A step by step guide to a 'revolutionary treatment'

This was part of an episode of the Pod Delusion a few weeks ago. Meant to put it up here then. Forgot. Doing it now. Don't worry, it's no more-or-less relevant now than it was then.

The following semi-coherent diatribe is step-by-step guide about how a ‘revolutionary treatment’ or ‘medical breakthrough’ comes into being in today’s society. What follows is theoretical chain of events based on my own experiences and understanding. As far as I know, these events has never actually happened as detailed here. As far as I know. But as far as I know, they easily could. As far as I know.

Step 1: Researcher A completes a research project. The project in question investigates the effect of substance A on biological process A. Biological process A is one of dozens that contribute to unpleasant disease X. Researcher A’s results indicate that substance A significantly reduces the rate at which biological process A occurs when administered to a small group of subjects that have been genetically modified so that process A occurs in them. The subjects are members of species A. Otherwise known as mice, because they definitely do exist.

Step 2: Researcher A, having spent 6 months on the project, writes it up as a paper for submission to a relevant scientific journal. He then forwards it to his immediate superior for checking before it is submitted. He then goes out to celebrate, become dangerously inebriated by consuming excessive amounts of alcoholic substance A, tries to chat up unknown attractive woman A, makes several appalling conversational errors due to drunkenness, eventually receives a vicious kick to testicles A and B, then limps home and sleeps for 18 hours straight.

Step 3: Researcher A’s immediate superior, Professor A, eventually reviews researcher A’s paper and considers it sound. However, Professor A is also putting together a large grant proposal and is keen to cite impressive research his department has produced, in order to improve its chances. As soon as the paper is accepted into a journal, Professor A sends an email detailing (and somewhat exaggerating) the results and implications of researcher A’s project. He includes the role of process A in disease X. The email is sent to the public relations department of his institution (Institution A), with the intention of getting his department some publicity, which could potentially aid his grant proposal.

Step 4: The public relations department, understaffed and underfunded after recent budget cuts, are similarly keen to gain attention for institute A and hopefully obtain extra funding. They quickly read Professor A’s email, and after adjusting it for succinctness by removing some of the ‘minor details’ they include it in their regular press release, which is sent to a wide variety of media sources.

Step 5: Journalists at a number of media outlets receive institute A’s press release. Several of the less-scientifically literate journalists read through it quickly and notice the phrases “results show” “substance A” “reduces occurrence of process A” “which is” “an” “important” “part of” “disease X”. There is also a collection of numerical results and analyses accompanying this, but numbers are boring and tend to put readers/listeners off so these are ignored. Many of the journalists know a relative/acquaintance/celebrity who was a victim of disease X, ergo many people must know/care about it. Logically, this discovery is newsworthy.

Step 6: After the story is passed between seeral people, becoming distorted with each retelling, public relations department at institute A receive dozens of phone calls regarding the discovery of a cure for disease X. After 2 hours of noncommittal responses made in purely to buy time, someone in the department recalls mention of disease X in the recent press release. This is traced to professor A, and all subsequent requests for information are directed to his office.

Step 7: Professor A spends an afternoon responding to enquiries from journalists about his ‘discovering a cure for disease X’. Mindful of the danger of making unsubstantiated claims, but also aware of the positive effect publicity could have on his grant application, he responds cautiously, but plays up the possible implications of the research while downplaying the fact that it is just a small result from a small study on a small component of a complicated disease, expressed entirely via an analogue of the disease as experienced by a non-human species. Mice, in this case.

Step 8: Professor B, of institute B, who is widely known for his work on disease Y (which affects similar areas to disease X) is contacted by journalists and asked for his opinion on professor A’s ‘revolutionary treatment’. Professor B, currently on holiday in Cannes, points out that he has not seen the findings of the experiment, is not an expert in the area in question, and doesn’t actually know who it is calling him and interrupting his holiday. After much cajoling, he admits that the results sound ‘intriguing’ but expresses his doubts at the ‘cure’ claims, given the scant information provided to him. Following several calls of this nature, he experiences an uneasy feeling for the rest of the day. He switches his phone off for the rest of the trip, and then spends 2 days on the toilet, as his uneasy feeling resulted in him being distracted and eating shellfish, which he had forgotten he was allergic to.

Step 9: A news story hits the media outlets about the new ‘revolutionary treatment’ for disease X, accompanied by pictures of a celebrity sufferer. The story is reported via each source in a manner alarmingly similar to the original press release, but with the removal of much of the data and experimental description, and with the inclusion of ‘criticism from professor B’ and a great deal of worrying but ultimately irrelevant statistics about the prevalence of disease X in society. In some media source, names and pictures of a few more famous sufferers are also included as an afterthought, mostly female ones who have at some point in their careers been photographed wearing a bikini.

Step 10: A nightly news programme features the ‘revolutionary treatment’ as part of the news round-up. Researcher A, watching this in his pants while eating corn-based chip-snack 'A' at home, recognises some of the terms and names used, but concludes that it can’t be anything to do with his research; he wasn’t investigating anything so ground-breaking (process A only occurs in disease X in 15% of reported cases at any rate), and anyway, somebody would surely have told him if his research was in the news. Surely…?

Step 11: Support groups for sufferers of disease X welcome news of the new treatment, substance A. However, they react angrily when they discover that it is not readily available on the NHS. Attempts are made by representatives to explain that the NHS does not treat patients with untested, unproven substances that are not readily available and would only work on a small percentage of sufferers if they were. However, the only aspect of this that registers is the term ‘small percentage of sufferers’. Accusations abound about the NHS sacrificing people in order to save money.

Step 12: Professor A is more regularly contacted by people asking him to explain or defend things he never actually said. Other experts in his field criticise Professor A for his ‘self-aggrandising’, ‘dangerous exaggerations’ and ‘bringing the profession into disrepute by potentially costing lives in order to satisfy his own ego’. This means he is dropped as a speaker form several conferences. After every third phone call or email, he finds himself searching the job vacancy listings for anything with the word ‘farm’, ‘library’ or ‘monastery’ in it.

Step 13: In response to the extensive media coverage of the ‘revolutionary cure’ for disease X, GPs report a significant increase in patients claiming to be suffering symptoms of disease X. Although disease X is a complex one with features and symptoms varying between sufferers, the symptoms reported correspond significantly to the ones described in the more popular results provided when ‘disease X’ is googled. GPs attempting to suggest a psychosomatic issue (as well as pointing out that ‘revolutionary treatment’ substance A is only shown to affect one facet of the disease in specially bred mice who don’t actually suffer from disease X in the strictest sense) become the subject of a media campaign attacking ‘uncaring, unfeeling health professionals’. This campaign has the opposite effect to that which is presumably intended, as it increases the level of contempt GP’s feel toward typical patients, and the general public overall.

Step 14: The journal in which researcher A’s original paper was published report that the paper has been requested/downloaded no more or less than what is typical for a paper in that area.

Step 15: Researcher A begins a new project, studying the effect of substance B on process A. He notices no change in his daily life, except that Professor A doesn’t answer many of his emails any more.

Step 16: The shadow government accuse the government of ‘spending lives, rather than money’ by neglecting to provide substance A on the NHS. The fact that ‘providing a relatively unknown substance which has not been deemed fit for human use to sick patients’ is a perfectly acceptable method of not risking lives is never mentioned by either political party.

Step 17: A pharmaceutical company that began a ridiculously accelerated drug development project to develop and patent a substance A based treatment for disease X decides that the marketing opportunity has passed. The project is slowed, and then abandoned as the realisation occurs that the accumulated data was obtained via such a rushed and haphazard method that it is effectively useless.

Step 18: Interest in substance A as a cure for disease X abruptly vanishes when researcher B at institute J discovers that common substance epsilon may contribute to disease J. The media then focuses on that for a total of two weeks, then lose interest entirely as a famous posh person reveals that they are engaged to a slightly less famous posh person.

Step 19: Researcher A begins actively asking people in his department where Professor A is. He is told that he is ‘on sabbatical in Nepal’, probably not returning. Researcher A is offered his vacant job. Researcher A is confused, but accepts. Occasionally he receives emails asking him to speak as ‘the discoverer of the cure for disease X’. He deletes them immediately, assuming that they’re spam.

Step 20: Disease X effectively dies out as, over time, an effective vaccine is developed. This is not given the same level of media coverage as the supposed ‘revolutionary cure’ as 1) it was a gradual development, and 2) a vaccine makes sure something doesn’t occur; thing’s not occurring are not newsworthy.

Step 21: Disease X sees a sudden resurgence when, years later, a ‘maverick doctor’ makes a fatuous link between the vaccine and illiteracy in children.

"Dear Andrew Wakefield, from Science" (No. 20)

Whoop whoop, here we go again. Admittedly, I had the idea for this a while ago, but only now gotten round to writing it.

"Dear Mr Andrew Wakefield

This is a letter to inform you that, regrettably, we will no longer be requiring your services here at Science. Although we do not have a policy of criticising or suppressing individuals with controversial or unusual theories and ideas, we do insist that they follow company procedure and provide evidence via experimentation for said theories before releasing them to the public. We cannot tolerate those who do things in reverse. Although I'm willing to believe you may have had extenuating circumstances (judging by your performance I'm prepared to concede that you may have read the employee orientation handbook backwards), I'm afraid that your overall actions have led me to decide that you are no longer welcome here at Science.

I assure you Mr Wakefield that this decision was not arrived to lightly

(and just to clarify, the term 'mister' is used in the sense of 'someone who is most definitely NOT allowed to do medicine on a professional basis', not 'someone who is such a good doctor they get promoted to consultant', I'm sorry if you find this clarification patronising but you do seem to have a habit of arriving at conclusions based on evidence which says the exact opposite to what you claim)

However, in the interests of fairness, what follows are the primary reasons for your dismissal, which are issues you may want to address when seeking further employment (if it helps, I hear the chiropractors are looking for people, and I'm sure you'd feel right at home there).

- Over the last decade, your actions have brought considerable negative publicity to Science. Despite the fact that you claimed to have used 'science' to prove your theories, the use of the same 'science' (properly, this time) has constantly disproved your claims. Your recalcitrant attitude to your colleagues has caused disruption, ill feeling and has damaged moral. We always ask for good teamwork skills when interviewing applicants, and you assured us you had these qualities. Now we discover that you do not.

It's possible that you felt you were in some way helping the company, under the axiom 'all publicity is good publicity'. However, we here at Science do not subscribe to that belief, in much the same way that I imagine BP no longer does. Your actions have caused considerable damage and disrupted the long term goals of the medicine division (in brief, these can be summarised as 'Where Possible, Stop People Dying!'). Though whether through self-aggrandisement or a misguided attempt to be helpful, your actions have had the same effect. To clarify, those signs in the lobby that say 'Please do not feed the Media'? They are there for a purpose.

- It has come to our attention that you have been moonlighting with law firms and other rivals of Science? According to our records, you were paid in advance to find a link between the MMR vaccine (one of our most useful innovations, I might add) and autism? Although there is also evidence to suggest that you weren't asked to associate MMR with a specific disease, but chose autism due to it's poorly understood nature? A simple request to upper management and it should have been simple to transfer you to the autism research division if you were that curious. But if you chose to exploit the health of children for your own ends, than that is simply against the values and ethics of Science, and as such your services are not desired.

- Speaking of which, your methods are not tolerated here. You may argue that there was no form or instruction ruling out 'stabbing children in the spine without their consent and the relevant training to do so', but we here at Science try to think well of our employees, and until now it was believed unnecessary for such a policy to be put in place. If you feel that was an oversight on our part and you are thus blameless, then please feel free to take your grievances to the ombudsman, I would very much like to hear how he responds to your argument.

- You continue to allow celebrities onto the premises. You are fully aware that this is against company policy, ever since the incident where Fiona Phillips was found rummaging in the company bins for 'dirt'. It was only disappointing good fortune on her part that prevented her from getting a serious infection and trying to treat herself with homeopathy or crystals, would have saved us a lot of bother. But celebrities have a sense of value of their own opinions that is massively disproportionate to their actual knowledge, and your antics have only made them worse.

There are other reasons for your dismissal, and you will not shoulder the full burden of responsibility.I shall be talking to your supervisors who let your actions go unchecked for so long. But from this point on, you are no longer welcome at Science. Please hand in your keys, badge and gun at the front desk (I don't know why you'd have a gun, but am not prepared it rule it out based on your past behaviour).

If you are spotted on the premises again, I have the security guard under instruction to drag you to the nearest ditch after shooting you with tranquillizer darts (in the spine preferably, for the irony)

Yours sincerely

The anthropomorphic personification of Science (C.E.O. of 'Science')'

email: humourology (at) live.co.uk

twitter: @garwboy

"Dear Antivaxxers, from Science" (No. 8)

Needs doing, might as well kick them when they're down.

(N.B. Some anti-vaccination protesters may indeed be otherwise pleasant, rational people undeserving of scorn or ridicule, but I'm not going to start making detailed exceptions. Some people have complained to me that this sort of generalisation is unfair and non-scientific so I shouldn't do it, completely missing the point that that's why I do this. Science being non-scientific is pretty much the theme of this series. If anyone else feels slighted or upset by the generalisations I've made, that you feel unfairly cast you or your chosen profession/beliefs in a negative light then send me a self-addressed jiffy bag and I'll return it full of good feelings, to replace the ones I've hurt)

"Dear Antivaxxers

Hello, how are you? This might end up being a bit confusing, as I'm the personification of the abstract concept of Science, and as such don't really exist, whereas when I say 'antivaxxers' I'm referring to the sum of individuals who collectively oppose the use of vaccination on the spurious and completely contradictory grounds that they're damaging to health.

I'm pretty sure you aren't part of one international organisation, but I'm lumping you together anyway. Aside from that detail, you do exist in a physical form, whereas I don't, so this letter might be weird for you, especially as it contains actual words and information.

It must be as if Santa Claus wrote to you first. In July. And you hate Santa Claus because he endangers your children (not like the traditional Santa Claus, a perfectly harmless symbol of goodness and generosity that teaches children to appreciate it when a fat sweaty old man in disguise breaks into their room at night bearing gifts, and to be really quiet about it when he does). But I digress.

Believe it or not, this is actually a thank you note. I wanted to say I appreciate it, all the things you've done to help me over that past decade. Not only have you helped me cut my research costs, but you've also opened up new fields of research for me that will no doubt prove very lucrative once I've made some headway, and in these troubling financial times that's nothing to be sniffed at.

For instance, I've managed to trim my research and associated costs by nearly 50% thanks to your shining example. Rather than have my people spend countless hours in labs and clinics, endlessly churning out data and results that might not even give the findings they want, before tediously writing them up then having numerous experts check their findings so that they can ensure the conclusions are appropriate, I've assigned most of them to adopt your approach.

Hysterical nonsensical screaming. Seriously, rather than do all that work to prove their theories about health, I've just got them going out into their street and yelling at passers by, about how if people ignore their theories then the children will be in danger (although with some of the physicists this is coming across as more of a threat, will work on that).

I've even got the paediatricians doing it. I did think that having people responsible for children's health wasting their time by shouting about children's health rather than doing things which were known to improve children's health would be detrimental to children's health, but I just followed your example; keep saying 'children's health' enough and it makes it OK.

Took me by surprise, but I have to admit it gets things done. I've seen a noticeable drop in reports about sick children, which may or may not be related to the fact that I've not bothered taking reports or analysing data for a while, it just gets in the way of all the shouting.

And another nice call on the spokespeople. I've been relying on trained and qualified people to convey facts and information about their chosen field, and it's never worked. If only I'd thought to get some middle-aged female celebrities to tell people what's what. The beauty of it is, they don't even need to be trained! They can talk about anything and people will believe them because media says they should. How ingenious. I only wish I'd gotten hold of some big celebrity spokespeople before Scientology snapped them all up (I'm also thinking of suing Scientology for copyright infringement, but that's another matter)

Either way, I now know in future to use only angry women as spokespeople, seeing as how they interpret every criticism and argument against them as wishing death upon their children, or potential children, giving them the upper hand in every debate even if they're stark raving mad. Maternal anger seems to trump reason and logic every time, I'll bear that in mind.

Also, as I said, thanks for opening new fields of research for me. For instance, I now know that 'harmless' low level or even inert doses of viruses injected from a young age are inherently dangerous, more so than exposure to the full strength virus which a non-vaccinated person is far more likely to succumb to. What an intriguing concept, the fact that tiny doses of measles/mumps/rubella can cause autism but the full-strength viruses don't. Inverse efficacy? I can't explain it. But I agree, can't be having children getting autism, much better they die of an easily preventable disease. Think of the children!

Unless you're one of those people like I implied Santa Claus, in which case do anything but think of the children.

And well done on exposing Big Pharma. That brute needs taking down a peg, admittedly. I mean, I thought I understood how business worked. I was wrong (you may be unfamiliar with this phrase, but just look it up). You revealed that Big Pharma is selling harmful/ineffective vaccines purely for profit. I would have thought that it would have been a major marketing mistake for a business to maim/kill potential customers, but I guess I was wrong. Toyota seem to agree. If I can work out how this is the case, I could make some serious money from it. Killing customers is a valid marketing strategy? I can't wait to ride the Disneyland Decapitator (The Decappiest place on Earth!), or enjoy a delicious McDonalds Cyanide burger. Mmm, lethalicious! I'm lovin' it! (For about 6 seconds)

So yeah, thanks for everything you've done, I appreciate it.

Love and Kisses

Science (BA hons)

P.S. You might want to watch where you tread, I dropped a vial of smallpox the other day, can't seem to find it. I'm sure it'll be fine, though

email: humourology (at) live.co.uk

Twitter: @garwboy