What doctors don't tell you

Warning: May cause apoplexy.

Since 1989 husband and wife team Lynne McTaggart and Bryan Hubbard have been running a website called What Doctors Don't Tell You. Now they are publishing a magazine with the same title.

It wasn't easy finding a copy, which is a mercy. One newsagent in Camden told me he received an unsolicited batch yesterday and sent them straight back because he didn't like the look of them.

Who are McTaggart and Hubbard? She has form as an anti-vaccination campaigner. In one of her books, The Intention Experiment, she says that the universe is connected by a vast quantum energy field and can be influenced by thought. He recommends vitamin C as a treatment for cancer and they complain about the Cancer Act which prevents them promoting their 'cures'. So I think we know what we're dealing with.

There is a bit of common sense here - get some exercise, don't eat junk - but my main issue with WDDTY is that the average reader has no way to tell crap from Christmas and, for some of the articles, nor do I without reading every single research paper they mention to check all the trials and tests were randomized, placebo-controlled, double-blind, peer-reviewed and had sound methodology and good sample sizes. But I do know when I'm being obviously manipulated. I may not be a rodentologist but I can smell a rat a mile off.

The main message of WDDTY is BE AFRAID. BE VERY AFRAID.

Doctors misdiagnose, make mistakes in prescriptions, constantly break the law by treating patients like 'lumps of meat' and not discussing treatment options properly. If your doctor doesn't kill you, your dentist will by X-raying your teeth. Whipping up fear that a visit to the doctor might kill you is McTaggart and Hubbard's strong suit. Even worse, it might kill your children. This is the trump card as the main audience for magazines like this is women. Around 80% of the pictures of people in WTTDY are of women (I'm not sure about the dogs and the piglet).

There's more. The antidepressants your doctor prescribes you will probably kill you. So will painkillers. Two thirds of people on prescription drugs end up in a worse state because of them. Cancer screening doesn't save lives. Sunblock causes diabetes. Prescription drugs 'are playing a big part in the mental and physical decline of the elderly, and may even be a contributor to premature death'. Note the 'probably' and the 'may even': there's a lot of that in WDDTY.

It's one scare story after another. But there is some good news. Forget about medicine, don't go to the doctor, take supplements. Pretty much every article has a suggestion of a 'proven' alternative to medicine which is either dietary supplements or 'alternative' medicine. Oh, and homeopathy works! This has been proven by a Swiss study that relies on 'real-life' cases rather than academic studies, they say.

There is a long list of superfoods too. Because they're natural. And natural is good. Unlike doctors and prescription medicines, which are unnatural and very very bad.

WDDTY is big on food allergies too. There are lots of stories about various conditions caused by them. Perhaps this is because the magazine is 'supported by some of the world's leading pioneers in nutritional, environmental and alternative medicine'.

Whatever is wrong with you, or whatever you fear you might get in the future, supplements will see you right. It's a bit like psychics who make a prediction then, if you say it hasn't happened, they tell you it soon will.

In the same way that cigarettes are nicotine delivery systems, WDDTY is a supplement advert delivery system.

There is a huge range of unscientific and anti-science propaganda here, all the usual cobblers that a proper scientist could spend weeks demolishing. There are also a couple of articles that are more worrying.

The first is the case study of Nerissa Oden. She says 'I healed myself of severe dysplasia (abnormal cell growth) and HPV (human papillomavirus) in just six months'. How did she do this? 'A friend who is a chiropractor and nutritionist suggested I get tested for hidden food allergies'. Nerissa also went to a naturopath 'who recommended a list of vitamins and supplements that I should start taking'. Nerissa turned down a biopsy and a D&C (dilatation and curettage). After six months on the special diet, she got a good result on a Pap test but then fell off the diet wagon and got a bad result, so she went back on the diet for another six months and upped the supplements.

Bingo. A Pap test came back normal and a gynaecologist declared her cured.

At the end of the article is a handy list of 'helpful supplements'. There's a surprise. It's like a kind of cult. A cult of idiocy.

Why is this worrying? It may cause women to self-diagnose, self-treat or turn down life-saving medical procedures. It will certainly cost them a lot because supplement manufacturers are not charities. It will put readers in the hands of unqualified, unregulated shysters. It may make them take an equally irrational and dangerous approach to other health issues and other areas of life. And if not them, then their children (see, I can play the kiddie card, too).

The second article, the longest one in the magazine, is about HPV vaccines. They are evil. Lynne and Brian don't seem to have read Nerissa's story where she lists all the cancers that HPV can cause and says how serious it is. Nor do they seem to know that the NHS and Cancer Research UK says that it's the second most common cancer in women under 35. In the editorial, they say it's not a serious issue and the article says it's 'uncommon'. But, given how inaccurate and unscientific the rest of the magazine is, why would this article be any different?

The article, by McTaggart, says that cervical cancer is a third world problem, a 'disease of poverty and unhealthy living'. She talks about the huge number of side-effects but lists only the serious, scary ones. The article bombards the reader with statistics and 'facts' and ends by claiming that the vaccination will 'at best' save 40 lives in the UK while harming huge numbers.

She accuses drug companies of using extreme scare tactics to promote the vaccines and make money - which is a bit rich when the magazine is shot through with scare stories to promote supplements and alt med. Incidentally, the supplement market was reported as worth 27 billion dollars in the US in 2009, and growing.

I don't know if the vaccine is safe or not. I don't know if it's as effective as it claims. I don't know how many lives it will save. But I'm much more inclined to listen to the opinions of scientists than quacks peddling what I do know are unproven and potentially dangerous treatments. There's some common sense about the vaccine 'controversy' here.

If this post has given you apoplexy, take a vitamin supplement and you'll be fine. I'm a doctor* and I'm most certainly not telling you to buy this magazine.




*Not a medical doctor. I may start a magazine on all the things that humanities PhD doctors aren't telling you.

Dr Jesus in the dock

In May last year I wrote about Dr Richard Scott who was being investigated by the General Medical Council for aggressively preaching at a vulnerable patient. Scott practices at the Bethesda Medical Centre in Margate, which is run by six Christian GPs.

The GMC has now reached a verdict and the findings are published here.

Scott's lawyer, Paul Diamond, works for the Christian Legal Centre and is no stranger to cases like this. He said that 'a degree of deference should be given to an experienced GP who is embedded into the local community, particularly one who has a reputation for the care he provides to his patients.'

Scott didn't give any deference to a vulnerable patient, or his beliefs. Deferring to someone simply because they are a figure of authority is a demand generally made by dictators and Victorian patriarchs. The GMC agreed and said:

In deciding whether to issue a warning the Committee must apply the principle of proportionality and weigh the interests of the public with those of the practitioner.

In other words, there should be no deference if it's harmful to patients. The GMC is not anti-religion or anti-Christian. The findings stated that GMC guidance acknowledges the role of faith issues in medical care and the right of doctors to raise such matters within the consultation provided that it is done with the patient’s consent and with sensitivity and respect for any faith they might have...on this occasion your behaviour in presenting your faith to Patient A had exceeded the boundaries set out in the guidance and, to use his words, “had gone too far.”

Way too far. Scott was found guilty of saying that:

If Patient A did not turn towards Jesus and hand Jesus his suffering, then Patient A would suffer for the rest of his life.

His own religion could not offer him any protection and that no other religion in the world could offer Patient A what Jesus could offer him.

The devil haunts people who do not turn to Jesus and hand him their suffering.

You told Patient A that you were not offering him anything else because there is no other answer and that he will keep suffering until he is ready to hand his suffering to Jesus.

This is way beyond offering to pray with a patient or asking them if they would like to discuss their beliefs. Scott was once a missionary in Africa; his behaviour in the surgery suggests that he is of the fire and brimstone school, threatening and bullying people into accepting his faith, conjuring images of the devil to batter them into submission. So much for 'first do no harm'. What's more, so much for 'God is love'.

The GMC found that Scott's actions also contravened Paragraph 33 of Good Medical Practice: You must not express to your patients your personal beliefs including political, religious or moral beliefs, in ways that exploit their vulnerability or that are likely to cause them distress.

They warned Scott that Further serious or persistent failure to follow GMC guidance will put your registration at risk.

In other words, he could be struck off. But further action relies on further evidence that he is ignoring the ruling. This means that other patients would have to be brave enough to stand up against this figure of authority, know enough to take their complaint to the GMC and be strong enough to give evidence at a hearing. Not everyone may be capable of doing this either against Scott or other doctors who behave in the same way.

The Committee ruled that this warning be attached to Scott's registration:
During a consultation with a patient in August 2010 you expressed your religious beliefs in a way that distressed your patient. You subsequently confirmed, via National media, that you had sought to suggest your own faith had more to offer than that of the patient. In this way you sought to impose your own beliefs on your patient. You thereby caused the patient distress through insensitive expression of your religious beliefs.

The warning will stay on his registration for five years.

Scott called the hearing 'a charade'. This translates as 'I didn't get my own way' or 'How dare they enforce the rules that I agreed to abide by when I became a doctor?'. Possibly, he stamped his feet as well.

Entirely predictably, the Christian Medical Fellowship has responded with its usual wailing about 'the growing marginalisation of Christian professionals and the rise of militant secularism in Britain’s institutions.'

Christian Concern commented that “Our society seems to becoming more and more repressive, with ordinary, decent people being reported to the authorities and disciplined, not for committing any crime, but just for expressing their Christian beliefs.”

Ordinary, decent people do not bully and threaten the vulnerable, they do not abuse positions of authority and they do not expect special exemptions from rules or laws when it happens to suit them. Whether a practice run by six Christian GPs who advertise their faith on the practice web site is serving the whole community in which Scott is 'embedded' is another matter.

ETA: 18 June

Christine Odone writes her usual ill-informed propagandist response in the Telegraph. However, she does make a good point that the GMC 'allows doctors to promote the healing effects of homoeopathy, chiropractic and reiki, also known as palm healing — which are all unsupported by Western, evidence-based medicine but are backed by belief systems'.

Dr Scott would of course claim that there is plenty of evidence that faith heals and has also spoken in favour of homeopathy.

This doesn't mean the GMC ruling on Dr Scott was wrong but it does suggest that they are inconsistent in their approach and need to be more stringent about evidence-based medicine.

ETA: 20 June
There's an interesting take on the story and the alleged efficacy of prayer by Dr Robert Winston.

ETA 22 June

Dr Scott has now told Pulse magazine that he is not going to change his behaviour.

He said: ‘If anything it will make me even more determined to do it. I showed the GMC all the statistics that showed that spiritual care really helps people's health. Doing God is good for your health. That is the message we tried to get across to the GMC, which they abjectively (sic) failed to grasp.'

He also said: ‘We have evidence-based medicine and if doctors are not providing spiritual care they are actually harming patients.'

It appears that Dr Scott and the GMC have a different interpretation of 'evidence'. They also appear to have a different interpretation of what abiding by a code of practice means. Scott appears to be saying that all the generations of doctors who have been keeping their beliefs out of the surgery have in fact been doing harm to their patients. That's a pretty big accusation.

In addition to spending years learning how the body works and how to fix it when it goes wrong, medical students really should be learning how to preach the gospel. And if they're not Christian, they'd better convert pretty damn quick because believing in any other faith is tantamount to gross medical negligence. Atheist doctors are just criminals.

Scott also ignores the difference between having a faith and being bullied. Some people may derive a sense of well-being from their beliefs, and may avoid more harmful behaviours because of them. But being told that your god is inferior and that the devil is after you when you're already ill or in a vulnerable state is not likely to make you feel better.

Dr Scott also said that the GMC had downplayed the severity of the warning. ‘It's a drag, because if someone else complains to the GMC, then it's two yellow cards equals a red.'

Yes, it's a real drag when you're forced to obey the rules. Bummer, dude.

Scott may see himself as a martyr but his reaction is neither scientific nor humane, two of the main requirements of a doctor. It's just plain arrogance.

Niall Dickson, chief executive of the GMC, said: 'Our guidance is clear - doctors must not impose their own beliefs on their patients or cause them distress by inappropriately expressing their own views. This is not about religion, it is about respecting patients and making sure doctors do not use the incredibly privileged position they hold to push their own beliefs, however strongly held they may be.'

Watch this space.

A Christmas Ghost Story

It's traditional to tell stories about ghosts and spirits at Christmas. Let's imagine it's a still, icy, night. Small things die silently in the dark and the light of the full moon glints on sharp, merciless teeth.

In 1990, consultant psychiatrist and hypnotherapist Dr Alan Sanderson M.B., B.S. (London), M.R.C.P., D.P.M., M.R.C. Psych. returned to clinical practice after years of 'personality research'. He found psychiatry 'still stuck in the pharmacological morass' so he came up with the Spirit Release Foundation (SRF) 'to train medical practitioners and others to help people who are troubled by spirit attachment'. The SRF's members 'share a belief in the primacy of spirit and the soul’s development through reincarnation' (although they claim not to be religious).

What might spirit attachment be? According to the website:

'A minority of those who die fail to make their transition from this physical world successfully. They become what is known as ‘earthbound’, because they remain mentally attached to the earth plane and so cannot progress. Reasons for this include a traumatic death, concern over some unfinished business or anxiety for a loved one on Earth. Attached spirits may manifest in a variety of ways. They may attach to a person, or to a place with which they were associated in life, that place becoming haunted'.

Basically, it's ghosts haunting buildings and possessing the living. Even though the therapy is aimed at medical practitioners (among others), there is no attempt at scientific evidence on the website. One practitioner does explain the mechanism on their own website: 'Everything in the universe is made up of energy, spirit release simply deals with energies most of us cannot see and for the most part are unaware of... Spirit Release is really all about how external energies can, on occasion, affect our energy system in detrimental ways'.

'Energy' is the alternative medicine practitioner's friend, an undefined, unscientific term to explain pretty much anything. It is not the capacity of a physical system to perform work. This 'energy' is not measured in joules, kilowatt-hours or kilocalories.

Diagnosis is hardly more scientific:

'Some of the more common symptoms of spirit attachment can be: lack of energy, memory disturbance, behavioural change, mood change, addictive behaviour, relationship problems and hearing disturbing voices. There may be bodily pain and other physical symptoms. The degree of attachment also varies. Some individuals are scarcely affected, while in rare cases the individual's body and mind have been taken over completely. There may, of course, be other reasons for the presence of these symptoms, which a practitioner should investigate'.

The range of symptoms is so vague and general that almost any condition can be ascribed to attachment. The caveat that there may be other reasons for symptoms has the appearance of responsibility but how many practitioners are qualified to diagnose symptoms - and then hand the patient over to medical care (thereby losing their fee)?

Why aren't doctors spotting that their patients are troubled by earthbound spirits?

'Spirit attachment is not uncommon and is often misdiagnosed because many practitioners are not aware of it and because the symptoms might fit a number of possible diagnoses. In some instances attachments exacerbate an existing complaint with similar symptoms. They may be the reason that recovery from a complaint is very slow.'

The implication is that trained doctors are getting it wrong with their insistence on using their medical training. Even if a patient has been diagnosed with a genuine medical condition, it could be made worse by spirit attachment. They really have covered all the bases.

How do they cure this terrible problem that no-one had heard of until the SRF came along?

'Spirit Release is a two fold process. Firstly it involves releasing earthbound spirits from their condition of attachment in a compassionate, non-confrontational way, by contacting the spirits and communicating with them. Spirit helpers are then called upon to move the spirit on to its rightful place in the universe. The person who has been affected by the attachment is also offered healing, counselling or other therapeutic help, including advice about psychic protection'.

So basically, they give the spirit a hug and call it a taxi? Once they've dealt with the dead, they help the living too -possibly because the dead don't have credit cards.

Pretty much anyone can be affected:

Spirit Release is also about 'freeing the ‘stuck’ aspects within ourselves that invite spirit attachment, which may involve looking at past-life patterns, ancestral karma and any difficult influences that stem from childhood or later life'.

This is their version of preventive medicine (or maximizing your market share).

Therapy takes two forms. 'The Interactive Approach involves putting a client into an altered state of consciousness, through a form of hypnosis, in order to allow any attached spirit to communicate safely through them. A dialogue ensues, in which the spirit is induced to leave'.

Hypnosis is a tricky process, it's very easy for an inexperienced or unethical therapist to plant ideas, deliberately or otherwise. There can also be issues with False Memory Syndrome. There is a huge amount of trust required - a patient is hypnotised and when they come round they're told that the spirit possessing them has been persuaded to move on. This treatment is open to considerable abuse, aided in part by the placebo effect.

Alternatively, the 'Intuitive Approach is made through the psychic awareness of the therapist who learns how to communicate directly with a spirit. This does not necessarily require the active involvement of the client. It may be practised directly or at a distance'.

There's no indication of what happens if the spirit doesn't want to leave. The process as described is very benign, very low-key and reassuring as if it's no more than having your ears syringed.

If you feel there's a spirit inside you, there's a list of practitioners in your area.

The SRF may be a small group but they shouldn't be too readily dismissed. For example, the SRF website also suggests that gender dysphoria could be caused by spirit attachment and that Spirit Release is an alternative treatment to gender realignment surgery. They are part of a larger movement ascribing a whole range of problems to spirit possession. The Christian Medical Fellowship (CMF) who are mostly GPs believe that mental illness among other problems can be caused by possession. There have been exorcists working with the NHS for forty years, as I wrote about here and you can read another piece I wrote on exorcism here.

The main problem with both the apparently cuddly SRF and the much less fluffy CMF is that practitioners' world view is predicated on unseen entities, some malevolent, some misguided. They are creating a problem and offering a solution to people who could well be in a vulnerable state and in need of proper medical attention. Even if the SRF are just treating people with more money than sense, they are dealing with people's mental and possibly physical well-being. Although the SRF claim that they are not a religious organisation, theirs is the same mentality as the churches that use violent - and sometimes fatal - methods to exorcise people, whether these are African evangelical churches or both the Catholic Church and the Church of England with their trained exorcists.

It would be interesting to know what church exorcists make of these rivals. As with religions, they can't all be right with their competing world-views of demons versus disincarnate humans.

Another problem is that anyone with a few hundred quid to spare can become a spirit release therapist. It costs £30 a year to be a member of the SRF and the Foundation Course costs £210. There's a leaflet about the upcoming London one here.

This way of thinking also leads people to blame outside agencies for problems in their lives rather than either taking responsibility or getting medical help. It can create a dependency on therapists. There's a kind of contamination theory at the root of the SRF; they are making people believe they have been 'infected' and need to be 'cured' except that they're not talking about bacteria or viruses, but the dead- truly alternative medicine.

This is a Christmas ghost story with no Tiny Tim happy ending.

We are Legion: religion and mental illness

One last look at the Christian Medical Fellowship (I hope). For first-time readers, the CMF is a group of British Christian doctors, around 4500 strong.

The CMF has a guidance section on its website called Demon Possession and Mental Illness which asks if doctors should 'see demonic influence as being a neglected aetiological factor within a multifactorial model for the aetiology of mental disorder?'

In other words, should doctors include possession by the devil in the list of causes for mental illness ?

The CMF's answer is yes.

This is in another category entirely to the usual CMF guidance as it is predicated on a world view that includes demons as real and active beings rather than a selective or fanciful use of data to support a religious moral stance. It is not a matter of claiming that condoms don't work, homosexuality can/should be cured or that abortion leads to insanity and social breakdown (as I have covered in earlier posts). This is a matter of practising medical doctors who believe that demons exist and possess people.

I suppose it shouldn't be a surprise that people who believe in the existence of a deity also believe in his opposite number but there are many doctors (and others) who have faith but do not go this far.

The guidance refers to an article called Demons and The Mind by Roy Clements, published in Cambridge Papers (Towards A Biblical Mind) vol 5 no 3 September 1996. Clements has a PhD in physical chemistry and a diploma in theology. At the time of writing, he was minister of Eden Baptist Church in Cambridge.

This article is not available online but I have a copy. In it, Clements argues for a more holistic model of the human personality in which 'mental illness might be caused by faulty body chemistry (physical influence), dysfunctional family experience (social influence), demonic assault (spiritual influence) and unresolved guilt (personal sin).' (my italics)

He recommends that 'drug treatment, psychotherapy and exorcism should not be regarded as mutually incompatible remedies but as complementary therapeutic interventions, each exploiting a different facet of human nature'. This holistic model, he believes 'can do justice to both modern science and the Bible'. In other words, he is placing science and the supernatural on an equal footing.

He is also seeking to exploit the current trend for so-called alternative and holistic treatments, stating that 'many people today are dissatisfied with the hubris of modern medical science and are sympathetic towards more holistic forms of therapy'. The CMF echoes this sentiment with 'not all human problems will be explicable by medical science'.

Three points come to mind:

1. These are scientifically trained doctors, paid for out of public money, many of them working in GP surgeries around the UK, not people who have bought bogus PhDs from imaginary American colleges seeking to fleece the gullible and the desperate or New Agers using vague terms like 'energy' and 'natural' and 'detox' to sell their products.

2. Medical science doesn't claim to treat all human problems. No branch of science claims to know or explain everything. It's not how much you know, it's how you know it - evidence-based, peer-reviewed, replicable testing would be a start.

3. Anyone talking about the hubris, arrogance, coldness etc etc of modern medicine usually has something to sell based on an unassailable certainty that they are right.

Clements is very clear that he wants exorcism and related 'treatments' to be firmly based in the English Protestant tradition, which would require an approach 'far more responsible than that which prevails in much of the deliverance ministry scene at the moment'. None of your foreign all-singing, all-dancing exorcism, then. (Much deliverance ministry is done in the UK by Afro-Caribbean churches).

Catholic exorcism has traditionally been far from the variety Clements is proposing. Just one example is Father Gabriele Amorth, a Catholic exorcist working in Rome. Amorth says that 'he always asks for someone's medical history and consults a psychiatrist if he thinks it useful. On the other hand, he argues that only performing an exorcism provides certainty, because it is in the reaction to the exorcism that one detects the presence of a demon. Besides, he said, "An exorcism never harmed anyone".' It would be interesting to know his definition of 'anyone'.

They really haven't thought this one through.

1. Would Clements' Protestant version be any safer?
   
2. What safeguards would there be?
   
3. Are the CMF proposing that deliverance should be recommended or even practised by NHS doctors?
   
4. Who would train these doctors to recognise the signs of possession?
   
5. Would there be a demon-spotting module in medical degrees?
   
6. What about non-Christian doctors (and nurses too), whether atheist or of other religions?
   
7. Would there be discrimination against patients who do not share this belief or who reject a diagnosis?
   
8. What about equality of service provision?
   
9. What do the BMA think about all this?
   
10. And many other questions.

The CMF guidance lists a series of examples from the New Testament where Jesus casts out evil spirits; the list includes an episode, repeated in all three synoptic gospels, where an epileptic boy is cured in this way. No doubt, as doctors, CMF members know the difference between epilepsy and mental illness, which makes it even more puzzling for them to include it. There are cases of epilepsy being confused with possession throughout history right up to the present day but lumping it in with mental illness does nothing to help the stigma of it.

Incidentally, demon possession 'may also be an aetiological factor in some non-psychiatric conditions' - although there is no mention of which ones. Kidney stones? Diabetes? Cancer? A broken leg?

The CMF guidance is reproduced on a website with the innocuous title of Ethics for Schools, which is entirely written by Christian doctors for students of philosophy, ethics and religious studies.

Just in case it looks like the CMF are the only villains or that I am unfairly targeting them, as a random sample, the website schizophrenia.com might be expected to deal with mental illness in a scientific or at least objective way. The home page seems entirely rational, helpful and informative. Except that the site also promotes schizophrenia as a marketing opportunity for God: 'the Bible has great relevance to the needs and questions among families of the mentally ill. (...) These families comprise a huge, overlooked target group for evangelism.' It's not the same thing, but it is another example of religion trying to stake its claim on mental illness.

On a personal note, the death knell of my (mercifully brief) teenage religious phase was sounded when the leader of a youth group I belonged to told me that he had visited a local mental hospital and was convinced that the illness of some of the patients was clearly caused by the devil possessing them. He was not a doctor but a dentist, someone who had also received science-based training.

I sincerely hope that I am now done with the CMF.