The Pie Man has been alerted to an article in the American Journal of Medicine by the erstwhile Edzard Ernst and Michael Baum, his co-signee of the notorious letter (inappropriately written on NHS note paper) to Patient Care Trusts (PCTs) all over the UK. In the letter – as you can see – they attempt to persuade these trusts (comprising mainly non-doctors) to thwart the desire of NHS GPs to send patients on the NHS to NHS medical qualified doctors practising homeopathy in NHS hospitals! I’ve written of this before and mentioned how I would have tolerated them writing to GPs to dissuade them from making these referrals but am abhorred by their attempt to go over GPs’ heads.

Anyway in this article in the AJMed. the two honourable and esteemed Disciples of Scientism (my words for them and the  other signees of the above-mentioned letter) once again lash out at homeopathy, this time in a crude and lazily written ‘article’. I have no intention of discussing their regurgitation of the same stuff they have been spouting for a long time but as they cite me personally, I feel I must respond.

Reference 1. in their article comes at the end of a paragraph that ends with a sentence that says ‘These individuals have a conflict of interest more powerful than the requirement for scientific integrity and yet defend themselvesby claiming that those wanting to carry out the trials are in the pocket of the pharmaceutical industry and are part of a conspiracy to deny their patients tried and testedpalliatives.’1

And the reference given is: 1. Kaplan B. Hypocrisy of attacks on homeopathy to be exposed soon. Available at: http://www.wellsphere.com/general-medicine-article/hypocrisy-of-attacks-on-homeopathy-to-be-exposed-soon/31269. Accessed April 3, 2009.

Now I can prove that I’ve not touched that article since April 3 so if you read what I said there, it will be crystal clear that it does not support the reference, thus illustrating just one aspect of how poor an article this is. I have never claimed that these professors are ‘in the pocket of the pharmaceutical industry and are part of a conspiracy to deny their patients tried and tested palliatives’. Perhaps Ernst just fingered me as what he thought of as an example of such an individual and pressed the speed-type button on one of the references he has on me. However  in the end I must admit defeat and take off my hat to these two eminent professors. It is no mean feat to get a lazily-written, supercilious diatribe, high on opinion and low on facts like this published in a prestigious medical journal. A colleague of mine has just had a brilliant riposte to the article turned down by AJMed – no surprises there! Perhaps he can be persuaded to put some of his excellent points in the comments section here.

So all that’s left to me is to order the Pie Man to deliver this pie to both Ernst and Baum. Ernst knows of this pie and once made a pathetic attempt to ‘refute’ it in his column in Pulse. To him I say: Meet me anywhere at any time for a debate on this. To Prof. Michael Baum, please study the pie carefully.  It was baked by the British Medical Journal after all.

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It’s official. Junk food is almost as addictive as heroin! And no I’m not being provocative just for the hell of it. (Provocative therapists should never be gratuitously provocative.) No, the men in the white coats with bad news this time are neurobiologists, Dr Paul Johnson and Dr Paul Kenny. The Daily Telegraph reports today how cutting edge rat-based research begun by Johnson at Guys Hospital London and continued in better weather at Florida Scripps Research Unit has shown that  ‘ brains may react in the same way to junk food as they do to drugs.’

Now let’s see what the Dr Pauls’ experiments on rats (a species with a huge overlap of DNA with humans as well as many other scientifically useful psychological similarities) tell us about addiction to Big Macs and other so-called junk food.

The long-toothed rodents were divided into three groups.

Group I: Normal amounts of health food.

Group II: Normal amounts of junk food (including ‘fatty meat products’ and ‘cheap’ (ie. Good value in the recession) ‘sponge cake.’ Yum-yum…

Group III: Same as II but in unlimited amounts.

The men in white coats found that the rats in Groups I and II were fine but Group III’s rats became binge eaters and quickly obese – addiction!  In an important announcement, Kenny revealed that ‘this is the most complete evidence to date that suggests obesity and drug-addiction have common neuro-biological foundations.’

I call on readers to resist all calls for increased tax and EU health warnings (including photographs of fat children and fat rats) on all junk food!

The Australian doctor Ainsley Meares was wrong when he wrote in A Way of Doctoring:

We learned great truths

Before the age of statistics

And we sensed where to go

Without rats to lead us.

As a concerned MD specializing in Provocative Therapy, it is my duty to inform you that the rat has much to teach the human about survival in adverse conditions. In the interests of the survival of the human race, I urge you to be as RATional as possible in your eating habits.

Good News!: A McDonalds restaurant will open next month at The Louvre in Paris. Cheap, tasty and scientifically proven addictive American junk food and the Mona Lisa available at The International Temple of Fine Arts – that’s what I call choice. As a devoted supporter of The French Revolution (Liberté, égalité, fraternité!) and the Constitution of the USA (Life, liberty and the pursuit of happiness!) all I can say is: “I’m lovin’ it!”.

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For many years husbands or partners of women giving birth have been commended for and even expected to be present during the process of labour. It was considered the modern norm even though holistic obstetricians such as Michel Odent warned against this. The results of multiple recent studies in different countries seriously questions the wisdom of applying this universally and even go as far as saying the father’s presence can increase the chances of a Caesarian section.

Fathers watching mothers giving birth is a relatively modern phenomenon. For many generations, birth was left to the women of the ‘tribe’ to support and help the mother through confinement. Then birth became a medical matter and obstetricians got in on the process. Although the medicalization of birth made some natural births unnecessarily stressful (compared to a normal home delivery)  doctors also saved many, many mothers and babies from horrible catastrophes. A hospital birth was considered the safer option because when things go wrong in childbirth, medical action often needs to be taken quickly.

In the 60s and 70s a new natural childbirth movement emerged. Headed by the holistic French obstetricians, Frederick Leboyer (whose wonderful book, Birth Without Violence – see great interview with him here – was a major influence on my medical career), Fernand Lamaze and the afore mentioned Michel Odent, the movement profoundly influenced our attitudes towards childbirth, interestingly much more so in Holland and the UK than in France itself. Suddenly home births were in fashion again and mothers were keen on giving birth in water.  Not surprisingly, fathers were encouraged to attend pre-natal courses and of course be there at the birth itself. However one of the pioneers of natural childbith, Michel Odent warned against the expectation for all fathers to be present at the births of their children. Now it seems that evidence has emerged to prove him right.

For many fathers this was a wonderful life-changing experience but for some it was a nightmare through which they were expected to put on not only a brave face but a smiling and happy mask as well! Some men were naturally terrified of the process and of course this was not exactly encouraging for their wives who sensed fear in the very partners to whom they turned to for encouragement and support.

Michel Odent always thought that the presence of an anxious father can make the mother tense and increase the incidence of Caesarian sections. The phrase ‘horses for courses’ comes to mind and perhaps it is now reasonable for me to say that not all studs make good midwives. For some husbands watching the birth of a child can be a miracle of rare device that makes them love mother and baby even more but others are better suited to pacing up and down the corridors of the hospital, cursing the No Smoking signs and waiting for that life-changing telephone call.

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People love to mock men who  buy Porches when they enter middle age. Common ways of belittling these guys is to mutter things like ‘mid-life crisis’ or ‘male menopause’. Well it turns out that fast cars, especially fast red cars really are good for the health of middle-aged men!

There is now evidence for this and it comes from the men in white coats at Concordia University in Montreul.  In the study 39 men were invited to drive two different cars for an hour, a sexy Porsche 911 Carrera Cabriolet and a less than sexy 16 year old Toyota Camry. While driving the Porche, testosterone levels were significantly (‘significant’ is a very important word for men in white coats) elevated while the old Camry either did nothing or decreased levels of this important male hormone. Healthy testosterone levels are not only good for libido, they actually prolong life.

Now here is another free health tip: If you are going to buy a testosterone-boosting car – the colour to go for is probably red. Football teams with red jerseys do better (sorry Roman Abramovich but there really are some things money cannot buy) so don’t take any chances and buy a red sports car. Actually this new evidence-based research has convinced me that the perfect car for my personal health is an Aston Martin DBS Infa Red. Initially I baulked a bit at the price – £105 000 – but then I remembered some wise advice given to me by my mother: “When it comes to health, you cannot afford to buy anything but the best.” Health is wealth dear reader, health is wealth

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On the website of Frank Farrelly, the founder of Provocative Therapy, is a quotation by a homeopathic doctor attending one of Frank’s courses in Germany. The doctor (unnamed) sees similarity between the processes of Provocative Therapy and Homeopathy in that they are both contrarian in methodology, paradoxical in effect and stimulate a natural healing response in the patient. As a medical doctor trained in both disciplines I concur, but want to say something about how my training in homeopathy helped me enormously in becoming an effective Provocative Therapist.

My training in Classical Homeopathy taught me to converse with patients not only about the symptoms of any particular illness, but to engage in a conversation about their whole life story leading up to the point they got unwell. Shocks, accidents, traumatic events, stories about their present relationships or how their hearts were broken in a relationship are all considered vital in understanding the background to a ‘disease’ in a human and are the very stuff (together with tremendous detail about the illness itself) that the homeopathic doctor needs to make a prescription. Of course a diligent homeopathic doctor would also ask all the questions an orthodox doctor would ask as well as do a clinical examination and order tests if necessary. However it was having listened to many thousands of life stories for over 25 years that was a tremendous asset to have when I started to study Provocative Therapy with Frank Farrelly in the mid 90s. Life stories are life stories whoever they are told to and my experience in listening to such stories was invaluable in Provocative Therapy where it was required of me to find ways of gently provoking people to come up with their own solutions to their problems, articulate them and enact them in their lives. As homeopathic doctors  see patients about once a month, I must have heard many more stories than the average psychotherapist in the same time period and certainly more than the average doctor who doesn’t need to listen to life stories in order to practise the current form of orthodox medicine. Thus I finally saw that my training in Classical Homeopathy was invaluable in my journey to become a Provocative Therapist. But strangely enough, Provocative Therapy also helped my homeopathy!

I found that talking with and therapeutically provoking patients in sessions of Provocative Therapy was revealing more and more therapeutically reliable homeopathic information. I began to realise that when asked questions in homeopathic conversations people spoke about their personalities, character and life stories but in sessions of Provocative Therapy, people revealed who they were and how the functioned in life. This information was clearly more direct and authentic and I was not surprised when homeopathic remedies whose choice had been influenced by this, seemed to work really well.

As I realised that the two approaches were synergistic in my experience, I started to offer selected patients (those where a psychological or emotional issue was the problem or an important part of the problem) about the possibility of using both approaches to treat the same issue. The idea was to have three sessions of Provocative Therapy and only then take a full homeopathic history. My experience doing this has been extremely encouraging and I have found the clinical results experienced by people undergoing those four sessions to be really gratifying.

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Just returned from holiday and glancing at the headlines saw this one warning all women to ‘Cut food and drink to avoid breast cancer’. The Daily Mail headline is explained further by the subheading ‘18,000 women a year could be saved by exercise and dieting’

Here’s the thing: Research by none other than the World Cancer Research Fund (WCRF) has shown that by keeping your Body Mass Index in the lower part of the normal range of 18 – 25, exercising 30 minutes a day (yes 30!) breastfeeding your babies and drinking no more than one small glass of wine a day, you can definitely decrease your chances of getting breast cancer.

Okay, okay I know that’s asking a lot so let’s see how girls who ‘just wanna have fun’ can still enjoy life.

Let’s look at some popular recreational activities enjoyed by women: smoking, recreational drugs, dancing, retail therapy and sex.

Smoking: Research has definitely shown that this is very bad for you. (And I’ve checked with my lawyers before saying this.)

Recreational drugs: Also bad for your health and even worse if you end up in jail for using them.

Retail Therapy: Yes, that’s okay. Oh, sorry I remember that nobody’s got any money these days.

So that leaves Sex and Dancing..

Sex: Yes, it’s still good for you as long as you keep it safe. Try hard to be  as active as possible so as to increase the exercise component (see above).

Dancing: It’s wonderful exercise, great fun and the best game in town for grown up boys and girls. Read this poem by the late Adrian Mitchell and then go out and dance, dance, dance…

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As a physician, I’m aware of the dangers of obesity to health of course. But never in my wildest dreams did I suspect that obesity could be the cause of the decline of Western civilisation? Did I even think that it could be a reason why we could lose the struggle in Afghanistan, a place from which even the lean machine of the USSR army was sent packing with its tail between its legs?

You cannot imagine my shock when I read this article in the Independent about how our soldiers are apparently ‘too fat to fight’. A spokesman for the British army, Major Brian Dupree apparently said in a leaked memo: “The numbers of personnel unable to deploy and concerns about obesity throughout the Army are clearly linked to current attitudes towards physical training.”

Allow me to explain: Apparently to be a fighting fit soldier you need to exercise a whole 2 HOURS a day! If you can’t/won’t/don’t do this and are fat – you will be punished for your obesity by not being deployed in Afghanistan! Does this mean you will remain in England training as a soldier (sans 2 hours exercise a day of course) while your thinner colleagues are privileged and honoured enough to be sent to fight in the desert for what is left of Western civilization? Surely this amounts to some form of politically incorrect discrimination?

Okay, I thought, but the British Army is surely not the main defender of the West. We depend on America, the land of the brave and home of the free and home too of non-obese heroes of mine such as Sylvester ‘Rambo’ Stallone and  Arnold ‘The Terminator’ Schwarzenneger.  Imagine my horror and distress to find out that America has the same problem as us with obese soldiers!  Oh, no – I lamented, the West is surely lost now.

And then like a phoenix from the ashes of a lost civilization, the image of a saviour of a man came to me! No it wasn’t the Chosen One, the non-obese, Barack Obama – it was a man who, if we would have let him have his way – would have prevented (yes prevented) Gulf War II ! Yes, ladies and gentleman, I’m talking about none other than the very last heroic American military leader of all time, Stormin’ Norman Schwarzkopf! To imagine what would have happened if he had been considered ‘too fat to fight’ is a thought too horrible to contemplate!

And slowly I began to see the light. Colour returned to my ashen face as I remembered other great military leaders (Patton, Churchill and many others came to mind) that would have also been considered too fat to fight.  It irks me to think of our enemies – if they have a sense of humour – enjoying these articles about obesity in the military of the West. A few jpgs.  sent their way of Stormin’ Norman and General Patton will surely spoil their party.

And as for obesity as a medical problem of the West – it’s simple to treat. Provocative Therapy is effective for civilians and soldiers alike. The only way not to lose weight is to not turn up for your sessions – or of course don’t consult a provocative therapist in the first place. However I refuse to ‘treat’ so called overweight military heroes such as Norman Schwarzkopf Jnr. Instead I call on him to speak out against the demoralizing nonsense being spoken about British and USA troops! Far from being a joke, the future of the West might depend on him doing this. Let ‘em have it Stormin’ Norman!

http://en.wikipedia

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In one of the most innovative and enterprising moves to stop the  obesity endemic in its tracks ever made by a nanny state, a prescient quango known as the Foods Standards Agency (FSA) has advised/warned chocolate manufacturers to keep the size of their chocolate bars down.

Hapless confectioners have been told that chocolate will be regulated as follows:

Chocolate ’snacks’: (eg. Mars bar): At present, Slough’s main contribution to the universe, has a mass of 58g. Chocolate tycoons have been given a mere 3 years to reduce this to 50g.

Chocolate ‘bars’: (eg. Dairy Milk and Yorkie) These must be reduced to 40g or less.

It is to my deep regret that no restrictions on advertising chocolate have been suggested. As a doctor and psychotherapist, I have long been appalled by the blatant misuse of Freudian psychoanalytic theory to sell chocolate to the young by inundating them with pictures of attractive young models of either gender consuming both chocolate bars and chocolate snacks in none too subtle images of fellatio! With rampant hormones and their unconscious minds manipulated by evil chocolatiers promising sexual bliss but delivering obesity, what chance do our young have in this world?

Manufacturers of ‘fizzy drinks’ are to be hit even harder. Any drink containing sugar should be reduced from 330ml to 250 by as early as 2015! This should save at least 4739.6 lives over a 37 year period according to unofficial calculations.

It is rumoured that computers have calculated that these changes will reduce obesity by 19.29% thus saving 66755.34 lives over the next 50 years. Deaths due to  chocoholic smokers compensating on oral gratification by choosing to smoke more and eat less chocolate have apparently not been figured in to the FSA’s computations.

A spokesman for the hamburger industry, already hard hit by the ban on supersizing, said there is absolutely no truth in the rumour that a quarter pounder will need to be downsized to a three sixteenth pounder by the year 2016. He admitted however that the FSA has absolute power in such matters and that cattle ranchers in Brazil have been warned that the demand for meat in the coming decade could be reduced significantly. Meat prices are presently high but the noble FSA, with the best intentions for the public of course, could well put an abrupt halt to the present bull market in beef. Time to sell beef stocks then? Don’t ask me for financial advice. Doctors are well known for doing their boots on the stock market.

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I switched on the radio this morning and immediately heard extremely important news from America. Apparently the President had appointed a very FAT doctor to the most heavyweight medico-political job in the country – surgeon general. Across the  media and the blogosphere, self-righteous commentators were self-righteously condemning the Chosen One for sending out the ‘wrong message’  to the lardos of America.  So I dashed to my computer to get a picture of the prospective big shot of American medicine. What an anticlimax!  Maybe I’ve just seen too many pictures of fat people gorging on fast food in America. When you say a fat woman in America, I expect to see a VERY FAT WOMAN and certainly not a voluptuously endomorphic lady like Regina Benjamin. How dare journalists speak of her as the ‘elephant in the room’ of American medicine? Who do these hacks think they are?  I refuse to join their ranks. I applaud Barack Obama for this appointment. Let me explain:

I know I’ve campaigned for fat people to pay more for air travel, but that is only because I resent being penalized for being 1kg overweight on my luggage while someone twice my weight, but whose baggage (if not BMI) is within the norm, waddles  happily through. The plane uses more fuel to carry overweight people as well as overweight luggage. So it’s logical for you to be asked to step on to the scales next to your luggage and pay per kg, but I digress… This Dr. Benjamin looks like a GP with kindness and largesse and a body shape that is most desirable in certain parts of the world and was worshipped by artists such as Peter Paul Rubens.

If I were sick I’d be more than happy to have Dr. Benjamin  at my bedside  as would the poet W.H. Auden who expresses his partiality to plump doctors in Give me a doctor:

Give me a doctor partridge-plump,
Short in the leg and broad in the rump,
An endomorph with gentle hands
Who’ll never make absurd demands
That I abandon all my vices
Nor pull a long face in a crisis,
But with a twinkle in his eye
Will tell me that I have to die.

Auden, an Englishman, must have written this poem during his long sojourn in the USA!USA! because he rhymes ‘hands’ and ‘demands’. When I googled the poem (Google is marvellous for poetry) to make sure I had it word perfect, I came across a blog of another doctor who quotes a poem of a retired London GP by the name of Dr. Marie Campkin. Clearly a pastiche of the Auden poem of the same name, Dr. Campkin’s poem  accurately depicts the  state of British general practice today:

Give me a doctor underweight,
Computerised and up-to-date,
A businessman who understands
Accountancy and target bands.
Who demonstrates sincere devotion
To audit and to health promotion -
But when my outlook’s for the worse
Refers me to the practice nurse.

Dr. Campkin clearly understands what modern medicine is all about – money. I feel she loses her teeth in the last line because many patients would be happy to be referred to the nurse or any one else willing to help them. I’d prefer:

‘But when my outlook’s for the worse
Suggests that I phone for a hearse.’

In short I’m appalled that pc America has suddenly decided that Size Matters when it comes to choosing a leader of medicine or any other type of leader other than the CEO of Weight Watchers. Imagine we applied this sort of ‘ethics by example’ to Winston Churchill. What example would he be to the young binge drinkers of today? Whereas Hitler was a slim vegetarian. Need I say more?

I say ‘Give ‘em hell Regina! Live up to your name, O  Queen of American medicine! From across the Atlantic one doctor at least sends his unequivocal support!

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