27/10/2010

Mean people are dumb

I was listening to a Women's Hour podcast this morning at the gym. While I just love Jenny Murray, I sometimes get pretty upset at the things I hear, especially now everything is going pear-shaped in Britain with the conservatives and all.

So I just wanted to remind myself and you all, that not only are the bastards trying to put us down mean, they are also pretty stupid. So here goes.


Vaginal atrophy

A woman describes her struggle with a symptom of menopause: vaginal atrophy. It's a sort of dryness, a bit like having chapped hands in winter, that can be really painful and make every thing you do extremely uncomfortable. Yikes. How come nobody ever talks about that? Are there any other 'secret symptoms' of menopause? If you know about them, please share!
Anyhow, this woman struggled for eight years trying out different remedies. She'd been a cancer sufferer, so wasn't keen on using HRT - which her doctor recommended early on - which she strongly suspected my increase the risks of the cancer starting again. Eventually she found one thing that worked: a vitamin E oil.

Dr David Sturdee, guest speaker on the show offers his opinion.
Whether she has vaginal atrophy depends on her symptoms, he says. Is it just dryness, maybe? If it is, then some of the over the counter moisturisers that she has tried and rejected may work, he informs her. Also, he tells us, 'true' vaginal atrophy only occurs after the menopause.
If the vitamin oil works for her, the he's sure it can't be doing her any harm. But, he adds, it's almost certainly the oil that is causing the relief, as, after all, there have been no research that show that vitamin E has any effect.

On the other hand, research shows that women who take the local HRT treatment do not get cancer. The studies have only been going on for a year, but logically, he says, there should be no changes in the future. This is because there are no other effective treatments for vaginal atrophy and the women on the study would suffer from it again if they were to stop the treatment.

I know it's hard to follow perfect logic when you're just chatting, and maybe he was so awed by Jenny Murray, the goddess of Radio shows, that he got lost in his arguments. But I do reckon a little modesty and compassion would go a long way towards strengthening his points.

Why be so patronising and assume that the woman on the show did not know for sure if she suffered from the real thing? And should a man so casually question a woman's description of her own symptoms when those pertain to her vagina?

Also we all realise that science relies on studies and that it is hard to draw firm conclusions withouth them. But that doesn't seem to stop our brave doctor.

Vitamin E has no effect, he says, because no studies have shown that it has. Does he mean to say that studies have shown it doesn't? Maybe so, but it sounded like he was saying that no study has been conducted from which the conclusion should simply be that we have no study-based evidence, one way or another.

On the other hand, when a study is being conducted, he feels confident that he knows what the long-term results are going to be. And his confidence is based on his belief (backed by the absence of study) that other cures don't work. So his argument is analoguous to something like this:
I know the bus is going to arrive on time today. I have no evidence for this, except that it arrived on time last time I took it, and that I don't think my car will start. I don't think my car will start because I didn't use it yesterday, so have no evidence that it will start. Therefore the bus will get here on time and I shouldn't even consider using my car.

Aside from the fact that this argument would be quite good for the environment, it is clearly silly. Even a five year old would spot the defective logic. So how come a gynecologist who also happens to be president of the International Menopause Society gets to say things like that? Don't they teach logic in science classes anymore? Are scientific studies just shiny objects that you can flash at patients to get them to do what's most convenient for you?

Child Benefit Cuts

Yes, so you know that's all a bit of a disaster. The British Goverment is cutting childcare from any household that earns 44k and over, regardless of whether there are two parents, whether both of them are working, and whether they live in a area where that money can actually get you anywhere. So it's not mean tested in any respect. Lots of bad things going on there. But the caller I'm about to pick on would have come accross as means without the help of the reform.

I don't want to have children, she said, I'm never going to use the education system, or benefits of any kind, so why should I pay taxes that contribute to other people's children's education?
Allright woman. Where the hell do you think you came from. Who the hell do you think paid for your education and healthcare so you could grow up to make those stupid phone calls?
Yes, the point is not: I don't have children so it's not fair to ask me to contribute. It's: I was once a child who was supported by a community and now it's my turn to help. And it takes not much more than two brain cells to see that.

So she might then argue that she had a crap childhood and doesn't feel she owes anyone anything. To which I'd say: I'm very sorry your community failed you. We're actually trying our best not to fail others now. If you don't want to help, if you're just interested in perpetuating the abuse you received, then piss off somewhere else.

So yes, mean people are often just plain dumb. It's good to remember that. And to swear about it a lot.

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8 comments:

Roger said...

Now I'm retired, I often listen to Woman's Hour on my wireless.
It's an eye-opener. To think I have gone over 5 decades without this ...

Liz said...

You see, this is why I had to stop listening to Radio Four podcasts on the bus to Bilkent. I don't want to swear on your blog, but at one point I did suggest under my breath that an intimate part of one contributor's anatomy had been transplanted to his head - a good teachable moment for my students about crude British English slang, but maybe best avoided, on balance.

Sandrine said...

Roger: how could you live so long without Jenny Murray's voice?
Liz: Go ahead, swear. (Student readers - I know you're here - cover your ears, please). I really like Jenny Murray, her voice soothes me, but sometimes I wonder if listening to the podcasts while I'm exercising isn't plain bad for my blood pressure.

Dr T said...

I do not understand your outrage. Not having heard the broadcast. Seeing as you did not post a link to a recording of it I only have your words to go by I have to draw my conclusions from them. A medical professional owes it to their patient or anyone they are speaking to inform them of convention wisdom in the field concerning a particular problem. I imagine he did not examine her on the show so I believe it is only normal that he would be reserved in his judgement and not provide anything that could be considered a proper diagnosis. He did say that based on what she said that it most probably was the oil however it was responsible of him to point out what is considered conventional wisdom on the subject. As a doctor myself I try to avoid following patients self diagnosis and follow my own examination and conclusions, things not easy to achieve on a radio show. I believe you are being a bit too sensitive and should remember that they call them medical professionals for a reason... don't abuse them when they are trying to be professional.

Sandrine said...

Dr T: I agree with you that a medical professional ought to inform their patient of what's known about potential treatments and to caution them against self-diagnosis. So Dr S ought to have said that to the best of his knowledge no study had been done on the effect of vitamin E on vaginal atrophy. Maybe even he should have suggested that she seek confirmation of medical advice (instead of saying that he was sure it wouldn't do her any harm).
What I object to is the patronising stance . Given, as I noted, that she was diagnosed by a member of the profession as having this condition, and given that as someone who suffered from cancer she has good reasons to be cautious about HRT, he really ought to be more respectful of a) her claim she has that condition and b) her desire to find an alternative treatment.
Also, there really was some poor logic at play in his references to medical studies. I strongly believe that medical professionals, for all their wisdom and their good will, owe the public and their patients to organise their thoughts logically and present them with respect.
As for the absence of link, yes, it's a bit sloppy... I can't get it for some reason. But you might be able to: it's the 6 October show of Woman's Hour, BBC4.

JulieB said...

My favourite argument to the second point; who do you think is going to pay your (ever-dwindling) pension...

Sandrine said...

Good point! There are so many responses to the 'I don't have kids so don't want to pay' argument that I'm always surprised when some body comes up with it...

Looking for Blue Sky said...

Wow, Woman's Hour has certainly moved on since the 1970s when my Mum's radio was permanently tuned in to radio 4.....On child benefit I feel i can comment as I had to become an expert last year when I helped out a campaign in Ireland that opposed cuts to child benefit. Yet I am still at a loss as to why child benefit is such an 'easy target' for cutting. When people who have no children complain, they are forgetting that we all pay through our taxes for all sorts of services and benefits that we may never use or enjoy. And as well as pensions, the next generation are the workers and taxpayers of the future who will provide all the essential services that keep childless people comfortable and healthy in their old age. Societies need children, and child benefit is just a very small contribution by the State towards the total cost of bringing up a child - Based on published figures, I estimated that in Ireland child benefit covers about a tenth of the total cost.

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