Tuesday, 19 June 2012

Are you a lizard person?

I have a theory, it goes like this: There are two kinds of people in the world- those who find animals in outfits adorable, and cold blooded psychopathic lizard people. Which are you? I think if there were more kittens dressed as bumblebees in the world, the whole apocalyptic recession thing would seem a damn sight sunnier. Conversely, my hubbie would probably lead the lizards. 

Despite hubbie's desperate pleas for dignity and sanity, our cat has a Christmas jumper:

If you didn't manage a fleeting “aww”, go eat some bugs and lounge in the sun. Otherwise, lets talk about harnessing The Power of Cute....

The Power of Cute can turn even the most rational person into a click happy giggling maniac going from clip to clip of animal antics. This 17 second clip of a kitten playing peekaboo has 63million views. Maru, a fat cat with a love of boxes, has had over 164 millionvideo views on his channel Not that cats have a monopoly on cute, this talking dog video was the most viewed youtube video last year, with a staggering 109 million views to date. The Power of Cute has reached a staggering number of people, uniting them in a love of all things fluffy. Imagine what we could achieve if we could capture this. I'm thinking big- displaying nerd facts, public health messages and a reminder of International Talk Like A Pirate Day along the bottom of the videos. Oooh, arr.

But maybe we don't need subliminal messaging, perhaps The Power of Cute alone can bring about actual behavioural change. A recent study in the journal Emotion looked at the impact of viewing cute images on “behavioural carefulness”. In one of the most entertaining study designs I've read in years, they got 40 female students to play the children's game Operation. (Incidentally, a SpongeBob SquarePants edition of this game exists in which you have to operate on his Patty Pleasure Centre. That does NOT sound like a surgical problem to me.) Half the participants were then shown very cute images (kittens, puppies) and the other half slightly cute images (dogs, cats, no outfits). Both groups then had another go at Operation. The very cute image group improved. Skipping over the tiny sample size and assorted study design issues, I love this paper. Mainly because it provides a clear basis for a patient safety campaign demanding surgeons watch a kitten playing peekaboo before they're allowed to operate. “Scalpel.” “No pointy things until you've watched the ickle fluffy kitten-witten”.

So, The Power of Cute unites a huge number of people in a common love of fluff, and it can make us act more carefully. Next stop: The middle east peace problem. Barack must be feeling its about time he earned that Nobel Peace Prize. I reckon his next step should be to dress his Portugese Water Dog like a pirate, like this:

You may scoff but its no crazier than his current world peace efforts of drone attacks and computer viruses. Nor is it half as wacky as the Foreign Office adviser Dr de Bono who gave a lecture to several hundred officials advocating the use of marmite to soothe conflict in the Middle East

So, that's how I'd harness The Power of Cute. What would you do with it? And, more importantly, what outfit do you think our cat should get this Christmas?

Sunday, 10 June 2012

Liar, liar

Do you tell lies? Anyone who says no, is a liar. We tell social lies to spare people's feelings- we say "your new haircut looks great" when we think "what in the hell happened to your head?! It looks like you gave a bad hair day picture of Baldrick to a blind, fingerless, unhinged baboon. Let me get you a paper bag with eye holes ..."

We accept these lies as the social glue which allows us to avoid anarchy. We call them white lies (which always amuses me and makes we wonder what a pink lie or a yellow lie is) to convey the idea that while they are lies, they are good lies, lite lies. But at the other end of the spectrum there are bad lies, we dont call them black lies but we definitely brand the people who tell them. Telling people your child is dying must rank pretty dark in the lie colour scheme. Telling this lie to people who really do have a dying child to get their sympathy must redefine the colour scheme. This is exactly what Abbie, a teenage girl, did on a Macmillan cancer support forum. She's not alone, other people have described painful accounts of battling diseases like HIV, anorexia, cancer and TB in online forums and blogs. Each one an in depth characterisation of how brutal these diseases can be. Each one recounting the physical and mental havoc they wreak. But not one of them true.

Yet, Abbie was suffering. Not for the reasons she gave, but I don't doubt for a second that she was suffering. Perhaps this was what made her character “Anna” so believable. Perhaps it was what helped her to extend support to others on the forum. Which ultimately is the entire purpose of these forums- to build relationships and support each other. Take Lauren who felt so moved by her friend 'Cara's' (fake) struggles she tattooed 'Cara' on her arm. Can a relationship that so moved Lauren be entirely fictitious? Surely relationships, especially those on the internet, are almost entirely defined by how people experience them. If Lauren felt supported and loved, and in turn she supported and loved 'Cara' wasnt the relationship a positive thing and the truth the real problem?

I think trust is the real problem. As anyone who has been cheated on by a partner or lied to by a friend knows, the thing that grabs your guts and twists them, is knowing that the person you made yourself vulnerable to wasn't truly opening themselves up to you. Without trust, relationships die.

This applies to every relationship- friends, family and the medical profession. It's why medics cant prescribe placebos even when they think the placebo effect might help a patient. Should the truth come out, as it tends to, the relationship is irrevocably damaged. And the damage can extend beyond that relationship, impacting on people's ability to trust others, making them less willing to open themselves up.

Yet Rebecca at Macmillans post notifying forum users of the fabrication was incredibly open, incredibly compassionate and wonderfully honest. Perhaps if we lived in a world where everyone showed the kind of compassion she did, people like Abbie and 'Cara' wouldn't feel the need to put a fake physical front to their real mental health problems. They wouldn't need a tale of cancer or HIV, they could be honest with us. We could trust them. Or perhaps not. But until we at least create the environment where they can be honest, we'll never know.

In the spirit of promoting mental health, lets end on something a bit easier on the brain: KittensAll together now, awwwwwwwwwwww!

Friday, 1 June 2012

How do you know if you're killing someone?

How do you know if you're killing someone? Sometimes it's easy, take Darth Vader- he's got a DEATH star with a super laser. Simples. Same goes for cigarette companies, they sell a pocket sized slice of cancer, they kill people. Easy peasy. But it's not always so straightforward. Take doctors. You'd think they'd be pretty freakin clear on whether they're killing people, right? It's got to be the first lesson, followed by other key classes like Perfecting Your 'Of Course You Fell On It' Face and How Not To Vom in Surgery. 

It turns out its not so simples, as highlighted by a recent article in the New England Journal of Medicine (NEJM) http://www.nejm.org/doi/full/10.1056/NEJMoa1113354. The paper looked at the treatment of Idiopathic Pulmonary Fibrosis (IPF) a rare disease that causes scarring of the lungs. People with IPF become breathless, and many sufferers die from it. We don't know what causes IPF which makes it tough to treat. This study compared the safety and efficacy of a drug combination used widely in the US (azathioprine, prednisolone, N-acetylcysteine) with placebo. The study was stopped half way through because the group receiving the standard drug regime were more likely to be hospitalised and more likely to die than the placebo group. The doctors were killing people, and they didn't know it.

This is why evidence matters. This is why we can't just say trying something is better than nothing. Sometimes our desperation to help, to treat, to save, actually does more harm than good.

The NEJM study seems shocking today, but actually medicine has a strong history of doing things that aren't beneficial for patients. We used to prescribe mercury, bleed people and dissolve their brains with ethanol. Ooopsie. Sometimes I try and figure out what will seem mad about current day medicine to future generations. NHS funded homeopathic hospitals rank high on my list. In my optimistic moments I hope there will be fewer examples of the truly loopy, because evidence based medicine should weed out the harmful and the useless. Complementary medicine lacks this filter, which is why "Urine therapy" has a disturbingly large wikipedia entry...

What do you think? What will we look back on and go they did whaaaaaaat?