Monday, March 31, 2008

If I Opened My Heart, There'd Be No Room For Air...

Back On Nights...

Maybe some good news in the personal life of Shroom....

However, what is really cranking my handle at the moment is the ongoing furore about MMR. For those of you disinterested, check here, or thereabouts. I am almost incandescent with rage; however, some of my anger makes me seem decidedly right wing. So what follows is mostly rant, based on some small professional knowledge, but mostly bile.

You have been warned.

Vaccines. Named after the humble cow (vacca) by Pasteur, in honour of Jenner and his work with cowpox. Jenner noticed that milkmaids, while oft afflicted with cowpox, rarely, if ever contracted the far more deadly smallpox. So he experimented, by inoculating healthy subjects with pus from cowpox pustules. The rest, as they say is history. Contemporary records show that people were against such odd behaviour, even then - cartoons depict subjects sprouting small cattle from the inoculations. Fortunately, science held sway.

Does it work? There hasn't been a recorded case of smallpox since the late 70s.

When I was a little Shroom, there weren't so many vaccines about. I had measles, mumps and rubella. It was encouraged, as was chickenpox. If any of you know anyone who has had chickenpox as an adult, you'll know why it's better to have it as a nipper.

Enter MMR. An all in one vaccine to prevent these diseases. Why bother? I had 'em, you probably had 'em... so what?

Because these diseases kill people. Not many, but that ain't much comfort if yours is one of 'em.

And then doubt was cast on the safety of the vaccine. The 'evidence' produced was seized upon by the ever rabid media - in this country at least- and hundreds and thousands of parents voted with their feet. And their children's health.

The problem here is that, as doctors, we have a duty to do what is right for our patients; and if that includes breaking the news that a widely used medication is unsafe, so be it. If I thought the man at the centre of this whole mess was acting in what he genuinely believed was the public good, I'd be less scathing. But I don't think he was.

His research was shonky, and his practices questionable to say the least. And yet the establishment failed in it's duty; the checks and balances, designed to prevent this failed. Medical research is under the cosh a little at the mo', cos it turns out people fudge their research. Well, colour me taken aback. This has always gone on - Mendel almost certainly faked his all too perfect results, and the Thalidomide team hedged theirs in an attempt to prove safety that was to have disastrous consequences.

But now the idea is out there, and there are a number of people who will never be convinced of the wrong-ness of this charlatan's research. Any other evidence will be dismissed as Government cover up; we're back to pictures of cows sprouting from forearms.

But how far can a Government go to enforce the health of a nation? If parents don't want to vaccinate their kids, however ill advised I may think it, can we force them?

Maybe not, but it makes it that much harder to sympathise with the mother who's child is critically ill with pertussis (something I've never seen before either), who explains they decided not to get the kids jabbed after reading the Daily Mail.

By all means make an informed choice, but for Christ's sake, make sure it really is informed.


Baby Blue Pyjamas said...

On a side note, man in minors, with chickenpox, that itched. The MINT told him to go away.

rlbates said...

Very nice post!

Alice said...

The scare was only about the combined MMR, wasn't it? What is the problem with parents being offered single jabs for the time being? Couldn't single jabs help to keep the population sufficiently innoculated until people come around to accepting MMR?

faith said...

Yo Shroom, i've tagged you over at the new blog by the way! Sorry love!

Nathan said...

By all means make an informed choice, but for Christ's sake, make sure it really is informed.

Indeed! The problem I find is that the way media report things can leave a lot to be desired. Case in point, the graph on the BBC page. Please, for the love of god, if you're going to truncate the axis also mark the plotted lines so it's clear that this has happened.

While I agree, in this case, it doesn't detract from the overall purpose of the graph I've seen many cases where this has deliberately been done to trick the reader into thinking something is much much better/worse than it really is.

Coming from a maths background and not a medical I know all to well that you can (dis)prove just about anything with statistics if you choose your sample (un)wisely enough.

While I'm ranting, the word "Average" should be banned. It's completely meaningless... what average are you using ? Did you discount extreme values ? What is the deviation from this so called "average" ??

Great post BTW :)


Chrysalis Angel said...