John Welch is spending the next year in the Czech Republic, so this will be the last Hokum Locum. NZ Skeptic thanks John for his excellent contributions over many years and wishes him well.
Hokum Locum
1 August 2009
Tim Hume (Sunday Star Times June 21) has written a good account of traditional Maori Medicine (Rongoa Maori). The Health Ministry provides $1.9 million annually for this nonsense. That money would pay for approximately 1000 hip replacements.
Hokum Locum
1 May 2009
Linley Boniface is to be congratulated for her humorous take on the prevailing hysteria around alleged "white-tail spider bites" (Dominion Post 9 March).
Hokum Locum
1 February 2009
I thought they were all bogus! A Motueka man, Michael Dawson, was fined $4000 for describing himself as a chiropractor. This upset Nelson chiropractor Dr John Dawson who was quoted as saying his "unrelated namesake tainted the industry." Quite apart from Dr Dawson's pretentious use of the title 'Dr', his description of chiropractic as an industry is particularly apt. It is a massage business based on aggressive marketing and creating a non-existent need for gullible people to have their backs rubbed and clicked.
Hokum Locum
1 November 2008
There is something rotten in the state of China, a country where greedy people are quite happy to poison their own citizens in the name of profit. Milk powder is assayed for protein content by detecting nitrogen levels. Melamine, being a nitrogen-rich compound, gives a return in this test which indicates for protein, so if you have a poor milk product or it has been watered down, melamine can be added to make the product look as if it is up to normal protein levels.
Hokum Locum
1 August 2008
Don't scoff. A magazine as authoritative as Woman's Day reports a case where a woman treated her breast cancer by drinking her own urine. Following a mammogram and ultrasound examination the patient reports: "I was introduced to a surgeon who said I needed to have both my breasts removed right away." This is complete nonsense as no surgeon would ever perform a bilateral mastectomy without a tissue sample confirming the diagnosis. It is quite clear that she never had cancer at all, but a condition colloquially known as lumpy breasts or benign fibrocystic breast disease.
Hokum Locum
1 May 2008
A surgeon claimed that an alcohol-based hand wash had been responsible for a failed evidential breath alcohol test (EBA). He had been operating all day, went home, had two glasses of wine went out again, and failed an EBA. He argued that "the moderate amount he had drunk was not enough to have put him over the limit." He claimed that an alcohol-based hand wash had been absorbed by his skin. What was he doing? Drinking it?
Hokum Locum
1 February 2008
I imagine that most people joining the Armed Forces would expect the likelihood of a posting to an area of conflict. I know I did. I spent six months in Iraq between the two Gulf Wars. I admit that it was stressful but it was also one of the most exciting and interesting experiences that I have ever had. But that's another story.
Hokum Locum
1 August 2007
Cranial osteopathy is based on the notion that the bones of the skull can be manipulated. Even doctors have been taken in by this nonsense. The following account is by a registered medical practitioner, Dr Putative (not his real name).
Hokum Locum
1 May 2007
I recently spent several weeks motorcycling around southern India and was on the lookout for interesting examples of folk remedies and frauds. Ayurvedic medicine is popular because the remedies are cheap and have a long history of acceptance by ignorant and poor Indians. Middle-class Indians tend to be dismissive of 'Godmen' and Fakirs who can be found near every temple or religious institution but gullible western tourists provide rich pickings. An Austrian woman paid 34,000 Euros for Ayurvedic treatment of her memory loss. It transpired that she suffered from bipolar disorder and after an altercation in a temple she was sent home to Austria and subsequently sued over her unsuccessful treatment. The New Sunday Express Kochi 4 Feb 2007
Hokum Locum
1 February 2007
Members of the Royal Society and other eminent doctors have written to every hospital in the UK urging them not to suggest anything but evidence-based medicine to their patients (Guardian Weekly Vol 174 No 23). This was a timely reminder given that Prince Charles had just been urging the World Health Assembly to promote alternative medicine. The letter writers reminded people that alternative and complementary medicine needs to be evaluated on the same criteria as conventional medicine. This was precisely the same argument most of us took when making submissions to MACCAH.
Hokum Locum
1 November 2006
It has become a cliché that whenever something bad happens, a horde of counsellors descend on the survivors to make their lives a misery. It's true. Counselling does make you more sick compared to doing nothing.
Hokum Locum
1 August 2006
There is little doubt there are criminals who are prepared to drug women in order to sexually assault them. History records the commonest drug used was chloral hydrate in an alcoholic drink (Mickey Finn). The modern equivalent is rohypnol, a drug discontinued in New Zealand owing to its abuse potential. However, as Ogden Nash observed "liquor is quicker" and alcohol remains the most likely cause of incapacity leading to unwanted sexual activity.
When good doctors go bad
1 August 2006
Alternative medical practitioners often start out in the mainstream, but other currents may take them into new channels. This article is adapted from a presentation at the 2006 NZ Skeptics conference.
Hokum Locum
1 May 2006
So-called conventional medicine isn't immune to nonsense.
Hokum Locum
1 February 2006
PHARMAC is the Government drug-purchasing agency. Pharmac's 2005 Annual Review showed that about eight prescription items were issued per adult in that year. In the course of my work I write a lot of prescriptions but I certainly don't consume eight scripts per year.
Hokum Locum
1 November 2005
During my recent overseas trip I had two stopovers in Hong Kong. The South China Morning Post (3 October) reports that demand from patients has led to a policy where acupuncture treatment will be allowed for patients recovering from stroke and cancer. This is rather an unfortunate move because a very recent study found no difference between acupuncture and sham acupuncture in their ability to perform daily activities of living or in their healthrelated quality of life. The study involved 116 patients who received 12 treatment sessions during a two-week period. [Park J and others, 2005: Acupuncture for subacute stroke rehabilitation. Archives of Internal Medicine 165: 2026-2031, 2005].
Hokum Locum
1 August 2005
The product Body Enhancer, marketed by the Zenith Corporation, costs $95 per bottle and is "claimed to assist fat burning, muscle growth and liver detoxification." A judge, however, found that the product offered 'bogus benefits' although the couple behind the company remained defiant and claimed that they were "scapegoats for the natural remedy industry."
Hokum Locum
1 May 2005
Now that Terri Schiavo has been allowed to die peacefully there is an opportunity to reflect on the matter free from the hysteria and religious arguments advanced as an excuse to maintain her in a vegetative state. When discussing the ethics of the situation with a local surgeon he commented that the main problem was that the feeding tube should never have been inserted in the first place. A feeding tube is surgically inserted into the stomach through a hole in the abdominal wall. Once such medical interventions have been made it is very hard to reverse them. In this case the debate appears to have been hijacked by Catholic pressure groups.
Hokum Locum
1 February 2005
If you don't get the answers you want from a Government inquiry, press for another inquiry. Vietnam war veterans have continued such a campaign and have produced a map to confirm that they were present in areas that were sprayed with the defoliant under the US Army "Operation Ranch Hand".
Hokum Locum
1 November 2004
It will be interesting to see how the government handles the latest health scare which is being helped along by the usual sensationalist media reporting. How about this example: "The men who made the poisons that blighted a New Plymouth community…." (Sunday Star Times, 12 September 2004).
Hokum Locum
1 August 2004
A drug company has been perplexed at a shortage of Vitamin B12 created by a surge in use. A spokesman for the company said "doctors had so far failed to come up with a convincing explanation" and "Vitamin B12 was also used to treat chronic fatigue syndrome (CFS) and as a vitamin booster."
Hokum Locum
1 May 2004
New Zealand soils are deficient in selenium and this can cause serious health problems for animals. A 500kg animal needs about 1mg selenium daily. There is no evidence that New Zealand adults need selenium supplements and this situation has been described as "a deficiency in search of a syndrome".
Hokum Locum
1 February 2004
Cellulite is the term used by women's magazines to describe dimpled fat. It has no scientific or anatomical validity and it is simply ordinary fatty tissue that assumes a waffled appearance because fibrous tissue prevents the skin from fully expanding in areas where fatty tissue accumulates. This has been confirmed by a study where biopsies of fat and cellulite were microscopically indistinguishable by pathologists who were blinded as to the samples' origin. Calling fat "cellulite" is part of the modern trend to seeking alternatives to the (unpalatable) truth, in this case an adipose euphemism.
Interview with the Giraffe
1 February 2004
Hokum Locum talks with one of the unsung victims of the Christchurch Civic Crèche
Hokum Locum
1 November 2003
The British General Medical Council (GMC) has found family practitioner Michelle Langdon guilty of serious professional misconduct and banned her from practising for three months. According to press reports, Langdon had advised a couple that the gastrointestinal symptoms of their 11-month-old were caused by "geopathic stress patterns" beneath their home and then "dowsed" for a remedy by swinging a crystal attached to a chain over a book of herbal remedies. A hospital emergency department subsequently found that the child had gastroenteritis. The GMC also examined evidence that another patient had been prescribed an herbal remedy for a sore throat after the doctor dowsed for the treatment.
Hokum Locum
1 August 2003
Fear of litigation is a powerful stimulus to over-investigation and over treatment. In an atmosphere of litigation phobia, the only bad test is the test you didn't think of ordering.
Hokum Locum
1 May 2003
Some doctors see a problem and look for an answer. Others merely see a problem. The diffident doctor may do nothing from sense of despair. This, of course, may be better than doing something merely because it hurts the doctor's pride to do nothing.
Hokum Locum
1 February 2003
If the caring practitioner has no idea of what to do next, the decision may be best left in the hands of the Almighty. Too many clinicians, unfortunately, are unable to resist giving God a hand with the decision-making.
Hokum Locum
1 November 2002
The year round suntan, carnation in the button hole, silk tie, Armani suit and tongue should all be equally smooth. Sartorial elegance and verbal eloquence are powerful substitutes for evidence.
Hokum Locum
1 August 2002
Vehemence based medicine: The substitution of volume for evidence is an effective technique for brow-beating your more timorous colleagues and for convincing relatives of your ability. New Zealand Medical Journal Vol 113 No 1122 p479
Hokum Locum
1 May 2002
I will detail these seven alternatives in forth-coming issues of the magazine. For now here is Eminence based medicine: The more senior the colleague, the less importance he or she places on the need for anything as mundane as evidence. Experience, it seems, is worth any amount of evidence. These colleagues have a touching faith in clinical experience, which has been defined as "making the same mistakes with increasing confidence over an impressive number of years." New Zealand Medical Journal Vol 113 No 1122 p479
Hokum Locum
1 February 2002
John Welch finds that the sexual abuse industry rolls on unabated.
Gulf War Syndrome
1 November 2001
Warfare has always been stressful for its participants. Before the psychological impacts of the conflict in Afghanistan became apparent, our regular medical columnist looks at the history of post-war syndromes
Hokum Locum
1 November 2001
Dr John Welch goes eyeball to eyeball with the iridologists, and takes a look at some famous faces
Hokum Locum
1 August 2001
A Colorado colour therapist was jailed for 16 years after being found guilty of causing the death of a 16 year old girl. It must have been quite traumatic for the jury who watched a videotape of the session in which the girl begged for air and screamed that she was dying". What we need in New Zealand are equally tough laws that protect children from acts of omission, particularly where children are denied safe and effective medical treatment in favour of ludicrous quackery. (Dominion June 20th, Hokum Locum #59)
Hokum Locum
1 May 2001
Recently returned from a posting in Saudi Arabia and now suffering from a cold and a bleeding nose, John Welch continues his column on medical matters.
Hokum Locum
1 February 2001
The Prevalence of HIV disease has continued to increase across the African continent and is a major public health concern due to cultural attitudes to sexuality and a degree of poverty which precludes effective pharmacological interventions. A quack Nigerian surgeon has been charging patients US$1000-1500 for a course of his vaccine which he claims has successfully treated 900 patients for HIV/AIDS. The Nigerian Academy of Sciences deemed the vaccine "untested and potentially dangerous". The Surgeon's response has been to allege that "he has been the victim of a conspiracy by transnational pharmaceutical companies, in league with the Nigerian Health Ministry, to steal his 'wonder vaccine'...." This is the familiar paranoid conspiracy theories of the quack.
Hokum Locum
1 November 2000
Thanks to reader Alan Pickmere for drawing my attention to colon cleansing. In a radio advertisement Alan heard the claim that the average adult has up to 10kg of preservatives and toxic waste in their colon. The actor, John Wayne had 20kg removed at autopsy, doubtless dating from the time spent venting his spleen against commie actors facing Senator Joe McCarthy's inquisition. Come to think of it, perhaps he should have "vented" more often.
Hokum Locum
1 August 2000
John Welch started writing for the magazine in Issue 16, but a posting with UNSCOM to Iraq meant he had to relinquish responsibility for the column. He is delighted to once again have the opportunity to indulge his interest in bizarre medical beliefs and wishes to thank Dr Neil McKenzie for his efforts to date.
Hokum Locum
1 February 1996
An article in NCAHF reminded me of past activities with respect to joint manipulation. Following a one week course I embarked on a short-lived career in spinal manipulation which is very easy to learn and causes a greatly inflated belief in one's ability to "cure" spinal ailments.
Hokum Locum
1 November 1995
The Canterbury ME (chronic fatigue syndrome, or CFS) are up in arms over proposed tighter controls on patients receiving both invalid and sickness benefits. CFS patients want funding for "residential detoxification services and "subsidies on natural remedies". CFS is a classical psychogenic illness and as such it is quite improper for any affected patient to be on any long-term benefit on their own terms. Because of self-denial these patients resist any sensible suggestions on treatment and end up chronically unwell in a fulfilment of Abraham Lincoln's statement that "most folks are as happy as they make up their mind to be."
Hokum Locum
1 August 1995
In the last issue I warned of the dangers of a medical ghetto developing on the Auckland North Shore. Fifty new doctors set up practice in Auckland last year and even more overseas doctors are pouring into New Zealand. There has not been a corresponding drop in consultation fees in a local aberration of the law of supply and demand. Fortunately, the Northern Region Health Authority has moved to cap any further increases in doctor numbers which have already cost an extra $20 million in subsidy claims. (Christchurch Press 24/4/95)
Hokum Locum
1 May 1995
The recent decision to award compensation to a lawyer who suffered depression because his bank loan was turned down is but one example of increasingly bizarre decisions by the ACC (Anything-goes Compensation Corporation). Money has also been paid out to victims for "memories" of childhood sexual abuse but in one recent case the alleged offender was aquitted and we are still waiting to see whether ACC will ask for their money back. (see Skeptic 34).
Hokum Locum
1 February 1995
An editorial in the Christchurch Press (23 Nov 94) was critical of the Universities who are seeking approval from the NZQA and argued that they should continue to set their own high standards.
Hokum Locum
1 November 1994
Another sacred cow from my medical school days has been laid to rest. A letter in the New England Journal of Medicine in 1968 triggered a rash of anecdotal reports about facial flushing allegedly caused by monosodium glutamate (MSG) in Chinese food. "Chinese restaurant syndrome" had entered the popular medical mythology. Finally, 26 years later, two Australian scientists conducted a double-blind placebo controlled trial and found that some reaction to MSG was experienced by 15% of the subjects but the same reactions were also experienced by 14% of the placebo subjects. The scientists believe that the true cause of Chinese restaurant syndrome are histamine compounds found in fermented ingredients such as soy sauce, black bean sauce and shrimp paste. New Scientist 15 Jan '94 p15
Hokum Locum
1 August 1994
Neither Nutrasweet nor sugar-rich diets produce any change in children's behaviour. (New England Journal of Medicine 330:301-307, 1994)
Hokum Locum
1 May 1994
In Skeptic 30, John Britten outlined the tragic results which can occur when patients fall into the clutches of quacks. In this case, a man with rheumatoid arthritis was not only starved but ended up paying for expensive and useless medications. Most doctors can relate similar examples.
Hokum Locum
1 February 1994
Some time ago I remember reading a letter in the Listener from a frustrated doctor who accused the public of being medically illiterate. Sometimes I feel this way myself but it is not a good practice to attack one's audience. Public education cannot be achieved within the context of traditional ten-minute medical consultations compared with quacks who may spend up to an hour providing mis-information. Drug companies are on record as cynically exploiting a gullible public eg. "...neither government agencies nor industry, including the supplement industry, should be protecting people from their own stupidity".
Hokum Locum
1 November 1993
Following his own empirical observations that bee "treatments" helped his arthritis, a Levin bee-keeper is claiming that he is being ignored by the medical profession. (Press 3/8/93) Not surprisingly, his trial of 11 patients failed to impress skeptical observers. Two patients dropped out and the remainder reported that the "sting" was effective. Having paid for the privilege of being stung, a sensation to be normally avoided, they are hardly likely to say that the treatment was worthless.
Hokum Locum
1 August 1993
The pop star Michael Jackson has denied that he uses chemicals to lighten his skin and claimed to be suffering from a disorder called "vitiligo," which is a spontaneous loss of skin pigment. Jackson said "There is no such thing as skin bleaching. I've never seen it. I don't know what it is." (GP Weekly 24 Feb, 1993)
Hokum Locum
1 May 1993
In the last issue I discussed how quackery can be practised by New Zealand doctors with impunity, "if they do so honestly and in good faith." Alaska has a similar clause which only disciplines maverick doctors if they harm their patients. In fact, the latest NCAF newsletter outlines how a Dr Rowen has been appointed to the state medical board after "curing" the governor's wife of lumbago by extracting one of her teeth. The link between the tooth and the back was made by an electro-acupuncture circuit using a Vega machine.
Hokum Locum
1 February 1993
An American study reported in the GP Weekly (2 Sep 1992) found that chronic fatigue syndrome was indistinguishable from depressive disorders. (Refer also Skeptic 21) Patients diagnosed as having CFS were likely to believe that their illness had a viral cause, but it is more likely that CFS is a new age variant of the 19th century neurasthenia.1
Hokum Locum
1 August 1992
One of the techniques used by quacks is to attack conventional medicine as being a conspiracy against the laiety.
Hocum Locum
1 May 1992
Last year there was an excellent article published in Metro magazine about a young boy, Kurt Boyle, with a mysterious illness causing paralysis. The family had featured earlier on the Holmes show when they alleged that their son had been mistreated by the Hospital staff, who were treating him for a psychological problem.
Hokum Locum
1 November 1991
Myalgic encephalomyelitis (ME) has been described as epidemic neuromyasthenia, Iceland disease, Royal Free disease and post-infective fatigue syndrome. I will refer to it as chronic fatigue syndrome (CFS), a good neutral description free of unproven association with infective illnesses.
Hokum Locum
1 August 1991
It's beginning! I have long wondered when our health system would give in to public demands for fringe medicine, and I see that the West Auckland Health District has appointed a part-time naturopath offering alternative or complementary methods for the treatment of smoking, alcohol misuse and high blood pressure and including nutritional advice. This at a time when the Board's own nutrition services are struggling for funding.
Medical Roundup
1 May 1991
In issue 16, I reported on an AIDS treatment scam run by a British doctor, James Sharp, and an Iraqi vet. This had been exposed as such by an investigative journalist.
Medical roundup
1 February 1991
"Repetitive strain injury": an iatrogenic epidemic of simulated injury.
Medical roundup
1 November 1990
Anabolic steroids were in the news during the Commonwealth Games and Dr Michael Kennedy has been studying their use by athletes for the past ten years. His conclusion is that "anabolic steroids have no effect on aerobic sports, such as running and swimming, but may lead to a small improvement in the performance of trained weightlifters." He quotes a 1972 study that showed when athletes were given placebo and told they were steroids, they got stronger and trained harder.
Medical roundup
1 August 1990
A recent leading article in The New Zealand Medical Journal looked at Diet and Behaviour. Food intolerance was strongly associated with the mother's level of education. A little knowledge is a dangerous thing? As regards the putative link between sugar and problem behaviours the article says "'...it is just as likely that restless or aggressive children seek out more sugar as that sugar causes the inappropriate behaviour." The authors conclude "...it should be recognized that modification of a particular child's diet is almost always accompanied by changes in management."