The journalist and broadcaster John Diamond was the unanimous choice for this year's HealthWatch award. Diamond wrote the acclaimed book "C: Because Cowards Get Cancer Too", which records his experiences since developing cancer of the tongue. He was present to receive the award at the HealthWatch Annual General Meeting on 24th October this year and HealthWatch Committee member Geoff Watts read out John Diamond's presentation to a packed audience. This is reproduced below in full.
The other week I wrote a piece in one of the papers I write for, about alternative medicine. If any of you have read more than four newspaper pieces with my name attached to them then the chances are that one of them was about the intellectual folly which is alternative medicine. I must have written that piece a hundred times now in various forms and the routine has become pretty standard: the true nature of scientific endeavour, the infallibility of the properly designed controlled experiment, the futility of purely anecdotal evidence-well, you all know how it goes.
This time among the outraged correspondence that these pieces invariably attract was a letter from a man in Liverpool. He'd read my piece and it had upset him. For he was a practitioner in alternative medicine and knew it worked. And what's more, he said, he also knew that orthodox medicine simply didn't work. He didn't say it didn't work as well as doctors thought it did, or as well as patients were suckered into believing it would by the grasping medical establishment. No: he was quite certain. Orthodox medicine is a complete sham. It just doesn't work.
He'd included an e-mail address on the letter and-what can I tell you? I was in front of my computer screen, I was bored with whatever it was I was writing-probably yet another piece on the intellectual folly that is alternative medicine-and I e-mailed him. Getting into e-mail arguments about alternative medicine on the internet is as foolish a waste of time as-well, getting into arguments on the internet about gun control or who killed JFK or any of the other cul de sacs up which internet users regularly disappear. But nonetheless I wrote the message and, fool that I am, pressed the 'send' button.
"If orthodox medicine doesn't work," I wrote, "how come life expectancy since, say, the turn of the century has almost doubled?" In fact I wasn't quite sure of the precise figure, but if my previous arguments with alternative medicine supporters are anything to go by, nor was he. He wrote back what they always write back: the reason life expectancy has increased is because infant mortality has decreased. Take out of the equation all those babies dying before they get to their first birthday, and your average Victorian, with his homoeopathy and naturopathy and Little Liver Pills and Tiger Balm, lived just as long as your 21st century pill-popper.
Up to a point he's right, of course. One of the reasons infant mortality has decreased is because of orthodox medicine. But that's not what I wrote to him. Instead I wrote something like this: yes, infant mortality is down. But life expectancy at 20 is up too. And at 30, 40, 50 and 90. A 50-year old with access to a reasonably sober GP and a branch of Boots has a greater chance of living to 80 or 90 than his father or grandfather did. And these aren't statistics worked out by evil doctors with their axes to grind, but by actuaries who work for life insurance companies and who have to get the figures right or the insurance companies will go bust.
I'll give the man his due. He was, by his lights at least, honest with me, for his next message said "Oh. I didn't know that. Look, let me get back to you." Yes, I thought. A result! For the first time in years of arguing the toss with these people, I've made a conversion.
His next message arrived the next day. He was grudging. He didn't know where I'd got my figures from, but he supposed I must be right. Nonetheless, he was sticking by his original statement: orthodox medicine doesn't work and alternative medicine does.
I, he said, was a case in point. I had cancer. The doctors had tried to cure me and had failed. On the other hand his mother had been diagnosed with cancer a couple of years earlier. She, like me, had been a scoffer, a cynic, an unbeliever and had put her faith in the wretched medical con-artists. But after a while he had persuaded her to take Essiac.
Essiac, some of you will know, is an ancient herbal remedy used by Native Americans in Canada to cure cancer, and was rediscovered by a Canadian nurse some time in the 30s. There's no evidence that cancerous Native Americans lived longer in Canada than anywhere else, but Canadian alternativists rather like having their very own national alternative remedy, and the stuff is now touted all over the place as a miracle cure. I don't have to tell you that it isn't, of course; or that every properly controlled study of Essiac has shown that patients might as well drink Tizer for all the good it does.
But this man had fed his mother Essiac and she had-well, since you ask, she'd died ten months later. And this proved Essiac worked? Yes, he said. Because the doctors had only given his mother two months to live. Now as it happens this is one of the things that alternativists are always telling me about in their success stories: "The doctors said the patient would be dead in two months, or a year or two years," they say, "but he took-insert name of alternative remedy-and lived twice as long". In fact doctors very rarely give a precise sell-by date for cancer. Until the very end is nigh, they can usually only ever give a ball park figure. But when doctors say "I'm sorry, we can't be precise. It might be a year, it might be as soon as a couple of months", what people hear, understandably enough, is "You'll be dead in two months." Believe me, I know. Before I had my last bout of chemotherapy I was forever telling people I had three months to live, because that was the worst-case scenario. That was over a year ago, and here I am talking to you tonight. Well, not talking to you exactly, but you know what I mean.
Anyway, the reason his mother had died wasn't because Essiac didn't work but because she'd taken it the wrong way. She had swigged it and she should have sipped it.
I know: the man sounds mad. But I promise you, I've had this conversation, or one like it, with dozens of people like him who make their livings passing on information like this to anyone who pays them: from people with vague symptoms their GPs have got bored trying to treat, to terminal cancer patients desperate for something, anything, to give them some hope.
And the thing about these people is they tell lies. They may not think they're telling lies, but that's what it comes down to. Those of us who doubt the efficacy of alternative medicine tend not to point this out; after all alternative practitioners are usually kind and gentle people who like to think they have their patients' best interests at heart. Saying a homoeopath tells lies is rather like saying that the tooth fairy sniffs glue. But they do. I keep on getting messages, for instance, from men and women who want me to try one or other of their cures, and who tell me a story which goes like this: "I had a patient/friend/client who had been given two months to live and sent home to die because the doctors said there was nothing they could do about the tumour on her liver/lung/brain. Together, though, we worked out a regime of coffee enemas/organic grape juice/zinc-and-aspirin (and I promise you, all of those cures come straight from my e-mail in-box) and what do you know? The next scan showed the tumour had shrunk by half." Which does, indeed, sound miraculous. But then you say to yourself, hang on: what are the doctors doing scanning the patient if she's been sent home to die? Even the best-equipped hospitals tend not to give expensive scans to patients whose time is up. And so after a bit of gentle prodding it turns out that actually the patient has been sent home, but comes in every day for some radiotherapy. Or is on chemotherapy. And, OK, the doctors didn't actually say that the patient was terminal, but ...
If orthodox doctors tried to get away with that sort of nonsense they'd be kicked out of the business in five minutes flat. But the alternativists do it all the time.
But then it occurred to me. Although my Liverpool correspondent was a resolute and unabashed alternativist and I'm a steely-hearted and over-rational supporter of the orthodoxy, we do share a single belief which is this: we both agree that it's possible, under certain circumstances, to alter the outcome of some illnesses by introducing some sort of specific preparation into the sufferer's system.
That basic agreement established, there are two differences between us. I think that the best way of determining what works and what doesn't is to try it out under controlled conditions. If you give Essiac to 100 patients with the same sort of cancer and they die as quickly as 100 patients not fed Essiac, then you can be pretty certain that Essiac doesn't work. Simple. But he doesn't believe that. His is an act of faith-a faith based on rumour, speculation, misheard anecdotage and all the rest of it.
The other difference is probably more telling. If you were to ask most alternativists they'd probably tell you that one of the big differences between their art and our science is that the medical establishment is so very sure of itself. It's closed minded. It knows it's right. But in fact that's the very opposite of the truth. Although we patients demand certainty of our doctors because we prefer certainty in our lives, medical science is as much about not knowing as it is about knowing. An experiment, by definition, is about what you don't know, about what you want to find out. It's the alternativists who are so certain of their beliefs that so many of them don't think it's necessary to submit them to proper scrutiny. Not that they dismiss experiment out of hand. Look through the alternativist's web sites and they have one thing in common: the slightest hint of experimental success is enough to support a vast body of alternative belief; the slightest hint of experimental failure is enough to demolish an equally vast body of established orthodox belief. To be more specific: I've been told scores of times that the Thalidomide case demonstrates how much nonsense orthodox medicine is (and it's interesting that 30 years after the discovery of Thalidomide's dangers, the alternativists still use it as their prime example of orthodox failure). Because Thalidomide was bad medicine it follows that all orthodox medicine is bad. You then go on to challenge them about homoeopathy and they'll tell you that the meta-research published by the EU last year showed that there are statistically significant results showing that homoeopathy has a benefit for hay fever sufferers and people with sore limbs. And on that tiny shred of evidence they start telling me about the wonders homeopathy can work in cases of cancer and heart disease.
It's nonsense. And much of it is offensive and dangerous nonsense too. And for as long as I can, and as long as I can sweet-talk indulgent editors, I hope I'll get the chance to say so again and again.
All of which is an unforgivably long way round of telling you how very honoured I am by this award, above any of them. Yes, I was grateful and usually pretty surprised to win prizes for my journalism and for the book. But to be told that I've done something to help people-too confused by the welter of nonsense about medicine they read in the papers to approach their illnesses rationally-to help them think twice about the claims made for the untested and the impossible...well as far as I'm concerned, that's something worth doing. Thank you.
John Diamond died on March 2nd 2001