Monthly Archives: January 2012

E.Coli in Organic Food Leads to 50 Dead in Germany

Maybe it is too late for anyone to care now, but we missed this Pajamas Media piece back in November, on the outbreak of E. coli in Germany from organic bean sprouts.

It is important to find the source of outbreaks not only for health but economic reasons. Before the source had been traced to an organic farm in Northern Germany, German health officials had suggested that Spanish cucumbers might be the source, and Spanish cucumber-growers had to destroy much of their crop. The European Commission generously awarded $300,000,000 of other people’s money to compensate the farmers for the initial, though understandable, mistake. A blanket ban on European vegetable exports to Russia was enforced, thus impoverishing the Russian diet yet further, until the elucidation of the cause of the outbreak. Overall, the cost of one organic farm in Germany to European horticulture is said to have been in the region of $600,000,000.

As a commenter here stated, “One German organic farm has killed twice as many people as the Fukushima nuclear disaster and the Gulf Oil spill combined. crickets.”

Medicolegal judgments

In the BMJ (subscription required) Dalrymple profiles an accomplished, but forgotten, doctor:
Even eminent people are soon forgotten, and I don’t suppose that the name of Sir John Collie (1862-1935) will mean much to most readers, even though he was knighted twice, first for his medical services to the Metropolitan Water Board, and second for his medical services during the first world war.
….
His obituary in the BMJ was not such as one might wish for oneself (BMJ 1935;1:807, doi:10.1136/bmj.1.3875.807). Although he was really very kind, said the obituarist, some people sent to him for examination were so frightened that they were left almost paralysed, if not by the industrial accident that had brought them there, then by the prospect of the encounter.
The trouble is, of course, that fraud and malingering really do exist, and unless they be counted as diseases in themselves a doctor sometimes has to pass judgment on them. Collie’s book, Medico-legal Examinations and the Workmen’s Compensation Act, 1906 (1912) elaborates on this at some length, in an excellent prose style.

Should the ‘Morning After’ Pill Be Available to All Ages?

I can’t remember Dalrymple ever having written of abortion before, and as he is a doctor I have wondered what his view of it would be. Now, on Pajamas Media, he addresses one aspect of the issue, the decision by America’s secretary of health and human services to require a prescription for use of the morning-after pill by minors.
That the secretary was making a political decision is certain; what is not certain is that she or anyone else could make a non-political decision, for facts do not compel policies as if, once enunciated, there was no choice to be made — though, of course, facts (one may hope) do affect policy decisions.
“First, the facts,” says the editorial magisterially, if a little condescendingly, as if bringing enlightenment to the benighted. But, as the on-line commentary that the editorial provoked demonstrated, facts do not always speak for themselves, nor is there universal agreement about which facts are relevant, conclusive, or even best-described.
….
The idea of handing out morning-after pills to 10 and 11 year olds with no questions asked seems callous and unfeeling. On the other hand, so does forcing them to go through with pregnancy or abortion because of delayed access to the pill. People can disagree on the matter without being moral monsters.

Dickens essay free in the American Conservative

A hat tip to reader Alphonsus for letting us know that Dalrymple’s essay on Dickens, Hard Times Again, has been made freely available. An excerpt:
The adjective “Dickensian” is more laden with connotation than the adjective that pertains to any other writer: Jamesian, for example, or Joycean, even Shakespearian. We think of workhouses, of shabby tenements with bedding of rags, of schools where sadistic and exploitative schoolmasters beat absurdities into the heads of hungry children, of heartless proponents of the cold charity, of crooked lawyers spinning out their cases in dusty, clerk-ridden chambers. We think of Oliver Twist asking for more, of Wackford Squeers exclaiming, “Here’s richness for you!”, as he tastes the thin slops his school doles out to his unfortunate pupils, of Mrs. Gamp looking at her patient and saying, “He’d make a lovely corpse!”
If he had been only a social commentator, though, Dickens would have been forgotten by all except specialist historians of his age. But he is not forgotten; he survives the notorious defects of his books—their sometimes grotesque sentimentality, their sprawling lack of construction, their frequent implausibility—to achieve whatever immortality literature can confer. Over and over again, in passage after passage, the sheer genius of his writing shines from the page and is the despair of all prose writers after him.
When Dickens called himself “the Inimitable,” he was speaking no more than the truth; he was the greatest comic writer in his, or perhaps in any other, language. And the comedy runs deep: it is not trivial, for while it depicts absurdity, pomposity, and even cruelty, it has the curious effect of reconciling us to life even as it lays human weaknesses out for our inspection.

Heart and science

In the British Medical Journal (subscription required) Dalrymple reviews a bad but interesting novel:

Wilkie Collins (1824-1889) was addicted to laudanum (tincture of opium in alcohol) for much of his life, but that did not prevent him from producing a vast corpus of work. Among his novels is Heart and Science, published in 1883, known (in so far it is known at all) for its protest against vivisection.
It is not a good novel, to put it mildly, and it would take several pages of convoluted prose to summarise its preposterous plot. But it has much, from character to incident, to interest the medical reader.
….
Heart and Science is not so much an attack on science as on the supposed all-sufficiency of science; it is not very effective, however, because it is such a bad book.

Misusing Copyright Laws in Medicine

At Pajamas Media Dalrymple reports on the assertion of copyright on a widely-used medical questionnaire:
The Mini-Mental State Examination (MMSE) is a questionnaire that has been used by doctors throughout the world for more than thirty years to test the cognitive function of those suspected to suffer from dementia. It is very simple and quick to administer, consisting of 30 items, and must by now have been used millions, if not hundreds of millions, of times.
….
It is only in 2000, 25 years after it was first published, that the authors, or inventors, of the MMSE tried to assert their copyright….Many doctors in all parts of the world have photocopied the questionnaire hundreds of times. In strict law they may be guilty of having infringed copyright and therefore liable, in theory, to penalties according to the copyright laws of their country. In the United States, unwitting infringement of copyright carries a fine of up to $30,000, and willful infringement up to $150,000, with the possibility of a prison sentence to boot.

Concordia disaster: Should a captain go down with his ship?

In the Telegraph Dalrymple addresses the apparent cowardice of Captain Francesco Schettino:
Courage is a virtue and heroism is admirable, but do we have a right to demand them? Which of us cannot look back on his or her own life and remember decisions, or compromises made, or silences kept because of cowardice, even when the penalties for courage were negligible?
If we are cowardly in small things, shall we be brave in large? Have we the right to point the finger until we have been tested ourselves? When we read of the seemingly lamentable conduct of the captain of the Costa Concordia, Francesco Schettino, who left his passengers to their fate, do we say, “There but for the grace of God go I”?
Of course, leadership entails an obligation to be courageous – morally, physically or both. It is the price of leadership; it is why leaders are more highly regarded and rewarded than the rest of us. But even subordinates in certain professions have the duty to be brave, as the rest of us do not. A soldier is expected unquestioningly to put himself in the way of bullets as a civilian is not.
There follow a couple of colorful stories of bravery from Dalrymple’s medical career, and a nuanced conclusion.

The European Crack-Up


In an extensive piece in City Journal (h/t Jonathan L.), Dalrymple provides a comprehensive analysis of the still-unfolding European debt crisis. He shows why the example of Belgium demonstrates the pointlessness of the EU’s ostensible raison d’etre


Reflection on the situation in tiny Belgium might introduce an element of doubt into the minds of the most fervent believers in the European Project. Belgium has existed ever since it was cobbled together in 1830; yet in all that time, it has not been able to create a durable national identity….Yet the political difficulties of Belgium do not give the European unionists pause for thought—or, if they do pause, they reach a peculiar conclusion: that what has not worked in two centuries in a small area with only two populations will work in a few years in a much larger area with a multitude of populations.

…delineates the differences between Ireland and Greece, why they matter, and lauds the reaction of the Irish as an example for the rest of us to follow….



The Irish understood, as no other people seems to have understood, that they were complicit in the crisis.


…and indicts the short-sightedness and lust for power of the EU’s founders:


The European Union that was supposed to put an end to war on the continent has resuscitated antagonisms that might end in bellicosity, if not in outright war. And the European Project stands revealed as what any sensible person could have seen it always was: something akin to the construction of a massive, post-Tito Yugoslavia.

This seems to be the bottom line:


The term “European” is not meaningless, but whatever content the term may have, it is not sufficient for the formation of a viable polity.

Malingerers

In the BMJ (subscription required) Dalrymple recounts Chekhov’s short story about homeopathy, Malingerers, and relates it to his mother’s own experience with the practice.
My late mother suffered a severe rash a few years before she died. She had to wait an age to consult a dermatologist, even privately, and then she saw several in swift succession. All their prescriptions made her rash much worse; the prescriptions were so bad that even stopping them did her no good.
Then she went to a homoeopath, took homoeopathic medicine for a week and recovered almost immediately. The rash melted away as the snow in sunshine. I was very pleased for her, of course, but kept a little corner of my heart free for the irritation that I felt. She, however, was delighted that there were more things in heaven and earth than are dreamt of in most doctors’ philosophy.
[In Chekhov’s story, the homeopathy practitioner] notices that a little packet of red paper falls from his pocket as he speaks. After he has gone, she examines it, and finds that it contains the very pilules that she has prescribed for him. He has taken none of them, and a doubt begins to enter her mind. This doubt is confirmed when all the patients who follow him praise her curative skill extravagantly—and then ask for economic assistance [as he had].
Chekhov draws a short moral: “The deceitfulness of Man!” Yet in the case of my mother . . . well, reality is a complex thing.

Medical Journal Myopia Regarding Third World Health Care

In a Pajamas Media piece Dalrymple has some fun with the language used in an editorial in the New England Journal of Medicine:
The authors of the editorial suggest that people like the Zimbabwean physicians migrate because of “push and pull” factors, or carrot and stick. With the mealy-mouthed delicacy of the politically-correct diplomat and careerist bureaucrat, they delicately refrain from describing the stick in any detail. The nearest they come to doing so is the following: “unstable working environments.” This reminds me a little of the Emperor Hirohito description of the dropping of the atom bombs: “The war has developed not necessarily to Japan’s advantage.”
With regard to Zimbabwe, the authors see reason for optimism:

In a draft national policy currently awaiting parliamentary approval, Zimbabwe addresses factors contributing to health workforce shortages; supports mechanisms and processes for stakeholder coordination and collaboration; and defines stakeholders’ roles and responsibilities in ensuring timely financing, implementation, and monitoring of national human resources for health and in promoting the development and retention of the health workforce.

Have the authors ever been to Africa in general, and Zimbabwe in particular? And if they have, did they ever see anything from anywhere other than through the tinted windows of an air-conditioned official car? Here again one cannot help but think in analogies, this time with Beatrice and Sidney Webb, who read the Stalin Constitution for the Soviet Union with minute attention (coming to the conclusion that it was the most democratic in the world), and every official statistic ever to emerge from Moscow, and then wrote a vast tome about the Soviet Union including everything they had read, missing only the twenty or thirty million deaths that were taking place there while they read it.