Bad Science, Washing your hands and Dick & Oscar

Positively the most charming company for lunch today - it wasn't at my house so I didn't have to cook, even better! This gives me the excuse and opportunity to share a prodigous talent - not mine, silly - one of the lunch time guests.



There's a few more, just look under Shelly Goldstein on YouTube.

A relaxing day yesterday. Decided to read one of the books that had been bought, borrowed, stolen by friends to relive the monotony of hospital. I haven't read any of them up until now because I couldn't. Though I normally read avidly, in the weeks following the stroke I could barely manage half a page. It was as though the concentration required to deal with written language, and more inportantly, ideas, concepts expressed through that medium had somehow vanished!

So today I decided to try once more and read Ben Goldacre's 'Bad Science'. Somewhat apposite, although I don't think the person who bought it is necessarily aware of my rants, especially about 'creationist science'. Now Ben is a medic and mostly goes on about the media, despite the fact that he's a part of it, part-time :), and the credence they give to crackpots who are just out to make money from some fad. He's also big on evidence, just as I am! I know anecdotes from a well designed clinical trial - and I know which to trust! If I am going to trust anything!

Well, there was a footnote which intrigued me so I went and done some digging for the background.

There was once a 19th century physician called Ignaz Semmelweis (crazy name, crazy (eventually) guy!). Hungarian by birth, he was appointed as physician to a Austrian maternity hospital in 1847, which catered without cost to mostly poor, underprivileged, unwed mothers (prostitutes too) as a way of combatting the rampant infanticide of those desperate enough to kill the babies they could not afford, or were unwilling, to support.

This particular hospital was divided in two wards. One, administered by the midwifes, one by the medical students, which it was Semmelweis' responsibility to supervise. It soon became clear to Semmelweis that there was a clear discrepancy between the mortality rates from puerperal fever in ward one and in ward two. It was doubtful that this was caused by inexperience and, whether by chance or judgement, Semmelweis put the cause down to the time spent in mortuaries by the students dissecting bodies (as much of a part a med students training then as now, if not more so). Somehow, Semmelweis reasoned, the decaying flesh of the corpses could somehow cause the disease, puerperal fever, in expectant mothers. Semmelweis did not know the cause of this, the germ hypothesius did not appear until 1864, but again reasoned that washing their (the students) hands prior to gynaecological examination with a solution of chlorinated lime might help to clear whatever it was that was causing the high incidence of childbed fever in the patients.

It worked...and then some! From a mortality rate of over 10%, Semmelweis reduced it to 1%. The simple fact of washing your hands reduced the mortality rate 10 fold. It seems to me that you don't need much more evidence than that to ensure you wash your hands in 'bleach' prior to inserting them in pregnant women's 'naughty bits'.

Within a year the practice had become so widespead that puerperal fever has slumped to less than 1% of expectant mothers, Europe wide.

Sadly not! They ignored him, the great and good, the most learned! Despite all the evidence to the contrary, it didn't fit with the medical profession's accepted theories. Didn't accord with custom and practice. Who was some two penny Magyar 'physician' in a one penny charitable hospice for 'whores' and 'vagrants' (not to mention the socially irresponsible) to tell the great and good how to conduct business? It was not until Pasteur's '(one of the great and good?) germ hypothesis became current that people began to see the wisdom of Semmelweis' approach. Well at least they eventually got it!

But how many women died because THEY could not see the evidence staring in their faces! (Oh well, no matter, they were poor. Worse they were irresponsible. Worst, they were women! And infamy, they might have been common whores!)

I am fortunate, I live in more enlightened times. I am not as they were. I can criticise and make judgement as though I were on high for the crass stupidity of it all. I am better than that! The society I live in is better than that! I make my judgements based on evidence. I would not have made the same mistake as Semmelweis' contemporaries. I would have used the evidence. Do this and you avoid that!

Ah, but we all have our prejudices. Are mine any better than yours? I would hope so but we are, in the end, just victims of circumstance. No?

Snippet from a conversation. "A gang of girls, late teens, got on the bus, raucous, shouting. 'I'm Wicka', shouts one. The kind of girl that makes voodoo dolls out of tampons!" Priceless! Thank you Shelly!