Health
A little business idea
The Scottish Executive’s war on booze is stepping up, with talk of price controls, making booze harder to get and, if doctors have their way, raising the legal age to buy booze in shops (but not pubs) from 18 to 21. Given that I have an estate car and England’s only an hour or two away, I feel a business venture coming on…
If it weren’t for smokers, smokers wouldn’t be so unpopular
As pubs go, my local is fairly smoker-friendly: there’s a nice outside area with an awning to keep off the rain (when they remember to put it up), halogen heaters to stop you freezing, and a bunch of benches and tables you can park your arse on while you puff. Plenty of ashtrays, too: a bunch of permanent wall-mounted ones, and ones on each bench.
The area is fenced off, and beyond the fence is some nice landscaping. Last time I was outside there - a few weeks back - it was grass. Tonight, it’s a solid carpet of cigarette butts. Hundreds, maybe thousands of the things.
OK, it’s a pub, so people are going to be there, a bit pissed, a bit clumsy. But the sheer number suggests that it’s more than that; it means that lots of people are going out there for a smoke and deliberately ignoring every single ashtray. Maybe I’m out of the loop and ashtrays are uncool, but whatever the reason the end result is that when non-smokers go out there - which they do, it’s a beer garden - they’re going to think that smokers are a bunch of inconsiderate wankers.
So when the Scottish Executive announces a new anti-smoking drive such as, I dunno, making us wear bells in public while we’re pelted with rotten tomatoes, or when pubs make their beer gardens non-smoking and effectively ban people from having a cig in the open air, the non-smokers will go “bloody right! Wankers, the lot of ‘em!” Considerate smokers can argue till they’re hoarse (which won’t take long, thanks to the cigs) that the mess is caused by an inconsiderate minority, and they’re right. But nobody will listen.
So thanks a lot, folks. Once again a minority of wankers makes life that little bit more shitty for everybody else.
The drugs do work
My recurrent back problems have been making it difficult to work for a while now, so the doc’s given me some horse tranquilisers so I can get through the working day. Unfortunately they make me so drowsy I’ve spent half the day asleep. Oops.
Paracetamol and a hot water bottle: the cure for everything
I’d love to panic about Wi-Fi and mobile masts, but this is the stuff that really scares me.
The elderly mother of a woman I know hasn’t been well for some time, and her GP has prescribed a few things - water tablets to help her kidneys remove fluid, warfarin to keep her blood thin. Recently, though, she’s been complaining of shortness of breath, and of quite severe pains, so her daughter has called out the GP a few times.
Incidentally, the woman has dementia, so her short-term memory doesn’t really work. On one visit she asked the GP, “Why are you here?” and he boomed, “Mrs X, you have human rights! If you don’t want me to be here, I will leave!” Her appalled daughter made it very clear to him what would happen if he left without first checking her mother.
The verdict? Nothing to worry about. The pains are muscular. Take two paracetamol, hold a hot water bottle where it’s sore and it’ll sort itself out.
Her daughter wasn’t convinced but hey, doctors know what they’re doing. But when the shortness of breath got worse and the pain got worse, and the GP once again said paracetamol would solve the problem, the daughter took her mother to hospital.
It turns out that there’s a real cause for the shortness of breath: her lungs are so full of fluid that they’re barely functioning. One lung is down to 10% of its normal capacity and the other one isn’t so far behind. That’s treatable, though, and all you need to do is drain the lungs.
One wee problem with that. It turns out that the warfarin she’s on has been massively overprescribed, and her blood is so thin that any attempt to drain the lung would almost certainly kill her. So she needs to stay in hospital for a bit while they thicken her blood.
The good news keeps coming. Thanks to the water tablets - which the hospital doctor says should not have been prescribed for her at all - her kidneys are utterly fucked, and could be days away from outright collapse. Go home and prepare yourself, he tells the daughter. Your mum might not live through the weekend.
But she does, and her blood thickens up, and (eventually - the procedure was cancelled several times before going ahead) they drain the lung (which, I’m told, was extremely painful for her. It’s certainly not a barrel of laughs when you’re otherwise fit and healthy). One lung collapsed and couldn’t be re-inflated, which isn’t fantastic news. But the good news doesn’t stop there. There’s a reason for the fluid in the lungs: cancer. She has three different, very advanced and therefore untreatable, cancers: in her chest, in her gut, in her reproductive system.
You know someone’s situation is bad when you’re glad they suffer from dementia and aren’t entirely sure what’s happening or where they are.
Still, two paracetamol and a hot water bottle will sort her out.
Mobile bloody masts and wireless sodding networks
We’re doomed! says the Times.
We’re doomed! says the Independent.
Not so fast! say the people of Fark.com, destroying the Indy’s alleged expert with one beautiful, beautiful link and throwing in tedious little facts about the difference between ionising and non-ionising radiation, how radiation exposure works, where wi-fi sits in the electromagnetic spectrum and why lightbulbs don’t kill you.
Besttreatments.co.uk is no longer free
When I was deciding whether or not to have back surgery, I relied heavily on BestTreatments and its sister site, ClinicalEvidence.com. Both sites come from the British Medical Journal, and they’re rare in health sites in that they don’t have an agenda, they’re not trying to flog you stuff and they don’t reprint pseudo-scientific bullshit. Instead, they take a simple formula: here’s what we know works, here’s what might work, and here’s stuff that there’s no evidence for whatsoever.
And now, they’re disappearing behind subscriber-only walls because the department of health isn’t willing to fund them any more.
You can’t get scanned when you’re skint
I know I rant about two-tier healthcare a lot (as in, it already exists in the NHS), so I’ll keep this reasonably short: after our pregnancy scan earlier this week, we had a chat with the midwife about the various tests designed to make sure your baby’s healthy. The biggie, it seems, is the 20-week scan: it’s when you check to see that the foetus is developing normally.
The room in which we had our 12-week scan was plastered with posters explaining why the 20-week scan is so important, so - being good little patients - we asked the midwife about it. Should we get it? Yes, she said. But not here.
It turns out that the NHS doesn’t do 20-week scans in Glasgow unless there’s already reason to be worried - something the midwife says is daft, dangerous and various other things beginning with “d”. Inevitably it’s because of cost-cutting.
So here’s your choice: if you can afford to go private, you can get a scan (which, incidentally, isn’t performed by a mere sonographer; no, it’s performed by a proper doctor. In this case, the doctor who’s a consultant at, er, the maternity ward that employs the midwife we were speaking to). If you can’t, you don’t get scanned. Simple.
Apparently the 20-week scans will be reinstated next year. Which is good news for skint mums-to-be this year.
One job ad sums up the problem with health reporting
Posted to a journalism forum:
Men’s Fitness is looking for an experienced staff writer to write and edit the Nutrition and Health sections of the magazine.
You don’t need to be an expert on health matters, but you do need a proven record of producing sharp, witty and accurate copy for a consumer title.
This isn’t about health. It’s hysteria
The good people of Belmont in California want to expand the city’s smoking ban to the point where the only place it will be legal to smoke is in your own home - provided that home is completely detached (such homes, apparently, cost around nine hundred thousand dollars). Smoking in your own car, by yourself: illegal. Smoking in the street: illegal. Smoking in parks: illegal. And so on.
What’s interesting about this isn’t the ban as much as the internet debates about it. Inevitably it’s brought out the pro-smoking “you can take my cigarettes when you prise them from my cold dead fingers… my grandad smoked all his life and the fact he died horribly aged 24 is not connected in any way” yahoos who give considerate smokers a bad name, but more interestingly it’s brought out the anti-smoking puritans. And they’re the ones who scare me.
The problem with the puritans is they talk about health, but they mean annoyance. So - and this is a real example by an anti-smoker - you’re in your car at a red light, and the guy in the car in front is smoking a cigarette, and you can smell it. He is, clearly, trying to kill you.
There are lots of examples like that one, and while some people are perfectly honest - they hate smoking because they hate the smell - others are nuts. The dangers of second hand smoke aren’t as clear-cut as anti-smoking groups would have you believe - it’s certainly a risk factor if you’re constantly exposed to lots of it, and only the most deluded pro-smoking advocate would attempt to argue otherwise, but there’s this hysterical interpretation that essentially goes like this: second hand smoke can be a health risk. If I inhale a single molecule, I’m going to die. Therefore anybody who smokes is murdering me. Smoking must therefore be banned everywhere, and smokers punished.
This is a real post, from Fark.com:
Smokers think like NAMBLA.
NAMBLA is the American group whose members want to fiddle with kids.
Smokers argue that people have been smoking for millenia; NAMBLA would argue that people have been engaging in pre-adolescent sexual behavior for millenia. But it’s still disgusting and hurtful… Smokers argue that they have civil rights, freedom to do whatever feels good to them, tossing in as an aside “as long as it doesn’t hurt anyone else”…and then descrying talk of second-hand smoke damage as non-conclusive. NAMBLA argues about freedom too; somehow discussion of emotional and physical damage to the young boys doesn’t ever resolve itself to a positive conclusion.
…there is no moderate level of carcinogenic gas.
What’s fascinating about that post isn’t the level of lunacy it’s exhibiting - NAMBLA? Carcinogenic gas? Jesus - but the complete lack of response to it. It’s actually quite a common viewpoint on US sites.
Now, smokers aren’t the most sympathetic of groups. It’s a bloody stupid thing to do, cigarette smoke annoys people who don’t smoke, some smokers give the rest of us a bad name by being inconsiderate twats and the smokers who are currently emailing anonymous death threats to Belmont’s mayor are utter arseholes. But there seems to be an attitude shift happening here: in the discussions on US internet sites, the *extreme* anti-smoking position seems to me as if it’s becoming the *mainstream* anti-smoking position. And of course, where California leads the UK eventually follows. We’ve already started with the “hospitals ban smoking in their grounds because they can’t be seen to condone smoking” nonsense, so the other stuff will follow.
So what we have here are two really scary, really popular viewpoints:
* I don’t like smoking, so the state must make sure that I never, ever encounter it.
And:
* I believe that if something is believed to be a health risk in certain circumstances, if it exists in the world at all then I am a murder victim who just hasn’t died yet. The state must eradicate every molecule of it.
Position number one, then, is a variation of the “I must never encounter anything of which I do not approve, and my view is all that matters” argument; position number two is the “despite all the scientific evidence to the contrary, I believe that electricity/paint/radio/the phone/flouride is EATING MY BRAIN and my feelings are more important than evidence. Yes, I am a hysterical nutcase but I PAY MY TAXES GODDAMMIT” argument. And increasingly, those are the mainstream opinions.
Am I the only person who thinks that’s utterly terrifying?
Smoking, stalking and unintended consequences
One of the dangers of knee-jerk legislation is that it sometimes has unintended consequences, so what is generally a good idea can have its downsides. Anti-harassment legislation is a good example of that - as this morning’s Guardian notes, its vagueness means it’s a handy tool for firms to stop people protesting about them - and as Mr Eugenides points out today, it applies to anti-smoking legislation too.
The quick summary: banning smoking in public places is good news for health, but too draconian a ban and it’s possible that you can actually end up doing more harm than good.
Mr E links to a Scotsman story, which mentions research that’s actually been kicking around for a while.
The researchers studied data from the US, where bans have been up and running in California and New York for a number of years. The presence of the nicotine by-product cotinine was recorded to see the effects of such bans.
The results found that bans on buses, in shopping malls and in schools had the desired effect of reducing the levels of tobacco inhaled by non-smokers. But once bans were imposed in recreational places such as pubs, the results shifted markedly.
The researchers said: “We find that bans in recreational public places can perversely increase tobacco exposure of non-smokers by displacing smokers to private places where they contaminate non-smokers.”
Smoking’s less prevalent among well-off people than poorer people, so such displacement is likely to adversely affect poorer kids. As Mr E. says:
Adda and Cornaglia suggest that this may be because the prevalence of smoking is higher in poorer households; as a non-smoker, you are more likely to share your home with a smoker if you are poor. Displacing smoking from the pub to the home will therefore affect the poorest section of society disproportionately hard.
I don’t think this is particularly surprising or controversial, and it’s something that may well disappear in the long term. However, the boss of anti-smoking pressure group ASH Scotland simply discounts it and implies - libellously? - that the researchers are in the pocket of Big Tobacco. Mr E, again:
The study quite clearly supports higher taxes on cigarettes as an effective way to reduce exposure to smoke, and also supports a workplace ban. The authors were sponsored by the ESRC and there is no evidence whatever of any support from the tobacco industry.
…The researchers concluded: “Governments in many countries are under pressure to limit passive smoking. Some pressure groups can be very vocal about these issues and suggest bold and radical reform. Often, their point of view is laudable but too simplistic in the sense that they do not take into account how public policies can generate perverse incentives and effects.”
I don’t have a particular axe to grind here - as I’ve said endlessly, I’m in favour of the ban but appalled by the some of the loons behind it - but I do think it demonstrates the problems of swallowing any pressure group’s agenda wholesale - whether they’re pro or anti-smoking, pro or anti-capitalist, pro-business or pro-environment or anything else. By their very nature, single-issue pressure groups have tunnel vision and a belief in the pure, simple truth - but as Wilde wrote, the truth is rarely pure and never simple.