Muddying the water: Rustum Roy in the Grauniad

For me, Christmas came early this year, in the shape of a Guardian ‘Response’ piece by Rustum Roy, of all people. Roy is an eminent professor of materials science at Pennsylvania State University, but he also appears periodically to try and give scientific justification for homeopathy. I’m sure others will write about this, but I feel vaguely involved because of Roy’s connections to the recent ‘memory of water’ fiasco in the journal Homeopathy. Roy’s piece is entitled ‘“Homeophobia’ must not be tolerated”, and it seeks to rebut Ben Goldacre’s excellent and celebrated piece on homeopathy that was published in the Guardian’s G2 supplement a little while ago. There’s a lot of drivel for such a short piece, but I’ll try to keep it concise.

Roy begins by stating “For the record, I have never studied or held a position for, or against, the clinical effectiveness of homeopathy”. This seems a strange statement, given that Roy is responding to Ben Goldacre’s piece which mainly discussed that clinical evidence. Avoiding discussion of clinical evidence allows Roy to erect a classic straw man. He suggests that scientists main objection to homeopathy is the very high dilutions, such that there is very little chance of any of the original substance remaining, that are routinely used in homeopathic remedies. Indeed, many scientists do quite reasonably object to this, but the main objection to homeopathy is simply that the clinical evidence shows that it doesn’t work.

Unfortunately, Roy is not on firmer ground when discussing his own field of materials science. He attempts to create a theoretical justification for homeopathy, based on the idea of water being able to structurally ‘remember’ substances that are no longer present. Roy states that it is the structure of water that is important, not what it contains, and references Prof Eugene Stanley of Boston University in saying that there must be at least 64 different structures that occur in liquid water. He compares this to graphite and diamond, which are chemically of the same composition but have radically different properties because they have radically different structures. In this way he seeks to get around the problem of homeopathic remedies typically being diluted so much that it is very unlikely that any of the original substance can possibly remain. It’s the structure of the water that has an effect, not the substances dissolved or suspended in the water.

The fact that water can have so many different structures is interesting, but in terms of homeopathy it doesn’t really get us any further forward. To demonstrate even a theoretical justification for homeopathy, Roy would still need to show that the hundreds of different homeopathic remedies could all create different structures in water; that only the specific remedy, and not any other impurities in the water, causes this structuring; that water with different structures has different biological effects, and that the strength of that effect could increase as a solution is further diluted. So far Roy has only shown that water can contain interesting structures. One thing you could do to test Roy’s hypothesis is try to distinguish homeopathic remedies on the basis of structural differences between them. In fact, Roy and co-workers claim to have done this using spectrophotometric techniques, in a paper recently published in Homeopathy. This paper is so flawed that it’s almost a shame Roy doesn’t mention it in his piece. It doesn’t contain any usable observations, and all it shows is that the alcohol used to prepare the tested remedies likely came from multiple sources.

Roy also states that Prof Martin Chaplin of South Bank University has, in the journal Homeopathy, “discussed how water could retain a ‘memory’”. In fact, Chaplin has done no such thing. He has simply demonstrated that water has a lot of unique and interesting properties, something which is not in dispute. He doesn’t show how the structure of water in a homeopathic remedy could be influenced by substances that are no longer present. I will have a critical letter to the editor of Homeopathy published shortly outlining this point in more detail.

Roy says that the placebo effect is ‘without doubt present in every homeopathic intervention’, but goes on to say that ‘it is far more powerfully present in orthodox medical pills because they are advertised so widely in billion-dollar campaigns’. I’m not aware of any evidence that this is the case, although I’m certainly not an expert in this field. It seems unlikely because orthodox medicines are usually trialled for efficacy and safety before they come on the market. But in any case it seems like a confused argument. If the placebo effect ‘works’ and it is more powerful in ‘orthodox medical pills’, isn’t this evidence that orthodox medical pills are better? The central point is that the clinical evidence shows that homeopathic remedies have no more benefit than a sugar pill, while orthodox medicines do. But Roy conveniently doesn’t take a position on the clinical evidence.

Roy closes by asking whether Goldacre ‘seriously believes that a homeopathy paper with a positive outcome would be treated fairly in any mainstream journal’. In fact, a number of such papers have been published, although they have generally turned out to be flawed. One example is a paper on homeopathic treatment of critically ill patients that appeared in Chest, and has been thoroughly trashed here. The problem is not with the bias in mainstream journals, it is with the quality of research into homeopathy. Hence the Shang et al. meta-analysis found only 165 trials of homeopathy that matched the inclusion criteria, compared to 353,809 conventional trials. Trials of homeopathy are usually published in specialised journals whose standards of scrutineering leave a lot to be desired.

Essentially, Roy has failed to show that what he calls ‘homeophobia’ is anything other than a sensible response to the evidence that homeopathy doesn’t work, especially given that homeopaths are giving irresponsible and dangerous advice about such things as malaria.

My own bad science

Well, that's science for you. A paper that I worked long and hard on was sent out into the world, and I've got it back torn to shreds and covered in red ink. Yes, my paper was rejected. These things happen.

One of the reviewers thought the paper was OK, while the other one thought it had some serious flaws. The editor agreed with the second reviewer. I can't say that I'm happy about it, but I have to admit that the criticisms are not unfair. Still, I think the observations in the paper are useful and interesting, so I'm going to mount a salvage operation, and attempt to re-submit the paper.

It's not nice to have your work criticised, but of course, that's how science works. You submit your work for rigorous examination by other experts in your field, and only the best stuff makes it through. If the paper does eventually get published, it will be much stronger as a result.

At least, that's what I'm telling myself, but I can't pretend that it doesn't feel like a kick in the teeth...

Labour 'flexibility' in our universities

I went to a meeting of the Universities and Colleges Union the other day, about fixed-contract staff at the university. I'm on a fixed-term contract myself which will shortly be ending, so this is of more than academic interest for me. I was astounded by the statistics presented. Apparently, in 2005/6 the proportion of research staff at UK universities who were on fixed-term contracts was 85%! And at Manchester, it was 94%! Although the University of Manchester is supposed to be committed to reducing the number of fixed-term contracts, the proportion has only decreased to 94%, from 96% in 2004/5. Meanwhile, the proportion of teaching staff on fixed-term contracts has soared from 46% to 63%. The proportion of staff responsible for both teaching and research who are on fixed term contracts has declined significantly, from 24% in 2004/5 to 12% in 2005/6.

This raises a number of problems. Staff who are both teachers and researchers (i.e. they are lecturers, readers or professors) are generally responsible for heading up research groups, chasing up funding, and supervising research. They're the brains of the operation, if you like. But the backbone, the people who are responsible for most of the actual research, are post-docs on short-term contracts and graduate students. Research is essentially being done by temps.

Since they have no long-term job security, post-docs tend to leave as soon as they have an opportunity to do so. Especially as only around 20% of post-docs will ever get a permanent position as a lecturer. Essentially you have the option of sticking around on short-term contracts until you become unemployable, or you go and get a proper job. People tend to stay longer than maybe they should, because research is what they want to do, and they'll put up with a lot to keep doing it. There are post-docs at Manchester who have been here for over 10 years, all on short-term contracts.

Obviously, this is stressful and demoralising for individual post-docs. But it also can't be good for research. Good people leave, and those who stay are looking over their shoulder. And after training for many years to become a post-doc, at the bottom rung of the academic ladder, you can't blame people for thinking that they deserve better.

The answer is 42

The government has decided that it wants to extend the limit for detention without charge to 42 days. Why 42? Who knows? The government certainly doesn't seem to have any particular rationale. 90 days has recently been floated again, as has 56 days. Apparently 42 days is thought to be a reasonable compromise.

The proposal follows on from Tony Blair's defeat in the Commons over raising the limit to 90 days. An amendment was passed reducing the limit to 28 days, which is the current limit. This is still significantly longer than any comparable democracy, as this report from Liberty shows. Apparently we are facing a new and different threat, but why this requires such illiberal measures has never been made clear. The UK has faced terrorism before from the IRA, at a time when the maximum length of pre-charge detention was just three days. Why is the current threat so much more serious? And why is the threat so much more serious here than it is anywhere else?

Who wants this extension? According to an article in today's Guardian, no-one except the police and Lord Carlile, the independent reviewer of terror legislation. No-one else seems convinced, which seems reasonable enough as the government has provided no evidence to show that 42-day detention is necessary or desirable. In a democracy, we shouldn't just reflexively give the police what they want. We should ask why they want it, and what the costs and benefits to our democracy might be if we do give them what they want. This debate is happening, but there doesn't seem to be any evidence that the government is listening to it.

There was a debate on this in the Lords yesterday, which makes interesting reading if you're into that sort of thing. Lord West is grilled on why the proposals have been made, even though the process of consultation is not complete. Lord Thomas asks "despite all the consultation about which the Minister has talked, there has been not a shred of consensus on the further extension. Why has the process stopped now? Why do we not further seek consensus on such a divisive issue?". Answer came there none. It seems that the government has decided to pick a random number between the current 28 days and the mooted 56 days, and call this a 'consensus'.

In his evidence to the Lords, Lord West talks about detailed 'trend analysis' that shows that some cases will need more than 28 days. Without seeing this data, it's difficult to say much about it. However, an alternative interpretation would be that the trend analysis is showing detention periods increasing towards the limit, not because longer detention is needed but because it is available. This could be an argument against an extension, as extended powers are likely to be used whether they are needed or not.

Anway, it seems as though I'll be writing to my MP again, although it didn't do me a lot of good last time.

Edit to add: You can get some of the documentation associated with this here. The Summary of Responses to the Counter Terrorism Bill Consultation clearly says that "The responses to the consultation clearly indicate that pre-charge detention is a controversial issue and the majority of the responses which we received did not support an outright extension to the current 28 day limit". So what was the point in the consultation again?

The way the proposal works is that the Home Secretary could increase the limit to 42 days immediately, if a chief constable and the director of public prosecutions back the move. It must then be approved by the Commons and Lords within thirty days. The independent reviewer of terrorist legislation, Lord Carlile of Berriew QC, specifically recommended against this proposal. To quote from Lord Carlile's report:

"This might involve the recall of Parliament during a recess to deal with a single case which in itself was not the cause of a national emergency. This could prove extremely impractical. Further, the potential unfairness to the uncharged suspect of a Parliamentary debate on his/her case is self-evident."

So what is the point in the independent reviewer again?

It's also worth noting Lord Carlile's point that "There has been no case so far in which it has been shown clearly that more than 28 days’ detention would have been likely to result in charges which in fact were not made, although there remain many terrorist cases which are yet to be tried".

Homeopathy in the Manchester Evening News

I had no idea, but it turns out that the Manchester Evening News employs a homeopath, Zoe Meachem, as a 'Health and Beauty' columnist. Here's her recent column on prevention of cystitis. In the column, she recommends a number of homeopathic remedies at a 'potency' of 30c. In a 30c remedy, the 'mother tincture' is diluted by a factor of 100, thirty times. This is a dilution factor of 1x10⁶⁰, or a 1 followed by sixty zeroes. The chance of their being any of the 'mother tincture' left after this dilution is vanishingly small. The best available evidence, i.e. meta-analyses of placebo-controlled trials, shows that homeopathy has no effect beyond placebo. In short, these remedies won't do a single thing to prevent or cure cystitis. Pity, because the other advice in the column is sensible. Drink plenty of water, and seek medical attention if you have a fever, lower back pain, blood or sediment in the urine.

Ms Meachem is registered with the Society of Homeopaths, whose code of conduct says that "No advertising may be used which expressly or implicitly claims to cure named diseases". While a comment piece in the MEN probably doesn't count as advertising, perhaps it should, especially given that the piece ends with the words "To make an appointment with Zoe call xxxx xxx xxxx".

Ms Meachem also has a BSc (hons) in Homeopathic Medicine, to which the only possible response is "You've got a degree in baloney!"

What's wrong with Shang et al.?

Shang et al. recently published a meta-analysis comparing homeopathy with 'conventional' treatments in the Lancet (Lancet 366; 726-732). This is the most recent of the meta-analyses cited by Ben Goldacre in his excellent Guardian piece on homeopathy. Homeopaths have not been amused by this paper, and have tried very hard to discredit it. This is perhaps predictable since the paper concludes that homeopathic treatments have no effect beyond placebo, once the poorly-designed and biased studies have been stripped out. The consensus amongst homeopaths seems to be that the study is outrageously flawed, and scientists show themselves up by referring to it. Some recent discussions of it involving homeopaths can be found here and here. Despite the large amount of noise surrounding the discussion of this paper, I haven't seen a lot of signal, and so far I haven't seen a critique that stands up to scrutiny.

What did the paper do? The authors set out to test the hypothesis that homeopathic treatment effects can be attributed to the placebo effect. If that were the case, then any positive trial results for homeopathy would have to result from poor study design and/or bias. The authors tested this proposition by identifying 105 papers reporting 110 trials of homeopathy, and matching them with 110 trials of 'allopathy', or conventional treatments, on the basis of disorder treated and type of outcome measured. The authors then assessed the methodological quality of the papers, based on factors such as whether the trial was adequately blinded and whether it was adquately randomised. The paper found that for all the homeopathic trials, there was an effect beyond placebo. However, when the trials that were of low methodological quality and/or had sample sizes that were small were stripped out of the analysis, the remaining 8 trials showed no effect beyond placebo. On the other hand, when the same procedure was followed for the conventional medicine trials, the six remaining trials did show an effect beyond placebo.

So far, so good. What have been the criticisms of the paper?

One criticism has been that the trials deemed to be large and of higher quality were not identified, and that the reporting of the meta-analysis was inadequate. This criticism does carry some weight, and the reporting in the original paper was not good enough. However, the authors recognised the problem, and rectified it by identifying the trials in a reply to published criticisms that appeared in the Lancet (Lancet 366: 2083). You can find all the details of the study via apgaylard's blog here. So, this criticism is no longer valid.

Another criticism has been that the meta-analysis only uses 8 papers out of 105 to conclude that homeopathic remedies are no better than placebo. This seems to totally miss the point of the study. For one thing, it's a meta-analysis, so it pools studies in order to get more statistically significant results than single studies. The eight studies of homeopathy have a total n of 1,923, which is quite respectable. Also, Shang et al. have not employed some sort of sleight of hand to dismiss the other 97 papers. They have filtered them out because they are of inadequate methodological quality and/or size, based on clearly stated criteria. This allows the authors to compare the results from all the studies with the results from the best studies. When you use only the best studies, there is no longer any benefit for homeopathy beyond placebo. In contrast, using the best studies of conventional treatments, there is an effect beyond placebo. Again, this is the whole point of the study, and criticising it on the basis that it seeks to use the best-quality studies seems somewhat misguided.

Another common criticism from homeopaths is that the study doesn't test 'real' homeopathy. Shang et al. split studies of homeopathy into four types:

1. Classical homeopathy: individualised treatment based on homeopathic history-taking
2. Clinical homeopathy: no history-taking involved, each patient gets the same remedy
3. Complex homeopathy: patients take a mixture of several different remedies
4. Isopathy: the agent judged to be the cause of the disorder was used

For example, here's a website where they state flat out that there is no such thing as clinical homeopathy. This would be news to anyone who has wandered into Boots and seen the homeopathic remedies on sale there. More commonly, the criticism is that only 'classical homeopathy' is really homeopathy, and the other types don't count. Even if we allow this criticism, the fact is that 18 of the included trials were of 'classical homeopathy', as defined by the authors, and two of those made it into the group of eight large, high quality trials. The statistical analysis also showed that there was little evidence that effects differed between different types of homeopathy. So, not only did the study include trials of individualised homeopathy, it showed that these were no more effective than the other forms of homeopathy.

So, on the whole, it seems to me that the methodology of Shang et al. is reasonable, and the conclusions justified. I think it's probably true that no study is entirely without flaws, and I'm willing to be corrected on this. But so far I've seen no good criticism of the Shang et al. study that invalidates its conclusions.

Edit: Just as an aside it's interesting to read the second last paragraph of Shang et al., where they discuss the place of homeopathy in treatment systems. I take the liberty of reproducing the paragraph below:

"We emphasise that our study, and the trials we examined, exclusively addressed the narrow question of whether homoeopathic remedies have specific effects. Context effects can influence the effects of interventions, and the relationship between patient and carer might be an important pathway mediating such effects. Practitioners of homoeopathy can form powerful alliances with their patients, because patients and carers commonly share strong beliefs about the treatment’s effectiveness, and other cultural beliefs, which might be both empowering and restorative. For some people, therefore, homoeopathy could be another tool that complements conventional medicine, whereas others might see it as purposeful and antiscientific deception of patients, which has no place in modern health care. Clearly, rather than doing further placebo-controlled trials of homoeopathy, future research efforts should focus on the nature of context effects and on the place of homoeopathy in health-care systems."

This seems to be entirely reasonable, and suggests that Shang et al. have no particular bias against homeopathy.

Something to prove

There's an interesting debate currently taking place in the pages of the journal Homeopathy. It's interesting in that there is actually an attempt to have a debate about one of the fundamentals of homeopathic practice. It's also interesting to see some of the anti-scientific responses to the debate. The original papers discussed can be found through the website of Homeopathy. Unfortunately, you probably won't be able to access them unless you or your institution subscribes to the journal.

In the January issue of Homeopathy, Dantas et al. published a review of homeopathic provings, or Homeopathic Pathogenetic Trials (HPTs), as the authors prefer to call them. The authors defined HPTs as being "clinical trials designed to investigate the effects of the exposure of human volunteers, in good health, to potentially toxic or pathogenetic substances, diluted and serially agitated according to homeopathic pharmacopoeial methods, with a view to providing data to inform their use as homeopathic medicines". The idea is that symptoms caused by the homeopathic preparations can be cured by the same preparations, under the principle of 'like cures like'. There is no good evidence that this principle can be applied as a general rule, but even so it has become one of the foundation stones of homeopathy. One problem is that the symptoms in an HPT are recorded by the volunteers who take part in the proving. No quantitative data is collected about symptoms, and there are well-known problems with such self-reporting studies. Also, in many cases there is no way of telling whether the symptoms occurred as a result of the homeopathic preparation, or for some other reason, because such trials are not always placebo-controlled (Dantas et al. claim that 58% of the trials in their review were placebo-controlled).

The review by Dantas et al. concluded that "Most studies had design flaws, particularly absence of proper randomization, blinding, placebo control and criteria for analysis of outcomes", and went so far as to state that "The central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered, because of methodological weaknesses of the reports". Their central point is that while provings often turn up all kinds of symptoms, methodological flaws mean that you can't tell whether the symptoms were caused by the homeopathic preparation or not. The authors recommend that improved methodology should be adopted for future HPTs.

This is interesting stuff, and suggests that there are at least some homeopaths who question the value of HPTs, and on perfectly reasonable scientific grounds. It all starts to go a bit wrong in the responses to the article, which were published in the current issue of Homeopathy.

Sherr and Quirk's response is probably the most fun, and I suggest you track it down for yourself (but only if you've got time for such nonsense). Their point of view can be summarised by a paragraph towards the end of the paper, where they state "Eliminating the majority of symptoms or characteristic single symptoms due to over scientific vigour or a concern about statistical significance or background noise, risks throwing out the baby with the bathwater. It is important to remember the proof of provings is first and foremost their clinical usability and efficiency". Over-scientific vigour or a concern over statistical significance, indeed. This is pre-enlightenment thinking if ever I saw it.

They also say that "A good proving is not about producing every possible symptom. It is about producing enough symptoms of quality so that the intelligent homoeopath can perceive a meaningful totality". I take this to mean that you don't have to worry about using the best possible methodology, because the homeopath has some magic way of 'perceiving a meaningful totality'. Also, the object of the proving is to produce 'enough symptoms', not the ones actually caused by the preparation. (Here I gloss over the fact that homeopathic preparations tend to contain no active ingredient, so will in all likelihood produce no symptoms at all). This is illustrated by a proving of hydrogen mentioned in Dantas et al., where the original trial produced 50 times more symptoms than a subsequent trial with improved methodology. According to Sherr and Quirk, the problem here is not with the original trial, but with the improved one, which produced too few symptoms to constitute a usable proving.

Dantas et al. respond with a paper entitled 'We must distinguish symptoms caused by the medicine from other symptoms'. In this case, the title is probably an adequate response on its own.

Then Harald Walach has a paper in response to Sherr and Quirk, entitled "Potential nonlocal mechanisms make placebo controls in pathogenetic trials difficult". This, once again, is quantum gibberish being used to claim that placebo-controlled trials can't work for homeopathy, because of 'entanglement' between patient, practitioner and remedy. Not to put too fine a point on it, this is bollocks, because entanglement has not been observed for systems containing more than a few particles. This is just homeopaths trying to find a way out of all the negative placebo-controlled trials of homeopathy. The attempts by those sympathetic to homeopathy to explain it via quantum mechanics are taken apart in some detail on shpalman's blog here and also here. My favourite bit of Walach's response is this: "It is a well-known lore of homeopathic proving that those in control groups, relatives, or even the pet dog may develop proving symptoms although they have not taken the remedy. This lore, although anecdotal and not scientific evidence at all, is valuable since it suggests that placebo controls might not be adequate". So, although this 'lore' is 'not scientific evidence at all' it is still valuable as evidence that placebo controls may be inadequate. Hm. Perhaps another explanation is that the proving symptoms recorded in the trial had nothing whatever to do with the homeopathic preparation being trialled, and so could be expected to be found in people (or dogs) not taking the preparation? That's why you do a placebo-controlled trial in the first place, and that's why quantitative data (as opposed to self-reporting) on symptoms are so important.

At the end of it all, you have to wonder what would happen if relatively sceptical authors such as those responsible for Dantas et al. started to address the results from meta-analyses that persistently show that homeopathic preparations have no benefit beyond placebo. Unfortunately, there seems to be no sign of this happening, as the authors conclude their paper by saying "As evidence accumulates for the efficacy and safety of homeopathy from rigorous clinical trials, there is an increasing need to investigate and develop valid methodologies for the experimental pillar of homeopathy—the homeopathic pathogenetic trial". Still, perhaps this drive towards better methodology may have unintended consequences. As we know from the Shang et al. meta-analysis in the Lancet, the better the methodology of your study, the more likely it is to show no effect beyond placebo for homeopathy.

References

Dantas, F., Fisher, P., Walach, H., Wieland, F., Rastogi, D.P., Teixeira, H., Koster, D., Jansen, J.P., Eizayaga, J., Alvarez, M.E.P., Marim, M., Belon, P. and Weckx, L.L.M. 2007. A systematic review of the quality of homeopathic pathogenetic trials published from 1945 to 1995. Homeopathy, 96: 4-16.

Dantas, F., Fisher, P., Rastogi, D.P., Teixeira, H., Eizayaga, J., Alvarez, M.E.P., Belon, P. and Weckx, L.L.M. 2007. Authors' response: we must distinguish symptoms caused by the medicine from other symptoms. Homeopathy, 96: 275-276

Shang, A., Huwiler-Müntener, K., Nartey, L., Jüni, P., Dörig, S., Sterne, J.A.C., Pewsner, D., Egger, M. 2005. Are the clinical effects of homoeopathy placebo effects? Comparitive study of placebo-controlled trials of homoeopathy and allopathy. Lancet, 366: 726-732.

Sherr, J. and Quirk, T. 2007. Systematic review of homeopathic pathogenetic trials: an excess of rigour? Homeopathy, 96: 273-275

Walach, H. 2007. Response: potential nonlocal mechanisms make placebo controls in pathogenetic trials difficult. Homeopathy, 96: 278.

Still more on memory of water

An update on the fall-out from the special issue of the journal Homeopathy that was devoted to the 'memory of water'. This was written about extensively by me and many others, and in the end there was so much annoyance at what Philip Ball called an 'intellectual shambles' that a number of people have submitted letters to the journal's editor.

This morning I heard that my comments on Martin F Chaplin's article have been accepted for publication. The letter critiquing the Rao et al. paper that was jointly drafted by contributors to the JREF forums (I'm the third author) has also been accepted. Both should appear in the January issue of Homeopathy. So, to give the journal its due, it has not shied away from robust debate. This has doubled my publication record overnight, but I'm not sure if I should include these on my CV...

I expect that the authors of the original articles will have a reply published in the same issue. It will be interesting to see what they have to say.

Incidentally, an erratum to the Rao et al. paper has been published in the latest issue of Homeopathy. It deals with a referencing mistake, and is really the least of the problems with the paper, but it's something.

Sinai fieldwork diary, October/November 2007

I've just spent the last three weeks in Sinai, Egypt, doing LiDAR-based fieldwork mainly. This is how it went. I'm now taking a well-deserved week off...

LiDAR is a laser-based system for collecting what are essentially high-resolution DEMs of rock outcrops (it's actually designed for architecture and surveying work, but it works pretty well for us too). It's heavy and cumbersome, and we have to carry it around the desert. But we do get to look at some pretty fantastic geology too...

Monday 22^nd October

Safely back in Moon Beach, although there were some shenanigans on the way. Dave Hodgetts had all the all equipment at his house, and by the time he brought it in to work Paul Woodman had already left. Oliver and myself have to take all the equipment between us. I’ve had a stressful week, with an interview at Birmingham; a seminar for the entire School of Earth, Atmospheric and Environmental Sciences; and a meeting with the industry sponsors of my project. I’m also coming down with my standard shitty head cold. What I really want to do is lie down for a bit, but instead I have to travel to Sinai for three weeks of fieldwork.

Despite having an enormous quantity of gear, the trip to Cairo goes OK. It takes a while to get past customs with the LiDAR. I tell them it’s a large 3D camera, and they look over it with suspicion. Eventually they decide it’s OK, but they stamp my passport to say that I have to take it back it out with me when we leave. Fine by me, so we get a bus from Abanoub travel to take us to the Cairo airport Novotel. By this time it’s nearly 2am, and Oliver and I have had enough, but the Novotel has somehow lost one of the room reservations that I had made online. I have a print-out that clearly shows that we have 2 rooms, but to be fair the hotel receptionist has a print-out that says I only have one room. Egypt probably isn’t set up that well for e-commerce. Ultimately, we sort this out, but we have to wait while they get another room ready. We get to bed before three, which is still pretty good going.

The next day we’re supposed to meet the Abanoub driver at 12 noon, but confusion sets in between Paul Woodman, Sayed and Abanoub. Eventually Gamal shows up at about 12:30, and we lash the spare tires to the roof of Gamal’s red Jeep so we can fit all the stuff inside. We crawl through the mid-afternoon Cairo traffic, and meet Paul, Sayed and the Abanoub driver at the MacDonald’s on Maadi’s road 9. Paul takes us for a burger at a small Egyptian restaurant, where we pay the equivalent of £12 for three meals with drinks. Then we hit the road to Sinai.

It’s hotter than the hubs of hell and I’m losing my voice, the air in Cairo is irritating my throat even further, and I’m just about fed up. Still, the drive is about as uneventful as it could be, driving three and a half hours in Egypt. Although a Lada in front of us catches fire near Ayun Musa…we pull up a safe distance away, even though all the car passengers seem happy to get as close as possible to the burning vehicle. Flames start to shoot out of the engine compartment. A northbound truck screeches to a halt, and the driver leaps out with a fire extinguisher, sprints across the road, and fills the car with carbon dioxide. That’s that sorted, then. We keep driving south, and 20 minutes later see a fire engine driving north, even though a fire station at Ayun Musa is much closer and the fire is out anyway. It gets dark before we reach Moon Beach, worst luck, so we’re subjected to the Egyptian use of headlights. In Egypt, you don’t use your headlights until you’re almost level with a car coming the other way, at which point you jam on your full beams. Also, oncoming buses or trucks might put on their left-hand indicator, giving us Brits the impression that we’re about to die. It’s a wonder that there aren’t even more accidents than there are. We get to Moon Beach in one piece about 6pm.

I get to eat some of the famous Moon Beach koftas, and turn in. I’m knackered, full of cold, and sleep fitfully. I look like death at 7:30 when we get breakfast. Luckily, we’re not doing too much today. We go to South Gushea, universally known as Mike’s delta, after a PhD student of Rob’s who worked on it. This is a spectacular clastic delta situated at the linkage point between two fault segments, and you can see delta foresets prograding across the shallow marine rocks below. We scope out a few scan stations. Sayed goes to Abu Zenima to get bread and tape measures. When he gets back he has two Imperial students in the Jeep. One of them is ill, so Sayed is taking them back to Moon Beach. There’s nothing worse than being ill in the field, especially when it’s so hot, and I feel sorry for them. We keep going, but finish what we want to do by 2:30. We’re back at Moon Beach by 3pm, so we sort out all the LiDAR gear for tomorrow, and have a beer on the beach as the sun goes down over Wadi Araba. Hard work, this. Into it properly tomorrow.

Tuesday 23^rd October

Today is a bit of a disaster. Instead of bringing batteries from England, we’ve decided to save weight by purchasing batteries in Egypt. This was never going to be a good idea. Still, Sayed gets us two leaky 12V motorcycle batteries that should, in theory, do the trick. So, we drive to South Gushea and set up for our first LiDAR scan station. We connect up the batteries, plug them into the LiDAR, and…’feesh! Nothing. We pratt around with different battery configurations for a while, even try to use the battery in Sayed’s Jeep. Nothing. It turns out that we’ve blown all the fuses in the LiDAR instrument. Prudently, we carry spares, so we replace them all and try with one battery. This works OK, but not for long. We do a couple of scans and as the voltage gets too low, the scanner shuts off. Meanwhile, we can’t get the GPS system to work properly, and then both the batteries we’re carrying for it run out. We end up not getting a GPS position for the station. I use the second LiDAR battery to finish off the scans we need, and we pack the kit up and have lunch. By now the heat is murderous, and we’re struggling for motivation, quite apart from the LiDAR mess we’re in. I start to mix up words and lose concentration (not a good sign even on a Friday night in Manchester), so drink two bottles of water right away. It’s too hot to eat, and I can barely finish two of Sayed and Gamal’s famous sandwiches. In the afternoon we build a cairn at the LiDAR station with the intention of getting a position later when everything is working, and go log a section. The section is not that interesting, as all the rocks here have been chewed up by the critters that lived here in the Miocene, so almost no original sedimentary structures are left. There is a neat ramp-flat fault, and we do find some very large cobble/boulder size clasts in the section, which is interesting. As the sun starts to go down, it gets cooler and we get happier, and I finish relatively happy at what we’ve done, at least in the afternoon. The LiDAR problems are a bit of a worry though, since that’s the main reason I’m here.

We get to Moon Beach just after sunset. I try out the GPS in my room, and within two minutes easily get a reading with the same battery we used in the field. It just about sums up the day, but it’s time to get a cold beer and eat some food. Tomorrow we’re ditching the LiDAR and going to Paul Woodman’s area.

Wednesday 24^th October

Today is OK, as it happens. A battery charger arrives from Cairo, and we get advice on battery usage from Frank and Dave via text message. Of course, I can’t help worrying about it, but today we go to part of Paul Woodman’s area. I should probably keep quiet about where it is, because it’s a big marijuana growing area and the Egyptian army is prone to going out and shooting Bedouin bango growers. Sure enough, we have company, with a couple of Bedouin hanging out with the Jeeps, and coming to check out what we’re doing as we look at rocks. They seem unimpressed, which is fair enough I suppose. One of the Bedouin has a fancy watch, but he still lives in a tarpaper shack in the desert (albeit probably one with satellite TV). They don’t really bother us, but it is annoying having people follow you around. Eventually they get bored and go hassle Sayed and Gamal for water and bread from the Jeeps.

This is an interesting area, and we do some logging of syn-rift sediments. The syn-rift onlaps the pre-rift here, and a couple of faults chop up the section. I find a fault that offsets a Quaternary gravel terrace, which excites me greatly as it suggests that faulting remained active until then. The section is almost like a slimmed down version of Wadi Nukhul, as we start with palaeosols and fluvial deposits and move up into tidally influenced marine sediments. It’s relatively easy to log, and we collect some palaeocurrents on Paul’s behalf.

A straightforward enough day, but I can’t help thinking that tomorrow is going to be testing. At least I get to speak to Jolan, who is in Sheffield.

Friday 26^th October

I now think that this trip has a reasonable chance of success, thought that was not what I thought yesterday morning. Sayed charged the batteries for the LiDAR, and we set off for Wadi Wasit, north of Mike’s delta for some scanning. We get set up, do a panorama scan, collect the photos, and start a fine scan. About five minutes later, the LiDAR cuts out because the battery is flat. We try with the other battery, and that too cuts out halfway through a scan. Gamal insists that the fuses will blow if we try to attach both batteries in series, and he’s an electrician (although we normally run it from two batteries in series). Frankly I’m not sure what to do, and it’s hard to communicate exactly what we need to Gamal. Sayed has gone to Abu Zenima for bread, so we wait for him to come back. Paul and I discuss all kinds of possible solutions, including sending Frank out to Sharm el Sheikh with the batteries we normally use.

The solution is simple, as it turns out, but cumbersome. We can connect our motorcycle battery in parallel with the battery in Sayed’s Jeep. We need to set up right in front of the Jeep, but it will allow us to get a few stations in that are near tracks. This works handily, and in the end we get 4 stations done before we get home.

Today, we decide to go to Paul’s area again. Oliver has tonsils the size of golf balls, and decides to stay in Moon Beach today. We send Sayed to Ras Sudr for a car battery we can use for further LiDAR work, and head off.

It’s another quite interesting area of Paul’s, with a thick section of mud containing large channel sandbodies close to the main fault. There are minor faults here too, and we map them in as we walk around the outcrop. We walk up one wadi and down another, and as we get back close to the road again I here voices. I look up and catch a flash of white (Galabier?) as it disappears behind a fallen block. Paul has heard something too, so we stick around for a while. Sure enough, a Bedouin appears around the side of the block, so we shout “Sabah il khayr!” (morning of the goodness). Two Bedouin come down to find out what we’re up to. Paul asks them if there’s a problem us being here and walking around, and one of them says “Kulu mish mushkella” (no problem anywhere). We shake hands, and the Bedouin walk along the wadi out towards the main road. The wadi is narrow and bounded by cliffs, and Paul and I scramble up one side of it to get a better view of the geology. I see what the Bedouin are doing here. There’s an enormous field of bango (marijuana) at the wadi entrance, hidden behind an earth berm no more than 150 m from the main road between Suez and Sharm. You have to admire the sheer effrontery of the Bedouin. Police and army drive up and down the main road every day, and anyone in a helicopter flying over the area would easily pick up the green field against yellow desert.

We do a bit more work, and walk out of the wadi (past the plantation) back to the Jeeps. I wouldn’t have done this myself, but when I had to deal with this sort of problem it was in Quebec where plantations can be booby-trapped. This is a much lower-key operation, and Paul knows the ropes. We decide to work in the other wadi (sans plantation) in the afternoon, putting in a couple of logs, but we go up to a high point to get a view across the area. We can just see the edge of the plantation, and as we take pictures and sketch, we see a man run into the plantation wadi from the main road. Perhaps the Bedouin have used a mobile phone to call in reinforcements.

We log in the afternoon, and it’s clear that the wadi we’re in has had plantations in the past. There are three or four areas of furrowed ground with a few scraggy plants needing water, but the main activity is clearly in the next wadi. Even so, nobody bothers us for the rest of the day and we get back to Moon Beach about 4:30. It’s Friday night, and the place is packed out.

Tomorrow, LiDAR again…

Monday 29^th October

We’re beginning to run out of ways in which the trip could get worse (although you never quite run out…). Oliver’s tonsillitis has failed to respond to antibiotics, so we’ve sent him back to Manchester. There’s no point having him here being miserable, and he probably needs to get some British medical attention. It cost me the entire morning to sort out a flight for him. First off, we’re 2 hours ahead of Britain, so the UK office of KLM didn’t open until 10am Moon Beach time. Then it took me an hour of phoning bad numbers, going through phone trees, and listening to portentous classical music while on hold, before I could get a new reservation. Hopefully that is now sorted. In any case, Ollie is now in Cairo, in the ‘executive suite’ of some hotel near the airport, waiting for home. The KLM flight is at 4:15 in the morning, so not exactly fun, but it should get him home before 11am. As long as nothing else goes wrong…

Once we get everything sorted about 11:30, we head out with LiDAR in tow. The plan is to drive to Abu Zenima for supplies, and then back to Mike’s delta to collect some data. We manage to get a couple of scan stations done, amidst constant battery problems, and we end up running the LiDAR from the Jeep battery for the second station.

Sayed’s son Bilal is coming to replace Ollie and help me with LiDAR gear, which is great, except that we have more battery problems and I’m not entirely sure that we’re going to get much more work done anyway. It’s preying on my mind now, and I want nothing more than to get home and forget all about this trip. Not much more I can do other than hope for a better few days ahead. Tomorrow is the halfway point of the trip, and I’m certain I haven’t done anywhere near half the work I need.

Tuesday 30^th October

Maybe the trip will go OK…

Paul got a text from Ollie to say that he was safely checked in on last night’s KLM flight, so we assume he got back to Manchester in one piece. If so, I’ve actually managed to achieve something on this damned trip.

On the way to the field in the morning, we get behind a truck full of bricks struggling up one of the inclines on the main road to Sharm. Naturally, the load isn’t secure, and bricks are periodically falling off the back and bouncing down the road, with Sayed having to lurch out of the way several times. Sayed flashes his lights and sounds his horn, but the truck driver refuses to stop. There’s nothing for us to do but get past, and avoid a brick through the windscreen. As we pass we see that the truck is leaking diesel all over the road as well. That’s Egypt for you.

We get to the field area in one piece, and today goes OK. I get 4 huge stations done, but fighting batteries all the way. Basically, the batteries we have are not enough for a days work. We’re running them until the LiDAR cuts out, and then charging them from the Jeeps. This is keeping us going, but it’s time consuming. Especially when we’re working some distance from the Jeeps and we have to carry batteries there and back. But, four stations is OK, and they involved some carrying. If we can keep this up, it’ll get done, just about. The only problem is that Paul needs to work in is own area, so it will be me and Bilal. This is OK, it just means that I have to do all the setting up, which makes everything a little more time consuming again. But, it seems at least possible now, and for just about the first time I get back to Moon Beach with a sense of a days work well done.

Wednesday 31^st October

Maybe the trip will work out OK, but it seems as if nothing is going to be easy. What else could go wrong, you might wonder. Just off the top of my head, I could have battery problems that wipe out the entire morning. I could spill battery acid all over myself, and ruin a perfectly good pair of trousers. Bilal could fall and hurt his leg. Naturally enough, these things all happen. Eventually I get two scan stations done. Still, this is better than it sounds because they’re difficult ones, a long way from Jeep access and high up. I don’t have to do them again, and they bring me close to the top of the hill. Maybe another half dozen scan stations close to the road would see me right, or at least give us enough data to work with. But who knows if that many stations will be possible? Ideally I need to finish with scanning by Sunday so I can do some logs (that is, actually look at some geology).

Not for the first time I feel that I’m going to kiss the tarmac at Manchester airport when I get home. I usually enjoy the better part of my trips to Sinai, but all I’ve done since I’ve got here is worry about stuff, primarily batteries and ill field assistants. It feels like three weeks I’ll never get back.

Friday 2^nd November

I break the back of the trip today. I smash each individual vertebra with a mallet, and then I kneel on the fucker’s windpipe to be certain. It’s been a relatively trouble-free day, although we did have a run-in with a Bedouin and his bango plantation. Actually, the Bedouin seemed happy enough. He told Bilal and Gamal all about his plantation. Sayed dropped by to bring us water and bread from Abu Zenima, and the Bedouin told Sayed all about it too. The Bedouin is happy for us to wander all around his plantation, collecting data with a large instrument mounted on a surveyor’s tripod. There is one man looking after two large fields, and there must be little danger from the army or police.

Anyway, I get 7 stations today, to add to 5 yesterday, and even if I don’t get any more it will probably be enough to do something useful. Two friends of Paul’s from Cairo are here for the weekend, and we’re going to take them to Wadi Baba and Wadi Nukhul tomorrow. Rob has asked to me do a scan station at Baba, and I’m supposed to get photographs and palaeocurrent measurements from Nukhul. Such is my state of mind that this seems like a day off, and I’m very much looking forward to it.

Sunday 4^th November

Today was the last day of LiDAR data collection, hamd'ullah. It went OK too, although I had some battery issues towards the end. Anyway, I think I’ve got the data I need. We finished scanning about 3pm, and I went to look at some faults for the last hour or so. It’s a totally different fault style to what you see at Wadi Nukhul. The faults here show ramp-flat geometry as they sole into mud horizons, whereas the Nukhul faults are generally very planar with little deviation between rock units.

Now I need some logs, so that’s what I’m mostly going to be doing for the next four days.

In the morning near Mike’s delta I see two Chinook-style army helicopters flying west over the area, and think no more of it. As ever, Paul has the best problems. The same helicopters were later to be seen circling over the Wadi Gharandal and Wadi Silfa areas, right where Paul was wanting to visit some outcrops. Possibly there’s going to be an army raid on the marijuana growers within the next day or so. The Bedouin have entirely disappeared from the area, and it’s probably not smart to be wandering around there just now. After being practically buzzed by the helicopters later in the afternoon, close to a known marijuana plantation, Paul decided to come back to Moon Beach, and I don’t blame him. The priority is always to get home in one piece.

Monday 5^th November

At last, I actually get to go and look at some of the geology of this area I’ve spent two weeks scanning. I go to an area just by Wadi Wasit where there are faults exposed, and sketch in the faults on a photopan. Then I put in a log. The logging here is not that interesting, as the sediments are all highly bioturbated and there’s nary a sedimentary structure to be seen. On the other hand, it’s good to actually get some idea of what I’ve been looking at. I also find a fish tooth in the very first unit of my log, which cheers me up a bit.

It’s not an easy area to work in. There’s a big cliff at the back, and then incised wadi systems in the front. Most of the rocks are poorly cemented, but there are laterally extensive hardgrounds that form waterfalls. To get around you have to climb across from one wadi to the next, often up soft scree banks. The area is eerily quiet, and all I hear most of the day is the buzzing of flies, and sometimes not even that. It’s hotter than the hubs of hell, and I eventually burn out about 3pm. I’ve been working quite close to cliff faces where there’s no breeze and no shade, and it’s just too much, even though I’ve drunk a good 4 litres of water. I have to go and sit in the shade and drink yet more water. I’m all in, so I decide to pack in for the day, and get back to Moon Beach for 4pm.

Thursday 8^th November

Well folks, that’s that. I’m back in Moon Beach, having completed my last day of fieldwork. Tomorrow we’re off to Cairo. At least I think we are. Paul seems to have gone to Sharm el Sheikh by East Delta bus in search of dollars to pay Sayed. I brought about $3000 dollars with me, and Paul was going to do the same, but the bank decided that him trying to get money in Cairo was dodgy, and suspended his card. This despite Paul having lived in Cairo for a year. Various other money-getting schemes involving the Cairo ex-pat community have failed, and we now owe Sayed about $3,500, without having any clear way of getting it. We’ll figure it out somehow. I think.

I’ve been doing a bit of logging, and a bit of LiDAR in Paul’s area. The logging is not particularly exciting, and today I basically take a hike in the desert. I go up some of the hills in my area, and get an overview of the geology, as well as getting some great views of the desert. I spot a bango plantation from way up high, but there seems to be no-one around today.

On the way back to Moon Beach, I see a Chinook-style helicopter flying north along the coast. We pass the place in Paul’s area where there’s a bango plantation right next to the main road. There’s an armoured personnel carrier (with a blue light on top: perhaps the police borrow it for protests) on the back of a truck at the very place, with a bunch of army guys stood around it. Not a Bedouin to be seen, and I suspect the bango is going to be burnt in the near future. I hope Paul wasn’t anywhere in there today. This probably helps explain why there was not a Bedouin to be seen at Mike's delta today.

If we avoid any more problems, I should be home in 45 hours or so.

Hawk/Handsaw on hiatus

I'm off to Egypt for fieldwork as part of my day job (see picture at top right), so I won't be able to post anything here until mid-November. Thanks for reading, and I hope I'll have some interesting stuff after I get back.

I have the best days out

If you've ever wondered what it's like being interviewed for a lecturer position at a Russell Group university, read on...

I applied for a lecturer position at the University of Birmingham, and they asked me to come down for an interview last Friday. This is quite an involved process, and I was asked to give a research presentation, a teaching presentation, and an interview. I was to give my research presentation at 9am, so it was the 6:17 train out of Piccadilly to New Street. The train was pretty quiet at that hour, until we got to Wolverhampton and the train started to fill up with commuters travelling to Birmingham. Arrived at New Street bang on time, and then the short hop on an electric commuter train to University. Yes, the campus has its own railway station, 6 minutes from New Street, which is a nice touch. I was asked to arrive 15 minutes prior to my presentation, but taking the advice of my PhD supervisor (I have always been 15 minutes early, and it has made a man of me: Lord Nelson, supposedly) I was there 30 minutes early. I assumed that mine was the first presentation, but in fact there was a guy who started at 8:30. I got to see some of his presentation through the door of the meeting room, and started to realise that it was a lot better than mine. The candidate made clear how his research would fit in with the department, use the facilities, how he would work with other research groups, and so on. My presentation is more along the lines of 'Here's some cool stuff I'm doing'. Oops.

I do the presentation from a Birmingham laptop, and none of the animations work, which throws me off a bit. I get quite a grilling from the assembled staff, post-docs and postgrad students. A lot of the questions are not about the research I'm doing, so much as the research I intend to do in the future and how I intend to fund it. I realise that these are the questions I ought to have addressed in my talk. Oops again. One of the staff, a geophysicist, seems particularly unimpressed with the LiDAR data I've been using. I handle the questions reasonably well, but I'm already pretty sure that I won't get the job. I wander around the campus and try to collect my thoughts a little.

The teaching presentation is supposed to be an introduction to a proposed third-year level course, delivered as if I was talking to the students. It's not easy to pretend you're talking to a bunch of students when the room is actually full of professors, lecturers and post-docs, but I give it a try, and actually it goes down reasonably well. I get a few questions about how I would handle assessment of the course and so forth, but I do OK. The problem is that the main criterion for awarding the position is going to be research excellence and not teaching. Oops yet again.

Two of the postgrad students give us a tour of campus, which is quite impressive. The Earth Sciences department is in one of the older buildings, close to the magnificent clock tower. Campus is leafy, quiet, clean and pleasant, a welcome contrast to the Manchester campus with the noise and bustle of Oxford Road cutting through the middle of it. The building is old but serviceable, and architecturally quite spectacular. It also includes the Lapworth museum, a nationally important geological collection. I look at some impressively spiky trilobites. Then we get to have some university catering sandwiches, which are tasty enough. Especially since it has been nearly 8 hours since I ate anything.

The afternoon brings the interview. This is perhaps the most intimidating part. The interview panel consists of the Dean, the head of school, the head of department, the leader of the research group I would be working with, a fellow from Archaeology and a lady from Human Resources. They grill me for half an hour, and the questions are again mainly related to funding, research directions, potential collaborations with others (internally and externally), and so on. I was asked what I thought were the main challenges for universities, and how I thought the work would differ from what I currently do. I handle this OK, but one question stumps me completely. I'm asked how my work would address the strategic objectives of NERC, the government funding council for Earth Sciences. I have no idea what those objectives, and have no option but to say so. That's not an error I will make in the future. If I get another interview, I'll have a slide on it in my presentation. I get to ask some questions at the end, so I do a little grilling myself, asking where the school and research group expects to be in 4 to 5 years, and what support there is for new lecturers. After that, they thank me for my time and I'm free to go.

I'm pretty much shattered at this point, so I decide to find beer in Birmingham. I get on the train to New Street. As you leave New Street station, you emerge into a huge shopping mall, with no clue as to where the exits are. My nerves are jangling enough as it is, and wending my way through the throngs of people past brightly lit shops full of tat doesn't help. I emerge into the open air eventually, and walk for what seems like miles until I find a pub. The Crown is possibly the dodgiest pub in Birmingham, but I don't care by now, and get myself a pint. The only bitter they have is something called Brew XI. I take a sip. "Bloody hell, that's even worse than Stone's", I think.

I sit down, and am joined by a friendly man tells me all about his court case. It turns out that the pub is outside the law courts, which explains a lot. The man is on trial for conspiracy because he was holding a banner at an animal rights demonstration at which some other people committed offences. His legal team come and join us for a pint, too.

It's then time for me to get home, so I hike back to New Street. I pick up a pasty, with extra gravy, and get on a packed Virgin voyager to Picadilly. I stand next to the toilets until Stoke, and then get to sit down. I get a bus at Picadilly gardens, but it's Eid, and traffic through Rusholme is pretty much stationary, so I end up walking the last mile or so.

When I get home at about 9pm, Jolan has a cold beer waiting for me, and I love her more than ever.

Well, I didn't get the job, but then getting it would probably have caused more problems than it solved...

Homeopathic dissent

In a spare moment, I was looking up the famous controversy involving Nature, Jacques Benveniste, and basophil degranulation. This was an experiment, reported in Nature, that purported to show that there could be a 'water memory' effect that could provide a mechanism for homeopathy. Essentially, the workers found that a substance diluted such that there should have been no molecules of it remaining still had a biological effect. There was naturally a lot of skepticism surrounding this paper, and Nature only published it on condition that they could send a team to Benveniste's lab to verify the results. The team found a number of statistical and methodological flaws in the study, and concluded that the results were erroneous. A useful summary of the controversy can be found here. Since then, a number of groups have failed to replicate the results (for example this one).

I came across a very interesting site belonging to George Vithoulkas (8 canards on the quackometer). It seems that not all homeopaths greeted the Benveniste study with unalloyed joy. Vithoulkas pointed out that the results of the study were the opposite to what would be expected from homeopathic theory. Apart from the idea that the 'potency' of a remedy is increased as it is diluted, the other unproven foundation of homeopathy is the 'law of similars'. This states that 'like cures like'; a substance that causes symptoms when taken in large amounts will cure the same symptoms when taken in homeopathic concentrations. According to this, if antibodies cause basophil degranulation in normal concentrations, the same antibodies should prevent it in homeopathic concentrations, the opposite to what Benveniste's team claimed.

Vithoulkas concludes that the 'memory of water' argument is a red herring, and has done nothing but damage the credibility of homeopathy. Given the recent fiasco surrounding the Homeopathy special issue on water memory, he clearly has a point. Even so, Vithoulkas isn't really engaging with the evidence. He just knows that the Benveniste research must have been wrong because it violated one of the (unproven) principles of homeopathy. What I find fascinating and brilliant about this is that plenty of homeopaths are happy to defend Benveniste's work, no matter the flaws, because it seems to support one of the basic tenets of homeopathy. For example, here's Dana Ullman on the study. In doing so, they miss that it completely undermines one of the other tenets.

Democracy, ask me if I'm bothered

You could hardly have failed to notice that there has been speculation about a possible snap election in the UK, with the first week of November having been suggested as the most likely date. The press has been having seizures over this, discussing every possible factor that could have influenced Gordon Brown's decision. Factors mentioned have included the likely turnout at a time of the year when much of the polling would take place in the dark; polling in marginal seats; the state of the economy; the events at the Tory conference; the weather; and just about everything but the thing that seems, at least to me, to be the most important.

The problem is that if an election were called for November, then the December 2006 electoral roll would have to be used. People who had moved home since that date would be in danger of losing their votes. Estimates are that this could affect up to a million people (e.g. see here). Where this has been discussed at all, it has been looked on as a minor inconvenience that could affect turn-out, as opposed to a threat to people's basic democratic rights.

Now, surely any Prime Minister who would consider holding an election at a time when up to a million people could lose their vote is not fit to hold office. At a time when Gordon Brown is trying to wear the mantle of a statesman by publicly opposing anti-democratic regimes such as those in Burma and Zimbabwe, it's surely not too much to ask that he take a little care with our own democratic institutions. It's also sad that the opposition and media have failed to make any kind of issue of this. I would like to have seen an enormous banner headline somewhere, anywhere, saying "A million to lose votes in November poll".

Thankfully, Brown has now bottled it, but this episode seems to put the lie to his conceit that he's governing for the country, rather than the Labour party. And it's clear that the UK is in desperate need of electoral reform, if the fact that people move house every so often can create such problems for the current system.

How wrong is it to speculate?

Just some thoughts that have been festering since the Hurlbert and Ling paper in Current Biology, the one that showed that women preferred pink hues when compared with men. I wrote about it, Ben Goldacre wrote about it, and I think more or less everyone with an internet connection wrote something about it somewhere.

The general gist of opinion on the article seemed to be that it was an example of bad science, because of the author's speculation that their results had some sort of evolutionary psychology explanation, perhaps that women needed to pick out red berries against a green background in the days when the men were out killing stuff and hauling it back to the cave. I would agree that the data presented in the paper don't support that interpretation. On the other hand, the authors clearly identified that hypothesis as speculative. I think it's worth asking whether speculation can have a place in scientific literature.

In my view, the answer is yes. In the case of the Hurlbert and Ling paper, data was presented showing that women prefer pink hues. The authors indulged in some speculation as to why this might be the case. It should now be the task of scientists to try and devise studies that could refute that speculation. It follows the pattern make observations, formulate hypothesis to explain observations, make more observations to test hypothesis. So I think the speculation in the paper is scientifically defensible. In this context, Kaj Sand-Jensen's famous paper on "How to write consistently boring scientific literature" is always worth a look, especially the section headed "remove most implications and every speculation". Scientific caution is generally sensible, but if taken too far it can mean that possible leads are not followed up.

The problem with that approach is the way such studies get reported in the media. As we've seen, most of the stories on the paper suggested that the authors had confirmed an evolutionary psychological explanation for gender-based differences in colour preference. In fact, they had simply showed that gender-based differences in colour preference exist. With scientists getting brownie points for media engagement, it is inevitable that the differences between results and speculation get lost.

Dana Ullman MPH gives me some homework

Dana Ullman MPH (the only person I've ever seen put their qualifications on their blogger username) commented on my piece on Alan Bennett's description of alternative therapies here, suggested that I'm confused about what homeopathy is, and gave me some homework to do. I've read Ullman's webpage, and I can tell you that it's a farrago of nonsense, written in superficially scientific language.

I was aware of some of Dana Ullman's work previously. For example, there's an entire thread dedicated to him at JREF, which you can find here. He posted there (under the username James Gully) to write some utter nonsense about famous scientific figures who supposedly used or supported homeopathy. Having had his arse handed to him by several posters on the forum, he accused them of 'intellectual dishonesty' and disappeared. But I hadn't seen this webpage before. It's entitled 'Why homeopathy makes sense and works', but fails to demonstrate either. You can find it here.

Ullman starts off by talking about side effects. He writes "It should be noted that people often incorrectly assume that conventional drugs have 'side effects.' Actually, in purely pharmacological terms, drugs do NOT have side effects; drugs only have 'effects,' and physicians arbitrarily differentiate between those effects that they like as the effects of the drug, while they call those symptoms that they don’t like 'side effects.' This is akin to saying that the effects of a bomb are that it destroys buildings, but its side effects are that it kills people. Needless to say, one cannot truly separate out one effect from the other. The reason that drugs create 'side effects' that are often worse than the original disease is that these drugs tend to suppress the symptoms the sick person is experiencing and push them deeper into the person’s body."

In fact, the distinction between effects and side effects is simply that the effects are desired, and the 'side effects' are not. It's not an arbitrary distinction, and no-one is trying to claim that side-effects are not effects caused by the drug. That's why medicines are tested for safety before they are licensed for sale. The reason why drugs have side effects is that they contain biologically active substances. A good explanation for the lack of side effects with homeopathic remedies is that they do not contain biologically active substances, that is, they don't work.

Ullman describes the principles behind homeopathy. In a section headed 'Determining what a medicine can cure', he writes about homeopathic provings. In a proving, subjects are given a dose of a substance, and their 'symptoms' are recorded. It is then assumed that a small (or nonexistent) dose of the substance will cure the same symptoms. Ullmann calls these provings 'toxicological studies', but it's easy to see that as scientific studies they leave a lot to be desired. It's an exercise in the post hoc ergo propter hoc fallacy, in that it's impossible to know whether the 'symptoms' were caused by the dose because there are no adequate controls.

Ullman then goes on to describe how homeopathic remedies are made, and talks about the power of 'nanodoses'. Firstly, this is a little disingenuous, as it suggests that homeopathic remedies contain very small amounts of an active ingredient, whereas in many cases they contain no active ingredient at all. Perhaps 'nonodose' would be a better term. Ullman describes the process of dilution and 'succussion' (shaking) well enough, but then bizarrely states that "It is inaccurate to say that homeopathic medicines are extremely diluted; they are extremely 'potentized'". It is not inaccurate to say that the medicines are extremely diluted: they are extremely diluted, as Ullman shows when he talks about serial 1:10 or 1:100 dilutions being conducted up to 1,000,000 times (as an aside, how can this easily be done? If I assume one 'potentisation' step can be done in one minute, it would take nearly two years to do 1,000,000 times, assuming I work 24 hours a day). The homeopathic theory is that this dilution and shaking makes the remedy more 'potent'. Apart from being against common sense (which after all can be wrong), this also goes against the dose-response effect well known from pharmacology, i.e. that a greater dose causes a greater effect. In a section headed "Other evidence on the power of nanodoses" Ullmann writes about certain compounds that have biological effects at very low concentrations, or that have very different effects at low concentrations than they do at high concentrations. This is not relevant to homeopathy, where substances are supposed to be biologically active at zero concentration.

Ullman also writes about clinical evidence for homeopathy. One thing about this section is that Ullman seems to misunderstand p values, when he writes that p=0.008 "means that there was a 99.2% chance that this treatment was effective". It means that if you conducted the experiment 1,000 times, you would expect to get a positive result 8 times through chance. It doesn't tell you about biases, poor experimental design, or other problems with the study (there's a useful discussion of some of these things here, here and here). For any of the examples Ullman gives of studies showing benefits for homeopathy, there are several that show the opposite. A recent well-conducted meta-analysis in the Lancet looked at homeopathy versus 'conventional' treatments. It found that the best conducted studies showed no benefit for homeopathic remedies beyond placebo, whereas the conventional treatments did show a benefit beyond placebo. Tellingly, Ullman mentions New Scientist, a popular science magazine that does not publish original research.

In the last paragraph of the 'clinical evidence' section, Ullman mentions 'water memory'. As regular readers of hawk/handsaw will know (hi to all two of you!), a recent issue of the journal Homeopathy was dedicated to this concept. None of the papers in it showed any 'memory' effect relevant to homeopathy, as discussed here, here, here, here, here and here. It's wishful thinking, at best.

For me, there's nothing on Dana Ullman's page that makes me think that homeopathy 'makes sense and works'. Not only that, but I didn't learn anything I didn't already know about homeopathy.

Edit: Here's a link to the Respectful Insolence blog on the COPD study mentioned by Dana Ullman in the comments to this piece.

Alan Bennett and homeopathy

I bow to no-one in my admiration for the writing of Alan Bennett. It probably helps that he's a Yorkshireman, albeit from the evil that is Leeds. I've recently been re-reading his book 'Untold Stories'. In a piece entitled 'An average rock bun', Bennett writes about his experience with cancer of the colon, the approximate size of the tumour lending the piece its title. This is typically modest, unassuming and moving stuff, but what I found most interesting was Bennett's experience with homeopathy.

After an operation to remove the tumour, Bennett is due to begin precautionary chemotherapy. At the same time, he explores some alternative treatments, and after talking to his GP, decides that homeopathy might help. I'm somewhat ambivalent about this. After all, as long as Bennett continues with the chemotherapy, a homeopathic treatment can't do any harm, and even if it only has a placebo effect it might still help him to feel better. What is disgraceful is what happens when Bennett visits a "reputable complementary health clinic in Harley Street". He manages to get an appointment at 7am, and sees the complementary therapist. He explains that he has already decided on a course of chemotherapy, and wants to take homeopathic treatments alongside it.

As Bennett writes: "He proceeded to pour scorn on chemotherapy, the benefits of which he said were unproven, and when I didn't budge, rather sulkily conducted some finger-tip tests, which I took to be to do with the homeopathy, but done in such a perfunctory fashion I'm not sure he thought much of the point of this either. People kept coming in with whom he chatted, and throughout treated the business so casually and with such a disregard for my predicament, and presumed agony of mind, that it reminded me of the arrogant and unconcerned conventional doctors one used to come across thirty years ago".

Not very nice, is it? But that's not all. Bennett agreed to have some blood tests done by the complementary clinic. He then received a letter from the therapist, telling him that his blood test results were 'a lot worse than we thought' and that 'without sorting this out, your chances are much less than 50-50'. The cure was a course of vitamin injections. As a playwrite, writer and sometime art historian, Bennett is probably not up to speed with the latest medical research, but he's certainly no fool. As he writes, "All I saw was a barefaced attempt at medical blackmail and a doctor trying to panic me into using his clinic's doubtless expensive facilities". Bennett did not go back to the clinic.

So here we have an example of a homeopathic practitioner rubbishing proven therapies, and suggesting that they be replaced with homeopathy, and then playing on the fears of the patient to get them to take an expensive course of vitamin injections. This is extremely irresponsible and dangerous. Having complementary therapies used beside conventional treatments, under the supervision of a GP, is one thing. Advocating vitamin injections and magic water as a replacement for chemotherapy is a very different thing. Regardless of the science, complementary and alternative medicine needs to get its ethical house in order as a matter of urgency. Then again, the first question they would have to resolve is how you can ethically sell bullshit to people, so you can see why this would be a difficult enterprise.

Edit: If anyone knows what this is doing translated into German here, I'd be interested.

Even more on memory of water

I had a go at critiquing the recent Homeopathy special issue on the 'memory of water'. Ben Goldacre has now suggested that people who have been critiquing the issue could submit comments for publication to the journal. This is the way a civilised scientific debate is conducted, so I decided to give it a go. The following has been submitted as a letter to the editor (cheers to JJM and Rolfe at the JREF forums who proof-read it for me) :

Martin F. Chaplin presents an interesting overview on the structure of water¹. Disappointingly, though, it seems to contain no useful evidence of a ‘water memory’ effect that would be relevant to the efficacy or otherwise of homeopathic treatments. As is well known, the probability of any dilution beyond about 12c (a dilution factor of 1x10²⁴) containing a single molecule of the ‘mother tincture’ used to prepare the remedy is very low. So homeopaths require that water (or water/ethanol mixtures) somehow structurally ‘remember’ the mother tincture, and it is this structure that is responsible for any effect of homeopathic preparations. But Chaplin¹ appears to be talking about an entirely different effect when he states that “If there is evidence that the history of a sample of water affects its properties, then the ‘memory of water’ concept is proven without the need for a rationale for its action” (p. 146). This apparently broad interpretation explains some of the examples given as “Evidence for the memory of water”, which otherwise appear to have little to do with homeopathic remedies, where the mother tincture must continue to influence water structure even when absent.

For example, Chaplin¹ (p. 146) states that “human taste is quite capable of telling the difference between two glasses of water, processed in different ways (e.g. one fresh and one undrunk for several days)”. There is nothing mysterious about this. Depending on the circumstances, this can be due to outgassing of Cl₂ and/or absorption of atmospheric CO₂. This has nothing to do with how a mother tincture diluted out of existence has any effect on water structure. In the homeopathic context, what would be really interesting is if it were possible to taste the difference, say, between two 30c dilutions made from different mother tinctures prepared under identical conditions. Chaplin also refers to the Vybíral and Voráček paper in the special issue of Homeopathy², stating that the authors “have shown that water changes its properties with time and its previous history”¹ (p. 146). There is no doubt that this is an interesting paper, but the authors specifically conclude that their results are a consequence of ions dissolved in the water, as the effect they observe is not present when deionised water is used. Again, it is unclear how this is relevant to cases where mother tinctures are diluted out of existence. What Chaplin seems to be talking about in his paper is how impurities might affect water structure, as illustrated when he states “The water used for dilution is not pure relative to the putative concentration of the ‘active’ ingredient, with even the purest water considered grossly contaminated compared with the theoretical homeopathic dilution levels. This contamination may well have a major influence, and itself be influenced by the structuring in the water it encounters”¹ (p. 148). Since the concentration of the mother tincture will always be dwarfed by the concentration of impurities, it is difficult to see why the mother tincture should have an effect more important than the impurities on the water structure. Homeopathic remedies are not ‘just water’: they will contain significant amounts of impurities, which might create interesting structures in the water. But how this would make them significantly different from any sample of water is not clear.

I am in agreement with Chaplin when he states that “simply proving that water does have a memory does not prove that homeopathic medicines work”. The best evidence as to whether homeopathic medicines work or not is to be found in randomised placebo-controlled trials of the medicines. A recent meta-analysis³ has demonstrated that the best-conducted trials show no effect for homeopathic remedies beyond placebo. The structure of water is certainly a fascinating subject, as Chaplin shows, but all the best evidence shows that homeopathy has no effect that requires an explanation.

References

1. Chaplin, M.F. The memory of water: an overview. Homeopathy 2007; 96: 143-150

2. Vybíral, B. and Voráček, P. Long term structural effects in water: autothixotropy of water and its hysteresis. Homeopathy 2007; 96: 183–188.

3. Shang, A., Huwiler-Müntener, K., Nartey, L., Jüni, P., Dörig, S., Sterne, J.A.C., Pewsner, D., Egger, M. Are the clinical effects of homoeopathy placebo effects? Comparitive study of placebo-controlled trials of homoeopathy and allopathy. Lancet 2005; 366: 726-732.