Sunday 27 September 2009

The Ig Nobel Awards for Rectal Massage & Rat Linguistics

Apparently, the government intends to rationalise funding for scientific studies, cutting back on the silly ones and directing funds to those which have 'impact'. This Telegraph article suggests a few candidates for wasted time and money, although given the world's malaria-related mortality rates I'm not so sure that 'mosquitos prefer limburger cheese to feet' is totally irrelevant. Ditto the 'rectal massage cure for hiccups'. (To be fair, the Telegraph itself points out that chronic hiccuping is a serious problem for some and the research may eventually contribute to an effective theraputic approach.)

I also have to take issue with the idea that 'Lap dancers get more tips while ovulating' is useless information. Human sexual behaviour is sufficient a conundrum to usefully muse upon the role of subconcious signals. It puts us in our biological place - not a bad philosophical endeavour.

So I was going to write about how stuff gets invented by accident and that our understanding of our place in the universe has been refined by all sorts of research that looked pointless at its inception - and then David Mitchell did it better. So go here if you'd like a good read and to find out how we got diverted from building the perfect mammoth trap.

Tuesday 22 September 2009

Conspiracies and Hitchhikers

I spent a very pleasant Monday evening in the company of David Aaronovich and a couple of hundred sceptics who had gathered at The Penderel’s Oak to hear his thoughts on Conspiracy theories. Dave Cole has written a good prĂ©cis of proceedings.

Rather than exhaustively covering each theory (The Protocols of the Elders of Zion, Princess Diana was murdered, Jesus founded a dynasty in the South of France et al), Aaronvitch engagingly discussed the very notion of conspiracy theories and the nature of their enduring appeal. Speaking as a person who maintains an official list of ‘Thoroughly Enjoyable Nonsense Books’ (top three BTW: ‘The Holy Blood and the Holy Grail’ by Lincoln, Leigh & Baigent; ‘The Ultimate Evil’ by Maury Terry; ‘Jack the Ripper: the Final Solution’ by Stephen Knight), I agreed with many of his thoughts and insights.

Conspiracy theories are optimised stories, tales with a pleasing narrative arc. So are fables, parables, folktales and urban legends. Their honed form helps to determine their survival and proliferation as memes.

In these other contexts, one of the best examples I can think of is the urban legend of the ‘Vanishing Hitchhiker’, first analysed in depth by Professor of English Jan Harold Brunvand1. Urban legends bear more than a passing resemblance to conspiracy theories in that they are allegedly true anecdotes. However, ULs are circulated by word of mouth and received from a friend of a friend. In other words, it is reportage close enough to not doubt but far away enough not to check. This urban legend story form is now well enough recognised that listeners may identify anecdotes as urban legends simply by their satisfying story structure. Urban legends are brief and to the point, there is often a moral lesson to be learned and they generally cover life’s critical and dangerous events. Brunvand’s awareness of more traditional folklore enabled him to see the similarities between traditional folklore and their modern sibling. The study of urban legends is interesting for any student of traditional folklore, as it gives an insight into the themes which continue to preoccupy people and how stories in general retain currency and are successfully transmitted.

In the Vanishing Hitchhiker a traveller stops to pick up a hitchhiker. The hitchhiker sits in the back of the vehicle and when they reach their destination, the traveller turns around to find that the passenger has disappeared into thin air. The hitchhiker is then identified by a person at the destination as somebody who died prematurely and whose ghost has done this many times before. There are sometimes chilling or poignant additions. In one, for example, the driver lends the (young female) hitchhiker his overcoat which he finds draped over her gravestone at their destination.

As you would expect, there are parallels (and probably antecedents) in tradtional folklore for the Vanishing Hitchhiker theme. Christina Hole2 recounted the tale of Madam Pigott of Chetwynd Hall who died in childbirth at the end of the eighteenth century. The doctor attending her parturition warned her husband that the lives of both his wife and his unborn child were in danger, to which the man’s callous reply was: ‘One should lop the root to save the branch’. The doctor’s impromptu surgery did no more good for the child than it did for the mother however - both were lost. Madam Pigott’s ghost was reputed to haunt an old tree stump which was shaped like a chair. She would jump up to ride behind anybody who went past at night, especially those on their way to collect midwives. Her spectre disappeared when the horse and rider crossed running water.

Brunvand reports a variant of this tale from the US in the 1890s, where a young woman would jump on young men’s horses when they passed through a certain wood on their way to parties and then disappear when they arrived. Other versions from the late nineteenth and early twentieth centuries place the traveller and hitchhiker in the more modern configuration of a vehicle, albeit a horse-drawn one. Where people were not affluent enough to afford a vehicle or a horse, the same motif appears with a walking couple, the young woman walking behind the young man: Brunvand’s example of this comes from Chinese immigrants in California. As you would expect, the automobile variant emerged and proliferated at the same rate as the machines themselves, to the point where most people now identify the theme exclusively with cars and a modern context.

A more macabre aspect enters the Vanishing Hitchhiker motif when she becomes associated with dreadful luck or ill health. A Korean version told of a cab passenger who travelled at midnight from the cemetary to a store, into which she went to obtain the fare. When she did not return, the cab-driver woke the people at the store who identified the woman as their daughter. The driver recognized her from a photograph and became fatally ill. A similar story from Russia in 1890 told of a priest who was entreated to attend a house to administer the sacraments to a man who was ill. The man was dead before evening, and the woman who had entreated the priest to visit him turned out to be the ghost of his mother.

Brunvand labelled this theme as 'the ghost in search of help for a dying man'. However, I have more reservations about the ghosts’ motives than Brunvand, and wonder if the kindly aspect of these stories has emerged recently in an age where the powers of the supernatural have largely been reduced and when we are prone to think of family ghosts as kindly. For most of our history, even the familial dead have been treated with fear. Vampires explicitly started with their own family as victims. If a causal relationship must be inferred, it is fair to say that traditionally the dead usually bring death rather than passively presage it.

The Vanishing Hitchhiker motif clearly has a substantial history in traditional folklore and it has retained a couple of the perpetual Unnatural Predator themes: the subject is young – prematurely dead, and may also bring death with them. As you would expect, in its new environments the Hitchhiker story has integrated local characteristics: In Hawaii, the theme has become associated with the volcano goddess Pele and in Chicago, hitchhiker stories were found combined with the tradition of 'La Llorona' or the Weeping Woman'. There is also a substantial sub-set of accounts where the hitchhiker is a beautiful young woman in shining white who speaks about the second coming of Jesus before she disappears.

If you’re interested in good introductions to urban legends and conspiracy theories, I can recommend both ‘The Big Book of Conspiracies’ and ‘The Big Book of Urban Legends’, both square bound comic books by Paradox Press. They’re regrettably out of print (so the ‘Conspiracies’ one may also be a touch out of date) but Abebooks may yield a few copies.

And since Crispian Jago himself brought the subject up, I’d like to add to the psychiatric profile we’re all building of his father in law - a man prone to believing in both conspiracy theories and that he has left the door unlocked. Is there a link? Aaronovitch would have none of it and put the door checking down to a bad experience. Plausible … but I wonder? One of the ‘big five’ personality traits proposed in modern psychological models is neuroticism3. As Aaronovitch pointed out last night, paranoia may actually be a ‘meaning-making’ type of psychological defence against a larger horror - the realisation that the universe doesn’t actually give a shit about you. So - paranoia/anomie … you choose. Several studies have found no correlation between religiosity and neuroticism4, but perhaps scrutiny of specific types of superstitious or religious belief would produce more correlations. Any volunteers for a survey?



1 The Vanishing Hitchhiker Picador 1983 Jan Harold Brunvand
2 Haunted England Charles Scribner’s Sons 1941 Christina Hole p90
3 eg. Costa & McCrae 1992; Russell & Karol 1994
4 Religious Behaviour, Belief & Experience Routledge 1997 Benjamin Beit Hallami & Michael Argyle p 164

Saturday 12 September 2009

‘The Ignominious History of a Noble Profession’, or, ‘A Quorum of Quacks: Qualms re Quangos & Quasi-Qualifications’, or, ‘Boy, Do I Rock at Scrabble'

For those of you who have never been festooned with so may needles that you looked like a archery target in fairyland, or else had your feet savagely mashed by a lady with a constipated grin who gaily announces: “Gall bladder a bit sluggish today” the regulation of Complimentary and Alternative Medicine may not be a pressing concern. If you wouldn’t dream of alleviating your IBS with some water that had once been exposed downwind of an igneous rock, you may wish to skip to the next blog. I can recommend several: the list is to your right.

But if CAM interests you, and especially if you’re a little sceptical, then here are some thoughts. You may have read similar elsewhere as I’m hardly the first on the scene, but I was busy washing my hair before. This entry, given that I’m supposed to write about the supernatural, probably represents a bit of mission creep. But if we’re going to talk about vampires and witches, why not talk about life-force and meridians?

As you may know, in November 2000 a House of Lords Select Committee on Science & Technology produced a report on the subject of Complimentary and Alternative Medicine in recognition of the fact that CAM was popular and probably getting more so. The purpose of the report was primarily to evaluate potential dangers to the public and secondarily to facilitate the evaluation of the evidence base, and thereby evaluate the costs/benefit ratio to the NHS. This, and a report and the Department of Health Response which followed a year later, explored the idea of regulation. There are only two Complimentary and Alternative Medicine (CAM) categories which are statutorily regulated at present: they are osteopathy and chiropractic. This means that the words are protected and that nobody can practice as an osteopath or a chiropractor without having a recognised qualification.

So since it’s such a hot current issue I thought I’d look at regulation by going through a potted history of another statutorily regulated profession – medicine.

In 1518, The Royal College of Physicians was created to supervise and licence physicians practicing within the City of London and its radius. Their remit was expanded to the rest of the country just five years later. What a responsibility – you think they’d have been churning out medics like bratwurst. But in the first few years, there were only a dozen or so members of the guild to attend a city of around 60,000 citizens. Seventy years later, the population had doubled to over one hundred and twenty so there were now, er, thirty-eight physicians. This veritable tide of medics had grown to forty individuals by the time of the Civil War. In these early days, the ratio was reckoned at the very best ever to be five thousand citizens to one physician.

To be fair, a natural restriction in the form of class-ism probably exerted quite a force; physicians attended to the rich, this remit being reflected in their fees which were far higher than those of the apothecaries and surgeons socially beneath them who attended to the poorer. By 1700 the apothecaries were reckoned to outnumber the physicians by five to one. In addition, midwives and folk healers operated at a local level and usually charged in kind.

So a highly-structured society had a medical care model which reflected its hierarchy. Not so peculiar. But for two things: firstly, the physicians sought vigorously to limit the practices of the other categories of medical practitioner and secondly, this without any actual better outcomes of their own. The physicians and apothecaries used different paradigms, the Greek humoural theory for physicians and the traditional herbal approach by apothecaries. This meant that the upper classes were more likely to accidentally die of bleeding and purging than the lower classes which were more likely to accidentally die of poisoning. If you were to hazard a guess at which was the more effective approach, the apothecaries would probably win out. (It’s hard to see how violent diarrhea could cure anything other than your chances on a hot date).

The 17th century saw a protracted legal battle in which the physicians sought to limit the powers of the apothecaries: this when they had insufficient numbers of their own to attend to the apothecaries’ patients, insufficient evidence of the superiority their own methods and were also unlikely to have adjusted their fees so that the poor could afford them. The apothecaries’ right to give medical advice (but not charge for it) was eventually upheld by the House of Lords.

In these early days there were many other attempts made at restrictive practices in the medical market – odd when you consider that the protectionist medieval guild model was changing in so many other areas. For example, licensing of quacks and midwives was supervised by ecclesiastical authorities under Henry VIII. This was probably an attempt in the sensitive era of the Reformation to regulate the scope for use of sorcery and enchantment (for which read ‘unauthorised religious models’). In a time where medical intervention was mostly ineffective, techniques often verged on the magical: for example, in 1606 The Royal College of Physicians attempted to stop one Reverend John Bell from treating high fevers by writing words on a piece of paper.

The history of the restrictive approach to medical practice is no better in the US. In the nineteenth century, the ‘regulars’ fought a series of battles with lay practitioners – again, when they were in no position to actually offer better results. The ‘regulars’ also railed against midwives, producing an adverse effect on the profession’s reputation which was apparent in the US until very recently.

At some point during the Enlightenment the medical profession started to assimilate some new ideas and by the early 20th century, there was more in a doctor’s bag than laudanum and leeches. The changes in just one century are stunning and these days I personally prefer to approach a member of the medical profession in order to receive empirically-based treatments. Homeopaths generally don’t have chemistry degrees (otherwise they’d know ‘Good Vibrations’ is just a Beach Boys song), reflexologists don’t employ phlebotomy labs and no-one has ever managed to X-ray my Chi (although perhaps I could try to donate it. Go here - it’s hilarious).

But my real point is that the statutory regulation – and the trade protectionism which accompanied it – came before the efficacy, the competence and the safety. In the same way that the Vatican certified the trade in relics and indulgences, the earliest incarnations of a now very respectable profession attempted to use their class, the law and their political clout to exclusively peddle mostly utter bollocks. Sometimes it was dangerous mostly utter bollocks.

So having looked at that, perhaps we should examine the proposition that ‘regulation as consumer protection’ may sometimes be a veil of decency worn over a shoddy, yellowing string-vest of self-interest. Which makes me wonder if we should save regulation for things that demonstrably work.

But here’s a further thought: my father has always maintained that it doesn’t matter if your car doesn’t go, but it does rather matter if it doesn’t stop. Good point. I, for one, am very grateful that the man who mends my brakes subscribes to a conventional code of practice.

So let’s refine things that demonstrably work to things that can actually do harm. Harm to your wallet and dignity doesn’t count: for one thing, the fashion industry would collapse overnight. For another, too much protection against ourselves would infantilise us beyond the ability to make any rational decisions at all. I really must reserve the right to be a common-or-garden idiot.

Actually, a recent Department of Health report is well ahead of me here. ‘Extending Professional and Occupational Regulation’ (2009) suggests that the regulation of CAM practitioners should be proportionate to risk. However some parts of the homeopathic profession are still seeking statutory regulation. Other parts are, for sound business reasons, resisting them. (Thanks to Andy from Quackometer for drawing my attention to all this).

In 2000 the House of Lords assigned homeopathy to its ‘Group 1’ – professionally organised therapies with a well-developed process of voluntary self-regulation. My worry is that, for many consumers, regulation may be regarded as approbation. In this respect, regulation can be bad. There must be many CAM bodies aware of the potential benefit to being highly structured (restricting numbers of practitioners, thereby raising fees, being just one). For this reason, I do hope that the Department of Health sticks to its guns and maintains the ‘harm’ criterion, thereby restricting the CAMs which add another layer of respectability by being statutorily regulated.

Links:
Gimpy's Blog on Regulation
Quackometer on Homeopathy in Africa
A scientific experiment by Crispian Jago