This blog posting represents the views of the author, David Fosberry. Those opinions may change over time. They do not constitute an expert legal or financial opinion.

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Florida Planning To Legalise Discrimination.

Posted on 14th April 2023

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This story on The Pink News reports on a new bill under consideration in Florida (USA) that would allow doctors, healthcare providers and medical insurers to refuse to treat patients or pay for their treatment on the grounds of “conscience-based objections without… threat of adverse actions".

Doctors could therefore claim to have religious, moral or ethical objections to treating LGBTQ+ patients, or to providing medical care such as birth control. Indeed, the list of groups to which religious, moral or ethical objections could be claimed is endless, and includes religions, ethnic groups, and genders.

This bill, if it becomes law, would undo decades of progress in the USA on equal rights.

I don't even see how such a law would be legal, since it seems to be in contravention of much federal law.

America seems to be regressing, and fast, at the moment.

Retiring Early Can Cause Cognitive Decline.

Posted on 26th March 2023

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This article on My Modern Met reports on a study which has shown that early retirement is not good for your mental health. Well, duh! There is already plenty of research that shows the same.

If you ask a man what he is, he will typically answer with his job, but if you ask a woman , she will usually reply with a more personal answer. Then when the man retires, unless he has one or more engrossing and challenging hobbies, he will often be dead in 5 to 10 years, with cognitive decline being a major cause. Often, his wife's raison d'etre was looking after he man, and once he dies, her decline begins.

My father always had many projects on the go, building and mending stuff, and thankfully never went into cognitive decline. He died from other illnesses, and almost immediately thereafter, my mother was diagnosed with dementia. This kind of scenario is repeated time and time again around the world.

So, not only is early retirement not good for you, retirement at any age can trigger the start of a decline in health, mental and physical.

I therefore find it bizarre that Germany has a compulsory retirement age (currently 66 years old). This condemns many people to failing health, adding a financial burden on the state, as well as robbing the government of much needed tax revenue. There are a number of other nations that have mandatory retirement, and the same consequences for people's health and the economy.

Many countries are currently reviewing their retirement legislation (the age, and whether or not it is compulsory), motivated, at least in part, by the fact that government pensions are underfunded as the age of their populations increases.

One thing that I do find bizarre is the reaction (protests and strikes) in France because the government is trying to increase the retirement age from its current 62 years. It seems that French workers do not know what is good for them.

British National Health Service Admits Liability.

Posted on 25th January 2023

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In the UK, the NHS (National Health Service) continues to collapse due to lack of funding and understaffing.

This article on Lad Bible reports on a disgraceful case in which a young girl was incorrectly diagnosed and discharged from hospital, only to be readmitted a few hours later. She had meningitis and sepsis, which can be treated (if caught early enough - her first visit to hospital was early enough) with antibiotics, which had by then become so severe that she had to have her arms and legs amputated.

The NHS has admitted liability for the wrong diagnosis and subsequent delayed treatment, and has agreed to a settlement of about £39 million. In the USA the settlement would probably have been much higher. I don't feel that £39 million is enough to compensate the poor girl for such life altering and avoidable consequences.

Dr. Rothörl: A Fantastic Doctor.

Posted on 27th September 2022

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For a change, rather than complaining or criticising, I am making a recommendation.

Yesterday I returned home from a week in hospital: the Isar Klinikum. I was there for another operation on my back to repair two prolapsed lumbar discs. I had a similar operation in 2020, but after that I managed to damage my back again (moving a washing machine), so I needed another operation.

My surgeon was again the head of the spinal department, Dr. Rothörl. Immediately after the operation I found that the pain in my left leg was gone, but, of course, I had pain from the incision in my back, and needed frequent intravenous pain medication (morphine). The nurses responsible for administering the morphine had other ideas about how often I should have it. In the end, Dr. Rothörl overruled them, and I was able to get my meds.

Talking to other patients, I discovered that Dr. Rothörl had done the same for most of them, fighting on behalf of his patients to get them what they needed. He also intervened on other issues of poor treatment and even non-medical services. The man is a hero to all his patients.

The Isar Klinikum is so much better than the Rechts der Isar where I was treated for high blood pressure and for a stroke:

  • The diagnoses are more accurate;
  • The treatment is better;
  • The food is better;
  • The staff are friendlier and more competent;
  • The medical facilities are better;
  • Waiting times are shorter;
  • The Isar Klinikum is not a teaching hospital, so there is no pressure to opt for surgery when it is not needed.

Dr. Rothörl, in particular, is very attentive (he does rounds twice a day - at the Rechts der Isar it is once per day). He also meets my requirements for a good doctor:

  1. He explains things;
  2. He listens to his patients;
  3. He treats his patients as customers;
  4. He understands that the patient is in charge of their health, not the doctor, so that he does not try to give patients orders, rather recommendations.

I can't recommend Dr. Rothörl and the Isar Klinikum enough.

The National Health Service, Britain's Pride And Joy, No Longer Fit For Purpose.

Posted on 13the August 2022

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In this report on The Mirror, a woman describes her dreadful experience at a NHS (National Health Service) A&E (Accident and Emergency) department.

The poor lady waited more than 15 hours for treatment (waiting times of over 17 hours were being predicted by staff at the A&E). In the end, she decided that "may as well have been in pain in bed at home", and went home. Such an occurrence might perhaps be forgiven if it was an isolated case, but it is not.

The whole concept of an emergency department is for dealing with emergencies: situations that require urgent treatment. Clearly, in this case, that department was not able to fulfill their purpose. Hospitals blame staff shortages as a result of the Covid-19 pandemic, but that seems a cop-out.

Britain's NHS was once a great source of pride for Britons. That pride no longer seems to have any basis in fact.

Other countries also have increased waiting times in their emergency departments; here in Germany, for example (I know this from personal experience), but the problem is not only with waiting times, as evidenced by a recent message from a friend. He had to cut short a trip to Germany in December last year, and rush home to Britain to his wife, because she had been diagnosed with bladder cancer (because of blood in her urine). It turned out that cancer was a misdiagnosis, but they have spent 8 months and lots of their own money confirming this, because none of the doctors seem to care. She still has blood in her urine, and they still don't know why, so there will be more worry and expense for them over the coming months.

So, long waiting times and poor doctoring: the NHS needs drastic improvement, and a major injection of funds, to fix the problems, which probably won't happen. Anyone who lives in Britain will probably remember the promises by Boris Johnson (Prime Minister at the time) that leaving the EU would allow the UK government to put £350 million per week into the NHS. Clearly the NHS saw none of that money; those promises were nothing more than propaganda.

A Tale Of Gross Medical Misconduct.

Posted on 28the July 2022

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I heard about this event this week; it happened within the last week, in Munich.

Doreen (not her real name) went to a clinic for a colonoscopy (a routine procedure, generally considered to be low risk). After she awoke from the anaesthetic, she was in a great deal of pain, and told the doctor about her pain. The clinic did an ultrasound scan and found nothing wrong, so the doctor insisted that there was nothing to worry about, but they nevertheless kept her in the clinic for two hours after she awoke.

Doreen's daughter came to the clinic to take her mother home, and was told that Doreen was still unconscious from the anaesthetic. At the same time, the clinic told Doreen that her daughter had not yet arrived to collect her. Eventually, Doreen's daughter heard her mother's voice, and barged into her room, to find her fully conscious, compos mentis and in lots of pain.

Despite the pain, the clinic felt that no further treatment was necessary, but Doreen sensibly decided to go to the hospital. The clinic felt that an ambulance was not called for, so Doreen got a taxi to the hospital.

The doctor at the hospital was worried enough to order a CT scan, which discovered that Doreen's bowel had three punctures, one of which was very large. She was given emergency surgery, in which they repaired the two smaller punctures, and removed the section of her intestine with the larger hole (because it was not repairable). Then, of course, Doreen's abdominal cavity had to be flushed out, because her bowel had been leaking for several hours. Normal procedure after a bowel leak like this also includes a strong course of antibiotics.

Doreen now has a surgical scar from below the navel up to her breast bone. She is probably still on antibiotics, and she can't lift anything.

The hospital is to be praised for acting correctly and quickly; they probably saved Doreen's life.

The clinic and their staff deserve to be punished for:

  1. Botching the colonoscopy;
  2. Not taking Doreen's reports of pain seriously;
  3. Failing to spot the damage to the bowel in the ultrasound scan;
  4. Claiming that there was no cause for concern, whilst clearly being aware that there was - otherwise they wouldn't have kept her at the clinic for so long;
  5. Lying to both Doreen and her daughter:
  6. Failing to order an ambulance to take Doreen to the hospital - if nothing else, patients arriving by ambulance get treated more quickly - patients who arrive at the emergency room under their own steam often have to wait hours for treatment, as I know from my own experience;

It is not as common in Germany to sue for things like malpractice as it is in the US, but in this case I think that Doreen should sue the clinic and the responsible doctor for her pain, stress and disfigurement. Her medical insurance could also attempt to recover the costs of Doreen's hospital treatment from the clinic, although they probably won't (they very rarely do). Doreen's employer could also attempt to use legal action to recover the costs of paying Doreen while she was on what should have been unnecessary sick leave (in Germany, employers pay the first 6 weeks of sick pay; after that, the medical insurer takes over the payment), but again, based on past cases, they probably won't. Finally, the responsible doctor should suffer disciplinary action; if this is not an isolated case, maybe even be struck off.

I don't yet know the name of the hospital which gave Doreen such excellent and prompt treatment; neither do I know the name of the clinic which is so incompetent and irresponsible. If I find out either name, I will edit this post to add the details.

A Good Side-Effect Of Statins.

Posted on 25the July 2022

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I recently blogged about an alternative to statins for lowering cholesterol, and how desperately needed it is (here), due to the side-effects of statins.

Now, someone has found a beneficial side-effect of statins, as reported here on The Brighter Side Of News.. It seems that statins slow down the metastasis of some cancers, stopping them from spreading to new locations in the body.

I suppose that nothing in this world is all bad.

Electrical Current 'Nanoknife' Operation To Cure Prostate Cancer.

Posted on 20the July 2022

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This report on The Brighter Side Of News describes a new, quick and simple operation to cure prostate cancer using an electrical 'nanoknife'.

Prostate cancer is relatively common, and is difficult to treat because the prostate gland is hard to reach. One of the current treatments, chemical castration, is not popular among patients, for obvious reasons.

The new one-hour 'nanoknife' operation has been described by surgeons as "amazingly simple and quick". I am sure that it will prove very popular among patients and doctors.

An Alternative To Statins?

Posted on 20the July 2022

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As someone who takes a statin, I was very interested to read this article on FreeThink.com, about a trial on humans currently under way to test a CRISPR (gene editing) technique to reduce cholesterol. The treatment is a one-time permanent cure for high cholesterol.

Statins are very widely prescribed; reducing cholesterol in the blood significantly reduces the risk of heart attacks and stroke, but there are a host of side effects, ranging from psychological effects to a long list of physical effects; they are also incompatible with grapefruit which vastly amplifies the negative side-effects of statins. Any alternative to taking statins would be very welcome for many people, including myself.

Doctors will be pleased to have an alternative treatment for high cholesterol. It will save them the time and effort of regularly prescribing statins. Also, because of the side-effects, many patients resist being prescribed statins, or stop taking them after a while.

Medical insurers will probably also be pleased to be able to replace the regular costs of prescriptions for statins with a one-time gene-editing treatment; although CRISPR treatments are not cheap, over the long term probably cheaper than the medicine.

US Health Authorities Pushing For Statins To Be Added To Public Water Supplies!

Posted on 31st May 2022

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Health authorities in the USA are pushing for statins to be added to public water supplies, as mentioned in this paper on PubMed. I am shocked and horrified, as, it seems, are the authors of the paper.

Statins have some pretty bad side-effects, the worst of which is muscle damage. This report on The Express describes how, for some people, these side-effects are permanent, even after the patients stop taking the anti-cholesterol drugs.

One of the things which seriously amplifies the muscle damaging side-effects is grapefruit. The pamphlets which accompany statins advise strongly against eating grapefruit and drinking grapefruit juice. Do American health authorities plan to outlaw grapefruit (destroying a whole industry in the process), or do they plan to just let people suffer the side effects of consuming grapefruit in combination with the statins they plan to add to public water?

Time To Ban Paraquat?

Posted on 1st April 2022

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The BBC reports that "some British farmers are calling for a ban on the UK production of toxic weedkiller Paraquat, saying studies suggest it could be a factor in the onset of Parkinson's Disease."

It sounds to me like there is a case to be seriously considered, but it seems unlikely that the UK government will ban this pesticide without more conclusive research. After all, the pesticide industry is a powerful lobby group in the UK and around the world.

The very least that the government should do is to urgently consider the necessary research, so that an informed decision can be made.

Opioid-Free Treatment For Chronic Pain.

Posted on 29th March 2022

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This report on "The Brighter Side Of News" describes the development by scientists at the University of California San Diego of a treatment for chronic pain which is not based on opioids.

The treatment uses CRISPR/Cas9 methods which are normally used for gene therapy, but in this case, no changes are made to the patients' genes; instead, the treatment temporarily inactivates a protein in pain-transmitting neurons, reducing sensitivity to pain. The effects last up to 44 weeks. The treatment is administered as an injection (e.g. to the spine), rather than as a tablet.

Obviously, the new treatment needs to be tested on humans (so far it has only been tested on mice), and then go through proper formal clinical trials, so it will be a while before we can get it from our doctors, but the impact could be huge. Very many people suffer from chronic pain, e.g. in the lower back, neck and shoulders, affecting their ability to work and their enjoyment of life. At the moment, such pain is treated with over-the-counter pain killers like ibuprofen and paracetamol (neither of which are very effective against severe pain) or opioids (which are addictive, and also directly impact the ability to work and drive).

Marshmallow-Like Implant Trains Patients' Immune Systems To Fight Cancer.

Posted on 29th March 2022

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This article on New Atlas describes a study on mice in which a "marshmallow-like" scaffold loaded with the patients' own T-cells that have been programmed to fight cancer is inserted into the body.

This type of immunotherapy proved faster and more potent against the cancer in the mouse subjects than other immunotherapies.

Diabetes Drug Metformin May Damage Sperm!

Posted on 29th March 2022

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A new study, reported on "Science" has suggested that men who take Metformin, a drug prescribed for Type 2 Diabetes, may suffer from damaged sperm.

Specifically, the sperm can suffer from genetic defects affecting the sexual organs of sons, if Metformin is taken long term. The caveat of long term use of Metformin is no encouragement, since this drug is only prescribed for long term use.

The study is an observational meta-study (a study of the results of other studies), which doesn't prove a cause and effect relationship, and the results need to be confirmed by further studies. Nevertheless, the study analysed records from more than 1.1 million babies born in Denmark between 1997 and 2016, which is a large enough sample to be taken seriously.

The article describes the defects as "relatively rare", but I don't think that most people would consider 0.9% to be rare.

The scientists "cautioned men with diabetes against abruptly stopping metformin before trying to conceive", which is an entirely sensible warning.

Another aspect of the report was very worrying. Although Metformin "has been in use since the 1950s", "this is the first large study to rigorously analyze any paternally mediated impact on human birth defects". I wonder how many other drugs are in use which have not been properly studied. There are some parallels here with the Thalidomide scandal (Thalidomide was also sold under the brand-name Contergan, as a treatment for morning sickness, although it has other uses).

House Representative Katie Porter Calls BS on Big Pharma's Lies.

Posted on 23rd May 2021

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I strongly recommend that you spend the two minutes needed to watch this video on Twitter (remember to click to enable sound), in which congresswoman Katie Porter questions the CEO of a big pharma company (Abbvie) about their bullshit.

Pharmaceutical companies regularly claim poverty because of the "huge costs" of research and development of new drugs ($2.45 billion for Abbvie from 2013 to 2018) , but in fact this pales into insignificance compared to the biggest outgoing, stock buy-backs and shareholder dividends ($50 billion for Abbvie from 2013 to 2018).

As Katie Porter points out, the "justification" for the astronomical prices for medicines in the USA is a fairy tale. It is time for consumers and government to stop buying big pharma's bullshit.

Psychological Effects of Statins and Other Medications

Posted on 24th December 2020

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I saw a very interesting report on the BBC about the psychological effects of medications.

Statins

The first part of the article focuses on the side-effects of statins (I am interested, since I was put back on statins in June), which apparently can make you bad tempered and aggressive. When discussing the report with Sheryl, she told me that I had definitely become more grumpy since starting the statins again, but luckily not as bad as some cases described in the BBC report (broken marriages, destroyed careers, and a surprising number of men who have come unnervingly close to murdering their wive). It turns out that there is quite a lot of research that shows that reductions in cholesterol levels make people and animals more aggressive.

Until now the main issue that I had with statins was having to give up grapefruit; the reason why I stopped taking them before. It seems that statins' incompatibility with grapefruit is just the thin end of the wedge.

Requip

Requip, a drug to treat (not to cure) the symptoms of Parkinson's was blamed for turning a man "into a gambler and gay sex addict, and was responsible for risky behaviours that had led to him being raped".

L-dopa

There's strong evidence that the drug L-dopa, used to treat Parkinson’s disease, increases the risk of Impulse Control Disorders (ICDs), which make it more difficult to resist temptations and urges. Some patients suddenly start taking more risks, becoming pathological gamblers, excessive shoppers, and sex pests.

Duromine

The anti-obesity drug Duromine was blamed in 2015 by a man who targeted young girls on the Internet. He used the argument that Duromine made him do it; that it reduced his ability to control his impulses.

Sedatives and Antidepressants

Every now and again, murderers try to blame sedatives or antidepressants for their offences.

Paracetamol (Acetaminophen)

Paracetamol is taken in enormous quantities around the world, not least because it is almost impossible to overdose, and it reduces fever and pain. Bizarrely, paracetamol can also make us feel better after a rejection.

A study revealed that paracetamol significantly reduces our ability to feel positive empathy. "Empathy doesn’t just determine if you’re a 'nice' person, or if you cry while you're watching sad movies. The emotion comes with many practical benefits, including more stable romantic relationships, better-adjusted children, and more successful careers – some scientists have even suggested that it's responsible for the triumph of our species."

Asthma Medications

It seems that it has been known for a while that the medications used to treat asthma are sometimes associated with behavioural changes, such as an increases in hyperactivity and the development of ADHD (Attention Deficit Hyperactivity Disorder) symptoms. This is in addition to a recently discovered connection between these two conditions, which means that having one increases the risk of having the other by around 50%.

Conclusion

There are a few problems around this issue.

  1. Patients often don't recognise the psychological side-effects of medications, and even if they do, they don't report them.
  2. Doctors often don't listen to patients' reports of psychological side-effects of drugs, so the problems are under-reported and usually there is no action taken to reduce or eliminate these effects.
  3. There is not much research into psychological side-effects, because they are hard to measure; researchers and the organisations who fund them prefer research into more concrete physical symptoms.

We should therefore assume that psychological side-effects might be more widespread and more severe than this report suggests. Let's hope that more research is done in this area.

Failure on Covid-19 Testing in the USA

Posted on 14th March 2020

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I am getting thoroughly tired of hearing President Trump and his lies about how Covid-19 (the coronavirus) is "under control" in the US. The facts do not support his position.

In this article on the BBC, Dr. Anthony Fauci, from the National Institute of Allergy and Infectious Diseases, is reported as saying that "The testing system for coronavirus in the US is currently failing". The numbers support his statement.

For example, this report from the Daily Mail, from the 10th of March, explains that 8,554 Americans have been tested for coronavirus (but the CDC director says there isn't [sic] enough staff to keep up). Of those 8,554 (and I am sure that in the 4 days since then, the number tested has increased, but I have to pick some baseline), there are 795 confirmed cases of Covid-19, that is around 10% of those tested are infected!

To put those numbers in perspective, the US population is around 330 million. If we simply extrapolate, that would mean around 30 million infected Americans! Clearly that number is an overestimate, because testing has so far been focused on contacts of infected people, and in areas where there are higher numbers of infected people, like Washington State. Nevertheless, the figures do not support the position that overall infection rates are low, because the government simply don't know, and they won't know until test coverage is significantly higher.

The pathetic testing performance of the USA is in stark contrast to all other developed nations, as described by Business Insider. Their report has a table comparing test coverage (tests per capita) for a number of nations: the USA trails the rankings by a huge margin (by a factor of more than 700 compared to South Korea)!

Added to that is the cost for US citizens and residents. Donald Trump announced that health insurers would cover the cost of testing, which is fine if you have insurance, but insurers will not necessarily cover the costs of treatment.

How is it that a rich nation like the USA has such poor provision of health care, especially during a world-wide health crisis? Why do the voters tolerate such a cavalier attitude to their health?

Dreadful Doctors

Posted on 21st January 2020

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Some people think that I am a little crazy in my attitude to doctors, so this post may shed a little light on that attitude.

Whilst visiting my family in New Zealand this Christmas and New Year, I hurt my back. I have suffered from occasional back pain since I injured my back at 18 years old. This latest attack was triggered, like most, from sleeping on soft and lumpy mattresses while staying with relatives.

This attack was probably the worst that I have ever suffered, resulting in not only very severe pain, but also partial numbness and loss of control of my left leg.

I went to a clinic in the Coromandel Peninsula for some treatment, and was prescribed Celebrex (a strong pain killer and anti-inflammatory), plus a muscle relaxant. At a follow-up appointment the next day I was also prescribed Tramadol, a powerful pain-killer.

After we returned to my sister's home near Tauranga, I went to the local A&E (Accident and Emergency) clinic. The doctor told me that the muscle relaxant prescribed by the clinic in the Coramandel was not optimal for my case, and prescribed me another. I asked the doctor about the possibility of a cortisone injection, and was told that this was not possible because I did not live in New Zealand, and because an MRI or at least an ultrasound would be needed for them to give the injection in the right place.

My pain got worse, not better, and 2 days before our flights home, I went to an A&E clinic in Auckland. The doctor (who introduced herself as Pip) whom I saw told me that the other clinics had prescribed me the wrong medications, prescribed be some new pain-killers, and told me to stop taking all other medications (except paracetamol). She even confiscated and destroyed my refill prescription for Celebrex. I again asked about cortisone, and was told the same bullshit; she told me that the A&E couldn't do a cortisone injection, and that, to get one, I would have to be admitted to hospital, and would not be treated until Monday (our flight home was on the Friday before).

Dr. Pip also refused to answer any of my questions about side-effects of the painkillers she prescribed, or about conflicts with other medications. I pointed out that she had taken me off of all anti-inflammatory drugs (best practice with collapsed disc problems is to treat both the pain and the inflammation, in order to break the vicious circle of pain causing inflammation, causing further pain), but again received no explanation.

After returning home to Germany, I went to an emergency clinic (at the Elisenhof), and was immediately treated by Dr. Eugen Dirr (whom I highly recommend) with a cortisone injection and a pain-killer injection in my back (all with no need for an MRI or ultrasound). You might wonder how he knew where to inject me; the answer is in these charts, which easily identify which vertebral junction to inject, based on the site of the pain and/or numbness. Failing that it is also possible to give cortisone intravenously (I had that once, while skiing, and it worked well). Dr. Dirr knew immediately, from my description of the location of my symptoms, where to inject me. I am now, finally, starting to improve, although I still have numbness and reduced control of my left leg.

I have several issues with the above saga:

  1. The doctors in New Zealand could not agree on the correct medication. If two doctors tell me that the previous doctor got it wrong, then at least two of them made a mistake. If they made a mistake, I should not be expected to pay for that faulty service.
  2. Not a single NZ doctor made any attempt to treat the underlying issue. This meant that I continued to suffer unnecessarily, and that the nerve damage causing my numbness and loss of control, which went on for 2 weeks, may now be at least partly permanent.
  3. The reasons I was given for not receiving proper (i.e. cortisone) treatment are simply false. I do not expect medical professionals to lie to me about my condition and the proper treatment.
  4. When I visit a doctor, I am not just a patient; I am also a customer, and expect to be treated as such. I normally insist on this strongly, and it was only because I was in such extreme pain, and being badly effected by my medication, that I didn't on this occasion, but I shouldn't need to insist; it should be automatic. One way or another I pay for medical service, and know quite a lot about medicine (more than some doctors, it seems) and more than anyone else about my own health. Doctors who ignore available information and patient/customer preferences are unprofessional and sometimes downright dangerous.

I am singling out Dr. Pip (surname Gaensicke, I believe) as the worst of the dreadful doctors, for lying to me (or worse, being so badly trained that she was unaware of how diagnose and treat me properly) and for failing to answer basic questions about the medication that she prescribed. She is one of those people who give other doctors a bad name. My flights back to Germany were pure torture, which this doctor could have helped to reduce, if not eliminate, e.g. by organising a cortisone IV.

Vaccinate your children, or home school them

Posted on 6th September 2019

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I was a little bemused, reading this article on The New York Times.

The reason is that the article is strongly sympathetic to the parents of unvaccinated children. In New York State, it will now be required to have your child vaccinated; if you do not comply, you won't be allowed to send your kid to school.

I'm sorry; to me this is a no-brainer. If you have not immunised your offspring, then you are putting the health and lives of my family and friends at risk. I and mine are not prepared to pay that kind of price for you to have the freedom to not vaccinate.

Maybe we should be even tougher. How about making all unvaccinated people live in special ghettos, and to ring a bell and shout "unclean" when they are near normal vaccinated people. [Just in case any readers are unsure, this is not serious - it is sarcasm.]

Eating Your Boogers Is Bad For Your Health!

Posted on 30th January 2019

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This article on Business Insider, describes the health risks of eating your own boogers (in British English, bogies).

This topic is especially relevant for people like me, who live in Germany, which is the nose-picking capital of the world.

Unsurprisingly, picking your nose is unhealthy; eating your boogers is even more so. Some of the rarer described health problems are rather nasty.

One of the things which the author seems to be unaware of is oral tolerance. This is a mechanism, which probably evolved to prevent us from having allergic reactions to our food, whereby the body identifies things in the mouth as non-threatening. Eating your boogers, which are filled with viruses and bacteria, therefore means that you are likely to have a reduced immune response to these same viruses and bacteria in other parts of your body. In other words, eating your boogers will likely mean that you will be sicker, and for longer, than if you didn't eat them.

The article mentions that there are some people who claim that eating your boogers strengthens your immune response, and that there is no proof of this effect. The truth of the matter is, due to oral tolerance, exactly the opposite.

Anti-Vaxxers Cause Chickenpox Outbreak

Posted on 21st November 2018

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This BBC report describes a chickenpox outbreak at a North Carolina school. 36 students at the school were diagnosed with chickenpox on Friday last week. Of the Waldorf School's 152 students, 110 have not received the vaccine for chickenpox, and 67.9% of the school's kindergarten students have religious immunisation exemptions on file.

So, the conclusion is that the lack of immunisation has caused the outbreak.The anti-vaxxers, in exercising their right to choose what is best for their child, have also chosen for other children (including those whose parents support immunisation).

If I was the parent of a child who caught chickenpox due to the decisions of anti-vaxxers, I would be suing those anti-vaxxers right now, and I encourage the affected parents to do just that.

The school says "We, as a school, do not discriminate based on a child's medical history or medical condition." Well, in not discriminating against the anti-vaxxers' children, they have discriminated against the rest of their school population, and potentially people in the wider community. The school should also be sued.

Choices and consequences!

Genetic Repairs To Embryos?

Posted on 17th July 2018

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This article by the BBC describes the results of an Inquiry into the ethical issues surrounding genetically altering a human embryo; their conclusion is that there is “no absolute reason not to pursue it”.

This seems to me to be the thin end of the wedge. Once genome editing of human embryos is partially allowed, it will only be a matter of time before absolutely anything is allowed in this area of medicine. Then we will be in the age of designer babies.

The question in my mind is, what problem, exactly, are we trying to solve with this? Clearly there are more than enough people on our planet already: over 7 billion and rising. There are also plenty of children available for adoption and fostering (which I have done), so there is no inherent problem of childless couples wanting to raise kids.

The core of the problem is that people want to raise children: their own children, not somebody else’s kids. People carrying genetic code causing illness and death, often making their embryos non-viable, still want to conceive, give birth to and raise children.

The question is, just because we can, should we be spending our tax money on enabling them to do so? Do people really (as so many seem to think) have a right to reproduce: yet another “inalienable human right” to add to the ever-growing list? If the human race were at risk of extinction due to low reproductive rates or genetic disease, I would say yes, we should help them, but that is far from the case, and I certainly do not subscribe to the idea that anyone has a right to reproduce.

I am sure many people disagree with my position on this very strongly. In that case, feel free to support the necessary medical research and costs of providing the service of genetic fixes to aid reproduction, yourselves (i.e. by private charitable donations). I do not want my tax being spent on this.

Anti-Vaxxers Are The Modern Lepers!

Posted on 25th September 2017

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Apparently, this story from NBC, on Flipboard is supposed to pluck at our heartstrings; we are expected to feel sympathy for the 5-year-old who can't attend school because she is not vaccinated, and for her family.

Well, I do not. They made a choice, as is their right, and they have to face the consequences. There are more and more outbreaks of disease due to the growing number of people who do are not vaccinated, and more and more diseases are becoming more dangerous (drug resistance of the diseases, reduced resistance to disease amongst people, etc.). Some families choose to not vaccinate their children on religious grounds, and some because they believe that vaccinations are harmful (this despite the claims of autism and other side-effects due to vaccination having been comprehensively debunked). We should remember, however, that having the right to choose to not vaccinate your kids does not give you the right to be protected from the consequences of your choices, even if the reasons for your choices are valid.

If you are allowed to send your child to school without vaccinations, you put at risk all the other children, and even adults. Schools have a mixture of ages, and some younger kids will be too young to have been vaccinated against some diseases. Some adults may have had vaccinations which have become ineffective over time, and need a booster; some adults cannot be given the necessary boosters due to being pregnant, or for medical reasons. Why should these people be threatened by your choices?

It may be that we are not being hard enough on the anti-vaxxers. The unvaccinated (children and adults) are a danger to others not only at school, but at social gatherings, in shops, on public transport, in restaurants, at swimming pools and beaches, and even at hospitals, doctors and dentists. The sensible precaution would be to shun them, and ensure that they can be easily identified in public, just like in medieval times with lepers (who were forced to carry a bell, shout "unclean", and live segregated lives), although, to be clear, I am not proposing this. Rather than complaining about the consequences that these people face now, with no access to schools in more and more places, they should rather consider themselves lucky that they are not treated like lepers. People can be very cruel when their health and safety, and that of their children, are threatened.

HIV Is Not A “Gay Plague”

Posted on 18th September 2017

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This report on the BBC shows that the world is still full of prejudice and stupidity, even amongst people who make and enforce laws.

On the island of Zanzibar (part of Tanzania) 20 people have been arrested for homosexuality, while they were receiving training about HIV/Aids education programmes. This is after authorities earlier this year banned many private health clinics from providing HIV/Aids services, saying they encouraged gay sex.

Time to wake up to the real world, Tanzania! HIV is now just as prevalent in the heterosexual community as it is amongst gays. Trying to stamp out homosexuality with the excuse that you are trying to reduce HIV is total rubbish.

I have been to Tanzania, including to Zanzibar, and I know that many people there are devout Muslims, especially on Zanzibar, where there seem to be a lot of religious schools. If you want to act against homosexuality because you believe it is against your religious law, then fine (that would be a matter to be discussed between Muslims, and not really any of my business), but please don't use ridiculous arguments about limiting the spread of HIV. Using such phoney arguments just insults our intelligence. Scientific studies show that encouraging the use of condoms (for gay and straight sex), and handing out free, clean needles for intravenous drug users, is much more effective in reducing the spread of HIV than trying to stamp out gay sex.

Incompetent Surgeon Struck Off

Posted on 16th May 2017

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Dr. Lawal Harun, a surgeon in the UK, has been struck off (no longer allowed to practice medicine) after a litany of messed up surgeries.

As detailed in this news report by the Telegraph, he:

  1. Removed a pad of fat, instead of the appendix, from a man suffering from acute appendicitis (which is life-threatening). The patient suffered another month of agony, until his appendix was removed in a second procedure.
  2. Removed an ovary and a fallopian tube, instead of the appendix, from a woman patient (luckily not of child-bearing age).
  3. Removed a skin-tag, instead of a cyst, from a third patient.

The third case occurred after an investigation which recommended that he "be restricted in what operations he carried out".

His excuse: he said he had been suffering from "poor vision" at the time.

There are several things which concern me about this situation:

  • Why did Dr. Harun not voluntarily stop operating, when he knew that his vision was impaired? What he did is the height of irresponsibility.
  • Why was the restriction on what operations he was allowed to perform not enforced by the health authority? What kind of messed up processes do they have, that he was allowed to continue to operate on patients?
  • Why is there no mention of compensation for the patients who were so badly treated? I hope that this is simply a matter of them being handled through a separate process. In the USA, people usually sue, and rightly so, in cases like these; just because health-care is usually free (costs covered by the NHS) in the UK does not mean that patients should in any way be treated less as customers.
The Health Risks Of Public Transport

Posted on 16th May 2017

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After reading this report from The Independent we should probably all be at least a little wary of travelling on public transport.

The story reports on a recent study, in which swab tests were performed on public transport in London. It showed that 121 types of bacteria and mould were present; some were antibiotic resistant bacteria. The tube (underground train) system was by far the dirtiest, with the Victoria line the worst of the lot.

I guess that we should not be surprised, as the tube system is an ideal incubation ground for bugs: warm and humid, with lots of places difficult to clean. It also confirms what we all really already know: that most people have poor hygiene.

The history of human civilisation is one of growth, interrupted by periods of no growth or even falling population (e.g. during the black plague) when new or mutated diseases become dominant. Population only starts to grow again when advances in medicine (e.g. the discovery of penicillin or the invention of vaccines) or public hygiene (e.g. the introduction of flushing toilets, drinkable water piped to houses or the banning of public spitting) are made. We are currently reaching a new limit on population density due to disease; there is a continuing problem with influenza, as viruses (e.g. bird flu) keep mutating and causing outbreaks; we have had outbreaks of Ebola; we do not have malaria under control and its territory is spreading due to global warming; HIV affects millions around the world; recently there was widespread concern about the Zika virus; drug-resistant TB is a growing problem in some cities. As people travel more, people in the west are getting more exposed to tropical diseases like yellow fever and the like. Diseases which we thought were under control, or even close to eliminated, like measles and polio, are making a comeback due to the refusal by some people to vaccinate their children.

The world is full of dangers. Maybe it is not such a good idea to shake people's hands, or kiss them on the cheek. Maybe, the next time that you notice that someone used the toilet and didn't wash their hands, you should say something.

There is also a very dangerous habit in some countries. In most of Europe, if you are sick, your doctor will write you off of work, partly to give you a chance to recover properly, and partly to ensure that you don't return to work while you are still infectious, and infect your colleagues or customers. In the USA, people often return to work while still ill and infectious, because they can lose their jobs if they take too much time off for sickness. I would argue that there is an economic imperative to change this behaviour, by ensuring people do not run the risk of being fired due to sickness, and by providing universal healthcare (so that people can afford to go to the doctor).

The Wonder Drug: Marmite!

Posted on 11th November 2016

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Being English, I love marmite (English marmite - the New Zealand version is nowhere near as good - it goes very well with cheddar cheese); English kids are raised on marmite. My German friends think that I am mad to eat it, and that it tastes disgusting, but that is their problem. Getting people who don't know marmite to taste it is great sport; the expressions on their faces when they try it the first time are wonderful.

I have always known that marmite is good for recovering from a hangover, as described on this page from Lifehack, due to the high concentration of B vitamins (and maybe also because of the salt content). Recently, however, I have seen quite a lot of reports about the health benefits of the dark and salty spread:

  1. This report on MailOnline describes how it helps heal damaged heart muscle, thus helping heart attack victims recover and survive longer.
  2. This report on MailOnline described how marmite is beneficial for energy production and brain function.
  3. This BBC story describes new research which has shown that "B vitamins may have protective effect against air pollution".
  4. This piece on EatThis.com includes marmite in a list of foods that improve your sperm count.
  5. This page on HealthTicket describes how high doses [of marmite] increase the body’s ability to fight off staphylococcus bugs like MRSA by 1,000 times.
  6. Marmite improves blood circulation (and is prescribed for those with poor circulation), and it is recommended that you eat marmite 30 minutes before going to the gym or playing sport, as described on the forum of Runners' World.
  7. Apparently marmite helps deter midges from biting you.

Those are just some of the claimed health benefits (some are better supported by research than others). Are you ready to start eating marmite?

Stupid Doctor!

Posted on 21st February 2016

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Over the last few months my fiancée has been suffering with a lot of allergy problems. As a result, she had a 5 day stay in hospital at the beginning of December, and now has to carry an epi-pen, some oral medicine and a letter explaining what to do in an emergency, at all times.

She has not been truly well since the middle of November, and occasionally has outbreaks: usually just hives on her skin, but sometimes also swollen lips. She had an attack with a swollen lip just a few days ago, and went to a pharmacy to get more medicine. She looked so bad that the pharmacist recommended she go to the hospital, which she didn't want to do for fear they would keep her in for another 5 day stay. Instead, she went to a doctor with a consulting room opposite the pharmacy, recommended by the pharmacist.

The doctor was a very sympathetic lady; it was just a shame that she was so stupid and ignorant. Her only recommendation for allergy problems was some herbal supplements to boost Sheryl's immune system. There are two problems with that suggestion: recent research shows that so-called immune boosters don't work, but if they did, that is the exact opposite of what a person with allergy problems needs. Allergies are the result of your immune system attacking otherwise harmless substances (food, skin products, cleaning products, etc.) as if they were harmful invading organisms, and boosting the immune system will only make the problem worse. This web-page suggests some treatments for allergies and, unsurprisingly, immune boosters do not feature,

I sometimes wonder how some medical practitioners get licences to practice, and how they manage to keep their licences.

No Vaccination, No Camp!

Posted on 10th January 2016

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Finally the world seems to be waking up to the fact that people who do not vaccinate their kids, or themselves, are a health risk to the rest of us, and that there are things that we can do about it.

This story on Forbes is mainly a tirade against a US doctor who is a proponent of holistic medicine, but it refers to a decision by one of our largest summer camps in the USA that all staff and campers must be fully immunised to attend camp next summer. About time too.

In related news, the Australian government has decided to stop welfare payments to parents who refuse to vaccinate their children (from April 2015); and California now requires most schoolchildren to be vaccinated against diseases including measles and whooping cough (from June 2015). I think there is more such legislation and business policy to come.

I know that there are tens of thousands (maybe more) of people around the world (but mainly in the civilised and healthy West) who complain that this is impinging on parents' rights to make decisions about the health of their children. There are two kinds of replies:

  1. One answer supports the right of parents not to vaccinate their children, but not to threaten the health of others (me and my children, and you and your children). Even though my children are thoroughly vaccinated, many vaccines are given after children start school, and some vaccines are given in the teens (e.g. TB). Most vaccines do not give 100% protection, and some (like Tetanus) have to be periodically refreshed. All this means that my kids' risk of infection by a disease for which there is a vaccination is vastly increased by them mixing with people who are not vaccinated. So, I support such unvaccinated people being barred from camps and schools, and also financially penalised to encourage them to vaccinate. Whatever rights you have over your own children's health and upbringing do not extend to putting me and mine at risk!
  2. The other answer explores the limits to parents' rights over their children. Modern life is full of constraints and obligations on how we bring up our children - limits on the age at which they can be left unattended, constraints on physical punishment, obligations to properly feed, dress and house our kids, etc. Why should we treat vaccination any differently from these?

If you are a parent who has chosen not to vaccinate your children, then know this: if me or mine are made ill (or even die) because of your choice, you will be sued, criminally charged, and run the risk of losing custody of your children. I am not the only person who will hold you responsible. YOU HAVE BEEN WARNED!

How Much Does The NHS Think A Life Is Worth?

Posted on 11th November 2016

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There has been a lot of discussion in the press in recent months about the costs, and cost-effectiveness, of the NHS. During the campaign for the Brexit referendum, there were totally fictitious figures bandied about on how much money Brexit would save, and how any savings could be ploughed into the NHS. Don't hold your breath waiting for that to happen.

There have also been some stories about treatments that the NHS will, and will not, pay for. In this report from The Guardian is a story about a cancer treatment, costing £15,624 per month, which they will not pay for, on the grounds of "cost-effectiveness". Admittedly, £15,624 a month is a lot of money, but even so. it is a life-saving treatment. There is also this story in The Guardian which describes a new drug for treating cancer. The new drug is currently only available for very specific cases (affecting about 300 patients), while the NHS assesses its cost-effectiveness. There have been other recent news stories also mentioning cost-effectiveness as the basis of deciding whether the NHS pays for drugs and other treatments.

I have written a large number of cost/benefit cases, which are the basis of any analysis of cost-effectiveness, and I know that you need two basic elements: the cost, and the financial value of the benefit. In the case of medical treatments, the financial value of the benefit is the value of a life, or the value of improvements in quality of life and savings on other care costs that may be saved, and any such financial value is inherently subjective.

So, what I would dearly like to know is what value does the NHS and the UK government place on a human life, and how did they decide on this value? They must have settled on a number, otherwise they could not possibly do a cost-effectiveness analysis (although I suppose they could be lying about doing such analyses). I suspect that they have a financial amount in mind, and that the value they have decided on is so low that there would be a public outcry if it became widely known. I think that the public have a right to know, and that there should be an open debate on whether it is reasonable and fair.

Still Using Larium!

Posted on 1st September 2015

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This report, from the BBC, is one of several recent stories about Larium.

The writer describes his experiences from 1998, but the side-effects of Larium were already very well known in 1995, when I was prescribed it for a business trip to French Guiana. I and a group of people went to Kourou for acceptance testing of our project for the ESA. Like in parts of East Africa, parts of South America also have drug resistant malaria, and Larium was the only option. In the end, I think that no-one in my group took their Larium, because of the side-effects, some of which can be very long-term, or even permanent; we decided to risk it (mostly we were indoors, and lots of insect repellent was used).

1995 is now 20 years ago, and the British Army is still using Larium (according to this web-site, it was introduced during the Vietnam war, which ended in 1975). It makes me wonder how effective our forces are when operating in malarial zones.

Admittedly, there hasn't really been much progress in anti-malarials since Larium was introduced, so in some scenarios it is a choice between Larium and nothing. Nevertheless, it seems like the military continue to treat our soldiers like cattle, or guinea pigs; things haven't really improved since the days of agent orange, or the deliberate exposure of servicemen, after the second world war, to nuclear fallout.

The situation with anti-malarial drugs is one of the big problems in medicine today. Malaria seems harder to fight than HIV, and the lack of effective drugs ranks with the growth in drug resistant bacteria (if we discount self-inflicted life-style and diet-related problems like obesity and heart disease).

Ebola: Coming Soon to a Town Near You.

Posted on 19th October 2014

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There has been a huge number of stories in the news lately about Ebola: one of the latest is this story on the BBC. The report is of a speech by Ellen Johnson Sirleaf, President of Liberia. She makes the case that everyone has a stake in the fight against Ebola. My opinion (and I am not alone in this) is that the problem is that the rest of the world is complacent about the risk, and so not enough is being done.

The complacency is illustrated by this BBC report, in which the head of the US Centers for Disease Control and Prevention (CDC) blamed the infection of a health worker in Texas on a "breach of protocol", a statement made before a thorough investigation. That investigation might yet show that the CDC's protocols are inadequate to contain the disease. Given that health workers continue to get infected in West Africa despite attempts to implement containment protocols based on the CDC's, two health workers in Texas have been infected (as described in this BBC story) and that a health worker in Spain has also been infected (as reported in this BBC story), people should be looking seriously at the possibility that Ebola's transmission mechanisms are more effective than the containment protocols assume.

The World Health Organisation (WHO) has been warning for some time that the mortality rate for people catching this particular strain of Ebola is 70%, not 50% as previously thought, and that the number of people infected is being significantly under-reported. In a recent bulletin from the WHO, covered in a report by The Guardian, they say that there could be as many 10,000 new cases of Ebola a week, within two months. Whilst the majority of these cases will be in West Africa, don't feel too cocky: it is coming to the country where you live too. Scientists have calculated that there is a 75% chance the virus could be imported to France by October 24th, and a 50% chance it could hit Britain by that date (as reported here by Business Insider).

There are reasonable grounds to believe that the better health infrastructure in Western countries will prevent an out of control outbreak of Ebola in North America and Europe (note: reasonable grounds, not a guarantee). Nevertheless, infected people will continue to arrive from elsewhere, and health workers will continue to get infected by patients: belief that it will be otherwise is naive. The richer nations will send more health workers and military personnel to West Africa to help fight the disease, as we should, and some of those will be infected, and will be repatriated for treatment, helping to spread the disease.

Another mechanism by which Ebola will spread is refugees. There is already a problem with refugees arriving in Southern Europe (Italy, Greece, Malta and Spain) from North Africa. Currently many of them are from Syria and North African states, but my guess is that there is already a wave of refugees on the move from West Africa, yet to reach Europe, and that eventually some of them will bring Ebola with them.

What the world desperately needs is a vaccine to protect against Ebola, and drugs that are effective in treating Ebola, but those are both not yet fully developed and tested.

I have been saying for a few years that such a health crisis is inevitable, and that history warned us it was coming. The history of the development of human civilisation is a series of (largely out of control) growth spurts, which end with a plateau as population becomes limited by some disease or other. Advances in medicine, sanitation and standards of personal hygiene have overcome each of these limitations, and allowed the start of another growth spurt. Ebola seems like it might be the latest growth-limiting disease.

From an environmental perspective, Ebola may be a good thing (and not just for Fruit Bats). Global warming, species loss, habitat loss, water and air pollution are all caused by people: by there being too many people. A pause in the growth of, or even a small reduction in, human population and our consumption of resources will maybe give the natural world a much needed breather. Of course, none of that makes it any easier if you are lying on a bed in an isolation ward suffering from Ebola, or if you lose a friend or relative to the disease.

Is there anything that you can do? Well, there are some things: choose your travel destinations carefully, whether for business or pleasure; think carefully before shaking hands or kissing cheeks in any society where the disease may be present; don't lie about your potential exposure when entering a country or being quizzed; and if you get sick, don't hesitate, but report it to a medical professional.

Many Doctors Can't Handle Statistics!

Posted on 7th July 2014

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This BBC story, based on a book, "Risk Savvy", by Gerd Gigerenze, is very worrying. It is quite a long article, but worth reading.

Gerd Gigerenze is the director of the Harding Center for Risk Literacy in Berlin, and is an expert in uncertainty and decision-making.

What the book and the article say is that a huge proportion of our doctors do not properly understand and cannot manipulate basic statistics. This is shocking and worrying because modern medicine is completely dependent upon statistics:

  • They are the tool used to identify which organism causes a disease;
  • They are used to balance the risks of treatments, and even diagnostic techniques, against the risks posed by diseases, to help decide whether and how to treat and how to diagnose, and at what age to begin standard screening procedures (e.g. for breast, cervical and prostate cancers);
  • They are used to decide which treatments to use, and whether new treatments should be introduced;
  • They are needed to explain risks to patients, and to make prognoses ("How long have I got?", "Will I die?", "Will I still be able to ...?", etc.).

In western cultures medical doctors have very high status: they are used to being able to dictate to patients (I don't accept this from my doctors, but many people do), and they are automatically considered trustworthy and well-informed (a doctor is one of the people who can authenticate your photo when you applying for a passport). It seems that maybe this god-like status is not always deserved.

Doctors have to complete a long and arduous eduction in order to qualify. Once qualified, they are expected to keep their medical knowledge up to date (lots of reading, and attending conferences) - in this respect their situation is similar to my own and other professions. What seems to be missing from this major educational programme is basic statistical skills (some of which are really only common sense).

I don't see any chance if this shortfall in statistical skills being corrected any time soon, so what should we all do? The answer is to ask your doctor questions, and not accept their advice as gospel. If you are not happy with what your doctor tells you, get a second (and even a third or fourth) opinion. Use the Internet (with the obligatory pinch of salt) to inform yourself of your options and the risks you face. If your doctor has a problem with you having your own opinions about your health and treatment, get a new doctor. You also have the option to report your doctor to your heath insurer and/or the appropriate medical board if you feel that they are being unprofessional.

Trust your doctor, not Wikipedia?

Posted on 13th June 2014

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I find this story rather disingenuous.

Whilst I agree that there is a lot of rubbish (propaganda, lies, rantings and badly researched material) on the Internet, Wikipedia is one of the better sources of data. Most of the entries are written and/or reviewed by experts in their field, whether medical, scientific or technical. If there are errors, they tend to be corrected reasonably quickly.

My own experience of doctors is that their knowledge is often not up to date with the latest medical research; in fact, quite often, more out of date than what I find on Wikipedia. Not so long ago, doctors at one of the leading hospitals in Munich wanted to perform two separate surgical procedure on me that not only did not address my medical issues, but one of them was based on unsound research (and has since been withdrawn).

Given the lack of expertise in the medical profession, thank goodness for Wikipedia and other sources on the web.

Of course, some common sense should be applied. The Internet should be used as one source of information, in combination with that from your doctors, but the days when we could blindly accept our doctors' advice are over.

My attitude to this is simple. I am not simply a patient; I am the customer, and should be treated as such. My doctor is not is charge of my health and its treatment; I am. When I get contradictory information about my health, I need to be convinced by my doctor (or he needs to be convinced by me). If my doctor can't work in this way, I will find one who can.

They don't even know if this doctor is qualified!

Posted on 23rd May 2014

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I find this story really rather strange.

The doctor in question, Dr. Daniel Ubani, practices medicine in Germany, but was working as a locum in the UK when he killed a patient by prescribing 10 times the safe dose of a morphine-based pain killer to David Gray. Dr. Ubani was tried in Germany, and convicted of causing the patient's death by negligence in 2008. He was also struck off in the UK, meaning that he can no longer practice medicine in Britain. Mr. Gray's family are not happy with the punishment, a nine-month suspended sentence, and I can understand why. They want him brought to trial in the UK, but The European Court of Human Rights says no.

The bizarre thing is that the family of Mr. Gray say that the court in Germany "don't even know if Dr Ubani is qualified", because no "effective investigation" was conducted. Germany is one of the most bureaucratic countries in the world, including requirements to provide documentary proof of qualifications (usually the original certificates), and the idea that the court could not or did not check Dr. Ubani's qualifications is simply mind-blowing.

The other oddity is that normally cases are tried in the jurisdiction where the supposed crime is committed, which is the main reason why extradition treaties exist, but in this case, because legal proceedings were started in Germany first, Germany seems to have had jurisdiction, which has been confirmed by The European Court of Human Rights. If this creates precedent for other types of case, it may create loopholes for many criminals.