Friday, 11 May 2012

Keeping it real...

I may have mentioned in passing that I've been receiving quite a lot of excellent medical treatment over the last few months...

Proper medicine, I mean. You know the thing: carefully worked-out treatments, tested on scientific principles, applied by highly-trained health professionals. Stuff that works.

OK, some of it is a bit harsh and has left me tired and occasionally feeling quite sick. But since it is also stopping me from dropping dead from brain cancer, I have to wholeheartedly regard it as A Good Thing.

But there is also the other kind of medicine, which ain't.

I was obliquely warned about it, back when I was diagnosed and my programme of zapping and poisoning was being explained to me: one of the nice medical professionals at the Beatson mentioned that I would come across alternative treatments, including homeopathic ones, and while I wasn't explicitly told not to pursue them, I was warned that they could be very expensive and told I would already be getting the best treatment available from medical science.

The implication was very much: "Don't waste your money and time, and our efforts, on such witch-doctoring. Stick with us, we'll look after you".

And I was more than happy to do that. In fact, at the mention of homeopathy in particular, I was keen to stress that I already had a water tap in my flat which provided all the useful drugs present in any homeopathic treatment. Which would be none.

The nurses and doctors in the room at the time seemed quite pleased about that. I wonder if it galls them that just yards away from the centre of clinical excellence which is the Beatson, there is the Glasgow Homeopathic Hospital, and both are funded by the NHS? That while they're saving the very, very ill with bleeding-edge science, often very expensively researched right there in Glasgow with hard-fought-for funding, just across the car-park someone else is handing out stuff which chemically can't contain the active ingredient it purports to but which has been rapped on the packet with a bit of leather?

It bugs the hell out of me, certainly. I'm not alone in this: a couple of years back a Parliamentary Select Committee even recommended that homeopathy should no longer be funded by the NHS  - there's a very good argument for why it shouldn't on Richard Dawkins' website if you're interested. The committee's recommendations don't apply in Scotland, though, so in the meantime we keep funding a whole hospital dedicated to the dispensing of stuff which we know works no better than placebo - only because, as far as I can gather, it became popular after some of the more bonkers members of the Royal Family expressed an enthusiasm for it.

At least the rest of the assorted quasi-medical toss out there isn't funded publicly. Which is good, because there's a lot of it.

I see it like this...

On the one hand, we have medicine. This is stuff which has been found to work over the years, then adapted, refined and tested until it works better. Some of it is still being tested, which is why I go for an itchy jag in the thigh once a month as part of a clinical trial; just doing my bit.

On the other hand, we have herbalists, the memory of water, non-contact massage, energy sources, chakras, crystals, chanting, and dried bits of endangered species - I have no idea why they have to be endangered, but apparently powdered scrotum is much more effective when it comes from a tiger rather than, say, a sheep.

Some of this stuff has been tested and been proven to be nonsense, but most of it hasn't because that would mean someone somewhere might have to stop charging people for it.

Dara O'Briain put it well: "Herbal medicine has been around for thousands of years. Indeed it has. And then we tested it all. And the stuff that works became 'medicine'. And the rest of it is just a nice bowl of soup and some pot-pourri."

But it is often more sinister than that: starting with the ground tiger 'nads, via African witch-murders, to this week's horrifying story that South Korea has on various occasions seized a Chinese-originated "drug" apparently made from dried human foetuses or possibly even dead babies, which people take as a stimulant presumably until in a flourish of natural justice they drop dead from one of the many nasty things contractible from cannibalism.

Fortunately, in this country the consumption of non-medicine is mostly just silly people dabbling in the likes of reiki and ear-candling because of some sense that all that conventional medicine is full of chemicals and they should really be taking something natural and ideally foul-smelling (as well as the conventionally-prescribed chemicals, if they have any sense left at all - well, you never know, they might just help the pebble-clutching work). It's mad, of course, but it's their choice.

Which is important in a free country. But in order to make a choice, we need to be given proper information which we can understand. We need our doctors to tell us what the stuff they're giving us is for and what effects to expect. Mine have been very good at this.

We also need our alternative therapists - if we really, really must go down that route - to tell us the same about their particular flavour of snake-oil. So it needs to be analysed and labelled with all the rigour of real medicine, so that at least if someone is deranged or desperate enough to put it in their mouth or other orifice of choice, they know in advance that it has this, that and the next chemical in it, in these quantities, which will react adversely with that, this and the other chemical they might also be buying or even getting off a real doctor with a degree and everything. And thus they’re fully informed that the combo may well make their spleen leap up through their neck and try to throttle what passes for their brain.

Not unreasonably, the EU decided last year that if you want to flog herbal remedies within its boundaries, you should give people that information: which means test the remedy, label the remedy, and get the remedy licensed. And you should bear the cost of this because it is, after all, your business from which you wish to make money.

One result of this Euro-tampering, reports are at least implying, has been the provisional liquidation last month of the grand old Scottish herbalist Napier's, some 150 years after its first shop opened in Edinburgh.

I admit it is sad to see a small business fold, and such an old one at that. But 150 years ago we had no antibiotics, we barely had antiseptics, and the available anaesthesia was reasonably likely to be a mallet. Doctors were also something of an expensive proposition, and people were still licking willow trees when they had a headache. The local remedy shop probably had its place.

Now, though, in this brave new world of face-transplants, anti-retrovirals and stem-cells, we don’t really have the same need for such places. Particularly not if the remedies they offer include shoving a burning wax tube in your ear to sort out sinus pain. If there is a place for such institutions in the modern age, then it's surely to provide harmless relaxation and beauty treatments, not to dish out drugs or make any claims at real therapy. We have a health service for that, even private health insurance if you must.

If there is still a treatment need which can only be met by a patent powders shop, then that's because there's a hole in the NHS, a wonderful institution but not one which has escaped perforation over the years.*

I can think of one such. For the last 20 years or so, I have suffered from acid indigestion. It is undoubtedly diet-related - I know that rubbishy bread brings it on, for instance, while a nice loaf won't - but since some things cause it sometimes and not others, I've never established a definitive list of don't-eats. About six or seven years ago I took it to my then-GP, who did a blood test for a bacterial cause. When that came back negative, the NHS would go no further, or at least that bit of it wouldn't: I was told that testing for food intolerances was something the practice just wouldn't do but Napier's would, although it would take some time. I considered it but went to the chemist and bought some Rennies in the meantime, and never got round to it.

Anyway, some years later I rather fortunately contracted brain cancer, which meant I needed radiotherapy, and therefore steroids to keep my brain smaller than my skull, and therefore Losec to stop said steroids from eating through my stomach lining. That cleared up the burn no bother - I now laugh in the face of petrol station sandwiches.

Besides, the holes in the NHS are few and far between, at least here in Scotland. Next Tuesday I will pop into the Beatson once more to give them a huge quantity of blood, in exchange for which they will give me some cytotoxins which will stave off, at least for the time being, any thoughts my cancer might have of making a comeback tour of my right temporal lobe. And I will go gladly and in gratitude for a system for which my grandfather’s generation fought and voted and have left behind them for me to use, even though the treatment itself will make me feel quite sick.

Although perhaps not as sick as I feel when I see the Glasgow Homeopathic Hospital on the way in.

*Note to my US readers - and, yes, I do have some - this wee hole in the NHS doesn't mean that what you insist on calling socialised healthcare doesn't work: it just means that, like lots of things, it breaks if you screw about with it. Real tax-funded universal medical care would mean these little gaps in the service wouldn't exist, and our teeth would be as shiny as yours, too.