Saturday, 23 May 2009

Part 2 - Edzard Ernst is a Professor of Complementary Medicine: And Sounds Like A Mysoginist (but isn't actually one)

At the start of the talk on the 20th May 2009, Professor Edzard Ernst gave us an anecdote about a homeopath he had encountered at a dinner party. As a side point, he added that homeopaths were "typically" women, but didn't really quantify this. As a woman, I was slightly taken aback, and I wondered if my chromosomes would make me susceptible to a bit of woo in the future.

"There was something that you mentioned quite early on in your talk and it was about a dinner party you had gone to, and a lady who had approached you... and you implied that most advocates of homeopathy are women. And I was just wondering if you had any theories as to why that might be?"

"Oh dear...I'd like to talk about science but that question you asked has swept under my feet [sic]! Well, why is it women? All the surveys, virtually all, not just in Britain, in America, Germany. All surveys show that the typical user of complementary medicine (more specifically homeopathy) but complementary medicine is... I call it “The Four F's” - Around forty, female, fertile... and I was going to say “fucking mad” "


He didn't really answer my question and it got me thinking. I waited until my hangover had subsided before doing a litle bit of research. Dishearteningly, Professor Edzard Ernst seems to be right. Am I destined to become an advocate of complementary medicine? I'm over halfway to “around forty”, I'm female. Luckily for me, I use contraception and I'm neither fucking or mad. With a little bit of luck, I should be safe.

Just a quick detour before I continue: I'm a bit new to this blogging business, and I wasn't sure how to present my findings. I'm a big fan of graphs, and I could definitely use a few of them here, but technical difficulties ensure that, once again, I rely on my clever and appropriate use of wit and charm to dazzle you blind.

Back to the issue at hand. I say this with much aplomb Professor Ernst, I think you'll find it's a bit more complicated than that. Essentially, he's right, but I don't think it's advisable to describe those you may be trying to convert as "fucking mad". In one study I looked at, patients were asked to tick boxes showing reasons for using complementary medicines.

45% cited "unpleasant side effects of conventional treatment"
43% had said they had "tried a conventional medical treatment and it didn't work"
33% reported that "a doctor had recommended a complementary or alternative medicine to them"


This study doesn't take into account the efficaciousness of different types of alternative therapies (it puts massage and chiropractic in the same band) and it also doesn't go into the details of the particular ailments treated.

A couple of months ago, I was the victim of a terrible toothache. It was fucking horrible. The left side of my face had swollen up, I couldn't eat or drink or smile or jape. I went to visit my lovely dentist, she prescribed me a three day course of antibiotics. The first day, my face still hurt, except I had a bit of a reaction to the pills. One of the side effects was that my lips swelled up. They swelled up so much that they burst open at the top and bottom. If you have seen my amazing youtube videos, you may notice that I am wearing very dark lipstick, this is to cover the scars two days later. I was in so much pain that day that if someone, anyone, in a perceived position of authority (like my Grandad, or my mum) had said to me "Swollen lips, eh? You should rub some stinging nettles on it" I can't honestly say that I wouldn't have given it a go. The point I'm trying to make is that when you're in a lot of pain, and someone recommends something to you, and it doesn't sound like it'll do you any permanent harm, perhaps you'd go for it.

If you have time, do check out this link to this study, it's fascinating. It is only concerned with female sufferers of depression, so it fits the "fucking mad" hypothesis fairly well. It also discusses loads of other interesting issues that I don't have space to write here. My favourite is that those who perceive themselves to be ill are more likely to take up the use of complemetary and alternative therapies. I can imagine going to my doctor because I've put on a bit of weight, and she says to me "You're not ill, you muppet. You need to stop eating Jelly Belly Jelly Beans at 3am" I might get a second opinion. Everyone eats Jelly Belly Jelly Beans at 3am, and not everyone is putting on weight. The logic is infallible.

I looked at several articles online (this one, this one, this one, and this one)and they all kind of say the same things regarding reasons for people in general to seek alternative treatments, and the kinds of people likely to be more vigorous in their acceptance of it.

To end this post, I'd like to finish with this study into why women wouldn't necessarily tell their doctors that they were seeking complementary or alternative therapies. One of the main reasons is that biomedical doctors are not that bothered about it, or in some cases actively derogatory, and they may have been intimidated by this. If Ben Goldacre was my GP, and I'd gone to see him because I was going through a pretty tough time and wanted some pills, I'd probably not bother mentioning that I'd paid £45 to reconnect with my angels, as I'd imagine he'd either laugh at me, or raise those damn sexy eyebrows in a patronising and scary way. Heaven forbid I may find them sexy no more.

On a serious note though, this is potentially dangerous, as they may be taking things that contradict the effectivenes of proper medicine, or they may actually be doing harm. How do we know that angels aren't right proper bastards?

My hoi-poloi opinion is that there needs to be an easy-access information services (why not call it "teh internets"?) for all people about complementary and alternative medicine as well as a more diplomatic approach to women who may be taken in by pseudoscience. Whilst there are excellent, useful, user-friendly websites one can visit, there is also a lot of bullshit, and sadly not everyone is able to differentiate the two.

If we go back to the original answer that Professor Ernst gave me, he's not wrong. Statistically, it is women in their forties who are more likely to get into CAM, they are often fertile, and in the small number of examples I looked at, they are fucking mad - not because they're weird and don't brush their hair, and wear hippyish clothing, but because they've reached a point where they want more options. Unfortunately, pseudoscience gives people false hope and one can only hope for a massive drive to weed out the really good alternative therapies (so that they can become a part of mainstream medicine) from the quacks.

Just in case I have depressed you a bit, please enjoy this video to lift your spirits :-)

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