The Way we see the world
This month I have been inspired by David Hockney’s brilliant, colour soaked, life affirming exhibition at the Royal Academy. Hockney is a great master of seeing, and much of his present enormous recent output at the Royal Academy is a lesson in the art of seeing.
This month how we see things is a theme that runs through a few of my diverse ramblings. How we see the role of exercise in our health, listening in medical diagnosis, clear discernment verses dogma, in science and taxes in our civilisation. Enjoy.
Inactivity Is a Universal Risk Factor for Heart Attack
A new study, drilling down into exactly how physical activity and its different components contribute to the risk of heart disease, doesn’t turn up any huge surprises but does confirm that inactivity is “a universal cardiovascular risk factor,” lead author Dr Claes Held. Held and colleagues published the results in January 2012 in the European Heart Journal (Click here to read more). Not all that surprisingly there is an association between TV and car ownership and the risk of heart disease, which really is telling us to get off the couch once in a while as well as to walk or bike rather than take the car.
As with all such studies, we get a little more confirmation of what we knew already. Which is; we need to move more to prevent things like heart disease. Hardly news, but the real challenge is as much for politicians and town planners. How to design a living/working environment where we all become a little more Danish. In other words we all cycle or walk to work more, and when we get there are not so confined to our chairs.
The study, once again, shows that, as far as exercise, something is invariably better than nothing. Even as little as 15 minutes a day, while too little for optimum benefit, will have some beneficial effect. New research from Nottingham University, recently reported on in BBC Horizon (read a review here) pitched the beguiling idea that all you need to do is 3 minutes a week. That is not quite the whole story, but an interesting insight into some of the power of High Intensity Training, HIT. What one does have to remember is, that although there are clear benefits from such intense and generally brief training, it hurts! Everything in your brain screams not to keep doing it. You can train your brain to ignore this to a large extent, pay a trainer to cheer you on, while some of us are sufficiently masochistic to go for it, generally many of us cannot get ourselves near this level of maximum exertion even for 20 seconds, accept, perhaps, at the opening of a major department store sale.
Beware of the chair, get up and keep moving, is the overall message for us all.
To see Why Bother with Exercise check out our interesting article of the same name here.
A New Medical Entity: McCoys Syndrome?
A nice little article in the Lancet, called the McCoys Syndrome, caught my eye recently. The authors, Martinez & Ignacio de Padua recall the science fiction character Leonard McCoy —the doctor of the starship Enterprise in the original Star Trek television series. (Read The Lancet article here) The story takes place in the 23rd century, where he uses a “medical tricorder” with a hand-held sensor to examine patients. This apparatus lets him make precise diagnoses, without the need to interview and examine patients in the traditional way.
While it is true that astounding advances in technology are cropping up everyday leading to previously unimaginable advances. Functional MRI is just one recent example, whereby we are able to look into the workings of our own brains. Such brilliance can lead to an over reliance on medical technology particularly imaging. As they say;
This is something that is so clearly seen in neuro-musclular-skeletal medicine, where with all the imaging in the world, the answer, more often than not, lies in the careful questioning and examination of the patient before you. Using nothing more advanced than your own hands and brain, allied to a good number of decades of hard won experience and learning.
The Witch-hunt boys are moving down under: Bellicose and Tribal.
It is always sad to see the constant and ignorant misuse of the term ‘science’ when those, who should know better, attack anything in science or medicine that they cannot understand. In a recent article in the British Medical Journal Ray Moynihan, author, journalist and conjoint lecturer at the University of Newcastle, Australia, reported on the latest campaigns to cleanse complementary medicine courses from universities to hit Australia from the UK.
“A new group called the Friends of Science in Medicine wants to stop what it calls “pseudo-science” on campus, and vice chancellors at many of Australia’s universities are in its sights. So is this a reasonable reassertion of scientific principles or a bellicose, tribal attack on the competition?
The campaign is targeting many modalities, from acupuncture, naturopathy, and chiropractic to energy medicine, homeopathy, and tactile healing. While saying that it supports research, Friends of Science in Medicine argues that “universities involved in teaching pseudo-science give such ideologies undeserved credibility, damage their academic standing, and put the public at risk.” Vice chancellors are being urged to discuss with science faculties the “withdrawal of these courses,” and further campaigns aimed at insurers are being flagged.
“It’s a witch hunt,” says Southern Cross University’s Stephen Myers, a leading complementary medicine researcher and trained naturopath, a medical doctor, and author of government funded reports urging the integration of traditional Chinese medicine and naturopathy into the mainstream. “All health professions are currently under a call to increase the evidence base. Complementary medicine is in a similar situation, yet what this new group is calling for will remove individuals from academic positions that have capacity to contribute to that evidence base.”
As so often happens the local tribal taboos of the scientific and medical establishment scare off many but the bravest and most discerning from ‘coming out’ and questioning such blatant bias and ignorance. In a future blog I will be reviewing Rupert Sheldrake’s interesting critique of such anti science dogmatism in his latest book, The Science Delusion. See Sheldrake ‘s article in the The Observer.As Sheldrake says;“A lot of our old certainties, not least neo liberal capitalism, have been turned on their head. The atheist revival movement of Dawkins and Hitchens and Dennett is for many people just too narrow and dogmatic. I think it is a uniquely open moment…”
His hope is that there will be a “coming out” moment in science. “It’s like gays in the 1950s,” he suggests. “I think if people in the realm of science and medicine came out and talked about the limitations of purely mechanistic and reductive approaches it would be much more fun…”
A key hostile campaign figure in the UK is the University College London professor David Colquhoun, who is helping his Australian colleagues. Asked about concerns from academics that a witch hunt might be under way, he said, “Good, that’s the intention. I’ve got no mercy for vice chancellors and senior medics. I don’t mind going for the jugular, because it’s a betrayal of what universities are for, it’s going back to pre-enlightenment.” Professor Colquhoun dismisses the field as nonsense, its advocates as quacks, and ancient wisdom as “mostly wrong.”
At the same time it’s no secret that much conventional medicine is unsupported by good evidence. As with many complementary therapies, the BMJ Group’s Clinical Evidence currently classifies many surgical and medical interventions as being of “unknown effectiveness.” In Australia it is estimated that most of Medicare’s 5000 items “have never been comprehensively assessed for their safety, effectiveness and/or cost-effectiveness.”Dis-investing from ineffective and potentially dangerous mainstream treatments can also prove difficult. And much of so called scientific evidence is debased through the systematic bias that tends to flow with commercial funding.
Any “friend of science” would surely be horrified by much of what happens inside conventional medicine, yet the campaign in Australia is aimed solely at the complementary sector.
As Ray Moynihan goes on to point out,
” Bensoussan, a complementary medicine researcher at the University of Western Sydney, says that although the Friends of Science in Medicine sounds innocuous enough, he fears it is an attempt to purge universities of learning about areas such as Chinese medicine, approaches that could produce new ways of dealing with some chronic diseases.
In any mode of medicine over-promoting what may do more harm than good is as bad as building markets by making healthy people feel broken and in need of fixing. No doubt academic standards in some complementary medicine courses could be tightened and materials improved or removed. But wielding the sledgehammer may well undermine campus conversations that could ultimately enrich our scientific methods and our capacity to face the complex health challenges of the future”.
So there you have it, once again an interesting area of research and debate is besmirched by dogma and fundamentalism. The use of money, power and prestige to crush things that are sometimes nuanced, hard always to immediately understand and often opposed to the prevailing market forces, is hardly new. Sometimes those who are most established in the power structures of wealth and prestige use these privileged positions, sadly, not always for the purest of motives. As we have seen, write large, in our economies of late.
Book of the Month
The Price of Civilisation: Economics and Ethics After the Fall.
If you were to tackle one book of economics this year, this would be high on my list.
That is even though it is almost totally dominated by the American experience; using other countries experiences mainly to point out, to the home crowd, how others can and do, do things differently.
We are in danger of a too myopic a view on the world, linked as we are in this Anglo-Saxon financial pact with the twin financial giants of London and New York. They tower over all our lives. We are fed a USA-led diet of news and media to the sad exclusion of other ideas, cultures and even gossip, closer to home. (Did you know, for example, that Princess Victoria, the Swedish princess, not long married to her charming commoner, her personal trainer, has just had a daughter? No I thought not. Not of any importance you might say, but I bet you heard all about the Oscars going on in far away California or the death of another American diva, recently.)
Back to Sachs. I enjoyed this book at the same time as America was being publicly shamed around the world by the sadly deluded, false ramblings of one excruciating Republican hopeful after another, bringing public debate to new levels of baseness. In counter distinction, Sacks, admittedly in the sometimes somber style of economists, lays out the sad state of affairs in the USA, not that dissimilar to our own similarly degraded affairs, and then like the clinical economist that he is, addresses the disease with his diagnosis and treatment. As Oliver Wendell Homes is reported to have said in a speech in 1904, Taxes are the price we pay for a civilized society. Sacks points out the impossibility of building a sound, just and economically balanced society when the rich scarcely pay taxes and the corporatocracy hold sway in all levels of government.
Part of his overall convincing medicine for the sick state is his prescription of “Mindfulness”, which in this case we learn, comes in eight dimensions, and is conveyed along three paths: cognitive, meditative, and practical. These paths lead to eight economic goals for the next 10 years – to “raise employment and quality of work life”, “improve the quality of and access to education”, “reduce poverty”, “avoid environmental catastrophe”, “balance the federal budget”, “improve governance”, “national security”, and “raise America’s happiness and life satisfaction”.
One can but dream that politicians could stay in power long enough to lay out and implement such clear and self evident goals.