On Wednesday 20th May 2009, I attended another talk at the Penderel's Oak pub in Holborn, this time given by Professor Edzard Ernst. A fascinating man, not least because of his incredible moustache. I have always been envious of men with facial hair.
Professor Ernst was introduced by my favourite soft-handed physicist, award winning broadcaster, and proponent of an awesome haircut – Simon Singh. He spoke briefly about the libel case (for the benefit of those who were not present on Monday, you poor things missed out on some prime schmoozing!). Something happened when he passed the mic over though... for the first 10 minutes or so, the talk was continuously interrupted by technical problems. Could it be the work of homeopaths, dousing the speakers in ionised water? Who knows. The talk did eventually resume, but at a very soft level.
He finally began by giving us a bit of his background, most of which can be found here, and then launched into a proper introduction by giving us some really interesting things to think about, which, for the benefit of those who weren't there, I shall put into bullet points:
-Doctors coming out of medical school are generally impressed by everything they do. Shit scared, but impressed.
-Homeopaths tend not to kill their patients as much as conventional doctors, because usually, their patients aren't really ill.
-There is an assumption across complimentary and conventional medicine that recovery is a direct result of treatment, and no one really seems to question this.
That last point seems to be particularly important, as there are several reasons why someone would recover from an ailment:
-Natural history of the disease – sometimes, things just get better. As Brian Cox knows only too well.
-Regression to the mean (if ever you meet Ben Goldacre, ask him what this is and try and get someone to film his answer)
-Patients may be seeking treatment elsewhere or self medicating without the practitioner's knowledge. An example of this is my frequent use of quinine, ingested in a diluted solution with alcohol and a twist of lime, commonly known as a “Gin and Tonic”. I have found this to be an incredibly effective treatment for many symptoms including social ineptitude, singing off-key, and for the thinning of mascara.
-Placebo effect – more research needs to be done into this. I once gave my little cousin some apple juice in a whiskey glass and told her it was bad for her, don't tell your mum, and she spent that whole Christmas stumbling about the house like grandma.
-Social desirability (being friendly to your patients)
After a quick show-of-hands for what Professor Ernst should talk about for 10 minutes, he went with “My most fascinating trial” obviously, because he sort of hammed it up a bit. His findings were published in The Lancet (under the heading “Scrutinising the Alternatives”) and The New Scientist (under the heading “From Magic to Medicine”). He focussed on the main branches of complementary therapies at the time: homeopathy, herbal medicine, spiritual healing, and acupuncture. Chiropractic was not on his list, curiously.
I was very suprised to be told that at the time this trial was implemented, there were 14,000 spiritual healers in the UK, and 20,000 GPs. That's a bit scary to me.
The goal of the trial was to find out if spiritual healing was better than a placebo. They brought in 5 actors, who were taught how not to heal – it was simple and yet so genius. Instead of concentrating on healing thoughts, they had to count backwards from 1000 in steps of 7, which takes full concentration. I haven't even bothered to try it, because I'd much rather have this last glass of wine before bed.
My suprise at the number of healers was soon diminished, as it turns out that these “actors” were healers themselves! Everyone has healing powers. Isn't that handy? Who-da-thunk-it?
To cut a long story short, the actors and the control group (of an empty room with a cassette recording of someone breathing) were more successful than the spiritual healers.
One patient in a wheelchair at the start of the trial was walking about fit as a fiddle just a few weeks later, which ultimately led to the demise of Professor Ernst's reputation.
In the Q&A afterwards, Crispian asked how the test subjects reacted when they found out which groups they were in, and Profesor Ernst divulged that very few of them wanted to know.
What I want to know, is why are people so ready to believe these quacks? What is it that is so appealing to them? And why do many of them wear hippyish clothes?