drowning” person was pulled from the Thames [river running through London], it was thought that two things needed to happen to successfully resuscitate them: warming of the body and stimulation. Tobacco was becoming popular in Europe thanks to its exportation from the Americas, and a well known stimulant thanks to the alkaloid nicotine. The nearly dead drowning victim can’t smoke themselves, and certainly can’t swallow anything. And since hypodermic needles weren’t to be fully-invented for another hundred years, the only logical way to administer tobacco was rectally. Plus, the warm smoke would warm the individual from the inside. Win-Win. Thus, the tobacco smoke enema was born, and devices placed all along the Thames river.’ ¹

From here came the mocking expression ‘Blowing smoke up your arse.’ Yes, doctors have always been keen on such activities. The first Chinese Emperor was advised by his doctors to inhale vaporised mercury – which was a magical substance so incredibly healthy that everyone should be ingesting it.

Inevitably he went mad through mercury poisoning, and started running around the forests naked before being overthrown and murdered. Still he did leave a nice tomb with terracotta soldiers and even, so it is said, an underground lake of mercury – to keep him healthy in the afterlife.

My how we laugh now at such silly ideas. But medicine has continuously felt the need to do something, anything, for the patient – even if they have not the faintest idea what will happen. Good, or bad. Bernard Shaw wrote about this over a hundred years ago in Doctors Dilemmas.

‘When your child is ill or your wife dying," when you are confronted by "the spectacle of a fellow creature in pain or peril, what you want is comfort, reassurance, something to clutch at, were it but a straw. This the doctor brings you. You have a wildly urgent feeling that something must be done; and the doctor does something. Sometimes what he does kills the patient."’

Leeches, other forms of bloodletting, trepanning, full frontal lobotomies, removal of the toxic colon, the radical mastectomy, strict bed rest following a heart attack – all these things and many more. The ‘sometimes’ that kill the patient.

These things have all gone – mostly. Evidence, science, got rid of them. Stupidity cannot run forever. At least this was once true. Today, I am not so sure. The need to do something, anything, still runs deep in the psyche of all doctors. The concept of ‘sorry, I can’t really do anything about that’ has never been front of mind.

My personal motto is ‘Don’t just do something, stand there.’ I call it masterful inactivity; others may call it laziness.

Anyway, to return to the main issue here, which is that medical science may now be incapable of self-correction. Erroneous ideas will be compounded, built on, and can never be overturned. Because of a thing called non-reproducibility.

In most areas of science, there is nothing to stop a researcher going back over old research and trying to replicate it. The correct term is reproducibility. In every branch of science there is currently an acknowledged crisis with reproducibility.

‘Reproducibility is a hot topic in science at the moment, but is there a crisis? Nature asked 1,576 scientists this question as part of an online survey. Most agree that there is a crisis and over 70% said they'd tried and failed to reproduce another group's experiments.’ ²

This is not good, but in medical research this issue is magnified many times. Because there is another in-built problem. You cannot reproduce research that has been positive. Take clinical trials into statins. You start with middle aged men, split them into two groups, give one a statin and one a placebo. At the end of your five-year trial, you claim that statins had a benefit – stopped heart attacks and strokes and suchlike.

Once this claim has been made, in this group, it becomes unethical/impossible to replicate this study, in this group – ever again. The ethics committee would tell you that statins have been proven to have a benefit, you cannot withhold a drug with a ‘proven’ benefit from patients. Therefore, you cannot have a placebo arm in your trial. Therefore, you cannot attempt to replicate the findings. Ever.

Thus, if a trial was flawed/biased/corrupt or simply done badly. That’s it. You are going to have to believe the results, and you can never, ever, have another go. Ergo, medicine cannot self-correct through non-reproducibility. Stupidity can now last for ever. In fact, it is built in.

We face a rather dismal eternity of blowing smoke up our arses.