Free Bad Science Book Give Away

August 21st, 2006 by Ben Goldacre in bad science, heroes, statistics | 40 Comments »

Okay not mine, because I’ve got a bit over-ambitious with the content, but this is a bit of a find: free books by one of the early pioneers of popularising critical appraisal, epidemiologist Petr Skrabanek. Few today will remember his fantastic “Follies and Fallacies in Medicine” (co-authored with GP James McCormick) in which they take on everything from the bad maths of breast cancer screening, through the validity of psychiatric diagnoses, and on to homeopathy and “electroquackupuncture devices”. Their “Fistful of Fallacies” is particularly good.

At the time, this was regarded as a visionary classic, a book that changed the outlook and practise of doctors and more, and ranked alongside Illich’s “Medical Nemesis”, McKeown’s “Role of Medicine”, Shaw’s “Doctor’s Dilemma”, or Moliere’s “Imaginary Invalid”, depending on how old you are.

Skrabanek was a lifelong champion of clear thinking, scepticism, and critical appraisal, and astonishingly – especially since I was about to try and buy a copy – all three of Skrabanek’s books are available for free download from the Skrabanek Foundation.

www.tcd.ie/Community_Health/Skrabanek/Petr%20Skrabanek's%20Publications.html

Do yourself a favour: download Follies and Fallacies, carry it around in your laptop, or print out the first fifty pages. Free stuff doesn’t get any better than this.

(Handy geek tip: in Adobe Acrobat PDF reader, go to the menu “View-> Page Layout -> Facing” and you can read it almost as if it was a book, without killing any trees.)


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40 Responses



  1. Dr Aust said,

    August 21, 2006 at 4:13 pm

    Thanks for the link, Ben.

    On the subject of not-always remembered classics, another one worth tracking down is Darrell Huff’s “How to Lie with Statistics”:

    en.wikipedia.org/wiki/Darrell_Huff

    …first published more than half a century ago (1954), but still required reading.

    I bought a copy in my local Oxfam shop for 50 p . It is apparently the best-selling stats book ever, and it is easily the most useful stats-related book I have ever owned, as well as the funniest (yes, a genuinely FUNNY book about statistics – read it and believe).

    After you’ve read “How to lie…” – less than a hundred pages – you will never again be able to listen to a politician quoting statistics on the TV/radio without giggling.

  2. Fyse said,

    August 21, 2006 at 11:44 pm

    On a vaguely related subject, have you read ‘How Mumbo-jumbo Conquered the World’ by Francis Wheen? I read it while back and remember being both mightily entertained and hugely impressed. Always a good combination.

  3. Pro-reason said,

    August 22, 2006 at 2:24 am

    On a completely different note, you have to write an article on these people:

    Steorn
    www.steorn.net/en/technology.aspx?p=5

    Yahoo news: Irish company challenges scientists to test ‘free energy’ technology
    news.yahoo.com/s/afp/20060818/bs_afp/irelandscienceenergy

    Slashdot: Irish Company Claims Free Energy
    slashdot.org/article.pl?sid=06/08/21/173253&from=rss

  4. Cargo Cult said,

    August 22, 2006 at 8:16 am

    On another entirely different note, fun with ants:

    news.bbc.co.uk/1/hi/sci/tech/5272094.stm

    ‘Their jaws spring shut at more than 100 km/h (66mph)- the fastest recorded speed at which an animal can move its body parts.’ … ‘This is really by far and away the fastest recorded animal limb movement” said lead researcher Sheila Patek, of the University of California, Berkeley, who worked with ants from Costa Rica.’

    What about a 70mph cheetah?

    en.wikipedia.org/wiki/Cheetah

  5. dbhb said,

    August 22, 2006 at 8:49 am

    The Francis Wheen book is a good read, yes, although there were some points at which I felt he was as biased as his targets!

    Another golden oldie from the 50s that’s worth a read is “Straight and Crooked Thinking” by Robert H. Thouless (1953). Much more general than the Huff or Skrabanek, I suspect- more about the use and abuse of misleading language- but it’s still one I think of all the time whenever I read about bad science in the media. Probably nearly impossible to get hold of now though.

  6. meigwil said,

    August 22, 2006 at 9:42 am

    dbhb: You’ll also find that Steorn are also top class urine extractors…

  7. coracle said,

    August 22, 2006 at 9:57 am

    Fyse,

    I sometimes think that Wheen’s book is a set text for forum members, I think we’ve all read and enjoyed it!

    Ben, thanks for the tip. It’s downloaded and I’ll break the office printer budget with it at some point…

  8. Ben Goldacre said,

    August 22, 2006 at 12:07 pm

    i hugely enjoyed wheen although it is a bit more “that” than “how”.

  9. profnick said,

    August 22, 2006 at 2:20 pm

    Dr Aust,
    Thanks for reminding me about “How to lie with statistics” I used to fall asleep in stats lectures as an undergrad until I bought a copy of this book; I must rummage through the attic and see if it’s still there.

  10. Snoop said,

    August 22, 2006 at 2:39 pm

    Thanks Ben – I read the whole of “Follies” last night. It was great. On to the other 2.

  11. JohnD said,

    August 22, 2006 at 7:49 pm

    Re: “Follies”
    Not read ‘Statistics’ – hope to be able to do so soon.

    But I downloaded and began to read ‘Fallacies’ today.
    Until I got to page 10, wher this quoted:
    “Blau put it bluntly when he said: “The doctor who fails to have a placebo effect on his patients should become a pathologist or an anaesthetist……. In plain English, if the patient does not feel better for your consultation you are in the wrong game”.

    Any pamphlet that uses such an abusive quote, even to back up an argument for the reality and benefit of the placebo affect, as exerted by a caring and effective doctor, destrys its own argument. Blau was talking nonsense; insulting, ignorant nonsense if that is his view of anesthetists. And if Skrabanek and McCormick quote him with approval and without qualification then they are as narrow minded and thoughtless as Blau.

    Among hospital specialists, the anaesthetist is the holistic doctor . He or she is presented with a patient for surgery, often at short notice and by surgeons whose clinical tunnel vision obscures everything except the patient’s surgical condition. The anaesthetist must consider the entire patient, assess, investigate, diagnose and treat, before the patient even moves towards the operating theatre. To do less will endanger the patient.

    What is more, anaesthetists need to be good at gaining rapport with the patient, informing them, often answering surgical questions that their colleagues are ‘too busy’ to answer or that the patient needs reassurance about. It is normal for patients to be far more frightened of the anaesthetic than even life threatening surgery. An anaesthetist who can exert the placebo effect is a good anaesthetist and a good doctor, and most are that.

    To read this folly in what started as an interesting monograph tells me that the authors are not the savants that they are painted. To have such an opinion of a fellow specialty, to denigrate them in public from their own ignorance, makes them and thier opinions rubbish in my eyes.

    I’m sorry, I can’t be bothered to read any more.

    John Davies
    Consultant Anaesthetist

  12. Ben Goldacre said,

    August 22, 2006 at 7:58 pm

    i’ve been very pleased to see the gasman in some sticky situations, and you’re right, they are the people who reassure the patients at the nastiest moments of their very human lives, and tie a lot of loose ends together, i’ve always been very impressed by them (“some of my best friends are anaesthetists” is in fact a true statement). but i’m not sure i’d bin a whole book just because of one cheap gag.

  13. Dr Aust said,

    August 22, 2006 at 8:21 pm

    Blau was wrong, of course. Based on my experiences of the medical profession, as a co-worker and as a patient, what he SHOULD have said was

    “…become a pathologist OR A SURGEON”.

  14. Ben Goldacre said,

    August 22, 2006 at 8:24 pm

    well you say that, i ran into a locum surgical registrar in the doctors mess a while ago who was sat down working out a John Martyn song on his acoustic guitar. seriously.

  15. JohnD said,

    August 22, 2006 at 8:28 pm

    Thank you for that, Ben.
    It is so disappointing to see such a crude attitude in the supposedly intellectual. You might like to run ‘Follies’ past some of your anaesthetist friends – I hope they are not as prickly as me!

    By the way – ‘gasman’ is neither accurate nor polite these days. I haven’t given anyone ‘gas’ for years. Intravenous and/or regional (local) anaesthesia has become a major part of the specialty.

    And I didn’t want any of your readers to go away thinking the same as Blau. 60% of people who need to go into hospital, for either medical or surgical reasons, are cared for by an anaesthetist. We are doctors, 48% of the public don’t know that, and our mission is to treat acute illness, enable surgery and relieve pain. And we care. How wide a remit is that?

    John

  16. Dr Aust said,

    August 22, 2006 at 8:32 pm

    To elaborate, anaesthetists are generally pretty good at talking to patients, partly because a calm and reassured patient needs less anaesthesia and pain relief – safer and better all around. AND they talk to the patient the morning of their operations (at least the good ones do), so they get good at recognising anxiety and fear and hopefully allaying it.

    But surgeons…. hmmm. In my experience, surgeons largely take the view that it is their technical skill that really matters (at least partly true), and (as a corollary) that talking to the punters is a waste of time / inconvenience to be got over with as fast as possible. “Sound business-like” is as polite as I can put it.

    Am probably feeling rather surgeon-phobic at the mo’, since I was recently in their hands for a minor op as a day case (in a major teaching hospital, incidentally ). I had the distinct feeling I was holding them up when I got the good old “We’re your surgeons. We’ll be doing your operation. Sign here so we can get on with it” routine. (The anaesthetist, in contrast, was a class act)

    Thinking about it later didn’t know whether to be “disappointed” by the surgeons’ communication skills, or reassured that all the stereotypes about speciaIties and their traits that I sometimes transmit to the medical students seem to be as alive as ever.

    Of course, one could go for a crafty second-guess and say that surgeons KNOW people have this stereotype of them, and play up to it so that the patient thinks: “Ah yes. A cutter not a talker. All business. Must be a PROPER surgeon”. … which could arguably have a POSITIVE placebo effect. But from my experience of surgeons that might be rather too sophisticated a piece of reasoning.

    PS In the spirit of declaring potential Conflicts of Interest, must confess that Mrs Dr Aust was once an anaesthetist, so perhaps I already had a rather jaded view of surgeons before the recent experience.

  17. Ben Goldacre said,

    August 22, 2006 at 8:45 pm

    “We are doctors, 48% of the public don’t know that, and our mission is to treat acute illness, enable surgery and relieve pain.”

    is that true about the public not knowing anaesthetists are doctors?

    pain is the big one of course. i remember when i was a medical student my friend paul the philosopher came to grab me from the medical section of the library, and found me sitting next to a journal called “Pain”.

    “you see,” he explained, “that’s what it’s all about. as a potential customer, i’m just incredibly pleased to see there is a journal called “pain”. is there one called “death” too? these are the subjects we want you to study. good work.”

  18. Dr Aust said,

    August 22, 2006 at 10:43 pm

    “Is that true about the public not knowing anaesthetists are doctors?”

    I seem to remember Mrs Dr Aust quoting this stat too, so perhaps it comes from a survey by the Royal College of Anaesthetists. I guess JohnD would know.

    Remember the TV ad for the NHS where the guy passes out and collapses down some stairs? Then they scroll across the screen all the NHS types (from all professions) who help him? I’m pretty sure the “scenario” included an operation but the anaesthetist(s) WEREN’T in the list… also feeding the anaesthetists’ slight paranoia.

    I tell my students something much along the lines JohnD mentioned re. anaesthetists. Fairly obviously we preclinical teaching drones use them as an example of where a lot of applied physiology / pharmacology is ultimately used (good for trying to persuade students to get into both the above), but I was always quite impressed by the range of what they did – regional blocks to pain clinics to ITU.

    Still don’t know why they need to be able to draw the CIRCUIT DIAGRAM for a defibrillator for their exams, though. In case they ever have to build one?

  19. Dr Aust said,

    August 22, 2006 at 10:53 pm

    On journals, “Pain” is certainly a good title for a journal, although don’t think “Pain” ever achieved the distinction of another one-worder, “Gut”, in being featured publication (from which headlines with missing words were cribbed for the panel to guess at) on “Have I Got News For You”.

    BTW, while I’ve never heard of a journal called “Death” there apparently IS one called “Death Studies”:

    www.tandf.co.uk/journals/titles/07481187.asp

    There is also a journal “Birth”:

    www.ingentaconnect.com/content/bsc/bir/

    ..so the big philosophical topics seem to be covered.

    .. though to keep your philosopher friend happy there really SHOULD hould be one called “Consciousness”. Sadly they seem to have blown it one-word wise by calling it rather wordily “Consciousness and Cognition”:

    www.elsevier.com/wps/find/journaldescription.cws_home/622810/description

    I think scientific and medical journals often like having one-word titles – nice and punchy and also makes you look modern, since “Journal of Wotsit-ology.” classically used to mean a dusty 100 yr old journal published by the learned Society of Wotsit-ology.

    One-word titles are common in journals devoted to a BIG disease:

    “Hypertension” “Diabetes” “Cancer” etc

    …or to a single organ:

    (!)…. “Brain”, “Heart”, “Placenta” ” “Pancreas” and even “Prostate”.

    “Liver” used to be a one-word but has now changed it’s name to “Liver International”. (So people would think they weren’t parochial, I guess…. “British iver”? “American Liver”? Don’t quite get it.). Since there is also “Kidney International” it looks like the internal organs are broadening their horizons.

  20. profnick said,

    August 23, 2006 at 7:04 am

    My word you medics are a touchy lot aren’t you? Not to mention the internecine niggles. Maybe if the monograph is read as a humourous view of some important issues, (as it clearly is since there are numerous “funny bits”), then you would be less likely to throw your toys out of the pram. Keep taking the tablets.

  21. JQH said,

    August 23, 2006 at 7:12 am

    In my own experience of hospital surgery, ALL the people involved, including the bloke wielding the knives and pliers (it was a dental op) were at pains (groan!) to reassure me. Maybe it was because my dentist forewarned tjhem that I’m inlined to climb the walls.

    Incidently, as a result of the Governments reforms of dentistry, I am no longer able to get sedation at my local NHS practice.

  22. Kells said,

    August 23, 2006 at 10:21 am

    Thanks for the book it looks good, i like the stated aim as I suffer a lot from scepticaemia.

    I always thought Popeye was speaking the truth about iron – I now see that Bluto may have been badly maligned, much like anaesthetists. All my anaesthesist ever said to me was ‘you can try counting backwards if you like…’ just before I felt a supreme high for about 0.2s. 🙂

  23. hatter said,

    August 23, 2006 at 11:27 am

    Have anaesthetists changed in the way they interact with patients? The only time I have ever been hospital, probably more than 20 years ago, I met the anaesthetist briefly on the table just before they knocked me out. I had more interaction with the surgeon.

    Then again the dentists from those days made Mr Hyde seem like a friendly safe haven, whereas today I find them friendly and supportive.

  24. hatter said,

    August 23, 2006 at 11:40 am

    I think getting upset about what is an offhand quip is taking things too seriously. Why would the author worry about hurting the feelings of pathologists or anaesthetist? If it was a diatribe about anaesthetists being useless amateurs I could understand getting upset.

  25. icarus said,

    August 23, 2006 at 11:55 am

    I’d be really interested to find out the stats on placebo effects in Psychiatry. Not sure where or how that could be adequately objective, when often the faculty for creating the placebo effect is that which is the pathology (I’m guessing most here would agree, un-conscious patients won’t respond to placebo).

  26. Ben Goldacre said,

    August 23, 2006 at 1:27 pm

    well for a start, to work out the size of the “placebo effect” in psychiatry you’d need to have a treatment arm, a placebo arm, and no treatment arm (and what would “no treatment” look like? waiting list?).

    in fact, psychiatry is a good place to unpack what we mean by placebo: its not just a sugar pill, i would say that a placebo is everything about a treatment activity that makes you feel better, minus the effects of the active ingredients in the pill. moerman called it the “cultural meaning” of the treatment (but i think my definition is neater).

    with psychiatry, the process of going to see a professional for help (itself a bit of a transformative and decisive manouevre for many people) is something that will affect the likelihood of you changing your circumstances, coping strategies, and ultimately mental state, or mood (or “psychiatric symptoms” if you prefer).

    this will also be true, of course, of somebody finally going to see a professional about their arthritis, say. and that’s before you even start to think about the beneficial effects of things like a diagnosis, information about prognosis, a kindly ear, the realisation that others have been through similar symptoms, and so on.

  27. kayman1uk said,

    August 23, 2006 at 3:30 pm

    On page 31 (possibly ironically just above the title “The fallacy of authority”), the author says
    “Hamblin debunked the belief that spinach is a rich source of iron by tracing the Popeye-spinach myth to a mistake by the original investigators in the 1930’s”

    Various net sources including, of course, wikipedia (en.wikipedia.org/wiki/Spinach), say that the error was made in the 1870s and corrected in the 1930s. Obviously, I’m trying not to fall foul of the Bellman’s fallacy here.

    More seriously, he says that there is more iron in shellfish than in spinach. I thought shellfish was a particularly poor source of iron. Am I completely wrong there?

    Great book so far, though.

  28. JohnD said,

    August 23, 2006 at 6:18 pm

    Ben,
    That figure on the public’s ignorance of anaesthetists as doctors is from a MORI poll done to set a standard before our first National Anaesthesia Day in 2000. It has been repeated afterwards in several forms to see if people know any better. How’s that for a devotion to data and evidence-based action?

    I regret that I’m at home now and cannot verify the figure from the papers I keep at work, and the ‘Net seems to have moved on – or possibly wasn’t extensive enough then. I can’t find any pages from 2000 about it. The RoCA has a page from the 2002 NAD, before which another poll asked who runs Intensive care Units and Pain Clinics. Anaesthetists (who are by far the majority of clinicians in such posts) came at or nearly at the bottom of the public’s expectation. See: www.prnewswire.co.uk/cgi/news/release?id=93783

    As this shows, the NAD efforts were largely fruitless, . Since then what has done more has been the appearance of anaesthetists as characters in TV series like Holby City. Even though those characters have had sensational non-clinical aspects, when played by actors with the charisma of Art Malik we have a lot to live up to!

    Yes, profnick, we are touchy about the public status of anaesthesia. A major reason is the intense anxiety that many people have about being anaesthetised. It would seem likely but of course unproven that their anxiety will be lews if they kne that their anaesthetist will be a doctor with years of postgraduate training. Did YOU know that we are doctors?

    And hatter, I’m sorry if your experience of anaesthesia and anaesthetists was unsatisfactory. I hope and believe that twenty years have improved our bedside manner!

    But now for something completely different:
    The Wikipedia article attributes the lack of available iron in spinach to the presence of oxalates. A similar question came up in New Scientist’s “Last Word” column, when the same effect was attributed to polyphenols, which were alleged to form insoluble and hence unabsorbable iron compunds.
    The responding author, Prof. Patrick MacPhail of the Medical School of Witwatersrand University, said that similar polyphenols, tannins, could be used in home experiment, of adding ferrous sulphate (once used as a dietary iron supplement) to tea. Anyone who wants to choose between Wiki and MacPhail may like to Google for him, and “iron”.

    John

  29. Dr Aust said,

    August 23, 2006 at 7:57 pm

    Ben

    Re. your placebo controlled psychiatry trial, where would you put “being given the title of a recommended self-help book”? Does this count as “no treatment”, “treatment”, or….??

    Given that the wait for CBT is typically a year, but that you can buy a “How to..” CBT-based book recommended by the community psych people for a few quid, this seems like quite a relevant question.

  30. Robert Carnegie said,

    August 24, 2006 at 12:12 am

    One has a vague idea that an anaesthetist just does the one thing all day so they can’t be a doctor really… on the other hand, a twitch of the hand at the wrong moment and you’re a statistic, so you should be as fearfully respectful of them as of the surgeon, to whom the same applies 😉

    The original remark with the unfortunate effect perhaps can be rescued by supposing that anaesthetists go on a special extra course in how to be nice to people, which most other doctors skip. The hypothetical doctor with bad placebo technique would therefore benefit. Or perhaps placebo effect is easier to achieve in the more limited domain of assuring the patient that they in fact will wake up afterwards, or perhaps the text was written back in the days when anaesthesia still meant a firm grip on the mallet, a good aim, and being sure to take off the patient’s spectacles first was all the bedside manner you needed for that particular job. For that matter it was only when the NHS got going that everyone had spectacles…

  31. JQH said,

    August 24, 2006 at 7:13 am

    JohnD

    “…ferrous sulphate (once used as a dietry iron supplement)…

    My father has been prescibed ferrous sulphate tablets. Should he be worried?

  32. Kells said,

    August 24, 2006 at 9:27 am

    How did I miss National Anaesthesia Day?? I must have been asleep. Oh dear…..sorry.

    I personally would not care if I thought anaesthists were nurses or doctors. When I go to surgery/ hospital there is a feeling of being in very good experienced hands and that people treating you are very capable. If they are not nervous, I am not nervous. I use the same thought process for air cabin crew. I know some people are nervous in hospitals but that won’t necessarily change because of the title Dr on a badge.

    I feel JohnD that you need some respect from your peers and not the public.

  33. JohnD said,

    August 26, 2006 at 10:47 am

    Oh,dear.

    First, JQH, I’m sorry to cause alarm. Like a politician, thank you for the opportunity to explain. Ferrous sulphate is still the simplest form of iron supplement, but it can cause gastritis (stomach inflammation, ‘indigestion’) and several other iron salts and delayed release formulations are available, which many GPs will use in preference.

    Robert,
    Thank you, but I would prefer to deserve your respect, not just for avoiding that fatal ‘twitch of the hand’ but for doing a thoroughly good job overall. Of course the latter is what avoids the first. You are taught and learn not to put your hand in a position where it twitches, or if it does that it will do no harm!
    Spend all our time doing one thing? No, anaesthetists on average spend only half their time in the operating theatre.
    Special course for anaesthetists in ‘bedside manner’? GP training emphasises the need to consider the patient as a whole, indeed the family as a whole. The training of an anaesthetist certainly includes the first, as we treat a whole patient, not an appendix or a broken leg. Not a special course, the entire training.

    Kells,
    Indeed, how did you miss National Anaesthesia Day? My department and I tried very hard before the first NAD to reach out to the public. However they weren’t interested. Two reasons, one mine and one not. First, something allied to what you fear is described by the business world as a ‘distress purchase’ – funerals, life insurance, until compulsory seat belts and helmets. You have to work extra hard to sell it. It is the business of business to do that. Anaesthesia does have other things to do.
    Second, there was NO publicity for NAD, then or since. I rang the news desks of several national newspapers, who all had the same reply. The Guardian said, “No ‘Day’ is news. Last week was ‘National Biscuit Day’, next week it’s another.” That’s why Art Malik as an anaesthetist in Holby City is worth two or more NADs!

    And Kells, my peers can only respect me for my work, and they do. I am happy when patients thank me for my work, though often thanks are from those whose anaesthesia or other care has been the most straightforward. The sicker the patient, the more likely they are not to remember the anaesthetist who saved their life, so that they make it to theatre for the surgeon to save their life. Most acute hospital wards often receive gifts for the nurses. It is rare for such appreciation to be shown to the nurses of an Intensive Care Unit, because the patients don’t remember their stay, even when they have not been sedated.
    No, it is not respect I want from the public, like that from my peers I must work for that. ‘Appreciation’? Perhaps, in the sense that there is a greater public understanding of what the anesthestist can and does do, so that there is less fear and anxiety about anaesthesia.
    For instance, the popular image of the anasthetist in the operating theatre is that they give you an injection to send you off to sleep. What do they do after that?
    Blank section.
    Please examine your own thinking and knowledge, before reading the next paragraph.

    If you think that the injection IS the anaesthetic, then you are far from alone. Because of this many people are afraid that they will not go to sleep, will wake up in the middle of the operation, or not wake up at all, because that injection is seen as the only anaesthetic you get. “If they get it wrong……..!!!”

    In fact that injection is for the ‘induction’ of anaesthesia, rapid, painless and, relative to breathing anaesthetic gas, undistressing. The anaesthetist continues to give you anaesthetic, to breathe or by intravenous drip, all the way through your operation. Moreover, to do so in the right qantities, they watch you and examine you, directly and through monitors, all the way through. To do so, they are with you, all the way through, committed to YOU, the whole you, not the operation alone. At the right time, we stop giving anaesthetics and continue to monitor you in the recovery room, until you are fit to leave the theatre area.

    Will that knowledge, of continuous watchfullness for you, compared to the false image, help preop. anxiety? I think so and that’s why I’m keen for the public to appreciate the anaesthetist and their work. My apologies for hijacking this thread for that purpose.
    So, wrenching the thread back to its orginal track, may I recommend another good, free read? The Royal College of Anaesthetists has several information leaflets on-line. See: www.rcoa.ac.uk/index.asp?PageID=68

    John

  34. Dr Aust said,

    August 26, 2006 at 2:49 pm

    Hi John

    In talking to my 1st yr medical students, I like to characterise what anaesthetists do DURING the operation as “manager of all the patient’s body systems” – i.e. they are in charge of keeping the nervous system, cardiovascular system and respiratory system just where they need to be for the patient to remain anaesthetised (pain free and not moving), breathing the right amount, and pumping blood to all the bits where it is needed… in addition to putting them under and bringing them round. This dovetails in quite well with their learning the basic cardiorespiratory stuff. Another more jokey line we sometimes like to use is “imagine you are the pilot of a plane with no auto-pilot or computer control systems – can you doze off if you are flying level at 30000 ft? How many dials do you have to watch?”

    I suppose the RCofA has thought of using these kinds of analogies in their public-facing material.

    Anyway, we try to spread the word early in medical school these days about what, in general, the different sorts of specialties do. Of course, medical students are not the general public, but one has to start somewhere.

    Re. public perception, since the med students coming in to Univ (who you might expect to be a bit more informed) tend to see anaesthetics largely in terms of knocking people out and waking then them up, no real surprise if the public does too.

    Your comments about Art Malik and having an anaesthetist as a character on Holby City remind me a bit of what scientists often say, in the sense of: “nobody knows what we really do because they don’t see people pretending to do it on TV”. The CSI-type shows have given experimental science (of sorts) a bit of a lift in this regard, although the way they show things being done is pretty unrealistic. Stereotypes, once fixed in the collective mind, are hard to shift. When I participated in a schools science film project for 14-15 yr olds recently, they were asked to produce a cartoon character of their image of a scientist. You perhaps won’t be surprised to hear it was “Mad Professor Brainstorm” all the way, loony hair and staring eyes, the lot.

  35. eponerd said,

    September 27, 2006 at 2:38 pm

    Thanks, Ben, for the reference to ‘Facts and Fallacies’ (which I only just noticed, as I only signed up a few days ago).

    I was particularly struck by a passage on page 50, which seems to have a very direct relevance on another subject which has been discussed on your website:

    “The fallacy of obfuscation

    Language may illuminate or obscure. It can hide ignorance or expose the facts. It can keep knowledge esoteric and so be an instrument of power, or it can make knowledge available to everyman and thereby undermine power. In medical writing, we should strive for clarity. This is not a matter of style, which is an aesthetic concept, although most clear writing is aesthetically pleasing. Tortuous verbosity may be mistaken by the naive for erudition.”

    Quite so. I had in mind persons of a Post-modernist persuasion.

    Keep up the good work,

    Alan Benfield,

    European Patent Office, The Hague

  36. sciencefan said,

    October 25, 2006 at 10:18 am

    The URL for Petr Skrabanek’s book given at the head of this thread has changed.
    The Trinity College webmaster has kindly tracked down the new location:

    www.medicine.tcd.ie/public_health_primary_care/skrabanek/publications

  37. sciencefan said,

    October 25, 2006 at 10:22 am

    “.php” somehow got lost from the above link, but an onward link is provided on the page it loads. The following should do the trick:

    www.medicine.tcd.ie/public_health_primary_care/skrabanek/publications.php

  38. sciencefan said,

    October 25, 2006 at 10:24 am

    or even better(!):

    www.medicine.tcd.ie/public_health_primary_care/skrabanek/publications.php

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  40. Roger said,

    December 28, 2014 at 5:52 am

    Broken link:
    www.tcd.ie/Community_Health/Skrabanek/Petr%20Skrabanek