Too little, too late.

Yesterday, Dr. Andrew Wakefield was found guilty of a number of misconduct charges, related to his medical research. This has caused quite a buzz, as the press and other media speculate as to whether he will be struck off as a result.

In 1998, Dr. Wakefield published a paper which speculated on a link between a rare bowel disorder, autism, and the MMR vaccination. He suggested that parents should give their children the vaccines individually (measles, mumps, and rubella), rather than as a triple vaccine. The paper also seemed to suggest a link to the MMR vaccine and to autism.

Despite the many flaws in this research (small sample size, no permission from parents, etc.) the research was published.  After its publication in The Lancet, the information was disseminated among the newspapers, gaining momentum at a furious pace. Before long, there were campaign groups, newspapers taking one side or the other, vox-pops of weeping parents and crippled children, etc.

Unfortunately, due in large part to the way the paper was reported, parents believed that they were doing the right thing in choosing to decline the MMR vaccination. They thought they were protecting their children from autism, a condition which must strike fear into the heart of any parent. What they should have been worried about was protecting their children from the crippling effects of measles, mumps, and rubella – diseases which can be fatal, or which can leave a child brain damaged and needing lifelong care. The effects can still be seen today, with many parents perpetuating the myth that the MMR will give your child autism. Unvaccinated children are contracting measles and they are infecting other unvaccinated children. In many countries, we are now seeing a rise in the number of outbreaks of measles, and deaths relating to those infections. The numbers are continuing to rise, whereas before the media circus relating to the MMR happened, numbers were at an all time low.

Now Wakefield is in the docks, and is being made to face the music for shoddy research, flouting the rules, and being irrespnsible with the lives of other people. But what of the journalists? What of those writers who read only the abstract of his paper, or worse, who read only the summary of his paper in other publications? What of the newspapaers who sold publications by splashing dangerous headlines about autism?

The sad fact is that the newspapaers, the journalists, they won’t be in the docks for their irresponsible reporting. Not many people outside of the medical and scientific worlds read journals like The Lancet, so had they been more responsible, it’s possible that the scare may not have spread so widely.

Wakefield will take a fall, and the newspapers that helped to bouy him up will now chronicle his demise, while they wait for another paper to tell them that cherries give you cancer, and three green tea enemas can cure it.

It’s easy to paint Wakefield as a scapegoat – after all, it was his paper that started it all. But he’s not alone in the blame. Sadly, there’s no way to punish those irresponsible journalists. The PCC is toothless, and has so many restrictions about taking a case that it’s barely worth the time at all. Legal action costs money, and it would be to difficult to prove damage as a result of any one article.

The lesson here is that same old tune you’ve been hearing your whole life – you can’t believe everything you read. As our information networks reach further around the globe, their scope is narrowed. One paper publishes an article, ten more simply rearrange that article and publish it as their own, and before you know it, there’s an MMR scandal all over again.The only thing that can be done is to keep checking sources, to keep checking facts, and to take everything that’s written with a pinch of salt until it’s verified.

The bottom line is this – it is safe to vaccinate your kids. It is irresponsible and dangerous not to. Read every newspaper with both eyes open.


A little knowledge is a dangerous thing

I used to think that the above quote was a little odd. I mean, surely knowledge is a thing to be shared, and the gaining of knowledge, something to be encouraged. I think I understand it now though. Knowledge, full and complete, is a wonderful thing. A little knowledge, however, really is a dangerous thing…

As an example, I present another fine article from that favourite of mine, the Daily Mail. The article deals with a planned protest of sorts by a group called 10.23. Members of the group plan to “overdose” on homoeopathic medicines in protest at Boots’ continued endorsement and sale of homoeopathic remedies. The Daily Mail article is sadly riddled with errors, and is attributed to a generic “Daily Mail Reporter”, who appears to have as poor an understanding of the subject matter as the many people who commented on the article itself. On reading the article, it’s clear that the author did very little research before writing (hardly surprising) and instead simply threw in a few names of “homoeopathic” products that he or she knew of. However, the products that are mentioned are not homoeopathic products at all – they’re herbal products.

The problem is that homoeopathic remedies and herbal remedies are not the same thing, and to imply that they are leads to confusion and, at worst, damage. A herbal remedy consists of dried, powdered, or otherwise prepared plant, mineral, etc parts and extracts, formed into pills, powders, liquids, etc. There are many herbal remedies for sale in Boots and in other health food shops. And there have been a number of studies that have shown that some herbal remedies can have beneficial effects on the conditions that they are supposed to treat. However, like “conventional” medicine, these herbal remedies are not without their side effects. Perhaps the most well known example of this is St. John’s Wort. This, to reaffirm the point, is a herbal, not a homoeopathic, remedy. St. John’s Wort (or Hypericum perforatum) is a small yellow flowered plant that is considered a noxious and toxic weed in many countries. It has been traditionally used to treat depression. Recent clinical studies have shown that it can be effective in cases of mild to moderate depression. However, clinical studies have also shown that the side effects of St. John’s Wort are many and varied, and it can interact with a number of prescription drugs, such as contraceptive pills, antiretrovirals, immunosuppressants, etc., making them less effective. So, like many over the counter medications, it has been shown to have both benefits and side effects. And like anything that you plan to take that may potentially effect your health, you would be well advised to consult a doctor (a real doctor) before taking it.

So, why isn’t it the same as homoeopathy? Well, when you buy St. John’s Wort over the counter, as a herbal remedy, what you are buying is part of the plant, processed and made into tablets or a similar delivery method. The tablet that you receive will have a defined amount of the plant in it. The same cannot be said of homoeopathic remedies, due to the nature of their creation.

Homoepoathic remedies are often based on a theory originally put forward by Samuel Hahnemann in 1796. The theory states that you should treat like with like – i.e. if you can find a compound which, when taken, causes the symptoms of malaria, then you will be able to cure malaria in an ill patient using this compound. The theory also states that the more diluted a preparation is, the more potent it is. The act of striking the preparation after each dilution (known as succussion) makes the mixture more potent. In Hahnemann’s time, knowledge of molecular chemistry was poor, so it was not unreasonable for him to assume that anything could be diluted infinitely and still contain some of the original chemical. However, the same excuse is not applicable to the people who now practice homoeopathy. Hahnemann advocated a dilution of 30C for almost everything – that is a dilution of 10 to the power of 60, or 1 part of the molecule in 1000000000000000000000000000000000000000000000000000000000000 parts of water. Modern science tells us that, using Hahnemann’s “C” scale of dilutions, that no trace of the original molecule is likely to be found at anything higher than a 12C dilution. Many homoeopathic remedies use dilutions even higher than advocated by Hahnemann, such as the infamous Oscilliococcinum homoeopathic flu remedy, which is diluted at 10 to the power of 400. As it is thought that there are only 10 to the power of 80 atoms in the whole universe, Oscilliococcinum would require several more universes (10 to the power of 320 universes, in fact) to even have a single molecule of the original substance in the final dilution. With those numbers in mind, you will hopefully see that it is extremely unlikely that a finished homoeopathic product (in the form of sugar pill or fluid) will likely contain absolutely none of the original molecule that it perports to contain.

This is the crucial difference between herbal medicine and homoeopathy, and it is a difference that the author of this article, and many of the people who left comments, have missed. Herbal medicinal products may actually contain some part of the plant they come from. Homoeopathic remedies are so unlikely to contain some part of what they originally came from as to be utterly laughable.

To those commenters, and the author, who spoke of the group members overdosing on things like St. John’s Wort and belladonna, you are sadly mistaken, and your little knowledge on the subject will go a long way to fuelling the misunderstanding and mistaken beliefs surrounding alternative medicines.  If the group truly choose only homeopathic remedies to overdose on, then they are in no danger at all. They will merely be swallowing water, possibly flavoured or coloured (such as in Rescue Remedy), or sugar pills. Unless an unfortunate member manages to drown whilst swallowing the remedies, I don’t expect that any medical treatment will be necessary in the aftermath. I expect that the members of the group will have done more than enough research to be aware of the difference between the medicines, as they seem well informed.

I do hope that others reading the article, and deciding to demonstrate the same way, do some research first. To swallow several hundred tablets of 30C nux vom. will be very unlikely to cause you harm. To swallow several hundred tablets of St. John’s Wort could very well leave you quite ill.

And so we return to my original point – a little knowledge is, indeed, a dangerous thing. A little knowledge, in the case of this author, has lead to a confusion between two very different kinds of alternative medicine, and one that could lead to trouble for a lot of people. As a journalist, it’s your duty to know what you are telling people and to make sure it is accurate. “Daily Mail Reporter”, whoever you may be, I’m sorry to say that you have failed.

Current Affairs

Churnalism at its finest

Courtesy of none other than the always resplendent Daily Mail. I regularly visit the Daily Mail site, for no other reason than to keep up with the constant stream of lazy and inaccurate “journalism” that it provides. It never fails to provide a giggle. The particular piece that has provoked my ire today, however, isn’t funny. It’s just offensive, irresponsible, and downright stupid.

On the 6th of January, the Daily Mail carried a piece about Marian Keyes, who had published a brief note in her monthly newsletter. In the note, she apologised to her fans for her absence, and told them that the reason for this was that she had been struggling with depression, and that this particular bout had been particularly crippling. That article is linked here, and I’ve saved a PDF (as the Mail has a habit of reviewing and changing pieces once enough criticism has been heaped upon them). The article is a fairly by-the-book piece of “churnalism”, inserting chunks of her note into a brief biography (no doubt gleaned from a quick wikipedia search). All in all, a bland and unoffensive piece which filled some space. What has really annoyed me, however, is a follow up piece, published on January 7th.

Written by Helen Weathers, this diatribe is titled “Author Marian Keyes has fans across the world and a husband who adores her. So why is she so depressed she can’t eat, sleep, or write a word?“, (link here, saved PDF here). The title does much to reveal the author’s attitude towards Keyes and towards depression, and the article continues as one would expect, attacking Keyes for daring to feel depressed when her life is apparently so easy. With statements such as “who wouldn’t wish to swap places with the 46-year-old chick-lit queen“, “Keyes’ achievements are enough to make those less talented feel depressed about their own lives“, and “A feeling that is perhaps best alleviated by picking up one of her pastel-hued, feel-good novels“, it is clear that Weathers holds no sympathy for Keyes or indeed for anyone suffering from depression. As the article goes on, she wonders why the lovely house and wonderful husband haven’t done anything to alleviate the depression, which she further undermines by highlighting the words “crippling” and “hell” as if they are patently untrue.

“All the plaudits, fan letters and riches her books have brought her  –  including a pied a terre in London and a house near the sea in Dun Laoghaire, Co. Dublin, which she shares with her husband Tony Baines  –  offer no protection from this ‘crippling’ disease she says is making her life ‘hell’.”

Continuing in the same vein, she points out that just three months ago, Keyes wasn’t feeling depressed (based on the fact that her newsletter of three months ago was cheerful). Then follows a re-hash of the note which Keyes wrote, and a not-so-sly stab at her readers. We continue by delving into the life story of Marian Keyes, making sure to point out the many problems she experienced as she grew up, and the desperate lack of self esteem that she can’t quite shake. The second half of this article is composed almost entirely of direct quotes from Keyes herself (from previous interviews, web posts, etc.), which is summed up with the tremendously insightful note that perhaps her self esteem problems, poor body image, and low self worth could be a contributing factor in her depression. Thank the Lord we have someone to make that vast cognitive leap, or else we would still be scratching our heads as to what could possibly be wrong.

All told, the article is a shockingly insensitive, badly informed, piece-meal space filler, and it’s a geniune shame that the only thing that Weathers could do to fill the space was to attack someone who’s having a hard time. Perhaps if she had spent half as long on Wikipedia reading about depression as she did reading about Keyes herself, she would have been able to put together a more informative and useful article. Perhaps she would have realised that depression is a problem that affects people regardless of their situation, and even when they have nice houses and stable incomes. Perhaps she would have realised that being unable to eat, sleep, or write is a common problem for people suffering from depression, many of whom are rendered literally unable to move by the depths of their despair. Perhaps she would have realised that to say something like “what have you got to be depressed about, look at all the good things you have” is absolutely shockingly ignorant, and only serves to demonstrate her lack of research and, dare I say it, intelligence.

I had thought that my respect for the Daily Mail was at an all time low when I read yet another “fat is great, a pox on all skinny women” article, but it has, in fact, sunk even lower. Weathers’ article represents an even deeper low, because it’s not only inaccurate, but it’s quite frankly rude.

One can only hope that Keyes finds whatever help she needs to lift the clouds that are currently obscuring the sky. And I for one will hope that Weathers never has the misfortune to experience real depression, lest we have to suffer through an article about that too.