Archive for July, 2009

Beware the spinal trap – with added amateur legal musing (updated four and a half times)

July 30, 2009

Having written some long-ish comments about it in a thread on something else, I have “promoted” them here, a bit altered, as an excuse for being the last blogger to reprint the “decaffeinated” version of Simon Singh’s now legendary article about chiropractic. So if you read my comments threads you’ve probably seen all this already. Apologies.

free debate

As ever, Dr Aust is a bit slow on the uptake, so it will surprise no-one that I am practically the last blogger in the known universe to reprint the redacted version of Simon Singh’s Zeitgeist-catching  article on Chiropractic. This version is lacking any mention of “legal entities” and is thus unlikely to stimulate parasympathetic muscarinic drive to the salivary glands of any “reputation management” lawyers. (Note the relapse into physiology – hangover from the day job).

This version, which hundreds of bloggers have re-printed worldwide in the last day or two, is de-libel-ized. But does that mean it is defanged?

Well, read for yourself:

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Beware the spinal trap

Some practitioners claim it is a cure-all, but the research suggests chiropractic therapy has mixed results – and can even be lethal, says Simon Singh.

You might be surprised to know that the founder of chiropractic therapy, Daniel David Palmer, wrote that “99% of all diseases are caused by displaced vertebrae”. In the 1860s, Palmer began to develop his theory that the spine was involved in almost every illness because the spinal cord connects the brain to the rest of the body. Therefore any misalignment could cause a problem in distant parts of the body.

In fact, Palmer’s first chiropractic intervention supposedly cured a man who had been profoundly deaf for 17 years. His second treatment was equally strange, because he claimed that he treated a patient with heart trouble by correcting a displaced vertebra.

You might think that modern chiropractors restrict themselves to treating back problems, but in fact some still possess quite wacky ideas. The fundamentalists argue that they can cure anything, including helping treat children with colic, sleeping and feeding problems, frequent ear infections, asthma and prolonged crying – even though there is not a jot of evidence.

I can confidently label these assertions as utter nonsense because I have co-authored a book about alternative medicine with the world’s first professor of complementary medicine, Edzard Ernst. He learned chiropractic techniques himself and used them as a doctor. This is when he began to see the need for some critical evaluation. Among other projects, he examined the evidence from 70 trials exploring the benefits of chiropractic therapy in conditions unrelated to the back. He found no evidence to suggest that chiropractors could treat any such conditions.

But what about chiropractic in the context of treating back problems? Manipulating the spine can cure some problems, but results are mixed. To be fair, conventional approaches, such as physiotherapy, also struggle to treat back problems with any consistency. Nevertheless, conventional therapy is still preferable because of the serious dangers associated with chiropractic.

In 2001, a systematic review of five studies revealed that roughly half of all chiropractic patients experience temporary adverse effects, such as pain, numbness, stiffness, dizziness and headaches. These are relatively minor effects, but the frequency is very high, and this has to be weighed against the limited benefit offered by chiropractors.

More worryingly, the hallmark technique of the chiropractor, known as high-velocity, low-amplitude thrust, carries much more significant risks. This involves pushing joints beyond their natural range of motion by applying a short, sharp force. Although this is a safe procedure for most patients, others can suffer dislocations and fractures.

Worse still, manipulation of the neck can damage the vertebral arteries, which supply blood to the brain. So-called vertebral dissection can ultimately cut off the blood supply, which in turn can lead to a stroke and even death. Because there is usually a delay between the vertebral dissection and the blockage of blood to the brain, the link between chiropractic and strokes went unnoticed for many years. Recently, however, it has been possible to identify cases where spinal manipulation has certainly been the cause of vertebral dissection.

Laurie Mathiason was a 20-year-old Canadian waitress who visited a chiropractor 21 times between 1997 and 1998 to relieve her low-back pain. On her penultimate visit she complained of stiffness in her neck. That evening she began dropping plates at the restaurant, so she returned to the chiropractor. As the chiropractor manipulated her neck, Mathiason began to cry, her eyes started to roll, she foamed at the mouth and her body began to convulse. She was rushed to hospital, slipped into a coma and died three days later. At the inquest, the coroner declared: “Laurie died of a ruptured vertebral artery, which occurred in association with a chiropractic manipulation of the neck.”

This case is not unique. In Canada alone there have been several other women who have died after receiving chiropractic therapy, and Edzard Ernst has identified about 700 cases of serious complications among the medical literature. This should be a major concern for health officials, particularly as under-reporting will mean that the actual number of cases is much higher.

If spinal manipulation were a drug with such serious adverse effects and so little demonstrable benefit, then it would almost certainly have been taken off the market.

Simon Singh is a science writer in London and the co-author, with Edzard Ernst, of Trick or Treatment? Alternative Medicine on Trial. This is an edited version of an article published in The Guardian for which Singh is being personally sued for libel by the British Chiropractic Association.

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Now, my correspondent Svetlana has taken great umbrage at the reprinting of Singh’s article without the contentious phrases, an action she characterized as cowardice. She has also contended, as has American medical blogger Orac, that printing the article in this “bowdlerized” form is tantamount to seeming to accept Eady’s, and thus the BCA’s, interpretation of how people would read Singh’s words. This, remember, was that they are readable as Singh accusing the BCA of making deliberately false claims – a meaning, to repeat yet again, that Singh has always stated clearly he did not intend, or feel the article or any part of it conveyed.

Anyway, I don’t really agree with Svetlana. My rather simple minded assumption was that Sense About Science  are just trying to raise awareness – of the case, of what was actually said, and of the way in which English defamation law “acts” on such matters.

Personally I would have liked to have seen the Guardian re-publishing this de-libel-ized version. But you can’t have everything, I suppose.

In any case, anyone who reads the article now and then wonders:

“Uh-huh. And what was this supposed libel, then?”

- can find out easily enough, e.g. by reading Jack of Kent’s blog, or Jack’s discussion of Judge Eady’s ruling, or even my own analysis of the case from last August.

But take care not to be found in contempt…

There is, of course, also a practical reason not to re-print it with the words in. The case is still before the court, with the watchers currently waiting to see if Singh is granted leave to appeal Sir David’s ruling.

As I understand the law (which is imperfectly, IANAL, see various caveats passim), while the case is active, and especially post Mr Justice E’s ruling on the defamatory meaning (as he sees it) of the debated words, Singh (or anyone else in England, Wales, and Northern Ireland) cannot re-publish the article in its original form without committing frank contempt of court. As well of course, as repeating the alleged defamation.

The English legal system (and other ones too) takes a very dim view of people “flouting” court decisions. This is not something confined to defamation cases. Were the Guardian, say, or Sense About Science, to try to re-publish the Singh article in its entirety, the result would undoubtedly be immediate legal injunctions to suppress the (re) publication. Further, if the republishing were done by Singh, or with his express or implied approval, this would certainly be taken as “compounding” the alleged libel (making the “damage to reputation” worse by saying it again after the judge had specifically ruled it was libel). This compounding would likely lead – in the event that Singh were ultimately to lose the case – to even higher damages being awarded against him.

However… none of this applies if the article is reprinted without the offending phrases about the original “offended entity”. The comments about chiropractic and chiropractors, and their much-demolished claims for their therapy for childhood ailments, are identical. But there is no defamation. So it seems a rather sensible measure to me.

But it’s backing down…isn’t it?  Can’t we pick a fight?

Again, the more “combative” might feel that there is being unnecessarily craven. After all, there is probably little chance of hordes of bloggers being pursued by the long arm of the libel law in the way that a newspaper probably would be were it to do something likely to be viewed as contempt of court.

Well, yes and no.

I certainly doubt individual bloggers would be pursued, unless they were very prominent and widely read – though as I understand it there would be nothing to stop the court seeking to punish such individuals for contempt. I would also hazard a guess that the more readers a blog has, the more seriously such an action would be viewed by the court. Which means I would be safe.

What I imagine might happen, let’s say if a blog was popular, would be that lawyers for the complainant could seek injunctions against the ISP and/or webhosting company that hosted a blog. These are (typically) companies with financial resources, and thus unenthusiastic about findings of contempt of court against them, or being fined large amounts of money. And the webhost would then take down the post, or even the entire blog.

We have, of course, been here before several times, e.g. with the Society of Homeopaths vs. the Quackometer, or the Quackometer vs. Joseph Chikelue Obi, and several others I could mention if I had more time. The last mentioned case is relevant because it was Netcetera, the Quackometer’s webhosting company, who insisted on taking down the post – necessitating the relocation of the Quackometer to another one, with attendant hiatus. And that was after just an utterly unconvincing threat of legal action – not an actual court ruling and the strong likelihood of being found in contempt of court.

Like it or not, once a court has started looking at the thing and made a ruling, flouting that ruling is not the same as re-publishing something that someone has merely claimed they think is defamatory (and muttered about “legal action”).

In the latter case – see the SoH vs. the Quackometer – by re-printing the piece one is showing solidarity, but also daring the offended person/organisation:

“Are you going to sue me too?”

(or yelling “Spartacus!”, if you prefer).

In the current situation one would be waving two fingers in the face of the judge, the courts and the legal system. Not a wise move. And unnecessary.

Because we are, arguably, past gestures now.  The CAM advocacy gang like to portray Badscience bloggers as a little clique of  like-minded obsessives. Things that can be portrayed as “acts of peevish-ness” can play into their hands. Far more sensible, in my view, to take things forward by mobilizing more and more people in a campaign to try and change the law, so that in future defamation suits will not be brought in such circumstances. And also to do what the bloggers have done – scrutinise the data underlying the disputed claims and show that Singh was speaking the truth about the lack of meaningful evidence for the claims made by the BCA and its members.

Ben Goldacre gives a lovely summary here , complete with Obi Wan Kenobi reference in the title. If you haven’t read Ben’s article, read it now.

It might even make you want to start a blog.

PS   - And if you aren’t one of the 15,000 people who have already signed Singh’s statement, please do that too.

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UPDATE – 31st July am: I see that Orac, who had originally reposted the original “unexpurgated” version of the article, has now changed it to the edited version, apparently at the request of Sense About Science.  Orac writes:

NOTE ADDED AFTER PUBLICATION: At the request of Sense About Science, I have removed the original version. They inform me that by reposting this I am potentially putting Simon Singh at risk for further action.

- which tends to rather bear out what I have written above.

To repeat: the solution lies in a change to the English Law of Libel.

The way in which the current law acts contrary to the public interest can also be seen in this excellent article by Nick Cohen. Cohen asks us to consider what might have happened to any academic who claimed that the financial model used by A.N. Other investment bank were flawed.  Or to take another example, what if there had been an English equivalent of Bernie Madoff, and an academic or journalist had tried to publish something claiming said hypothetical person’s multi-billion investment management business was all built on sand?

Remember that defamation lawyers in the UK do not term what they do these days “defamation”. Their preferred term is the more soothing (but actually more sinister):

“Reputation Management”.

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UPDATE No 2  – 31st July pm – STOP PRESS: Via Jack of Kent, I just saw that Simon Singh has been refused permission to appeal Sir David Eady’s ruling on meaning.  Permission to appeal had been refused at the initial hearing, and has now been refused by the Court of Appeal.

Simon can apparently still make an “oral renewal” of his petition for permission to appeal before the Court of Appeal.  This is presumably his next step. Beyond that there may be further appeals (all specifically of Mr Justice E’s preliminary ruling on meaning), to the House of Lords (or perhaps the Supreme Court of England and Wales, which I understand takes over formally as the highest English court towards the end of this year, though it will be the same old Law Lords as the “Supreme Justices”).  And  possibly thereafter as far as the European Court of Human Rights, should Singh claim that the ruling on meaning has the effect of violating his right to free speech.

Keep an eye on Jack of Kent’s blog for more information as it emerges.

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UPDATE No 3  –  1st August:

Jack of Kent has now posted a must-read post for all those following the case, in which he briefly sets out Simon’s options. The main one is, of course: quit or persevere?

Jack thinks that permission to appeal (PTA) is unlikely to be granted by the Court of Appeal, even on a further application. This would mean that “persevering” would imply either:

(i) a trial fought on Judge Eady’s interpretation of the contentious words, or

(ii) an appeal ultimately to the European Court of Rights, as happened in (e.g.) the McLibel case.

Neither of these options is exactly attractive, for different reasons – though both have in common that they are likely to be expensive.

The other option is to settle, perhaps with a very limited acknowledgement by Simon that he did not intend the meaning Eady and the BCA put on his words, and is sorry if anyone took them that way (a strategy termed by Jack the “Heresiarch Manoeuvre”, after the blogger who first suggested it) .

Importantly, Jack is soliciting opinion from the blogosphere. What do you think Simon should do? It Though ultimately the decision is Simon’s, it is commonly understood that he and his legal team read the blogs, and your opinion matters to them. So pop on over to Jack of Kent and have your say.

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UPDATE No. 3A

- more on the reasons for the Appeal Court’s decision- or more precisely, the decision handed down in writing by a single Appeal Court Judge who read the Singh team’s submission  – can be found over at Jack of Kent. In a classic piece of impenetrable egal-ese the judge refers to:

“…the length of the applicant’s [ i.e. Simon Singh’s] skeleton”.

Essentially the decision is as Jack had predicted; despite the extended arguments produced by Singh’s legal team (this is the aforementioned “length of the applicant’s skeleton”, i.e. his outline argument) the judge does not find anything of great legal import, or any obvious errors, in Sir David Eady’s ruling on meaning (yes, the words “happily….promotes….bogus” again).

This is as expected, Jack tells us,  since Eady was  asked to rule on the meaning, and such rulings on the meaning of words and phrases are rarely, if ever, reversed by the Court of Appeal.

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UPDATE No. 4 – 17th August

As probably all readers will all know, Simon Singh has decided, as of last Tuesday the 11th, to press on with the case. He has therefore applied, notwithstanding the earlier ruling against him by the Appeal Court Judge, to make an oral submission to the Court of Appeal.

Jack of Kent summarises succinctly:

Simon Soldiers On

Simon Singh has today confirmed that he will ask for an oral re-consideration of his application for Permission To Appeal.

Simon Singh also outlines his current thinking, including a full response to The Heresiarch’s Open Letter.

In practical terms, all this means that there will be a public hearing at the Court of Appeal in London on 14 October 2009.

This oral hearing will deal with whether Simon Singh can have a full appeal hearing against the adverse ruling on meaning.

Did you catch that last bit? The hearing will not, repeat, not, be an actual appeal against Eady’s ruling on meaning. It will be a hearing to argue that Singh should be allowed to contest the ruling on meaning at a subsequent full hearing.

Once again I am inspired to pinch the line:

“Confused?  You will be….”

Thus we are on hold again until mid-October. Though in the meantime Singh’s legal team will doubtless be busy; and there remains a good reason to keep exhorting people to sign the petition.

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SELF-PUBLICIST CORNER

Since no self-respecting blogger misses a chance of a bit of “Self-Biggin'”, here are links to the previous Dr Aust coverage of the case, from the beginning:

Back Quack crack attack – it’ s a legal matter baby – detailed amateur legal analysis from last August, plus some musing on libel tourism.

It’s Quiet – too quiet – an end-of-2008 round up, wondering what had become of the case and discussing Singh’s proposed defence and the nature of CAM belief.

Truly Much Bogosity – some thoughts on the Eady ruling, the much-debated word “bogus”, and the chilling effect of English Libel Law.

Back Crack Quack Attack – the song – sadly as yet unrecorded, though it did gain me the scorn of a rather serious person styling themself “Cochrane Reviewer” over at Science Punk.

BCA say they want scientific debate – bears eschew woods for proper flush toilets and soft toilet paper – Dr Aust’s lower mandible almost dislocates under the jaw-dropping effect of a startling BCA press release

Down these mean streets

July 17, 2009

Instead of Bad Science, more ephemera and academic angst. Dr Aust has been missing his meetings. Well, I don’t mean “missing”, more missing, if you see what I mean.

While Dr Aust was away at his conference last week he managed to miss a couple of staff meetings. One of these was a “Principal Investigators Meeting”.

“Principal Investigators”, or “PIs” is what we are now encouraged to call lab heads, or group heads, or “academic staff”.

I don’t much like the term “PI”, which strikes me as a slightly heavy-handed attempt to make us sound like a US University. Having said that, I guess it is slightly useful as a term which differentiates us from the teaching-only academic staff (“investigator”), and “PI” does usefully encompass both lecturers etc. (staff paid from public funds to teach and to do research) and research fellows (paid by public or charity money to do almost exclusively research). But it still grates a bit.

And personally I can’t say or hear “PI” without thinking “Private Investigator”.

Perhaps I should start wearing a trench coat and carrying a loaded water pistol.

Anyway, at this PIs’ Meeting we were to meet our new Line Manager. The Line Manager is somewhat like a Head of Department in the old days, though the Department no longer exists as a geographical entity (the grouping our line manager manages is now split over three, or possibly four, buildings), and now contains some sixty-odd “PIs”.

Now, one of the difficulties with the kind of re-organisations that David Colquhoun is always bemoaning is that they inevitably lead to situations where people do not know the people they are officially being managed by. Or, conversely, the people they are managing. Hence the need for meetings to Meet the New Boss.

Though Dr Aust missed the meeting, he is fortunate (or perhaps unfortunate, depending on how you look at it) that he already knows the New Boss from having taught on the same course unit a few years back.

It’s, like, the matrix, dude

Another characteristic of large “matrix management” systems is that one inevitably ends up being “line-managed” by different people for different parts of one’s job.

While this may not seem that odd, and is commonplace in the commercial sector, it does potentially present problems when the different parts of the job all have to occupy the same time, and when many bits of the job (notably research) are “elastic” – as in, they expand to fill any available amount of time.

Academics in UK Universities have classically had three jobs – research, teaching, and University administration. (Nowadays one might add a fourth, public engagement activity. I am still trying to work out if anonymous blogs count for this bit, by the way)

Much of setting workloads in academia involves the trade-off between research on the one hand, and [teaching plus admin] on the other. The notional percentages in this split vary between jobs, and institutions, and perhaps between managerial regimes. Historically the split was very vaguely defined – indeed, when I started twenty-plus years back nothing was said at all, and you were left to get on with it.

Anyway, getting back to the trade-off of research against the other stuff. It is fairly obvious that this trading off (and the setting of tasks) is intrinsically easier and quicker if the person for whom one does these two jobs  – the “line manager” – is the same person.

If the people are different, as is now commonplace, it is more difficult to make the trade:

“I can’t take on X job (teaching on course Y) as well as Z job (admin task) because I will then not have the time to do ABC jobs (research) effectively”.

Not impossible, note – just more difficult, involving more arguing and running backwards and forwards from one line-manager to the other, none of whom may know you and your work very well.

The Spreadsheet has Spoken

Nowadays this sort of discussion also usually involves a very very large Excel spreadsheet.

Sometimes I actually have the feeling that my bosses see me almost entirely as a line of cells in an Excel spreadsheet. Probably with many of the cells coloured red.

Indeed, with the computing power and logic operations now available, I am pretty sure the Excel spreadsheet can identify me automatically as a “possible problem”, without any input from my human bosses being required at all.

Still, at least I don’t work at the neighbouring North of England University whose academic staff were telling me at the conference that they are being threatened with having to re-apply for their own jobs.

So as usual, “tout va au bien”, as Voltaire might have said, “dans le meilleur des mondes possibles”.

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PS – If you hadn’t spotted it, the title of this post is a reference that I have dragged in kicking and screaming from the work of Raymond Chandler, noted writer of classic Private Eye (PI) fiction and creator of the immortal Philip Marlowe.

“Down these mean streets a man must go who is not himself mean, who is neither tarnished nor afraid. The detective must be a complete man and a common man and yet an unusual man. He must be, to use a rather weathered phrase, a man of honor. He talks as the man of his age talks, that is, with rude wit, a lively sense of the grotesque, a disgust for sham, and a contempt for pettiness.”

– Chandler “The Simple Art of Murder”

Apart from the fact that I have always loved Chandler’s books, the phrase “a disgust for sham” makes me think that Chandler would have been a natural sceptic.

Of conferences, 5 yr olds and Professors

July 12, 2009

No bad science this time – Dr Aust muses on scientific conferencing, family life, and the usefulness of child psychology

As indicated over on the diary page, Dr Aust has been away this week at a conference.

Sadly this was not the conference where Bad Science guru David Colquhoun was delivering his latest broadside against Inhuman Resources, Homeopathy-loving Vice-Chancellors, Herbal Remedy Entrepreneurs and the like. However, Dr Aust’s conference was in a different EU country, there were some good talks, and plenty of old friends to catch up with. Which almost made up for the rather spartan University accommodation, and particularly the need to walk 300 yards to get a breakfast cup of coffee and a Pain Chocolat.

Now, conferences and travel are part of a scientist’s life, but one tends to go through phases of more or less enthusiasm. As a youngster I would have told you that the travel was very definitely one of the best bits of the job. In my thirties in particular I wholeheartedly embraced the global travel possibilities of science, spending a couple of European Summers on “working holiday” enjoying the Australian Winter – which was actually far better weather than the Northernshire Summer – and visiting plenty of other interesting spots.

However, I found that as I approached my forties it all began to get less enticing, and when Jr Aust arrived even less so. And since this time last year, when Baby Aust joined us, my “conference drive” has reached a historical low.

Though conferences still have their attractions. Most parents occasionally fancy a night or two away from the kids. This, and the promise of a few beers and potentially a good night’s uninterrupted sleep, gives child-free conferencing a bit of allure. On the other hand, when I get there I find that I miss the little blighters terribly. Together with the fact that I can’t drink like I used to – getting old, I fear – this means that “conference fatigue” sets in earlier than it used to. Currently I find two and a half days of concentrated conference is about my limit.

Of course, when you get back, the happiness at being home lasts about a day before it is replaced by the usual family mayhem, which starts you thinking about conferences again.

Vive la resistance… er?

Now, a key part of the family mayhem at Aust Acres at the moment is the continued inter-generational psychological warfare being waged mostly by Jr Aust. This titanic struggle alternates between armed guerilla action and Gandhi-style passive resistance (though with added screaming). In essence it involves Jr Aust (just turned five) and Baby Aust (eleven months) competing for Dr Aust and Mrs Dr Aust’s attention.

Baby Aust is simply being a baby, and does not realise he is competing, of course. The same cannot be said of Jr Aust.

It is all very tiring, though I am sure it will all work out in the end. If we all survive with our sanity intact.

Is child psychology the answer?

Actually, I have recently come round to thinking that I may have been approaching this family dynamic problem wrongly. In particular I have, I think, been guilty of treating Junior Aust as too much of a small adult. She is, after all, only just five.

But of course, five years olds and adults do have some things in common.

Dr Aust has an ex-Head of Department, now retired, who had originally trained as a clinician, and much later became Dean of a Medical Faculty. Once upon a time, many years ago now, two of Dr Aust’s colleagues and friends at work were engaged in a bitter feud, with Dr Aust haplessly trying to mediate. The ex-HoD, who also knew both parties, used to offer Dr Aust occasional sage advice.

In one of these conversations, the ex-HoD and Dean told Dr Aust:

“Do you know, I never could really work out what the point had been of having to study child psychology during my medical training…. Until I became Dean of Medicine and had to deal with lots of Clinical Professors”.

Now, Dr Aust only has the one daughter, but he has dealt over the years with lots of Professors – mostly non-clinical but with occasional clinical ones thrown in.

So anyway – no more treating Junior Aust like a small grown-up.

Instead I shall try treating her like a Professor, and see if that does the trick.

Rank… in more ways than one

July 1, 2009

In which Dr Aust considers his lack of promotion prospects, but does attain rank in the “Anti-CAM brigade”

Dr Aust is feeling very sheepish about his lack of blog activity, and even more so since the much-appreciated plug (combined with a bit of gentle chiding) from ace legal blogger Jack of Kent a couple of weeks back

Indeed, a bit earlier last month Jack had even appointed Dr Aust to a rank in the “anti-CAM brigade”:

Which is curious, in one way, since I started off being neutral or even vaguely sympathetic to the less loony bits of CAM. Honestly.

I was recently reminded of this as I came across an old letter I wrote to Prof David Colquhoun almost three years ago, when I first started commenting on the blogs. As a chemistry undergraduate many years ago I was fascinated by natural product chemistry, so I have always found natural product-based remedies intriguing. (Like most biological scientists, I use various natural products as reagents in my scientific work.) And over the years I have taken a number of herbal pills – valerian and hops for poor sleep being an example. I was also probably influenced by Mrs Dr Aust, who trained in medicine in a European country where complementary therapies are more widely used by doctors than in the UK, and are rather more stringently regulated.

So why would I now be pretty relaxed about being labelled “anti-CAM”?

The reason is that the more I have had to do with the CAM folk over the last 2-3 years, the less and less sympathetic I have become. The reasons for this, I think, lie in the behaviour and evasions of the pro-CAM people, neatly summed up in Edzard Ernst’s personal paper here.

If you wanted to boill it down to a brief statement, my objection would be twofold:

Why do people have to invent fanciful and frankly ludicrous explanations for stuff, when there are perfectly reasonable ones around that do not require you to conjure up a special personal reality?

Why do the same people then cry (variously) “Foul!” “Not Fair!” “Leave my reality alone!” or “Libe!!” when people point this out?

In the specific context of science and medicine, if the CAM lot want to play in the game, then they have to play by the evidentiary rules that apply, notably the ones in which good evidence trumps bad. Otherwise, as David Colquhoun often says, it is like throwing the last 50-60-odd years of medical and scientific advancement in the dustbin.

So how did Jack of Kent come to be handing out ranks in the anti-CAM brigade? The answer is that this arose as a result of a mildly surreal letter that noted CAM apologist Prof George Lewith (who seems to have become the go-to-guy when an academic medical defender of CAM is required) wrote to the New Scientist earlier last month. The letter was in turn prompted by an article Jack had written in the New Scientist“Don’t Criticise Or We’ll Sue” – noting the enthusiasm of Alt.Reality folk for calling in M’Learned Friends.

Prof George concluded:

“It should be noted that the article you published on this matter is from a prominent member of the anti-CAM brigade.”

Which strikes me as rather a cheap shot coming from a “medically-qualified researcher of CAM”, as Professor George describes himself.

Jack of Kent tells the full story here, noting that his only interest in Alternative Medicine has been the use (or misuse, if you prefer) its practitioners make of the Threat of Legal Retribution to salve their wounded reputations.

Jack was rather amused at Lewith’s parting jab:

Gosh!

But I think this [that JoK is a member of the “anti-CAM brigade”] is incorrect.

Not that there is any shame being a member of such a “brigade”. If so, I would want to be Captain Jack serving below Brigadier Ernst, Colonels Colquhoun and Goldacre, and Majors Noir, Aust, and Gimpy.


Gentleman rankers?

Now, though I happily plead to membership, I’m not sure what rank I should be accorded in the “anti-CAM brigade”. “Major Aust” does, I admit, have a certain ring. And I have been variously described by several of my line managers as “a major something-or-other”. (The something might be “puzzle”, or sometimes “pain”.) However. I have to say that I’ve never really seen myself as officer material.

In fact, a certain aversion to the officer class seems to run in the Aust family. Dr Aust’s father, who was a national service conscript in the early 50s, was the only family member to be a commissioned officer, but he insists this was due to a combination of his technical aptitude for fixing things and his left-wing politics. It was, according to Dr Aust’s dad (or “Grandpa Aust” as he will henceforth be known on the blog, since this is approximately how Jr Aust and her cousins address him), viewed as a bit dangerous to have well-educated and articulate leftie types in the ranks, as they might foment discontent among the enlisted men. Therefore it was safer to make them junior officers and stick them variously in the Education, Intelligence, or Engineer Corps. As Grandpa Aust was both mechanically skilled and a keen teenage radio ham, he was sent to officer training school and then off to the Royal Engineers as a 2nd Lieutenant.

No other member of the Aust family, as far as we know, has ever achieved officer rank. Indeed, Dr Aust’s maternal grandfather, a career soldier who became a Regimental Sergeant Major, turned down a battlefield commission in World War 2.

Anyway, Dr Aust’s failure ever to get promoted in two decades in his current job seems to me to be more of a pedigree for a cynical old NCO than for an officer. And sergeants do feature among Dr Aust’s comic heroes, notably Sergeant Wilson from Dad’s Army, and the wonderful Sergeant Bilko.

So all in all, I think it will have to be Sergeant Aust of the anti-CAM brigade.

But what kind of a Sergeant?

Now, Dr Aust has always had a kind of unofficial job advising on scientific equipment, particularly for optical microscope-based imaging, plus rescuing and renovating older bits of scientific kit and re-distributing it to where it is needed around the Department.

So perhaps his brigade rank ought to be Quartermaster Sergeant.

Though come to think of it, an alternative job might be as a Sergeant Instructor. I do have plenty of teaching experience. And the anti-CAM brigade seems to be gathering fresh recruits by the day.

For which, I think, we must thank our old friends at the British Chiropractic Association.

Indeed, if I may allow myself a brief officer-style compliment:

Cracking work, chaps. Carry on.


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