Monday, 21 October 2013

A skeptic's experience of a "cancer scare"

Less than three weeks ago I was sitting opposite my GP when I heard the words any sensible person would dread. Well not really all of the words; it was every other phrase or so. "Shadow on the lung", "urgent referral", "need to exclude cancer", "this is not a diagnosis"…

Well, there you go. Looked pretty bad from where I was sitting. After all, I was carrying the two biggest risk factors for cancer: smoker; old.

One always wonders how one will react to such a conversation, and it's impossible to predict, however well one knows oneself. In particular, how I might react as a trained scientist and atheist. My variety of atheism is probably the variety you simply can't undo. It's based far too much on a deep love of and joy in being rational. And a powerful resistance to simply "believe what I'm told", a modality of thinking not easily undone.

As I walked slowly back home from the surgery, what was my state of mind? I can tell you this: I was completely calm and completely terrified all at the same time.

I know that it's hard to believe that two such seemingly mutually exclusive emotions can live together, but there you are. Playing a sort of background noise to all this was a welter of practical questions such as, Who should I tell (or not tell)? How will I manage my working life (I had immediate work commitments away from home)? How long shall I have to wait (was it going to be the full two weeks)? How will I cope with the uncertainty?

I can also say this: at no time - not for an instant - did I feel the slightest urge to pray, or to wish I had the "comfort" of belief. In fact, my unalloyed atheism was itself a great constant and comfort during the waiting and the wondering.

Did I have hopes? Well obviously in the sort of everyday sense I "hoped" that I didn't have cancer. But I am a realist. I discovered that unfounded, irrational hope was not for me. I couldn't "unknow" the odds. Better to deal with the likelihood...

In the days of waiting I discovered how immensely helpful to me was my training as a scientist, my understanding of statistics, my previous months and months of learning about the great harms done by false hopes peddled by the alternative medicine industry, my much deeper understanding of all this which came from reading the likes of Simon Singh, Edzard Ernst, David Colquhoun, Ben Goldacre, Margaret McCartney, Rose Shapiro, Steven Novella, Rob Buckman, John Diamond, Christopher Hitchens, James Randi and many others.

Therefore I was wearing powerful protective armour when I did my inevitable googling.

For the scared patient, the internet is not a minefield of dangerous batshit. "Minefield" is too weak (and clich├ęd) a metaphor. The internet is a turbulent ocean of dangerous batshit with a few tiny, scattered islets of fact and rationality. But I had good pilots with me, and the islets are there for those who know where they are, or for those who are guided to them by a the good and brave people such as those I have mentioned.

One of the most truly helpful things I had learnt was that there is no good evidence that "maintaining a positive attitude" has any effect on one's outcome, should one indeed have cancer. This was helpful because when my mind wanted to think through the worst, I simply let it. I did not try to distract myself. Nor put on a "brave face" to myself, even if I did to the few people that knew of my worries. The rational, thinking mind needs to think, not suppress that thinking, however unpleasant or frightening those thoughts may be.

And a few, angry, words about "being brave" and "battling" against cancer. The patient doesn't (can't) battle against cancer. That's what the clinicians and the researchers do. Bless them. (Shame there's not an atheist equivalent of "bless"!) The patient is the one most intimately concerned with a very serious problem, and the rational thing to do in that situation is to seek the help, support and advice of those most realistically able to deal with the problem - all those involved in modern, science-based, evidence-based medicine, and in the best clinical care. And if the patient dies, it’s not the patient’s fault and they haven’t “lost” through some moral weakness. They were gravely ill and they died. There’s a difference!

Well I had my appointment. The news looks good. There will be follow-ups, but that’s good precautionary clinical practice.

What have I learnt?

·       It is perfectly normal to be a rationalist atheist and skeptic - and thoroughly terrified all at the same time

·       It won’t harm you to be frightened

·       It helps to think, even when the thoughts are scary. Having a reasoning mind is at least as great a comfort as having “belief”, and will lead you to good, sound information

·       I’m even more angry now with the quacks who prey on the vulnerable

·       More than ever before, I value and honour those who battle (correct word this time) against superstition, unreason and quackery

Tuesday, 15 January 2013

Brief Encounter with Joy

Just when you least expect it, truly lovely things can happen. And in a day which held no more than ordinary promise, two things happened to me. I was working for a day at Exeter University and the first loveliness came at morning break. I went outside to get a bit of fresh air and was astonished at the warmth. The sun was shining strongly, and the skies were almost clear. In this week of freezing temperatures and snow, I sat on a bench and wondered just how warm it could get.

That would have been quite enough loveliness for one day, wouldn't it? But then the lunch break held in store something almost magical.

By this time, the weather had reverted to type: cold, overcast, drizzly. I happened to be passing the chapel when I heard someone playing Chopin rather beautifully on the piano. The sound was arresting. I went inside. The only person in the chapel was the young man who was playing and I sat on one end of the wooden pews and just drank it in. The playing was not faultless but the feeling and the depth of his interpretation was quite simply, well, beautiful. It was a privilege to be there.

After a while the young man glanced at his watch and saw that lunchtime was almost done. He got up and gathered his things to leave. It was then I told him how lovely I thought his playing was. He smiled and thanked me and we went our separate ways.

Turned out he was doing a degree in business studies. No surprise or inconsistency to anyone who works with students.

Tuesday, 2 October 2012

"What Doctors Don't Tell You" - Another Strategy

A quick post on a very encouraging experience.

Interested to see if my nearest high street retailers are stocking the infamous "What Doctors Don't Tell You", I had a look around both Waitrose and WHSmith this afternoon.

Waitrose, Bath, is so dark and gloomy inside that seeing which titles are on display would tax the persistence of a polar explorer. I did my best to do a systematic check and could not see any copies.

I then moved on to WHSmith and spotted them there. I took one down and had a leaf through. It's pretty dodgy stuff, in my opinion. I replaced the copy back on the shelf backwards and upside down as at least a temporary fix, and went in search of the store manager.

I showed him the magazine on the shelves and said, "I realise it's not your decision, but please could you tell me why you are selling this title?" He took a look at it and said something like, "I will certainly feed back your concerns. It doesn't seem an appropriate magazine. We get big deliveries and it's very difficult to monitor everything."

He then did something even better. He grabbed the remaining copies and told me he was removing them from sale. I thanked him very much and, shaking hands, we parted company.

During our brief conversation, it became apparent that he knew about the controversy and certainly I needed to provide no explanation for why I was complaining.

Whether this title stays off the shelf in this branch, only time will tell. His decision may well be overridden. I hope not.

The point is that this illustrates that a courteous engagement with a store manager, person to person, may result in immediate action. In most cases it probably wouldn't. But then, what have you to lose except a few minutes of time? And the possibilities of a good outcome are always there.

Friday, 28 September 2012

On Not Jumping to Conclusions - and Why It Matters To Us All

I have been fascinated by the very mixed reactions to the current media narrative of one single couple during the last week. I refer of course to Megan Stammers and Jeremy Forrest. This mixture has included everything from "lock him up and throw away the keys!" to "good luck to them!". As to the bare bones of the narrative, the BBC has usefully outlined the key events in the timeline.

As well as noting the very mixed public reaction, I have been trying to form an opinion of my own. I may as well say that I don't believe that we always have "a right to an opinion", though this phrase is often used (usually with a hurt tone of voice) in many an argument. It seems to me that we should be slow - treacle-slow - in forming an opinion, especially with such emotive matters. Surely, if we want to have a "right to an opinion" we ought to make some sort of serious effort to dig beneath the surface of the media blarings and try to sift out the facts.

The facts in the public domain this matter are scarce. Megan Stammers is below the age of consent in the UK. Jeremy Forrest was a married man of 30 and a teacher at Miss Stammers' school, the Bishop Bell School in Eastbourne. People in positions of trust, such as teachers, health workers, youth leaders, must not attempt, or form, a sexual relationship with those in their care in a number of situations, even if the person in their care is over the general age of consent, or even if so, the persons in their care are vulnerable. The school was graded "outstanding" in the area, inter alia, of "safeguarding" in an Ofsted report of 2010. The pair left the country on a Dover to Calais ferry at 21.20 on Thursday 20th September. They have now, thankfully, both been found safe and well in Bordeaux, and Mr Forrest has been arrested on suspicion of child abduction.

These are the "hard" facts. There is other relevant evidence, not so easily verifiable to the public, such as the reports of hand-holding on planes, exchanges of text messages and so on. I do not intend to discuss such things, because they are really not my business and I have no way of checking whether they are true, not true at all, or recollections more appropriately examined in any future legal proceedings. I suggest that we should step way back and leave things alone for the time being. Mr Forrest has rights which we should all hold precious. Rights which may help us all one day.

Let's leave Miss Stammers and Mr Forrest out of it altogether. Things must have been immensely difficult over the last week for all immediately concerned.

Let's return to the fact of the mixed public reactions and opinions on this sort of story.

The problem is that human emotions and behaviour are scalable. The law is not. This is essentially why no law can ever be perfect for all cases, and why English Common Law is such a sound idea in principle. In any criminal case there is a binary outcome: guilty, or not guilty. You either did it, or you didn't. Never mind why. Never mind mitigating or aggravating circumstances. Never mind the impossibility of defining such material emotions in criminal cases such as "love", "fear", "hate", "fury", "loyalty", "pity", and so on. It's tough enough to define these words in any debate, let alone one where a person's liberty and reputation may depend on the outcome. That is why good and wise judges are so vital.

It's exactly the so-called "grey" boundary layers of any law that may well be causing such a mix of emotions I referred to. It may be that the statutes involved need to be amended. It may be that they don't.

I've heard a lot of toxic nonsense in the past week - from both "sides".

It seems to me that the truly civilised and humane reaction is to say, "I just don't know enough. This story should make us think. This story should make us realise that, because we are human, we need to think very intelligently about the law and its application - and to realise that gut reactions make lousy laws."

I declare now that, about this particular matter, I have no opinion and have no right to an opinion.

How about you?

Friday, 14 September 2012

Our meeting at Morrison's Supermarket, Bath

The area manager, Jason Lucas, had invited us to this meeting in response to a number of concerns we have recently expressed regarding the continued availability of products during and after the store makeover and he, and the Store Manager, Jeff Gardner, made us welcome in the cafe.

Firstly let me say that it says something for a retailer when they make a real effort to listen to their customers with face-to-face meetings like this.

I am not going to turn this post into a detailed meeting report, but if anyone has a specific question, leave a comment, and I will - if I can - answer it. Though bear in mind, I am just another customer, not an employee of Morrisons!

We started by saying that Morrisons "had it made" in Bath because of the generally poor supermarket offering in the city, and that in any case, we liked Morrisons, could get almost everything we needed there (before the makeover project) and felt that the store was exceptionally well-managed by Jeff and his team. Also we have found that many of Morrisons own-brand products were superior in quality to those of Waitrose.

Our recent problems in being able to buy our routine items at Morrisons, however, had by necessity driven us away. They are very well aware of this as a problem and the possibility that non-availability can cause people to change the supermarket they choose for their main weekly shopping, sometimes for good. For this reason, they do think carefully about the impact of withdrawing low-volume items, but obviously the impact of these decisions is not easy to forecast. In response to a question from me, they are thinking about perhaps making local suppliers part of their local offering in the store, but this has to be very carefully managed.

There have been serious problems at the store recently with the customer-operated checkouts. This, they explained, was not their fault. The supplier of the equipment had changed the specification of the hardware without even telling them. They are just as upset and frustrated about this as their customers. I made the point that one reason I never choose to use these checkouts was an ethical one, to do with the possible reduction and laying-off of checkout staff. The area manager assured me that this was not their policy at all. We shall see. Things can change, after all!

We talked about quite a few other things, such as pricing. But I'm not going into those here. I want to keep this short.

One last point: the appearance of the store is certainly bright, and the food looks very appetising. We understand that the works will be completed next Thursday. Time will tell if Morrisons get the right balance of their lines, both volume and minority, but they appear to be very keen to get it right and to listen. They stressed how important feedback was and  showed today that they valued it.

One last last point! Throughout the Morrisons makeover works, the store remained clean and tidy. In fact Jeff pointed out that they monitored hygiene very closely and took a pre-emptive and cautionary decision to individually wrap certain open-food items while the works were ongoing. This is is stark contrast to what is happening in Waitrose Bath, where the dust is very evident, collecting visibly on things like dark bottles. Yet Waitrose appear happy to continue to sell open foods for immediate consumption, such as salads for the lunchtime and tourist trade.

In conclusion, well done Morrisons for listening. It's all too rare these days.

Tuesday, 11 September 2012

Disability: An experiment in cool thought

Now, in these rather bleak post-Olympic and Paralympic days, when we realize that the emotions we have all felt are to be replaced by a grimmer set of realities, it's perhaps time to reflect on some less than worthy thoughts I have heard expressed, especially regarding the paralympians.

One thought in particular strikes me as especially unpleasant and difficult to deal with. I have heard people say, "I certainly can't run a hundred metres in eleven or so seconds. Yet these so-called disabled people can. So who are the disabled? Why should my taxes be spent on benefits for them? Where's the logic here?!"

Let's for a moment set aside the politics of this and see if we can approach these questions from another point of view. A cooler, more logical approach may help to reconcile these seeming contradictions and inequities, while justifying the continued state support of people with disabilities. For, make no mistake, continued state support requires that we convince the "able-bodied" taxpayer that it is justified and that it is fair.

Firstly let's agree that Paralympic competition is something which is seen every four years and is not part of everyday living (though of course for the athletes, the training and preparation are part of their everyday lives; but only part).

Next let us acknowledge a clear truth: we all have talents and we all have weaknesses. We are all on a spectrum of ability and disability (in the widest senses of the words). For example, I wonder how many of you reading this post need glasses to see it. Visual impairment is a remarkably widespread purely physical impairment - or disability if you like - so is a good example around which to build my argument. Perhaps, even if you need glasses, you may not think you are disabled. After all, glasses & contacts are so common, and can even be fashion statements and designer status symbols. But stop to think. If your sight was not corrected by these aids, what could you no longer do? I, for example, couldn't drive, read nor write. I couldn't do my present job, except in the most limited way. I couldn't enjoy my favourite pastimes, nor even pursue them anymore. Sounds like a disability, doesn't it? But I don't go around thinking I am "disabled" much less lamenting my impairment. That would be plain weird. I'm just very grateful that there's a solution.

So I feel we should remember this when we think about "benefits for the disabled". Though glasses are a shocking price, we who wear them, "benefit" from them. You can probably think of other common examples where impairments or weaknesses are helped and corrected, while not being normally considered "official list" disabilities. Many helped with state support, either wholly or partly.

A more ethical and logical approach to thinking about disability, it seems to me, is to remember the old principle which, if applied, is good for everyone: maximise talents and manage around weaknesses. This principle does away with the binary classification of abled/disabled and allows for more nuanced solutions. It also allows us to think about people as a valuable and fascinating mixture, and each one unique.

And every one of us deserving of both support and development.

Monday, 10 September 2012

The Motorhome Show, Shepton Mallet


The internet is a wonderful thing when you are thinking of doing something you have never done before, such as buying a camper van. Buying a half-decent even small camper van requires the spending of a fair few thousands, so information is essential in reducing the chances of making a sorry mistake.

Many years ago we had a camper van, a conversion built on a Sherpa body, bought in haste, with all the consequences of buying in haste, including - in its later years - a pop-up roof which not only leaked buckets, but would pop-up whether you wanted it to or not if you exceeded about 40 mph. We still have fond memories of the fun we had, though.

Now we want to have more fun, but realise that £2,000 will not get you very much more than what is called a "project" requiring a total re-build.

Yes, the internet is a great starting point, but nothing beats actually being able to climb inside these things and have a good look. Last weekend was our chance. The Motorhome Show at the Royal Bath & West Showground at Shepton Mallet.

Arriving early, it took a while to get our bearings. The place was full of dealers selling motorhomes at breathtaking prices, and plenty of stalls selling every possible gadget for the motorhome or caravan owner. Our two particular "favourite" items were the miniature folding toilet brush and the astroturf and pot-plant, ready-made miniature garden. There were some possibly useful items, too, but not many for people who want to use a motorhome for travelling and seeing things rather than reproducing their suburban home on a campsite, complete with television, a garden and neighbours to compete with.

After about an hour, we actually did find a small motorhome which seemed to fit our essential specs: footprint about the size of an estate car, liveable layout, shower and toilet. And at a price we could afford. We didn't buy it on the spot. Never buy in haste, remember! But at least we discovered that such a thing existed, which was nice.

That job done, it was time to look around in wonder at those crazy American RVs parked up and inhabited by what we discovered was a community of people who showed every sign of political leanings which no doubt would engender in them some uncharitable views on "Gypsies" and "travellers". The pictures give perhaps some idea of both vehicles and inhabitants:




A very common sight was a collection of over-sized cuddly toys ranged behind the windscreens of these amazing vehicles, and, of course, the flags (Cornish flag in the picture above, for example).

At the end of the day (that's actually at the end of the day, not the cliche), we concluded that people who own motorhomes fall into two broad categories: the Way of Lifers and the more or less adventurous holidaymakers, who like a bit of spontaneity and flexibility and who like to leave home behind, not drag it all with them.

A final thought. Some things you Just Know. And one thing I just know is this: when it comes the time to empty the toilet cassette, it will be my job.