Sunday, June 24, 2007

Alcohol pushes you into the river

Oh dear, oh dear; that fine team of sweary medicos at Dr Rant have taken offence at my telling doctors to shut the fuck up and, in their distress, have lost all semblance of decent argument. As David Bowie once said, "such a pity."
The DK is ranting on again about getting doctors to shut the fuck up and get on with patching people up. All because doctors want anti-binge drinking policies brought in.

"All because"? It sounds so reasonable don't it, to bring in "anti-binge drinking policies"? And your humble Devil is utterly unreasonable for objecting? How could I possibly object to people being banned from drinking on the street?

So, what is binge drinking precisely? Let me hand you over to the poor little Greek boy for one of the more memorable definitions.
Terrifying news from the Centre for Public Health: (full report here (pdf))
The Centre for Public Health analysed statistics from the past two years for all 354 local authority regions. [...] Experts warned that England had gone from a country "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction".

How exactly do the experts define binge drinking? Brace yourself...
consuming double the recommended daily limit - the equivalent of a large glass of wine for women and a pint-and-a-half of lager for men - in at least one session a week.

Let's repeat that for emphasis; if you have two glasses of wine tonight, dear female reader, you are a binge drinker. If you have three beers with friends after work, be-testicled browser, you are a binge drinker. And binge drinking is defined as doing this just once a week. You can be dry till next Friday, then have another three pints. You're still part of the statistic.

Looking a bit further, one finds this (A more detailed/long-winded explanation of how these figures were reached can be found here):
While alcohol problems can end people’s lives at any age, across England the average loss of life due to alcohol is nearly 10 months for men and five months for women.

This statistic is clearly meant to scare us. It doesn't scare me. The last ten months of my life - spent in a care home on a cocktail of pills and mashed-up turnips, looking for my teeth and failing to recognise my family - versus the unquantifiable pleasures of a life lived to the full? No comparison at all. You might as well put out a press release warning that there's a small but statistically measurable risk of being blinded by a sharp elbow every time you bang a supermodel. I'll take my chances, doc.

Do you see, Dr Rant: what Mr Eugenides is doing here is expressing what we terrible libertarians call "his personal choice"; further he is quite willing to "accept responsiblity for the consequences of his choice". Now, being doctors, these phrases are probably fairly unfamiliar to you, Team Rant, but perhaps you could ask a non-medical friend to explain them to you?

Mr E, like myself, does enjoy a drink or several. Neither of us have, as far as I am aware, beaten anyone up or caused any marked distress to anyone else after doing so; as such, we should be allowed to drink when, where and as much as we like because that is what we want to do. We accept that we may have a shorter life but we neither of us are particularly keen on spending anymore time in that nursing home than we absolutely have to (and remember, I've worked in one: I know what I'm talking about in this case).
Stop being such a tosser, DK.

What a naughty, little Devil, I am! I consider myself suitably chastised.

Much as I agree that the BMA should spend more time getting the basics right (such as MMC, NPfIT and so on) and stop fiddling while Rome burns...

Well, that would be nice. On the other hand, maybe we should be treating the BMA with the contempt reserved for all unions. But actually, the BMA are worse than other unions who, after all, only try to get the very best deal for their members: the BMA wants to control the lives of the entire population.
... public health is the most important area of medical intervention.

"Medical intervention"? What a wonderful phrase!

Now listen up, Rant, public health issues are for the government to deal with; that is why we elect politicians. We don't want you unelected fuckers lobbying for your special interests. I don't like it from charities, I don't like it from businesses and I certainly don't like it from you lot.

In an ideal world, the government would not have the power to do anything anyway but, in this benighted country in which we live, the state is all too keen on repressive knee-jerk legislation.

What does "medical intervention" actually mean? What it means is stopping people from living their lives as they see fit—and taking the responsibility for their actions. It is hardly a surprise that a profession that is almost entirely dependent on the state for its training and employment should be in favour of increased state powers, but it is not a situation that should be lauded.
Why should we keep pulling people half-dead out of the water, when we could save far more lives by putting a stop to the fucker who is pushing them in up river?

Ah, yes; statists do love to do this; imbue a substance with anthropomorphic characteristics. In our libertarian worldview, we say that a person (knowing the risks) has decided to drink heavily—they have, in fact, made a "personal choice".

In the world of the medical profession, he has not made a choice: the demon drink is just that—a physical demon pushing the person into the river. The person has not made a choice: he has been attacked and is helpless before the power of the eeeeeevil drug.

What a big, fat load of stinking bollocks: your analogy might work for Dr Shipman (a cheap jibe, I know) but not for alcohol. Sorry. But, in Dr Rant world, this is what drugs are like and we must be protected from the terrible booze as though from a doctor with a syringe full of morphine.

But how to do this? Yes, let us further emasculate the population; let us encourage them to believe that they cannot responsibly choose their own lifestyles, eh? Because then you and your buddies, the government, can assume more power.

And I, quite correctly I think, told your precious BMA, and doctors in general, to fuck off. I don't see an inconsistancy here.
Have you heard of the Broad Steet pump?

Now, having already compared alcohol—an intoxicating drug which people can choose to drink in large quantities or, crucially, not to—to a physical assailant, Dr Rant now compares it to cholera, an often fatal bacterial disease. That's right, alcohol—which is, let me reiterate, an intoxicating drug which people can choose to drink in large quantities or, absolutely crucially, not to—is now actually a pathogenic organism. Oh yes, Doctor, I can see how alcohol is exactly analogous to Vibrio cholerae.

Are you sure you're a fucking doctor? One can only hope so, because your lack of facility for logical argument would lead me to suggest that you are certainly no philosopher.
Binge drinking is causing enormous problems and is fueled by a profit-hungry drinks and entertainment industry who show as much interest in public health as the tobacco industry did.

Ah, I knew we'd get onto those eeeeevil corporations sooner or later. Whereas everyone in the medical profession is a saint, of course. Unless, of course, we try the Dr Rant trick and make the medical professon analogous to something? I know, why don't we say that the entire medical profession can be represented by Josef Mengele? Or, to take another tactic of yours, why don't we say that the medical profession is like the MRSA bacterium (or any of the variants) which your medical colleagues keep spreading around hospitals?
Or do you think that attempts to combat the marketing power of the tobacco lobby are also an example of "when will these fuckers stop trying to involve themselves in things that they don't understand and just concentrate on the pill-rolling".

Oh dear, oh dear. You people really are a scream! You crack me up, really.

Look, sunshine, I believe in free choice, OK? Without all of the information, people cannot make a free choice because they do not understand the consequences. Have you got that? Therefore I am all in favour of education; to an extent I am in favour of curbing certain types of advertising (although I do not think that it has anywhere near the impact that you do; it certainly has none on me, except to occasionally inform me about certain products that I didn't know about). Advertising is, in any case, a nebulous area; after all, this Australian advert seems to have had the opposite effect to that intended.
An anti-smoking ad screened before movies may actually be encouraging young Australians to keep smoking, a landmark survey has found.


But your perception of informing people and letting them make their own choice as being analogous to banning activities by law is as misguided as your comparison between alcohol and cholera. Apart from anything else, although people may binge-drink on the street, not everyone who drinks on the street is binge-drinking. OK? Can you understand that, you thick bastard?
Exactly what are your qualifications to give an opinion on health policy, DK?

Given your post, I would say that my qualifications are rather better than yours, Doctor. They include the ability to construct a logical argument, an understanding of basic economics (including incentives, perverse or otherwise), a lack of a meglomaniac desire to control others, a healthy cynicism of those that who profess to choose for me, an extreme loathing of those who do so, and a passionate belief in liberty and personal choice.
How about you shut the fuck up about things about which you are, frankly, ignorant, and stick to euro-bashing.

And so we see the inherent arrogance of the medical profession [1]: if you have not completed a medical course, naturally you must be totally ignorant of any science or medical issue.

But if we bloggers are not to comment on things of which we are judged to know nothing, can I ask you to avoid talking about the politics and economics of NHS reform?—it has become painfully obvious that, just because you are a doctor, it does not, I'm afraid, mean that you know what the bloody hell you are talking about on that score.

But let's not get into that too much; after all, next time I want to see an argument with a bunch of lazy, know-it-all stick-in-the-muds who are only interested in having an easy life, a fat cheque and a return to the days when everyone would pay unquestioning deference to their expertise, I'll send Gerry Robinson around to do it for me.

Whilst we are about it, had I not bollocksed up Chemistry A Level, I would be cutting up people in London right now. As such, I researched a lot before I ever applied to medical school—because I was interested, you see, in more than simply a hundred grand a year and a safe, fat-cat job—and I have remained an extremely interested and informed amateur since then.

Oh, and some years as a microbiology undergraduate taught me really quite conclusively that ethanol is not, in any way, the same a cholera.
There's a good Devil.

Fuck off, Doctor. Do your job; patch people up and leave policy to the politicians, why don't you?
(I should point out that I agree with much - but by no means all - of DK's critique of much of what is wrong with the suggestions, such as prohibition not working, but am pissed off at the suggestion that we have no right to get involved in the debate).

Oh dear fuck, will you have the courage of your convictions, please? I don't mind doctors getting involved in the debate; as you point out, they do know a bit about it.

What I fucking well object to is an organisation like the BMA calling for particular policy decisions to be made. Doctors may know about toxicology; they do not know about policy. That was my objection and it has been my objection throughout the last couple of years as doctor after doctor has proposed stupid, illiberal laws which will not work and which curtail the freedom of others.

Yes, some people binge-drink; most people do not. Again, why punish the innocent for the sins of a minority? If one child in a class misbehaves, does a teacher put the whole class on detention? No (or, at least, I hope not).

And in any case, how we live and what we do to our bodies, provided we are adequately informed of the consequences, is nothing to do with the medical profession; your job is, as I said, to patch us up: that is what we, the citizens who supply the cash for your damn salaries, pay you to do.

Advise on public health by all means, my dear doctor, but, in the meantime, do your fucking job and stop proposing yet more totalitarian legislation. As long as you or your representatives (or do the BMA not represent you? Have you cancelled your subscription?) keep trying to curtail my freedom to live my life as I please, I will continue to tell you to FUCK OFF.

OK? 'Kay.

[1: RETURN TO TEXT] And should anyone wish to point out that, given the profession's arrogance, I would have fitted in nicely then—believe me—you would not be the first.


Arthurian Legend said...

*claps loudly and cheers*

Surreptitious Evil said...

Err, wow. I think he, errm, sort of pissed you off. Wow.

Well done, anyhow. It's not as if we can nom you for a BD anyway ...


Twenty Major said...

My name is Twenty Major and I'm a bingeoholic.

Old BE said...

I didn't realise that having a couple of quiet glasses of wine after work was a binge. I really MUST cut down!

JuliaM said...

"On the other hand, maybe we should be treating the BMA with the contempt reserved for all unions."


"If one child in a class misbehaves, does a teacher put the whole class on detention? No (or, at least, I hope not)."

Well, they did when I was at school. But that was long ago...

ThunderDragon said...

People will "binge drink" if they want to do so, and no amount of legislation will be able to stop it.

Neal Asher said...

"Experts warned that England had gone from a country "enjoying a harmless tipple" to one developing "a dangerous alcohol addiction"

Are these people as ignorant about the history of this country as those pricks in Nulabour? I wonder if any of them have seen certain William Hogarth prints?

Mark Wadsworth said...

Well said Neal.

the A&E Charge Nurse said...

Neal asher - yes, I'm sure punters enjoyed the odd flagon back in the maestros day.

But Hogarths contemporaries [about 5million of them] would hardly be likely to seek out health services for their panreatitis, cirrhosis or alcohol induced dementia, would they ?

Alcohol related deaths have doubled since the early 90s and as 60milion or so Brits squabble over basic housing, education and health it seems churlish to complain when a few health fascists point out that life is not a sweet shop and you are no longer a disinhibited 4yr old screaming for more choccy.

Admit it, alcohols not that great, or at least not for those subclinical depressives grinding out a few more hours in a smokey snug, muttering about their gouty big toe.

Paradoxically shrivelled up livers pay the mortgage for health workers, so given the symbiotic relationship between adventourous drinking and financial gain perhaps dos & nurses should be singing the praises of each new advertising campaigns for alchopops and the like.

Think of all the challengers that arise from demon drink - domestic violence, car crashes, heart failure, impotence and that's even before we get to the GI tract, yes, I wish those nannying docs would shut the fuck up, I've got serious monthly repayments to worry about.

Devil's Kitchen said...


I've said this before: you see the shit side of stuff because of your work. Not everyone binge drinks; not everyone drinks to excess.

You see the effects of a minority. We regulate booze and, recognising that it can have negative externalities, we tax it to pay for them.

Just as we should with all drugs.


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