What's Behind the Green Door? More Unorthodox Thoughts from Glastonbury

Monday, June 30, 2008

It's Sunday, day three at Glastonbury, the world's greatest rap music festival, and the seagulls are now circling the farm in their thousands. Maybe, it is some Sheldrakean morphic resonance animal text-message vibe that sends them here. Or, it could be just the emerging smell engulfing the 900 acre site - redolent of municipal tip.

There comes a time in every festival goer's experience when they have to contemplate the inevitable and confront the end-point needs of their digestive system. A diet of falafel, Goan fish curry and rough cider is bound to have consequences. My moment of truth came yesterday during a rather good set by Elbow. Luckily, I was quite near the back and so could make a quick exit. In fact, we were so far away from the front that Mrs Canard Noir thought we were watching Will Young. But then she never could tell her... never mind.

There is a stark choice - chemical or long drop. Year's of experience have taught me that the chemical loos, often preferred by newbies, tend to fail under the daunting load. The long drops, in contrast, are a simple working technology, consisting of a big deep pit with rows of green tin boxes lined up above with simple wooden seats with holes in them. This is a good, traditional, Glastonbury technology, stemming from the days when the Glastonbury Beard Index was running at 63% (including women; the GBI is now so low that the beards have lost their deposit - something closely correlated, I believe, with the rise of on-site saunas and Japanese restaurants.)

Freediving apnoea techniques might be useful on approach to the green tin boxes, including rapid hyperventilation. Yesterday, we watched Shakin' Stevens wonder what secrets were lurking behind the Green Door. I am not so keen to find out. But now, there is now no turning back. The smell hits you like a Winehouse punch. And so, whilst trying to concentrate on anything rather than my current surroundings, I spot an advert on the back of the long drop door. Surely, this is not what Shakey, the Welsh Elvis, was on about?

On inspection, it looks like just about every bog door on site (some 3,225 or so) had one of these adverts from the Travelling Homoeopaths Collective - a group of homeopaths who pitch up tent at festivals in search of new customers. Their advert reads (pictured above),

Feeling Unwell?
Need some Help?

(They know their audience.)

Come and find out how safe and effective homoeopathic medicine is.
The on-site homoeopaths are even given a plug in the official guide to the festival offering to treat 'sunstroke and upset stomachs' and they make a tempting offer of massages to get you in (cunning). It looks like the homeopaths are advertising hard. The homeopaths want to be taken seriously. This is rather in stark contrast to the other denizens of the Healing Fields who are much more low key.

I spent a pleasant half hour with some witches from Hertfordshire, who made me a lovely cup of raspberry and nettle tea and dropped a potion on my tongue of cinnamon, ginger and compress of daisy. They asked me, "Have you ever noticed how daisies spring back after you step on them?". Apparently, by boiling the daisies you can extract their energies and make potions that will give you resilience - just what you need at a festival. And it worked for me. Although, not quite enough resilience to avoid the green tin box.

The Witches of Herfordshire were quite clear they were casting a spell and offering magic. I (jokingly) asked a homeopath, that although being in the best of health at the moment, did they have any equivalent to Imodium - the 'festival goer's friend' - for preventative purposes? A rather stern and shocked face told me that homeopathy was gentle and natural and had no side effects. No shit?

The homeopaths are offering me magic too, although they will not admit it. All that shaking and diluting their concoctions and the use of their weird and wonderful ingredients. Homeopaths use daisy too - Bellis - it too can be good for injury recovery, allegedly. They also use much more magical things from Hyena saliva and chips of rock from stone circles, to 'the light from venus', camel's milk and 'condom'. The big difference is that we still have five NHS paid for homeopathic hospitals to spend our tax money on indulging in magical thinking. We have the University of Westminster and others with their Departments of Magic, teaching students how to precisely shake their potions. As far as I am aware, my Witches Coven from Hertfordshire do not teach at the University of Luton or hold day clinics in St Albans City Hospital. The witches do not get 200 MP's signing an Early Day Motion calling on the government to support witchcraft in the NHS in the name of patient choice. At least not yet.

And despite homeopaths trying to wear the mantle of science, their practice is as magical in its thinking as my herbalist witches. In fact more so: homeopathic pills contain no active ingredients - all the 'ingredients' have been diluted away to nothing. At least I got some nice tea and some festival breath freshening spice drops from the coven. Visitors to the Festival Homeopaths will get plain sugar pills for their hangovers, paranoia and trench foot.

It struck me that these toilet door adverts might make the basis of the funniest ever complaint to the Advertising Standards Authority. My sense of civic duty tells me that I ought to see this through. Old timers at Glastonbury are now resigned to the presence of Babylon within the festival walls. Can we expect a contingent of Somerset Trading Standards Officers on site next year to ensure that claims being made can be substantiated and are truthful? Now that would be unorthodox. I would particularly like to see Trading Standards get into the festival spirit by wearing pink faerie tutus and zapping rogue traders with wands, before fining them, naturally.

But the festival is coming to a close now for another year. Peace and love abound. We have seen Mr Jay Zed kick off with a smashing rendition of 'Wonderwall'. It's just the Verve left to see now. I can't wait - 'The drugs don't work'.


 

 

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Dispatches from the Sceptic Fields

Saturday, June 28, 2008

It's Shakin' Stevens o'clock here at Glastonbury. Lunchtime. Saturday, as we emerge from the first full day of hard core mud action.

It's not my first time here. I am not wearing flip flops and I did not bring a suitcase. My first visit was in the (coughs) mid eighties. Many things have changed. Gone are the rows of blackboards advertising various alternative pharmaceuticals. No more communal showers. There are now onsite loo cleaners.

Somethings don't change. Norman Cook in various guises. Billy Bragg is still fighting the miners strike. Rain.

The healing fields are a permanent fixture. Somehow, in order to become a member of the alternative culture there is a package of beliefs you have to buy into. Worrying about oil consumption in the greenpeace fields means that you have to empty your brain when worrying about providing health for people. GM crops. Bad. No debate. Nuclear power - nein danke.

So, I was offered Nux vomica for my hangover by a crystal therapist. I love the sincerity streaming from her. More disturbingly, I see I can get a dispossession if I have a serious mental illness.

So I am setting up the Sceptic Fields here now. There are just a few of us. With a cup of refreshment from the cider bus. We are enjoying not feeling the vibes. Should we do a double blind randomised controlled test in the stone circle? I feel a bit of a killjoy.

 

 

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£10,000 if you can show homeopathy works

Wednesday, June 18, 2008


Edzard Ernst and Simon Singh have issued a challenge to homeopaths: show the world your evidence that homeopathy is effective for any single condition. After recently publishing a book on the merits of various alternative medicines, there has been a near universally negative response from alternative medicine practitioners, particularly the homeopaths, who would prefer to try to smear the Professor than engage in argument.

The most common claim from homeopaths is that they have all the evidence they need that homeopathy works and that Ernst and Singh are not trained enough, too biased or have not done their research.

It looks like the two are now putting their money where there mouth is and asking homeopaths to show that their assessment of homeopathy is wrong.

Their challenge is as follows:




We challenge homeopaths to demonstrate that homeopathy is effective by showing that the Cochrane Collaboration has published a review that is strongly and conclusively positive about high dilution homeopathic remedies for any human condition.


Or, we challenge homeopaths to have such a review published within 12 months of the first publication of extracts from "Trick or Treatment?" (8 April, 2009).


The Prize will be £10,000 – it will be paid by Ernst and Singh out of their own pockets to the first person or persons to present such evidence.

Despite the challenge only being a day or two old since the Daily Mail broke the story, the excuses for ignoring the challenge are already being discussed on homeopathic sites and message boards. Of course, James Randi has for many years offered a much bigger prize to anyone who can demonstrate real homeopathic effects. This challenge it rather different. It is directly asking homeopaths to show that Ernst's research is incomplete or wrong and that his summary of this research with Simon Singh is incomplete, cherry picked or misleading. Put up or shut up.


What we can expect now from homeopaths, based on recent form, is a whole range of bluster, insults and excuses. I would like to try to tackle some of the excuses homeopaths will use to ignore this challenge based on their responses to both Randi's challenge and the new Ernst and Singh challenge.

1. Homeopathy has been used successfully for 200 years. We have no need to prove anything.

Has it? The evidence for this is very weak, based mainly on anecdotal evidence. There is anecdotal evidence that bloodletting and voodoo dolls work too. A modern society with a publicly funded healthcare system should expect a little more.

2. Trials have show that it works for animals and babies who cannot experience the placebo effect?

Have they? Where are the high quality trials on animals and babies that show this? There are many poor quality trials that do not blind practitioners and animal owners and so reporting biases can easily creep in. The placebo effect is not the only way you can be fooled into thinking a treatment works.

3. Conventional trials are not suitable for the 'individualised' approach of homeopathy.

That is not true. Many individualised trials have been conducted, e,g, see Linde 1998.

4. Critics cherry pick negative trials and ignore positive ones.

Well that is what this trial is about. If you can show this to be true, then the prize is yours. Critics do not 'ignore' positive trials, they ignore poor quality trials - which just happen to be positive more often than not. Poor quality trials provide highly unreliable evidence.

5. 'What is needed is more investment in homeopathy research, not facile enticements by scientists who should know better.' (Robert Mathie, of the BHA)

There have been over 200 trials of homeopathy to date. The results are not good as Ernst and Singh show. What would you expect more research to show?

6. Homeopaths do not have the money to conduct trials.

An hour browsing Cochrane could prove Ernst wrong. Failing that, any of the academic homeopaths out there could do their own literature review and publish it. The challenge does not ask you to conduct vast, expensive trials - just show how the current evidence supports homeopathy.

7. Yes but, homeopaths do not have the money to conduct good trials.


But many trials have been done. In most cases, simple changes could have vastly improved their quality. And lots of homeopathic money is out there. Boiron is a half a billion dollar company. It spends 18.5 times as much on advertising as it does on research. (Pharmaceutical companies, on average, have a 2 to 1 ratio). Boiron's absolute research budget is near non existent. Budget is not the factor - it is the will to do good tests that is lacking.


As a side note, my own challenge would only cost around £50 and after six months, all I have had is excuses.


8. Why the Cochrane review? Aren't they biased towards pharmaceuticals?


The Cochrane Collaboration is completely independent of any pharmaceutical company and forbids contributors from accepting payments. Its reputation rests on its integrity and high standards. Cochrane does publish reviews of homeopathy, e.g. asthma.


9. This is a fraud / stunt / Ernst will never pay out.


The easiest way to prove this is true is to claim the prize and make it public. If your claim matches the simple conditions then homeopathy wins. If Ernst and Singh fail to pay then you will be vindicated and their reputations diminished.


10. Ernst should be promoting homeopathy, not knocking it.

Ernst is a Professor of Complementary Medicine and is paid to critically appraise the evidence for homeopathy and other practices. He is not paid to uncritically promote such things.

11. "The real problem here is Ernst’s and Singh’s attempt to use a tool of conventional medicine to study alternative medicine." (Lynne McTaggart)

Meta analyses and randomised and double blind trials are not tools of 'conventional medicine'. These are general experimental and statistical techniques that make no assumptions about what they are applied too. Indeed, the medical profession fought for many years against the imposition of such techniques on their authority. Homeopaths still do so.

12. Most trials of homeopathy show a positive result.

You are doing your own mini meta analysis here. But your technique (counting positive trials) ignores the negative trials and fails to weight each trial according to its quality. When you do this, you see that poor quality trials tend to come out in favour and high quality trials do not - exactly what we would expect if homeopathy were a placebo therapy. If you can show that high quality trials consistently show positive and strong effects for homeopathy then you bag the money.

13. £10,000 is not a persuasive amount for me to bother.

I am glad you do not think so. Homeopathy must be very lucrative. An hour's work could win the prize.

14. "We have nothing to prove..." (Steve Scrutton of the Alliance of Registered Homeopaths)

And yet you feel it is OK to provide a health care role to people who may be very ill and you are prepared to offer advice to people who may face serious health risks. Frankly, attitudes like that make we want the government to ban unlicensed medical practitioners and I am not one for heavy handed legislation.

15. "...especially to people with closed minds" (Steve Scrutton of the Alliance of Registered Homeopaths)

I am not sure what is closed minded about asking people for evidence. Real close mindedness is displayed by homeopaths who cannot contemplate being wrong.

I will add more as they come forth...

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Sip Drink: Unnatural, Unethical, Farcical

Monday, June 16, 2008

If you were a dodgy plumber or made misleading double glazing adverts, you could expect Trading Standards to fine you and the BBC to make a Rogue Traders programme about your mischief. Make misleading and inaccurate health claims about a 'health' drink and the same BBC executives will be forking out license fee money on the product for their expensed lunch with their rocket, cous-cous and feng shui salad.

Sip Drink is a new bottled water, fresh on the market this year, and unashamedly aimed at women. At lunch today in a trendy salad bar in London I saw this new range on sale for £1.99 a pop. The bottle screams that it is "your way to better, beautiful skin." This fruit flavoured water is telling us that it has 'skin healthcare benefits', is 'natural and pure' and is ethical and environmentally friendly.

And all this is bullshit.

Their web site tells us about 'favourable reviews' in the Times Style supplement and asks us to read AA Gill's review. They are obviously hoping no one does. This is what Gill thinks of the health claims,

There is nothing in this stuff that will take you on for a single day longer than your allotted span. They won’t cure anything, stop you catching anything, make you a better shag, unless you use the empties as a butt plug.
So, obviously a 'favourable review' now is someone in The Times mentioning that your empty bottle might make an oxymoronically puritanical sex toy. Gill is comparing a range of similarly ridiculous health waters and says this specifically about Sip:

Sip says: “We all know water works wonders on our skin.” Well, most of us do. Some teenagers don’t. We use it for washing, generally.
Sip does not win the contest though. He describes the range as having "infantile and monosyllabic flavours".
Grudgingly, we all agreed that if we really, really had to choose the best one, that is, if we were all crawling through the Sahara with tongues like carpet tiles and were confronted by the full range, then it would have to be Firefly.
What Sip is doing is playing on the old canard that we are all constantly living in a caffeine and alcohol induced state of permanent skin shrivelling dehydration, and we need to drink 'pure' water to correct this. Gill pricks the 'alternative medical orthodoxy',

This contemporary truism sprang from a misunderstanding of a piece of ancient research that measured the amount of liquid a healthy body needed in a day. Nutritionists, only just clever enough to be nutritionists, thought this meant pure water. It didn’t; it meant liquid. Which we get from all sorts of things, including everything we eat and everyone we snog.
Sip's canards do not stop at the health claims. We are compelled to believe 'sip’s eco ethics' by reading that they "are proud that sip is made entirely in Britain so has a small carbon footprint: our skincare botanicals are sourced by an organic farm in Herefordshire, and sip is bottled in the Black country."

Considering that Sip is no more than flavoured water, we have to question the environmental claims. A glass of water from the tap will cost you five thousand times less, require no plastic packaging and no transportation costs. Squeeze a 10p lime or lemon into your water and you can gave your vitamins and antioxidants too - but from a really natural source.

Sip was not invented by scientists or dietitians, but unsurprisingly by Kate Shapland, beauty editor of the Telegraph Magazine. Her 20 year's of experience, as a beauty editor for glossy magazines, has apparently given her the 'expert heritage' in understanding of skincare to make this drink and these claims.

New Trading Standards laws came into force a few weeks back. I find it difficult to see how such nonsense could stand up to scrutiny under these new rules. I, for one, cannot wait to see one of these firms in court trying to explain how their claims have any relationship with reality and how they are not exploiting their customers.

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Bravewell and the Prince

Thursday, June 12, 2008

Anyone entrusted with power will abuse it if not also animated with the love of truth and virtue, no matter whether he be a prince, or one of the people. - Jean de la Fontaine.

Quackery in the UK has friends in the highest places. Despite constitutional restrictions on the monarch's role in politics, our heir to the throne, Prince Charles, has decided to meddle most wholeheartedly in how public healthcare is provided.

The main channel for this interference is the Prince's Foundation for Integrated Health. This organisation claims not to promote alternative medicine, but instead to "offer healthcare which makes use of all appropriate therapeutic approaches, healthcare professionals and disciplines."

Strip away the rhetoric and what is revealed is the uncritical promotion of the public funding of quackery, fraudulent treatments and pseudoscience. 'Integrated health' is an idea borrowed from the American rebranding of alternative medicine. Rather than marketing quackery as 'alternative', it became 'complementary' and then 'integrative'. Quite how it is possible to integrate science with nonsense, reason with irrationality and thought with ignorance is never made clear.

Professor David Colquhoun has been recently exploring the rise of 'integrative medicine' in the USA. He says,
Remember that the terms ‘integrative’ and ‘complementary’ are euphemisms coined by quacks to make their wares sound more respectable, There is no point integrating treatments that don’t work with treatments that do work.

His blog entry charts the penetration of quackery into medical schools. Being America, money is the major motivational factor involved here and we are shown where the money to corrupt is coming from. One of these sources is the Bravewell Collaborative, a 'charity' run by the wife of the billionaire boss of Morgan Stanley. Bravewell conducts 'initiatives' to change the way physicians are educated. They want to ensure that American doctors are taught baloney treatments such as homeopathy and herbalism. Research is not the major focus - rather cash 'Leadership Awards' are made to those academics and doctors who 'champion' quackery in previously prestigious medical schools, such as Yale.

And so it is rather disturbing to see that Prince Charles has signed an agreement to "establish a partnership with the Bravewell Collaborative focused on improving the health of the public in both countries by advancing the use of integrated health."

We are beginning to see what this means. Already, the Prince's Foundation are offering all-expenses-paid 'Fellowships' to GPs and academics to become promoters of quackery within the NHS.

What we will not see is this money being used to understand if any alternative medicine actually works and to conduct research into the impact of quackery on the public health. Only one department in a medical school in the UK appears to undertaking proper academic research into this area under the Professorship of Edzard Ernst at Exeter University. Despite the fevered imaginations of homeopaths, this department is not awash with the dirty money of pharmaceutical companies and no doubt would benefit greatly from the committed income of philanthropic billionaires. But Prince Charles is no fan of Ernst as he has been rather effective at establishing a sound evidence base into the effectiveness of various alternative therapies - and that evidence base is not good news for quacks.

What Prince Charles and his mindless followers feel unable to grasp is the difference between the critical appraisal of alternative medicine and the unquestioning promotion of organisations like Bravewell. Ernst is an academic and has a 'love of truth' that our Prince feels so ready to abuse. Uncritical promotion will not serve patients well. It corrupts the notions of patient choice, informed consent and medical ethics. If Charles genuinely cares about the health of the nation he will one day reign, his ignorant fairy tale fantasies of magical cures need to be abandoned in favour of proper intellectual enquiry. At the very least, he could stop meddling in the politics of healthcare and simply shut up.

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